Serum 25-hydroxyvitamin D levels in patients with Granulomatosis with Polyangiitis: association with respiratory infection

Abstract

OBJECTIVES:To determine the possible association of serum 25-hydroxyvitamin D (25OHD) levels with disease activity and respiratory infection in granulomatosis with polyangiitis patients during two different periods: winter/spring and summer/autumn.METHODS:Thirty-two granulomatosis with polyangiitis patients were evaluated in the winter/spring, and the same patients (except 5) were evaluated in summer/autumn (n=27). The 25OHD levels were measured by radioimmunoassay. Disease activity was assessed by the Birmingham Vasculitis Activity Score Modified for Wegener’s Granulomatosis (BVAS/WG) and antineutrophil cytoplasmic antibody (ANCA) positivity. Respiratory infection was defined according the Centers for Disease Control and Prevention criteria.RESULTS:25OHD levels were lower among patients in winter/spring than in summer/autumn (32.31±13.10 vs. 38.98±10.97 ng/mL, p=0.04). Seven patients met the criteria for respiratory infection: 5 in winter/spring and 2 in summer/autumn. Patients with respiratory infection presented lower 25OHD levels than those without infection (25.15±11.70 vs. 36.73±12.08 ng/mL, p=0.02). A higher frequency of low vitamin D levels (25OHD<20 ng/mL) was observed in patients with respiratory infection (37.5% vs. 7.8, p=0.04). Serum 25OHD levels were comparable between patients with (BVAS/WG≥1 plus positive ANCA) and without disease activity (BVAS/WG=0 plus negative ANCA) (35.40±11.48 vs. 35.34±13.13 ng/mL, p=0.98).CONCLUSIONS:Lower 25OHD levels were associated with respiratory infection but not disease activity in granulomatosis with polyangiitis patients. Our data suggest that hypovitaminosis D could be an important risk factor for respiratory infection in granulomatosis with polyangiitis patients.

Vitamin D Supplementation Could Potentially Reduce Risk of COVID-19 Infections and Deaths

“…Granulomatosis with polyangiitis is an autoimmune disease characterised by vasculitis that primarily affects the respiratory tract and the kidneys. Vitamin D deficiency has been shown to be an important risk factor for RTI in this group of patients (82). The effects of vitamin D on lung immunity and respiratory diseases are well established (83).…”

Vitamin D supply in patients with rheumatic diseases in Poland. A pilot study

“…Regarding antineutrophil cytoplasmic antibody (ANCA) associated vasculitides (AAV), Perez et al [26] noted the influence of lower vitamin D serum levels on the increased risk of respiratory infections in patients with GPA. No relationship, though, between 25(OH)D 3 concentrations and disease activity has been found, but further investigation is needed to determine the prevalence and significance of hypovitaminosis D in AAV.…”

Vitamina D e a COVID-19: impactos no sistema imunológico e os riscos da auto-suplementação

“…Trazendo ao contexto da infecção por COVID-19, uma série de estudos tem examinado o papel potencial da vitamina D na proteção contra infecções do trato respiratório superior e inferior (PEREZ et al, 2017). Considerando-se a expressão de receptores de vitamina D em macrófagos e linfócitos, é amplamente especulada a hipótese de ações não calcêmicas deste hormônio e a relação entre níveis de vitamina D e o prognóstico pós-infecção por coronavírus (BILEZIKIAN et al, 2020).…”