2014 Volume 2 Issue 2 Pages 153-159
Vitamin D is a secosteroid hormone that has nonclassical, pleiotropic effects on various cell types, as well as classical effects on bone and mineral metabolisms. In immunocompetent cells, vitamin D induces cathelicidin production in macrophages that play a central role in innate immunity, while it reduces the adaptive immune response, inhibiting differentiation, proliferation, and function of activated T and B cells. Several studies have shown that vitamin D also induces regulatory T cells. Recently, epidemiological studies revealed that vitamin D deficiency is common among kidney transplant recipients, especially in the early period after transplantation, and that it is associated with kidney function decline, interstitial fibrosis and tubular atrophy in allograft kidneys, and rejection episodes. Vitamin D also has anticancer effects, and its deficiency before kidney transplantation is associated with the development of post-transplant malignancy. Kidney transplant recipients receiving active vitamin D compounds are less likely to develop post-transplant malignancy. Several randomized trials are now being conducted to evaluate the nonclassical effects of vitamin D in kidney transplant recipients, as suggested by these experimental and observational studies.
