Effects of vitamin D supplementation on interleukin-17 in children with nephrotic syndrome

Abstract

Background and objectives. Nephrotic syndrome (NS) is characterized by massive proteinuria, which may lead to urinary loss of vitamin D-binding protein and subsequent vitamin D deficiency. Vitamin D has immunomodulatory effects mediated through vitamin D receptor activation, including modulation of the T helper 17 (Th17) pathway and interleukin-17 (IL-17), a cytokine involved in podocyte injury and inflammation. This study evaluated the effects of two doses of vitamin D₃ supplementation on serum 25-hydroxyvitamin D [25(OH)D] and IL-17 levels in children with NS. Materials and methods. In this randomized, double-blind, controlled trial, children aged 1-18 years with NS were allocated to receive standard therapy plus oral vitamin D₃ at either 400 IU/day (Group I) or 1000 IU/day (Group II) for four weeks. Serum 25(OH)D and IL-17 concentrations were measured at baseline and after the intervention. Within-group and between-group analyses were performed to assess changes in these parameters. Results. After four weeks, serum 25(OH)D levels increased significantly in both groups. The median increase was 4.7 ng/mL in Group I (p = 0.001) and 5.1 ng/mL in Group II (p = 0.018), with no significant difference between groups (p = 0.903). IL-17 levels decreased in both groups; however, these reductions were not statistically significant. The median change was −0.26 pg/mL in Group I (p = 0.057) and −0.18 pg/mL in Group II (p = 0.469), with no significant between-group difference (p = 0.682). Conclusions. Vitamin D₃ supplementation at 400 IU/day and 1000 IU/day modestly increased serum 25(OH)D levels in children with NS but did not significantly reduce IL-17 levels over four weeks. The short intervention duration, relatively low supplementation doses, and persistent proteinuria may have limited the detectable immunomodulatory effects of vitamin D in this population.

Access to Document

Other files and links

• Link to publication in Scopus
• Open Access Version Available

Fingerprint