The aim of this work was to study the levels of 25 (OH) vitamin D
(calcidiol - CD) and 1.25 (OH)2 vitamin D (calcitriol - CT) in the blood of
patients with hemorrhagic fever with renal syndrome (HFRS) depending on the
severity, the period of the disease, and elucidation of the role of vitamin D
metabolism disorders in the pathogenesis of HFRS.
Patients and methods. 114 patients with HFRS, aged 18–55 years
(average age 37.4 ± 2.6 years) were under the supervision. Among them 53
patients were with moderately severe form, 61 - with severe one. The
determination of serum calcidiol and calcitriol levels was carried out by high
performance liquid chromatography. Determination of the level of cytokines
(INF-γ, TNF-α, IL-2) was carried out by the enzyme immunoassay using
reagents of Vector-Best CJSC (Novosibirsk).
Results. The lowest concentration of calcitriol and calcidiol in the blood
serum is observed in the oliguric phase with moderately severe and severe forms of HFRS. The more severe the disease, the more evident the deficiency of
vitamin D active metabolites is. The study of cytokines in these patients revealed
a sharp increase in TNF-α, a monotonously low level of IFN -γ, and a decrease
in IL-2 in the febrile and oliguric phases. A reliable direct correlation between
calcitriol and IL-2, as well as between calcitriol and INF-γ, and a significant
inverse correlation between the concentration of calcitriol and the level of TNFα were revealed.
Conclusions. Deficiency of vitamin D active metabolites may be one of the
mechanisms contributing to the appearance of hypocalcemia affected
hypocalceuria in the midst of HFRS. The presence of correlations of calcitriol
with IL-2, INF-γ, and TNF-α indicates a possible role of deficiency of the
vitamin D active metabolite in the development of immunological disorders in
HFRS.