Effect of Cholecalciferol Supplementation on Vitamin D Status and Cathelicidin Levels in Sepsis: A Randomized, Placebo-Controlled Trial
Quraishi SA, De Pascale G, Needleman JS, Nakazawa H, Kaneki M, Bajwa EK, Camargo CA, Bhan I
Critical care medicine · 139 citas
Cómo se estudió
- Diseño
- Ensayo controlado aleatorizado (indexado por PubMed)
- Estudiado en
- Personas
- Resultado principal
- Marcadores de salud y funcionamiento
Quién lo pagó
- Financiación
- Financiación independiente
- Gobierno
- National Heart, Lung, and Blood Institute
- Gobierno
- National Institute of General Medical Sciences
- Gobierno
- National Institute of Allergy and Infectious Diseases
- Gobierno
- National Institute of Diabetes and Digestive and Kidney Diseases
- Gobierno
- National Center for Advancing Translational Sciences
- Gobierno
- NCATS NIH HHS
- Gobierno
- NIGMS NIH HHS
- Gobierno
- NIAID NIH HHS
- Gobierno
- NIDDK NIH HHS
- Gobierno
- NHLBI NIH HHS
- Subvenciones
- National Institute of Allergy and Infectious Diseases (U01 AI087881); National Center for Advancing Translational Sciences (L30TR001257); National Heart, Lung, and Blood Institute (R01 HL119344); National Institute of Allergy and Infectious Diseases (R01 AI093723); National Institute of General Medical Sciences (P50GM02700); National Institute of Diabetes and Digestive and Kidney Diseases (K23DK081677); National Institute of General Medical Sciences (T32GM007592)
Según 10 financiadores declarados.
Publicación
- Publicado
- 2015-06-18 · Crit Care Med · vol. 43 · número 9 · págs. 1928–1937
- Editorial
- Lippincott Williams & Wilkins
- Citado
- 184 citas · más que el 99% de estudios similares · 9.6× el promedio de su campo
- Impacto
- Entre el 10 % más citado de su campo
- Referencias
- 76 trabajos
- Acceso
- Acceso abierto (copia en repositorio)
- Áreas de investigación
- Vitamin D Research Studies · Sepsis Diagnosis and Treatment · Vitamin C and Antioxidants Research
- Palabras clave
- vitamin D3 supplementation, vitamin D status, cathelicidin, LL-37, sepsis, septic shock, intensive care unit patients, 25-hydroxyvitamin D, bioavailable vitamin D, C-reactive protein, vitamin D binding protein, albumin, vitamin D deficiency, immunomodulation, sepsis mortality, length of hospital stay
- MeSH
- humans, sepsis, shock, septic, cholecalciferol, calcifediol, vitamin d, antimicrobial cationic peptides, c-reactive protein, serum albumin, dietary supplements, adult, middle aged, hospitals, teaching, intensive care units, female, male, cathelicidins, biomarkers
8 autores
- Sadeq A. Quraishi🇺🇸Harvard University; Massachusetts General Hospital; Shriners Hospitals for Children - Boston
- Gennaro DE PASCALE🇺🇸Harvard University; Massachusetts General Hospital
- Joseph Solomon Needleman🇺🇸Massachusetts General Hospital
- Harumasa Nakazawa🇺🇸Massachusetts General Hospital
- Masao Kaneki🇺🇸Harvard University; Massachusetts General Hospital; Shriners Hospitals for Children - Boston
- Ednan K. Bajwa🇺🇸Harvard University; Massachusetts General Hospital
- Carlos A. Camargo🇺🇸Harvard University; Massachusetts General Hospital
- Ishir Bhan🇺🇸Harvard University; Massachusetts General Hospital
Resumen
El texto original del estudio, en el idioma en que se publicó.
Objectives
To compare changes in vitamin D status and cathelicidin (LL-37) levels in septic ICU patients treated with placebo versus cholecalciferol.
Design
Randomized, placebo-controlled, trial.
Setting
Medical and surgical ICUs of a single teaching hospital in Boston, MA.
Patients
Thirty adult ICU patients.
Interventions
Placebo (n = 10) versus 200,000 IU cholecalciferol (n = 10) versus 400,000 IU cholecalciferol (n = 10), within 24 hours of new-onset severe sepsis or septic shock.
Measurements and main results
Blood samples were obtained at baseline (day 1) and on days 3, 5, and 7, to assess total 25-hydroxyvitamin D, as well as vitamin D-binding protein and albumin to calculate bioavailable 25-hydroxyvitamin D. Plasma LL-37 and high-sensitivity C-reactive protein levels were also measured. At baseline, median (interquartile range) plasma 25-hydroxyvitamin D was 17 ng/mL (13-22 ng/mL) and peaked by day 5 in both intervention groups. Groups were compared using Kruskal-Wallis tests. Relative to baseline, on day 5, median change in biomarkers for placebo, 200,000 IU cholecalciferol, and 400,000 IU cholecalciferol groups, respectively, were as follows: 1) total 25-hydroxyvitamin D, 3% (-3% to 8%), 49% (30-82%), and 69% (55-106%) (p < 0.001); 2) bioavailable 25-hydroxyvitamin D, 4% (-8% to 7%), 45% (40-70%), and 96% (58-136%) (p < 0.01); and 3) LL-37: -17% (-9% to -23%), 4% (-10% to 14%), and 30% (23-48%) (p = 0.04). Change in high-sensitivity C-reactive protein levels did not differ between groups. A positive correlation was observed between bioavailable 25-hydroxyvitamin D and LL-37 (Spearman ρ = 0.44; p = 0.03) but not for total 25-hydroxyvitamin D and LL-37.
Conclusions
High-dose cholecalciferol supplementation rapidly and safely improves 25-hydroxyvitamin D and bioavailable 25-hydroxyvitamin D levels in patients with severe sepsis or septic shock. Changes in bioavailable 25-hydroxyvitamin D are associated with concomitant increases in circulating LL-37 levels. Larger trials are needed to verify these findings and to assess whether optimizing vitamin D status improves sepsis-related clinical outcomes.
Resumen vía Europe PMC. Los derechos de autor siguen siendo de los autores o la editorial.
Confianza de la comunidad
Cargando…
¿Cuánto confías en los hallazgos de este estudio?
Comentarios
¿Algo está mal aquí?
Señala este estudio si su información, etiquetas o financiación parecen incorrectas. Un editor revisa cada señalamiento.
Información educativa sobre investigación publicada. No es consejo médico ni una recomendación para empezar o dejar nada.