Cathelicidin as a link between sarcoidosis and tuberculosis

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Ercan Korucu
Leyla Pur Ozyigit
Mediha Gonenc Ortakoylu
Ayse Bahadir
Esma Seda Akalin
Asuman Kara
Hafize Uzun
Burak Onal
Emel Caglar

Keywords

Vitamin D, innate immunity, granulomatous lung disease

Abstract

ABSTRACT

Setting: Sarcoidosis and tuberculosis share notable clinical, radiological, histological, and immunological similarities. The importance of vitamin D has long been investigated in these two granulomatous lung diseases. Cathelicidin is an antimicrobial peptide of the innate immune system, directly induced by vitD3.

Objective: To evaluate the role of cathelicidin in sarcoidosis and tuberculosis development.

Design: The study included 30 consecutive patients with active lung tuberculosis, 30 patients with sarcoidosis, and 20 healthy controls. 25-hydroxyvitamin D [25(OH)D] and cathelicidin levels were measured in blood samples.

Results: Vitamin D levels were significantly higher (p<0.001) in tuberculosis patients (22.5±9.96 ng/ml) than in sarcoidosis patients (11.75±8.92 ng/ml). Severe vitamin D deficiency was as frequent as 47% in sarcoidosis patients compared to only 3% in tuberculosis patients. Cathelicidin levels were significantly higher in the control group (120.37±41.03 pg/ml) than in sarcoidosis (67.68±38.03 pg/ml) and tuberculosis (68.74 ±39.44 pg/ml) patients (p<0.001). However, no significant difference in cathelicidin levels was observed between tuberculosis and sarcoidosis patients (p=0.966). The optimum cathelicidin cut-off value to distinguish sarcoidosis patients from healthy controls was 107.14 pg/ml  (sensitivity 81.5%, specificity 71.2%).

Conclusion: Cathelicidin appears to play different roles in the development of granulomatous lung disease.

 

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