Anti-inflammatory profile of paricalcitol in kidney transplant recipients

Background and objectives: Paricalcitol, a selective vitamin D receptor activator, is used to treat secondary hyperparathyroidism in kidney transplant patients. Experimental and clinical studies in non-transplant kidney disease patients have found this molecule to have anti-inflammatory properties. In this exploratory study, we evaluated the anti-inflammatory profile of paricalcitol in kidney-transplant recipients. Methods: Thirty one kidney transplant recipients with secondary hyperparathyroidism completed 3 months of treatment with oral paricalcitol (1 mu g/day). Serum concentrations and gene expression levels of inflammatory cytokines in peripheral blood mononuclear cells were analysed at the beginning and end of the study. Results: Paricalcitol significantly decreased parathyroid hormone levels with no changes in calcium and phosphorous. It also reduced serum concentrations of interleukin (IL)-6 and tumour necrosis factor-alpha (TNF-alpha) by 29% (p < 0.05) and 9.5% (p < 0.05) compared to baseline, respectively. Furthermore, gene expression levels of IL-6 and TNF-gamma in peripheral blood mononuclear cells decreased by 14.1% (p < 0.001) and 34.1% (p < 0.001), respectively. The ratios between pro-inflammatory cytokines (TNF-alpha and IL-6) and anti-inflammatory cytokines (IL-10), both regarding serum concentrations and gene expression, also experienced a significant reduction. Conclusions: Paricalcitol administration to kidney transplant recipients has been found to have beneficial effects on inflammation, which may be associated with potential clinical benefits. (c) 2017 Sociedad Espanola de Nefrologia. Published by Elsevier Espana, S.L.U.