INVITRO STUDY OF ROLE OF VITAMIN D ON MACROPHAGES DYSFUNCTION IN PATIENTS WITH DIABETIC FOOT INFECTION.

In addition to macro and micro vascular complication, hyperglycemia also causes dysfunction of immune system that protects the individuals against infection. Vitamin D deficiency, which has very high prevalence among the diabetic population, might contribute to impairment of macrophage dysfunction. The present study aimed to accesses the effect of vitamin D on phagocytic activity of macrophages in patients with diabetic foot infection in an in-vitro experimental model. The subjects included in the study were divided in to three groups. Serum vitamin D level of all groups was measured by Radioimmunoassay methods. Human PBMC were isolated by density- gradient centrifugation and cultured for 5 days in presence and absence of vitamin D. Phagocytosis was assessed by Confocal and fluorescent microscopy. Comparisons were performed using ANOVA and data were expressed as mean ± SD. The increased percentage of phagocytosis was observed in macrophages treated with 1X10-7M concentration of vitamin D3 in comparison to untreated sample among the diabetic foot group. In conclusion this study demonstrated that vitamin D deficiency lead to impaired phagocytosis of macrophages from diabetic subjects. Addition of vitamin D in culture medium of the macrophages improves phagocytosis significantly. This remarkable observation strengthens the concept of vitamin D supplementation to the diabetic foot for improving innate immunity.