Potentiation of the macrophage 25-hydroxyvitamin D-1-hydroxylation reaction by human tuberculous pleural effusion fluid.

1,25-Dihydroxyvitamin D [1,25-(OH)2D] is classically viewed as a steroid hormone of renal origin that regulates mammalian and avian mineral ion homeostasis. More recently, 1,25-(OH)2D has been shown to be produced by and act on human inflammatory cells in vitro, suggesting that the hormone may be an important modulator of the host immune response. We have recently detected high concentrations of 1,25-(OH)2D in the pleural fluid (PF) of patients with tuberculous pleuritis. Working on the hypothesis that tuberculous PF contained a soluble cytokine which stimulated 1,25-(OH)2D production by tissue (pleura)-based macrophages, we examined the potential for PF from five patients with tuberculous pleuritis to potentiate 1,25-(OH)2D synthesis by heterologous pulmonary alveolar macrophages (PAM) from patients with sarcoidosis; PAM from patients with active pulmonary sarcoidosis constitutively express a 25-hydroxyvitamin D3-1-hydroxylation reaction in vitro. We demonstrated that tuberculous PF had a concentration-dependent potentiating effect on PAM 1,25-(OH)2D synthesis. The potentiating activity was positively correlated to the interferon-gamma (IFN gamma) concentration of the PF (r = 0.98; P less than 0.01) and was inhibited by 49-89% after coincubation with anti-IFN gamma monoclonal antibody (1:20,000-1:200 dilution). These data suggest that IFN gamma may be an important peripleural regulator of macrophage 1,25-(OH)2D synthesis in patients with tuberculous pleuritis and a high pleural fluid 1,25-(OH)2D concentration.