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Background  Regulatory T cells (Tregs) are a cornerstone of graft acceptance. High numbers of Tregs are associated with better long-term graft survival. Recently, Vitamin D was suggested as an immunomodulator, in addition to its classical role in calcium metabolism. Vitamin D modulates Tregs and might, thereby, promote graft acceptance and long-term graft survival.    Methods  One hundred twenty-three renal allograft recipients attending either Heidelberg nephrology or Giessen internal medicine clinic were enrolled in this cross- sectional study. Sixteen healthy controls were studied in addition. Sixty-nine patients were receiving no vitamin D, 38 calcitriol, and 16 cholecalciferol supplementations. We evaluated whether there was a difference in the absolute numbers of Helios + , Helios − , CTLA-4 + , IFNg + , and total Tregs among the patient groups.    Results  Cholecalciferol supplementation was associated with higher absolute numbers of Helios + , CTLA-4 + , and total Tregs than calcitriol ( p  < 0.001,  p  = 0.004,  p  = 0.001 respectively). Helios +  Tregs were also higher in cholecalciferol than no vitamin D supplementation patients ( p  = 0.001), whereas CTLA-4 +  and total Tregs were similar in both groups ( p  = NS). Helios + , Helios − , CTLA-4 + , IFNg + , and total Tregs were similar in the cholecalciferol and healthy control groups ( p  = NS).    Conclusion  Our findings indicate that cholecalciferol, even when administered at low dosages, has a stabilizing effect on Tregs (particularly the Helios + subset), in contrast to calcitriol which showed neither a stabilizing nor a proliferation-inducing effect on the same cell population.

bmc pharmacology and toxicology

Low-dose oral cholecalciferol is associated with higher numbers of Helios+ and total Tregs than oral calcitriol in renal allograft recipients: an observational study