Vitamin D supplementation improves cytokine profiles in patients with congestive heart failure: a double-blind, randomized, placebo-controlled trial

Abstract

Vitamin D(3) reduces the inflammatory milieu in CHF patients and might serve as a new antiinflammatory agent for the future treatment of the disease. Our data provide evidence for the involvement of an impaired vitamin D-parathyroid hormone axis in the progression of CHF.

Relation of Vitamin D Status to Congestive Heart Failure and Cardiovascular Events in Dogs

“…However, one would expect excessive diuresis to lower serum calcium concentration and activate parathyroid hormone, which enhances the absorption of calcium in the intestine by increasing the production of activated vitamin D 39. Despite the complex interactions of diuretics on calcium, vitamin D, and parathyroid hormone, our results are similar to what is found in humans with cardiovascular disease 4, 14, 15, 16…”

“…Knockout mouse data are even more convincing because vitamin D receptor knockout mice develop typical signs of CHF, such as cardiac hypertrophy, hypertension, and increased concentrations of atrial natriuretic peptide 12. In large epidemiologic studies in humans, with rare exceptions,13 most groups of CHF patients studied have shown insufficient or below reference range limits serum concentrations of 25‐hydroxyvitamin D [25(OH)D], the best indicator of an individual's vitamin D status 14, 15, 16. In a study by Zimmerman et al, for example, adults with CHF had 34% lower 25(OH)D concentrations than healthy subjects 17.…”

1,25‐dihydroxyvitamin D3 promotes IL‐10 production in human B cells

“…Pro-vitamin D is a storage metabolite with a long half-life in vivo and does not mediate hypercalcemia, not even at high doses [12]. This explains the limitation of calcitriol therapy today, i.e., short half-life in vivo and hypercalcemic side effects.…”

“…It has been shown that IL-10 inhibits IL-4-driven IgE production in human PBMC [8] and purified B cells [9], and that calcitriol induces IL-10 expression in dendritic cells [10] and enhances it in T cells [11]. Nutritional supplementation with the calcitriol precursor 25-hydroxyvitamin D 3 , leads to increased serum IL-10 levels in vivo [12]. Levels of 25-hydroxyvitamin D 3 in cord blood correlate to IL-10 levels and inversely to total IgE titers [13].…”

Vitamin D deficiency and myocardial diseases

“…At the end of the study, there was a significant improvement of left ventricular function with decreased end-diastolic and end-systolic diameters in patients receiving 25(OH)D treatment, whereas there was no significant change in echocardiagraphic parameters in the control group [94]. Schleithoff et al performed a randomized double-blind placebo-controlled trial to evaluate the impact of vitamin D supplementation on survival and biochemical and hemodynamic parameters [95]. In total, 123 heart-failure patients were randomly assigned to either receive 2000 IU (50 mg) vitamin D3 daily or placebo and 500 mg calcium was supplemented in all study participants.…”