RESUMEN
It is unknown if cholecalciferol is able to modify defects in regulatory T cells (Tregs) in type 1 diabetes (T1D). In this randomized, double-blind, placebo controlled trial 30 young patients with new-onset T1D were assigned to cholecalciferol (70IU/kgbodyweight/day) or placebo for 12months. Tregs were determined by FACS-analysis and functional tests were assessed with ex vivo suppression co-cultures at months 0, 3, 6 and 12. Suppressive capacity of Tregs increased (p<0.001) with cholecalciferol from baseline (-1.59±25.6%) to 3 (30.5±39.4%), 6 (44.6±23.8%) and 12months (37.2±25.0%) and change of suppression capacity from baseline to 12months was significantly higher (p<0.05) with cholecalciferol (22.2±47.2%) than placebo (-16.6±21.1%). Serum calcium and parathormone stayed within normal range. This is the first study, which showed that cholecalciferol improved suppressor function of Tregs in patients with T1D and vitamin D could serve as one possible agent in the development of immunomodulatory combination therapies for T1D.
Asunto(s)
Colecalciferol/uso terapéutico , Diabetes Mellitus Tipo 1/tratamiento farmacológico , Suplementos Dietéticos , Linfocitos T Reguladores/efectos de los fármacos , Adolescente , Péptido C/sangre , Niño , Colecalciferol/administración & dosificación , Colecalciferol/sangre , Diabetes Mellitus Tipo 1/sangre , Diabetes Mellitus Tipo 1/inmunología , Método Doble Ciego , Ayuno/sangre , Femenino , Humanos , Masculino , Proyectos Piloto , Estudios Prospectivos , Linfocitos T Reguladores/inmunología , Factores de Tiempo , Resultado del Tratamiento , Vitaminas/administración & dosificación , Vitaminas/uso terapéuticoRESUMEN
In case of dehydration, lithium can cause acute intoxication. This picture is mainly manifested by neurological disorders that can go as far as coma, digestive disorders, hydroelectrolytic disorders, and cardiovascular disorders. We report the case of a patient followed for bipolar disorder for 20 years and treated with lithium for 14 years and who presented an acute lithium intoxication resulting from a diabetes insipidus. Our objective is to underline the importance of good hydration and strict monitoring of lithium levels especially in situations favouring dehydration, notably the polyuria of diabetes insipidus.