Abstract: Poster Presentations |


Ali A. Kanchwala, MBBS*; Barbara P. Barna; Ravinder J. Singh; Daniel A. Culver; Anagha Malur; Susamma Abraham; Irene Marshall; Mani Kavuru, MD; Mary J. Thomassen
Author and Funding Information

Brody School of Medicine, East Carolina University, Greenville, NC


Chest. 2009;136(4_MeetingAbstracts):127S. doi:10.1378/chest.136.4_MeetingAbstracts.127S-a
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PURPOSE:  The antimicrobial peptide, cathelicidin, is considered to be critical to innate immunity in alveolar macrophages. In sarcoidosis, a chronic granulomatous disease of unknown etiology, pro-inflammatory cytokines, such as interferon-gamma (IFN-γ) are overproduced. Previous reports suggest elevation of 1, 25 dihydroxyvitamin D (1, 25 vitD) in sarcoidosis, and implicated IFN-γ as a promoter of 1, 25 vitD, now known to be a potent cathelicidin inducer.

METHODS:  Based on such data, we hypothesized an increase in cathelicidin expression in sarcoidosis bronchoalveolar lavage (BAL) cells compared to healthy controls. BAL cells from patients with biopsy proven sarcoidosis (n = 26), and healthy controls (n = 18) were analyzed for messenger ribonucleic acid (mRNA) expression of cathelicidin, (IFN-γ), and the vitamin D receptor (VDR) by quantitative PCR. Sarcoidosis was classified as severe (requiring systemic therapy), or non-severe (never required systemic therapy). Circulating vitD and 1, 25 vitD levels were also determined.

RESULTS:  Compared to healthy controls, cathelicidin mRNA expression was 30% lower in BAL cells of patients with severe sarcoidosis (n = 14, p < 0.002); and 14% lower in patients with non-severe disease (n = 12, p = 0.037). VDR mRNA expression of either group did not differ from controls. Circulating vitD was lower in severe than in non-severe patients (p < 0.05) and values for both groups were below the recommended normal level (30ng/ml). Circulating 1, 25 vitD levels, however were within normal range (22–67pg/ml). IFN-γ, as anticipated was higher than controls (p = 0.009), and in vitro, IFN-γ repressed alveolar macrophage cathelicidin (p < 0.05; n = 3 healthy controls).

CONCLUSION:  Data indicates that in sarcoidosis, cathelicidin expression is deficient and directly correlates with disease severity and deficient circulating vitD levels.

CLINICAL IMPLICATIONS:  Results further suggest that despite normal 1, 25 vitD levels and normal VDR expression, repressive mechanisms (possibly involving IFN-γ) may play a role in reducing cathelicidin expression in sarcoidosis BAL cells.

DISCLOSURE:  Ali Kanchwala, No Financial Disclosure Information; No Product/Research Disclosure Information

Wednesday, November 4, 2009

12:45 PM - 2:00 PM




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