Johann Wolfgang Goethe University Hospital, Frankfurt am Main, Germany
Vitamin D metabolism – potential interactions with hepatitis C or other liver diseases Hepatitis C Virus
Skin, Food Cholecalciferol
? Liver: 25-hydroxylase
?
Cell proliferation Cell differentiation Apoptosis
Immune modulation 25-hydroxyvitamin D
1-25-dihydroxyvitamin D = Calcitriol Kidney: 1α-hydroxylase (CYP27B1)
Calcium homeostasis
Clinical evidence that vitamin D can be beneficial beyond bone metabolism Vitamin D metabolism was associated with: Autoimmune diseases (diabetes, multiple sclerosis, …) Cancer (colon, breast, ….) Infectious diseases (sepsis, tuberculosis, flue, ….) Death (>4000 persons, > 11 years follow-up)
Normal VD levels Low VD levels
Levin GP et al, JAMA 2012; Rosen CJ, NEJM 2011
Proof-of-concept studies of therapeutic application of vitamin D Days to conversion
Martineau et al. Lancet 2011 50 40
25(OH)D3 in addition to standard
30
therapy reduces time till sputum
20
conversion in lung tuberculosis
10 0
+
- Vit. D
Proteinuria (%)
De Zeeuw et al. Lancet 2010 0
Paricalcitol in addition to ACEinhibitor reduces albuminuria in
- 15
diabetic nephropathy - 30
-
+
+
+
Paricalcitol
Does viral hepatitis impact on vitamin D metabolism?
Stage of liver disease correlates inversely with vitamin D serum levels
Petta S et al, Hepatology 2010
Chronic hepatitis C is associated with severe vitamin D deficiency
