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The percentage of elderly people among the total population in Taiwan is increasing dramatically, and HD is the primary alternative for renal replacement therapy when renal function declines. Activated vitamin D is widely used in HD patients with secondary hyperparathyroidism (SHPT) and is a well-known immunomodulatory agent. Personalized medicine and integrative medical approach has been a trend in current clinical practice. Can we improve their immune function using vitamin D in spite of the mineral aspect? Here, we investigated the relationship between serum 25-hydroxyvitamin D (25(OH)D) level and T cell differentiation in chronic HD patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Forty patients with chronic HD were enrolled. HD patients with SHPT had been treated with activated vitamin D for 3\u00a0months. Peripheral blood mononuclear cells obtained from the patients were cultured and stimulated by mitogens, and T cells were analyzed by flow cytometry. Serum 25(OH)D levels were detected by enzyme-linked immunosorbent assay.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The incidence of T cell differentiation to the T helper cell (Th)2 subtype was more prevalent in the elderly group than in the controls (<jats:italic>p<\/jats:italic>\u2009=\u20090.001). Th2 differentiation was also correlated with age (<jats:italic>p<\/jats:italic>\u2009=\u20090.004) and serum 25(OH)D levels (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05). After treated with activated vitamin D, the level of Th1 cytokines decreased while the Th2 cytokine level increased in the sera (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05). The T cell differentiation tended toward the Th2 subtype (<jats:italic>p<\/jats:italic>\u2009=\u20090.027) after treatment of activated vitamin D in SHPT patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>These results demonstrated that Th2 differentiation is correlated with age and the serum 25(OH)D level of patients. Treatment with activated vitamin D influenced T cell differentiation and cytokine expression in SHPT patients. Taking vitamin D is the possible prediction and targeted treatment in the immune dysfunction in chronic HD patients.<\/jats:p><\/jats:sec>","DOI":"10.1186\/1878-5085-4-17","type":"journal-article","created":{"date-parts":[[2013,6,21]],"date-time":"2013-06-21T20:49:31Z","timestamp":1371847771000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Altered molecular repertoire of immune system by renal dysfunction in the elderly: is prediction and targeted prevention in the horizon?"],"prefix":"10.1186","volume":"4","author":[{"given":"Cheng-Lin","family":"Lang","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Min-Hui","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kuan-Yu","family":"Hung","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chih-Kang","family":"Chiang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kuo-Cheng","family":"Lu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2013,6,21]]},"reference":[{"key":"5024_CR1","doi-asserted-by":"publisher","first-page":"712","DOI":"10.1038\/ki.1993.102","volume":"43","author":"R Schindler","year":"1993","unstructured":"Schindler R, Linnenweber S, Schulze M, Oppermann M, Dinarello CA, Shaldon S, Koch KM: Gene expression of interleukin-1 beta during hemodialysis. 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