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Vitamin D has been reported contribute to the regulation of immune responses by inhibiting DC maturation, T cell-dependent DC activation, reduce the secretion of Th1 and Th2 cytokines and induce the development of regulatory T cells. The aimed of this study to determine the association of vitamin D level with DC maturation, IFN-γ and IL-4 cytokine expression in Indonesian SLE patients. The study was conducted in fifty four active disease SLE patients (SLEDAI score>5). Twenty three healthy volunteers serves as controls. The level of vitamin D (25(OH)D3) was assayed by ELISA. The exspression of CD11c+/CD86/CD40/CD83, IL-4 and IFN-γ molecules were measured by Flowcytometry. Differences levels of vitamin D, the maturation of DCs (moDC, iDC, mDC), the expression of IL-4 and TNF-α between SLE patients and healthy controls were analyzed with independent T test. Correlation of vitamin D level with the differentiation of DC maturation, Th1-Th2 cytokine exspression were analyzed by Spearman test. The level of vitamin D in SLE patients was significantly difference compared to healthy controls (35.15±7.61 ng/mL vs 22.80±16.23 ng/mL ; p =0.00). There was no difference in the percentage of moDC between two groups, however, the percentage of iDC significantly increased and the percentage of mDC were slightly higher in SLE patients compared to the healthy controls. The percentage of cells producing IFN-γ and IL-4 in SLE patients tend to be higher than those of the healthy controls (9.08 ± 6.52 vs 13.19% ± 9.44% ; p = 0.062 and 5.05±8.53 vs 3.35±5.31 ; p = 0.058). While the ratio of IFN-γ/IL-4 in SLE patients were similar in two groups (1.29 and 1.20 ; p = 0.520). There were negative correlation between vitamin D levels and the expression of CD11c+/CD86/CD40/CD83 at iDC and mDC, however, there were no correlation with IFN-γ (r = 0.069, p = 0.712) and IL-4 production (r = 0.146, p = 0.433). Vitamin D (1,25(OH)2D3) serum concentration was significantly lower in Indonesian SLE patients compared with healthy controls. The low concentration was related to higher expression of CD11c+/CD86/CD40/CD83 in iDC cells and higher secretion of Th1 cytokines (IFN-γ) and Th2 cytokines (IL- 4).

Low Level of Vitamin D Increased Dendritic Cell Maturation and Expression of Interferon-γ and Interleukin-4 in Systemic Lupus Erythematosus