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. 2020 Nov 1;183(5):R133–R147. doi: 10.1530/EJE-20-0665

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© 2020 European Society of Endocrinology

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Antimicrobial actions of vitamin D. Schematic showing possible macrophage responses to microbial infection. Pattern recognition receptors such as toll-like receptors (TLR) signal responses to pathogens. This includes transcriptional induction of 1α-hydroxylase (CYP27B1) and the vitamin D receptor (VDR). Serum 25-hydroxyvitamin D (25-OHD) bound to vitamin D binding protein (DBP) allows intracellular access of free 25-OHD for conversion to 1,25 (OH)₂D, which then bind to VDR. Transcriptional responses to 1,25 (OH)₂D (shown with red arrows) include induction of cathelicidin and β-defensin 2 (DEFB4), NOD2, and nitric oxide (NO). Intracellular iron (Fe) is exported via ferroportin which is targeted for degradation by hepcidin. The bacterial cell wall product muramyl dipeptide binds to NOD2.