Abstract:[Objective] To investigate the effect of 1,25 dihydroxyvitamin D3 on macrophage polarization in ankylosing spondylitis (AS) and its regulation mechanism by Toll-like receptor 4 (TLR4) /myeloid differentiation factor 88 (MyD88) /nuclear factor-κB (NF-κB) signal pathway. [Methods] Phorbol ester was used to induce human monocyte line THP1 differentiate into macrophages. Subsequently, the cells were cultured with 5% serum of healthy subjects (normal group) , 5% AS patient’s serum (the AS group) , whereas 5% serum of AS patients, and 1 ml of 100 nmol/L 1,25-dihydroxyvitamin D3 solution (the trial group) . ELISA method was used to detect the content of interleukin10 (IL-10) , IL-6 and tumor necrosis factor-α (TNF-α) in the supernatant of each group of cells. Western blot was used to detect the cell signaling pathway related protein expression. [Results] Compared with the normal group, the AS group and the trial group had significantly decreased IL-10 in the cell supernatant, while significantly increased IL-6 and TNF-α in the cell supernatant, as well as the expression of TLR4, MyD88, NF-κB, which were statistically significant (all P<0.05) . Compared with the AS group, the trial group had significantly in- creased IL-10 content in the cell supernatant, whereas significantly decreased IL- 6 and TNF-α, as well as expression levels of TLR4, MyD88, and NF-κB with statistically significant differences (P<0.05) . [Conclusion] 1,25-dihydroxyvitamin D3 might regulate polarization process of macrophages in ankylosing spondylitis by the TLR4/MyD88/NF-κB signaling pathway.