Calcitriol inhibits hepatocyte apoptosis in rat allograft by regulating apoptosis-associated genes.

Calcitriol, the active form of vitamin D, exerts important immunoregulatory effects. After rat liver allografting, calcitriol suppresses acute rejection. The aim of this study was to investigate whether calcitriol regulates hepatocyte apoptosis, in parallel with its inhibition of acute rejection in rat liver allografts. Liver allografts were transplanted in a high responder strain combination (SD to Wistar rats) and calcitriol was administered to the recipients, while control recipients received no immunosuppressant. Graft specimens were harvested on postoperative days 1, 3, 5 and 7 for histological analysis and protein assay. Hepatocyte apoptosis was assessed by the TUNEL method. Levels of intragraft Bcl-2, Bcl-xL, Bax, TNF-alpha and IFN-gamma proteins were measured by Western blot analysis. Expression of Fas, Fas ligand and caspase-3 was determined by immunohistochemical analysis. Calcitriol markedly inhibited hepatocyte apoptosis. In the calcitriol-treated allografts, Bcl-2 and Bcl-xL levels increased while Bax and caspase-3 levels significantly decreased. The expression of Fas ligand was clearly reduced while Fas remained unchanged. TNF-alpha and IFN-gamma proteins were also significantly decreased in the presence of calcitriol. These results show that calcitriol acts as a promoter of the anti-apoptosis genes Bcl-2 and Bcl-xL and an inhibitor of the pro-apoptosis genes Bax and caspase-3. These effects may be related to its suppression of the Fas/Fas ligand pathway and its inhibition of cytotoxic T lymphocyte products.