Konstantinidis Iordanis, Fotoulaki Maria, Iakovou Ioannis, Chatziavramidis Angelos, Mpalaris Vasilios, Shobat Kseniya, Markou Konstantinos
Rhinology Clinic, Second Academic Otorhinolaryngology Department, Papageorgiou Hospital, Aristotle University, Thessaloniki, Greece.
Am J Rhinol Allergy. 2017 Nov 1;31(6):395-400. doi: 10.2500/ajra.2017.31.4484.
Currently vitamin D3 (VD3) or cholecalciferol is considered an immunomodulator that may be implicated in nasal polyposis (NP) pathophysiology.
This study aimed to investigate if deficiency of VD3 is associated with the presence of NP in patients with cystic fibrosis (CF) and patients with chronic rhinosinusitis (CRS).
In total, 152 adult participants were included in five phenotypic groups: CF with NP (CFwNP) (n = 27), CF without NP (CFsNP) (n = 31), CRS with NP (CRSwNP) (n = 32), CRS without NP (CRSsNP) (n = 30), and controls (n = 32). The serum levels of 25(OH)-VD3 < 20 ng/mL are considered as a deficiency, 21-29 ng/mL as insufficiency, and >30 ng/mL as sufficiency. Endoscopic and imaging staging of the mucosal disease performed with the Lund-Kennedy (LK) and Lund-Mackay (LM) scoring systems, respectively. The genotype of the patients with CF and the nasal microbial colonization of the patients with CF and patients with CRS were also recorded.
The patients with CFwNP had the lowest percentage of sufficiency in VD3 and the highest percentage in insufficiency among all the groups. The LM imaging scores were inversely correlated with the VD3 levels in both arms of the study (CF and CRS). Moreover, the LK endoscopic scores had a similar correlation in the CF groups; however, this was not the case with the CRS groups. The genotype of the patients with CF was not correlated with the VD3 serum levels. The patients with positive microbial colonization (mainly Pseudomonas and Staphylococcus aureus) had significantly lower VD3 serum levels in both the CF and CRS process.
VD3 deficiency seemed to be associated with the presence of nasal polyps in the patients with CRS and in the patients with CF in a similar manner. The lower the level of serum VD3, the more severe the mucosal disease was found in the imaging studies and the more frequent microbial colonization of the patients with CF and the patients with CRS.
目前，维生素D3（VD3）或胆钙化醇被认为是一种免疫调节剂，可能与鼻息肉（NP）的病理生理过程有关。
本研究旨在调查VD3缺乏是否与囊性纤维化（CF）患者和慢性鼻-鼻窦炎（CRS）患者中NP的存在相关。
总共152名成年参与者被纳入五个表型组：患有NP的CF（CFwNP）（n = 27）、不患有NP的CF（CFsNP）（n = 31）、患有NP的CRS（CRSwNP）（n = 32）、不患有NP的CRS（CRSsNP）（n = 30）以及对照组（n = 32）。血清25（OH）-VD3水平<20 ng/mL被视为缺乏，21 - 29 ng/mL为不足，>30 ng/mL为充足。分别采用Lund-Kennedy（LK）和Lund-Mackay（LM）评分系统对黏膜疾病进行内镜和影像学分期。还记录了CF患者的基因型以及CF患者和CRS患者的鼻腔微生物定植情况。
在所有组中，CFwNP患者的VD3充足率最低，不足率最高。在研究的两个分支（CF和CRS）中，LM影像学评分均与VD3水平呈负相关。此外，CF组中LK内镜评分也有类似的相关性；然而，CRS组并非如此。CF患者的基因型与VD3血清水平无关。在CF和CRS病程中，微生物定植阳性的患者（主要是铜绿假单胞菌和金黄色葡萄球菌）的VD3血清水平显著更低。
VD3缺乏似乎以类似方式与CRS患者和CF患者中鼻息肉的存在相关。血清VD3水平越低，在影像学研究中发现的黏膜疾病越严重，CF患者和CRS患者的微生物定植越频繁。
