CONCLUDING REMARKS: VITAMIN D, FRIEND OR FOE IN HIV INFECTION?

There is a general agreement that vitamin D sufficiency contributes to good health, being essential to regulate the absorption and metabolism of calcium and phosphorus resulting in health bones [226].

There is no data in the literature about the effect of HIV-1 infection in the expression of VDR and vitamin D- related enzymes. In the case of the chronic retroviral infection with MuLV, it has been observed an alteration on both the local vitamin D metabolism and the VDR expression by immune cells [227]. Over 30% of the myeloid cells from MuLV infected mice expressed VDR, whereas less than 1% of the uninfected cells did so. This suggests that retroviral infection induces the VDR expression in monocyte/MAC. There is a correlation between the increase in functional receptor protein and increased response to 1,25-(OH)2D3 in many cellular systems [5]. In this retroviral infection the vitamin D treatment leads to increased cytopathic effects and lower survival.

Recent studies demonstrated that inhibition of antigen-presentation attenuator drastically boosts memory HIV-specific T- and B-cell responses induced by DC- and DNA-based HIV vaccines [228]. Therefore, inhibition of antigen-presentation attenuators has been considered as an alternative strategy for enhancing the effectiveness of different prophylactic and therapeutic vaccine strategies against HIV [229]. Vitamin D inhibits APC maturation and antigen presentation acting as antigen-presentation attenuator. Subsequently, the use of VDR antagonists and/or inhibitors of the vitamin D pathway enzymes could be proposed as co­adjuvants in HIV therapeutic approaches. Further investigations are warranted to develop vitamin D related drugs that, avoiding non-desired side effects, could be used in such strategies.

ACKNOWLEDGMENTS

This work was supported by Grants “Fondo de Investigaciones Sanitarias” (FIS) to J.F. (ref.: PI021476 and PI051778) and A.C. (ref.: PI021205). “Fundacio Marato TV3” to J.F. (ref.: 020730) and A.C. (ref.: 020732).

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