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Nephrol Dial Transplant (2001) 16: 246-252
© 2001 European Renal Association-European Dialysis and Transplant Association

The anti-proliferative effect of calcitriol on HL-60 cells is neutralized by uraemic biological fluids

Griet Glorieux,1, Chen Hsu3, Rita De Smet1, Annemieke Dhondt1, John van Emmelo2, Marie-Anne Waterloos1, Norbert Lameire1, Jean Plum2 and Raymond Vanholder1

1 Renal Division, Department of Internal Medicine and 2 Department of Clinical Biology, Microbiology and Immunology, University Hospital, Gent, Belgium and 3 Renal Division, Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, Michigan, USA

Background. It has been demonstrated that uraemic serum/ultrafiltrate inhibits cell-mediated immune response in vitro, and that it suppresses calcitriol synthesis and its biological actions.

Methods. In the present in vitro study, the effect of calcitriol, uraemic ultrafiltrate (UUF) and a combination of both on the human promyelocytic leukaemia cell line, HL-60, was studied by evaluating bromodeoxyuridine (BrdU) incorporation into the DNA, luminol-amplified chemiluminescence (CL) production, expression of CD14, and levels of vitamin D receptor mRNA (VDR mRNA) and CD14 mRNA.

Results. The ability of calcitriol to block cell proliferation (37.4±5.4 to 30.5±5.6% cells incorporating BrdU, P<0.01) was neutralized when UUF was applied together with calcitriol (53.4±21.3% cells incorporating BrdU, P<0.01 vs calcitriol alone). Similarly to what was observed for BrdU incorporation, the CL production of HL-60 cells was enhanced in the presence of calcitriol (20126±10154 to 61528±24021 cpm, P<0.01), and was suppressed again in the presence of calcitriol and UUF (20916±12075 cpm, P<0.01 vs calcitriol alone); finally UUF also inhibited the calcitriol-induced CD14 expression (71.1±11.2 to 54.9±17.7% CD14 positive cells, P<0.05). On the other hand, the calcitriol-induced CD14 mRNA levels were not significantly different in the presence of calcitriol and UUF compared to calcitriol alone. This points to an inhibition by UUF at a post-transcriptional level. Similar data were found for VDR mRNA levels. UUF was fractionated by HPLC in four fractions, hydrophilic uraemic solutes being eluted first (F1) and hydrophobic solutes being eluted last (F4); fractions 1, 2 and 3 simultaneously affected both BrdU incorporation and CL production in a significant way.

Conclusions. It is concluded that UUF contains factors that impair calcitriol-activated function of HL-60 cells. Hence, the differentiation and immune response of these promyelocytic leukaemia cells, as induced by the supplementation of calcitriol, is neutralized in the presence of uraemic biological fluids. This may be of relevance for the propensity to infection and malignancy of the uraemic patient.

Keywords: calcitriol; HL-60 cells; immune system; uraemia; vitamin D

Correspondence and offprint requests to: Griet Glorieux, University Hospital, Nephrology Division, De Pintelaan 185, B-9000 Gent, Belgium.


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