Määttä Anette M, Kotaniemi-Syrjänen Anne, Malmström Kristiina, Malmberg L Pekka, Sundvall Jouko, Pelkonen Anna S, Mäkelä Mika J
Skin and Allergy Hospital, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.
Skin and Allergy Hospital, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.
Ann Allergy Asthma Immunol. 2017 Sep;119(3):227-231. doi: 10.1016/j.anai.2017.06.014. Epub 2017 Jul 28.
Vitamin D insufficiency might be associated with biased T-cell responses resulting in inflammatory conditions such as atopy and asthma. Little is known about the role of vitamin D in low-grade systemic inflammation and airway hyperresponsiveness (AHR) in young children.
To evaluate whether vitamin D insufficiency and increased serum high-sensitivity C-reactive protein (hs-CRP) are linked to AHR in symptomatic infants.
Seventy-nine infants with recurrent or persistent lower respiratory tract symptoms underwent comprehensive lung function testing and a bronchial methacholine challenge test. In addition, skin prick tests were performed and serum 25-hydroxyvitamin D (S-25-OHD), hs-CRP, total immunoglobulin E, and blood eosinophil levels were determined.
S-25-OHD was lowest in infants with blood eosinophilia and AHR (n = 10) compared with those with eosinophilia only (n = 6) or AHR only (n = 50) or those with neither (n = 13; P = .035). Moreover, vitamin D insufficiency (S-25-OHD <50 nmol/L) was most common in infants with blood eosinophilia and AHR (P = .041). Serum hs-CRP was lower in infants with recurrent physician-diagnosed wheezing (P = .048) and in those with blood eosinophilia (P = .015) than in infants without these characteristics and was not associated with S-25-OHD or AHR. S-25-OHD levels were significantly lower (median 54 nmol/L) during the autumn-winter season than in the spring-summer season (median 63 nmol/L; P = .026).
Vitamin D insufficiency could underlie eosinophilia and AHR in infants with troublesome lung symptoms, whereas hs-CRP-mediated low-grade systemic inflammation is rare in early childhood wheezing.
维生素D缺乏可能与T细胞反应偏差有关，从而导致诸如特应性和哮喘等炎症性疾病。关于维生素D在幼儿低度全身炎症和气道高反应性（AHR）中的作用知之甚少。
评估维生素D缺乏和血清高敏C反应蛋白（hs-CRP）升高是否与有症状婴儿的AHR相关。
79例有反复或持续下呼吸道症状的婴儿接受了全面的肺功能测试和支气管乙酰甲胆碱激发试验。此外，进行了皮肤点刺试验，并测定了血清25-羟基维生素D（S-25-OHD）、hs-CRP、总免疫球蛋白E和血液嗜酸性粒细胞水平。
与仅有嗜酸性粒细胞增多（n = 6）或仅有AHR（n = 50）或两者均无（n = 13；P = 0.035）的婴儿相比，有血液嗜酸性粒细胞增多和AHR的婴儿（n = 10）的S-25-OHD最低。此外，维生素D缺乏（S-25-OHD <50 nmol/L）在有血液嗜酸性粒细胞增多和AHR的婴儿中最为常见（P = 0.041）。与没有这些特征的婴儿相比，经医生诊断有反复喘息的婴儿（P = 0.048）和有血液嗜酸性粒细胞增多的婴儿（P = 0.015）的血清hs-CRP较低，且与S-25-OHD或AHR无关。秋冬季节的S-25-OHD水平（中位数54 nmol/L）显著低于春夏季节（中位数63 nmol/L；P = 0.026）。
维生素D缺乏可能是有肺部症状婴儿嗜酸性粒细胞增多和AHR的基础，而hs-CRP介导的低度全身炎症在幼儿喘息中很少见。
