1 Department of Endocrinology, Medical Center, Amager and Hvidovre Hospital, The Capital Region of Denmark2 Department of Infectious Diseases, Amager and Hvidovre Hospital, The Capital Region of Denmark3 Clinical Research Centre, Amager and Hvidovre Hospital, The Capital Region of Denmark4 Gastrounit, Medical Division, Gastrounit, Amager and Hvidovre Hospital, The Capital Region of Denmark5 unknown
A Randomized Controlled Trial
OBJECTIVES: We studied the impact of changes in 25-hydroxyvitamin D (25OHD) and 1,25-dihydroxyvitamin D (1,25(OH)2D) on regulatory T lymphocytes (Tregs) in patients with chronic pancreatitis (CP) and fat malabsorption in a prospective clinical trial. METHODS: The patients were randomized to 1 of 3 treatments during 10 weeks: weekly UV-B in a tanning bed (group A), 1520-IU/d vitamin D supplement (group B), or placebo (group C). A placebo tanning bed was used in groups B and C. We determined the levels of CD4 Tregs (CD3CD4CD25CD127lowFoxP3) and CD8 Tregs (CD3CD8CD25CD127lowFoxP3), together with 25OHD and 1,25(OH)2D. For baseline comparisons, we included 8 healthy individuals. Of the 30 included patients, 27 (group A, 7 patients; group B, 9 patients; and group C, 11 patients) completed the protocol. RESULTS: The baseline levels of CD4 Tregs relative to total CD4 count were higher in 22 patients with CP compared with healthy controls (2.8% vs 1.9%, P <0.05) and were comparable for CD8+ Tregs (0.13% vs 0.05%, P = 0.3). Increases in levels of CD4 Tregs correlated to changes in 1,25(OH)2D (2% per 100 pmol/L, P = 0.002) and 25OHD (3% per 100 nmol/L, P = 0.01). CONCLUSIONS: Patients with CP have elevated relative levels of CD4 Tregs. Increases in 25OHD and 1,25(OH)2D were both related with increases in levels of Tregs.