Anti-inflammatory profile of paricalcitol in kidney transplant recipients

Nefrologia. 2017 Nov-Dec;37(6):622-629. doi: 10.1016/j.nefro.2017.03.028. Epub 2017 Jun 15.
[Article in English, Spanish]

Abstract

Background and objectives: Paricalcitol, a selective vitamin D receptor activator, is used to treat secondary hyperparathyroidism in kidney transplant patients. Experimental and clinical studies in non-transplant kidney disease patients have found this molecule to have anti-inflammatory properties. In this exploratory study, we evaluated the anti-inflammatory profile of paricalcitol in kidney-transplant recipients.

Methods: Thirty one kidney transplant recipients with secondary hyperparathyroidism completed 3 months of treatment with oral paricalcitol (1μg/day). Serum concentrations and gene expression levels of inflammatory cytokines in peripheral blood mononuclear cells were analysed at the beginning and end of the study.

Results: Paricalcitol significantly decreased parathyroid hormone levels with no changes in calcium and phosphorous. It also reduced serum concentrations of interleukin (IL)-6 and tumour necrosis factor-alpha (TNF-α) by 29% (P<0.05) and 9.5% (P<0.05) compared to baseline, respectively. Furthermore, gene expression levels of IL-6 and TNF-α in peripheral blood mononuclear cells decreased by 14.1% (P<0.001) and 34.1% (P<0.001), respectively. The ratios between pro-inflammatory cytokines (TNF-α and IL-6) and anti-inflammatory cytokines (IL-10), both regarding serum concentrations and gene expression, also experienced a significant reduction.

Conclusions: Paricalcitol administration to kidney transplant recipients has been found to have beneficial effects on inflammation, which may be associated with potential clinical benefits.

Keywords: Citocinas inflamatorias; Inflammatory cytokines; Kidney transplantation; Paricalcitol; Trasplante renal.

MeSH terms

  • Adult
  • Aged
  • Anti-Inflammatory Agents / pharmacology
  • Anti-Inflammatory Agents / therapeutic use*
  • C-Reactive Protein / analysis
  • Cytokines / biosynthesis
  • Cytokines / blood*
  • Cytokines / genetics
  • Ergocalciferols / pharmacology
  • Ergocalciferols / therapeutic use*
  • Female
  • Gene Expression Regulation / drug effects
  • Humans
  • Hyperparathyroidism, Secondary / blood
  • Hyperparathyroidism, Secondary / drug therapy*
  • Hyperparathyroidism, Secondary / etiology
  • Inflammation
  • Kidney Transplantation*
  • Leukocytes, Mononuclear / metabolism
  • Male
  • Middle Aged
  • Postoperative Complications / drug therapy*
  • Postoperative Complications / etiology
  • Prospective Studies
  • Receptors, Calcitriol / agonists

Substances

  • Anti-Inflammatory Agents
  • Cytokines
  • Ergocalciferols
  • Receptors, Calcitriol
  • paricalcitol
  • C-Reactive Protein