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Volume 2
Journal of Clinical Diagnosis and Treatment
Annual Nephrology & Chronic Diseases 2019
May 20-21, 2019
Page 29
Nephrology
Chronic Diseases
May 20-21, 2019 London, UK
19
th
Annual Conference on
3
rd
International Conference on
&
Meg Mangin, R N
Chronic Illness Recovery, USA
Intracellular bacteria cause chronic disease by altering the immune response
P
atients with chronic diseases have elevated 1,25-dihydroxyvitamin-D and low 25-hydroxyvitamin-D.
The absence of hypercalcemia, hypercalciuria, elevated parathyroid hormone, and chronic
kidney disease indicates extra-renal production of excess 1,25-dihydroxyvitamin-D. In normal
immune function, extra-renal 1alpha-hydroxylase (CYP27B1) catalyzes 25-hydroxyvitamin-D to
1,25-dihydroxyvitamin-D in immune cells, leading to transcription of antimicrobial peptides via the
vitamin D receptor (VDR). CYP27B1 transcription in macrophages is regulated by cytokines (e.g.,
Interferon-y). L-formbacteria invade immune cells anduse strategies to avoidphagocytosis. Parasitization
of macrophages by these pathogens is the stimulus for persistent production of cytokines which induce
CYP27B1 activity and excess 1,25-dihydroxyvitamin-D production. Down-regulation of the VDR
by intracellular bacteria interferes with 1,25-dihydroxyvitamin-D production regulatory processes
and thus, prevents transcription of antimicrobial peptides to allow bacterial persistence. Bacterial
interference with enzymatic traffic patterns allows production of excess 1,25-dihydroxyvitamin-D and
prevents normal 1,25-dihydroxyvitamin-D functions which inhibit the expression of inflammatory
cytokines. In summary, non-resolving inflammation associated with many common chronic
diseases is caused by survival strategies of intracellular bacteria and is evidenced by elevated
1,25-dihydroxyvitamin-Dand depleted 25-hydroxyvitamin-Dasmarkers of an infectious disease process.
Biography
Meg Mangin, R.N. is the founder and Executive Director of Chronic Illness Recovery. She has served on a National Institutes of Health State
of the Science panel and an NIH Data, Safety and Monitoring Board. Ms. Mangin has presented at numerous conferences, including Days
of Molecular Medicine in Karolinska, Sweden, the International Conference on Autoimmunity in Porto, Portugal, the American Society of
Hypertension Annual Meeting, Enabling Future Pharma, Perspectives in Rheumatic Diseases, Immunology Summit, ILADS and 8th Global
Summit on Microbiology & Infectious Diseases. She is the co-author of a chapter in the medical textbook Vitamin D: New Research and the
lead author of a ground-breaking review article on vitamin D, inflammation and infection published in the October 2014 issue of Inflammation
Research.
tmmangin@charter.netMeg Mangin, R N, J Clinical Diagnosis and Treatment, Volume 2