(SLB-053) Association of serum vitamin D status with VDR and CAMP gene expression and their influence on biofilm formation in diabetic foot patients

Background: Many infectious diseases are affected by vitamin D, which works through the vitamin D receptor (VDR) and the cathelicidin antimicrobial peptide (CAMP) gene. Currently, there is a limited amount of evidence to suggest that the levels of vitamin D influences the expression of VDR and CAMP gene, as well as the biofilm formation by microbial isolates in diabetic foot infections (DFI). Hence, we hypothesize that the levels of serum 25-hydroxy vitamin D [25(OH)VD] could influence the expression of the VDR and CAMP genes, as well as biofilm formation in patients with DFI.

Objectives: To determine whether 25(OH)VD status was associated with VDR and CAMP gene expression and biofilm formation in patients with DFI.

Methods: A cross-sectional study was carried out in a tertiary care hospital in South India, involving 65 patients with DFI. Serum 25(OH)VD levels were evaluated through chemiluminescence immunoassay, and the expression levels of VDR and CAMP in peripheral blood were measured using real-time quantitative PCR. The measurement of biofilm formation was carried out utilizing the tissue culture plate technique. Statistical analysis was conducted using Chi-square and Kruskal Wallis tests.

Results: The vitamin D status among 65 patients with DFI revealed that 45 patients (69.23%) were vitamin D-deficient, 15 patients (23.07%) were insufficient, and 5 patients (7.69%) were sufficient. The DFI group with vitamin D deficiency exhibited lower expressions of VDR (p < 0.001) and CAMP (p < 0.001) genes and increased (p < 0.001) biofilm forming capacity by infecting isolates.

Conclusions: Vitamin D deficiency, potentially contributed to the reduced expression levels of VDR and CAMP genes and heightened biofilm formation in DFI patients. Therefore, the study highlights the importance personalized medicine approach based on vitamin D status for managing DFIs.