Wróblewska Joanna, Złocińska Hanna, Wróblewski Marcin, Nuszkiewicz Jarosław, Woźniak Alina
Department of Medical Biology and Biochemistry, Faculty of Medicine, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, 24 Karłowicza St., 85-092 Bydgoszcz, Poland.
Brudziński Provincial Children's Hospital, 44 Chodkiewicza St., 85-667 Bydgoszcz, Poland.
Biomolecules. 2025 Apr 11;15(4):566. doi: 10.3390/biom15040566.
Urinary tract infections (UTI) are among the most frequent bacterial infections in children, representing a significant cause of morbidity with potential long-term complications, including renal scarring and chronic kidney disease. This review explores the multifaceted roles of vitamins A, D, E, and C in the prevention and management of pediatric UTI. Vitamin A supports mucosal barrier integrity and immune modulation, reducing pathogen adhesion and colonization. Vitamin C exhibits antioxidant and antimicrobial properties, acidifying urine to inhibit bacterial growth and enhancing the efficacy of antibiotics. Vitamin D strengthens innate immunity by promoting antimicrobial peptide production, such as cathelicidins, and improves epithelial barrier function, while vitamin E mitigates oxidative stress, reducing renal inflammation and tissue damage. The interplay between oxidative stress, immune response, and nutritional factors is emphasized, highlighting the potential of these vitamins to restore antioxidant balance and prevent renal injury. Complementary strategies, including probiotics and phytotherapeutic agents, further enhance therapeutic outcomes by addressing microbiome diversity and providing additional antimicrobial effects. While these approaches show promise in mitigating UTI recurrence and reducing dependence on antibiotics, evidence gaps remain regarding optimal dosing, long-term outcomes, and their integration into pediatric care. By adopting a holistic approach incorporating vitamin supplementation and conventional therapies, clinicians can achieve improved clinical outcomes, support antibiotic stewardship, and reduce the risk of renal complications in children with UTI.
尿路感染（UTI）是儿童中最常见的细菌感染之一，是发病的一个重要原因，可能导致包括肾瘢痕形成和慢性肾病在内的长期并发症。本综述探讨了维生素A、D、E和C在小儿尿路感染预防和管理中的多方面作用。维生素A支持黏膜屏障完整性和免疫调节，减少病原体黏附和定植。维生素C具有抗氧化和抗菌特性，可酸化尿液以抑制细菌生长并增强抗生素疗效。维生素D通过促进抗菌肽（如cathelicidins）的产生来增强先天免疫力，并改善上皮屏障功能，而维生素E减轻氧化应激，减少肾脏炎症和组织损伤。强调了氧化应激、免疫反应和营养因素之间的相互作用，突出了这些维生素恢复抗氧化平衡和预防肾损伤的潜力。包括益生菌和植物治疗剂在内的补充策略，通过解决微生物群多样性问题并提供额外的抗菌作用，进一步提高治疗效果。虽然这些方法在减轻UTI复发和减少对抗生素的依赖方面显示出前景，但在最佳剂量、长期结果及其纳入儿科护理方面仍存在证据空白。通过采用包括维生素补充和传统疗法在内的整体方法，临床医生可以改善临床结果，支持抗生素管理，并降低UTI患儿发生肾脏并发症的风险。
