2nd Department of Pediatrics, Children's Hospital of Athens "P. & A. Kyriakou", National and Kapodistrian University of Athens, Athens, Greece.
2nd Department of Pediatrics, Laboratory of Clinical Biochemistry - Molecular Diagnostics, Children's Hospital of Athens "P. & A. Kyriakou", National and Kapodistrian University of Athens, Athens, Greece.
Pediatr Pulmonol. 2021 Jun;56(6):1673-1680. doi: 10.1002/ppul.25349. Epub 2021 Mar 13.
To investigate the association of serum vitamin D and nasal secretion antimicrobial peptides (AMPs) levels with the severity of acute bronchiolitis.
We conducted a prospective single pediatric tertiary care center cohort study of inpatients aged 0-18 months with a first episode of acute bronchiolitis from November 1st 2014 to April 30th 2017. Disease severity was determined by the length of hospitalization and supplemental hospital data. Qualitative measurements included serum 25(OH)D and nasal secretion LL-37 and β-defensin-2 levels. Correlations were examined with the Mann-Whitney and Kruskal-Wallis criteria for qualitative and the correlation coefficient Spearman's rho for quantitative factors. Multiple linear and logarithmic regression were performed to adjust for confounding factors.
The study population consisted of 153 infants and toddlers with median age 3.1 months (interquartile range:1.6-4.9). No association was found between serum 25(OH)D and AMPs nasal secretions levels. Serum 25(OH)D and nasal secretion β-defensin-2 levels were not associated with the severity of bronchiolitis. In contrast, LL-37 levels were inversely associated with the length of hospitalization (rho = -0.340, p = .001), the need for medication use (p = .001), as well as the duration of oxygen supplementation (rho = -0.339, p = .001), and intravenous fluid administration (rho = -0.323, p = .001). This association remained significant after adjustment for potential confounders.
A significant association between LL-37 nasal secretions levels with the severity of acute bronchiolitis was found in hospitalized infants and toddlers. The role of LL-37 in the pathogenesis of bronchiolitis merits further investigation.
研究血清维生素 D 和鼻分泌物抗菌肽（AMPs）水平与急性细支气管炎严重程度的关系。
我们进行了一项前瞻性单儿科三级保健中心队列研究，纳入了 2014 年 11 月 1 日至 2017 年 4 月 30 日期间首次发作急性细支气管炎的 0-18 个月龄住院患儿。疾病严重程度通过住院时间和补充住院数据来确定。定性测量包括血清 25(OH)D 和鼻分泌物 LL-37 和β-防御素-2 水平。用 Mann-Whitney 和 Kruskal-Wallis 检验进行定性因素的相关性分析，用 Spearman's rho 相关系数进行定量因素的相关性分析。进行多元线性和对数回归以调整混杂因素。
研究人群包括 153 名婴儿和幼儿，中位年龄为 3.1 个月（四分位距：1.6-4.9）。血清 25(OH)D 和 AMPs 鼻分泌物水平之间没有相关性。血清 25(OH)D 和鼻分泌物β-防御素-2 水平与细支气管炎的严重程度无关。相反，LL-37 水平与住院时间（rho=-0.340，p=0.001）、用药需求（p=0.001）、以及氧疗时间（rho=-0.339，p=0.001）和静脉补液时间（rho=-0.323，p=0.001）呈负相关。在调整了潜在混杂因素后，这种相关性仍然具有统计学意义。
在住院婴儿和幼儿中，发现 LL-37 鼻分泌物水平与急性细支气管炎严重程度之间存在显著相关性。LL-37 在细支气管炎发病机制中的作用值得进一步研究。
