Background In recent years immunomodulatory action of vitamin D3 was clearly confirmed, when its used in high doses. 1-alpha (OH) vitamin D3 (alphacalcidiol) analogue was shown to induce less hypercalcemic side effects.
Objectives We organised open-label therapeutical trial in 20 RA and 15 JRA patients who have had three months active disease on basic therapy. Therapy regime remained unchanged but alphacalcidiol in high oral dose was added during next three months (2μgr/day in RA or 0,05μgr/kg/day in JRA pts.).
Methods Spontaneous and PMA stimulated IL1 and TNF production was measured in all patients before and after the trial by ELISA method in PB mononuclear cells after 24 h cultures. GSH-Px (glutation-peroxidase) and SOD (superoxide-dismutase) activity was measured by RANDOX kits.
Results Three months high oral dose therapy significantly improved clinical signs of disease activity in correlation with parameters we evaluated. Increased IL1 and TNF production was significantly lowered after the trial and riched values in healthy controls. GSH-Px and SOD activity were lowered in all patients before entering into the stady. Alphacalcidiol therapy induced significant increase of GSH-Px and, on contrary, decrease of SOD activity. Positive correlation trends among this enzymes during disease activity were turned into negative according to disease improvement after the trial finished.
Conclusion High dose alphacalcidiol is powerful immunomodulatory agent as it is shown for other vitamin D3 analogues. Its main function seem to be stabilisation of impared immunoregulation in RA and JRA which could be of benefit as possible therapeutic agent.
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