The aim: Research of dynamics of the levels of lymphocytes with determinants of CD3, CD3CD4, CD3CD8, CD19, CD3CD56NK, IFN-γ, IL-4, IL-19, IL-23, immunoglobulin (Ig) classes of A, M, G, total complement (CH50), circulating immune complexes (CIC) under the influence of long-term use of vitamin D3 in the elderly. Forty patients aged 65 to 79 years old, with vitamin D3 deficiency, were randomized in the 2 groups. Twenty one patients in the group “1” took vitamin D3 over 2 months by 4,000 IU per day. Nineteen patients in the group "2" did not take cholecalciferol. Groups were comparable by gender and age, p ≥ 0.05. Patients had polymorbid pathology, the first three places in which were given to arterial hypertension, coronary heart disease, osteoarthritis. The average number of diseases per 1 patient in the group "1" was (M ± SD) (6.3 ± 2.1) versus (6.2 ± 1.9) in the group "2", p ≥ 0.05. The study did not include patients with autoimmune diseases. Determination of the number of lymphocytes in the peripheral blood with antigenic CD determinants was performed using kits manufactured by BD Multitest, USA. Levels of cytokines, CH50, CIC, 25-OH Vitamin D were determined by kits manufactured by DRG International, Inc., USA. Content of serum Ig classes A, M, G, using ready-made sets of reagents "Ig A, M, G – IFA" ("Granum", Ukraine). The research was carried out in compliance with the basic bioethical provisions of the Convention for the protection of Human Rights and Dignity of the Human Being with regard to the Application of Biology and Medicine: Convention on Human Rights and Biomedicine (of 04.04.1997), the Helsinki Declaration of the World Medical Association – Declaration of Helsinki – Ethical Principles for Medical Research Involving Human Subjects (1964-2008), as well as the order Ministry of Health of Ukraine No. 690 dated September 23, 2009. Indicators of humoral immunity were initially comparable in groups "1" and "2". The intake of vitamin D3 was accompanied by an increase in the content of the total complement of CH50: (70,5 ± 15,7) g/l vs (75,8 ± 17,4) g/l and Ig M (1,04 ± 0,3) g/l vs (1,84 ± 0,6) g/l and a decrease in the values Ig G (11,0 ± 3,2) g/l vs (9,9 ± 3,2) g/l and the CIC (12,2 ± 3,5) vs (10,1 ± 3,3), p < 0,05 in all cases. The level of Ig A has not changed. In group "2" none of the indicators significantly changed. Accordingly, differences in the levels of CH50 and Ig M were formed after 2 months between the groups that were significantly higher in the group "1" and the content Ig G - significantly less in the group "1". There were no discrepancies in the levels of CIC and Ig A. The baseline levels of cell-mediated immunity between groups "1" and "2" did not differ significantly. The content of CD3 and CD3CD4 in patients in the group "1" was raised in response to the use of vitamin D3 compared with baseline: (852,15 ± 278,26)% versus (1104,28 ± 317,97)% and (410,23 ± 127.85)% versus (782.51 ± 264.15)%, respectively, p <0.05 in all cases. The values of CD3CD8 decreased: (493.19 ± 158.64)% versus (383.16 ± 131.27)%, CD19: (133.41 ± 43.3)% versus (101.98 ± 32.5)%, and CD3CD56NK (62.2 ± 21.3)% vs. (48.4 ± 16.4)%, respectively, p <0.05 in all cases. Similar dynamics in group "2" were not observed. Accordingly, when comparing the studied parameters in 2 months, patients who received vitamin D3 had higher CD3 and CD3CD4, and lower CD3CD8, CD19. The CD3CD56NK level did not differ between groups after 2 months. Patients in both groups were comparable output levels of IL-23, IL-4, IL-19 and IFN-γ. Patients in group "1" after the course of vitamin D3 intake had a decrease in IL-23 levels: (9.3 ± 3.1) pg/ml versus (7.2 ± 2.4) pg/ml, p <0.05. The IFN-γ concentration did not differ significantly before and after the course of treatment. The opposite results were obtained for IL-4 and IL-19: (17.8 ± 6.2) pg/ml against (25.5 ± 7.1) pg/ml and (35.5 ± 11.7) pg/ml (48.7 ± 13.4) pg/ml, respectively, after the course of vitamin therapy among patients in group "1" levels of these cytokines significantly increased. The following analysis data in group "2" did not differ from the output. Our data indicate that patients receiving vitamin D3 had higher rates of total complement CH50 and Ig M, lower Ig G and CIC values after 2 months of admission compared to non-vitamin D3 patients. Thus, taking vitamin D3 provides beneficial immunological effects in inclined patients associated with normalization of indices of humoral immunity. It also provides a reduction in the number of B cells, effector T cells and an increase in regulatory T cells, a decrease in the level of proinflammatory cytokine IL-23, and an increase in levels of anti-inflammatory cytokines IL-4 and IL-19. In this case, the IFN-γ content required to maintain the anti-infective response is not reduced.
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