Role of Vitamin D in Regulation of Immunity, Prevention and Therapy of Infectious Pediatric Diseases

The article presents the results of vitamin D tests in children with cystic fibrosis and in healthy children living in the South of Russia. The study showed the high prevalence of vitamin D deficiency and inadequate levels in patients with cystic fibrosis (86.7%). 25(OH) D level characterizing the vitamin D status decreases progressively in patients and healthy children. With regard to the above mentioned, it is significantly lower in patients with cystic fibrosis than in healthy children in all age periods. The correlation between the serum calcidiol level and the age of patients with cystic fibrosis was r = -0.44 (p = 0.015). Intake of prophylactic (500--1000 IU/day) and therapeutic (1500--3000 IU/day) doses of cholecalciferol results in a less significant increase in calcidiol levels in patients with cystic fibrosis compared with healthy children. A significantly lower 25(OH)D level was detected in patients with cystic fibrosis infected withStaph. aureus.The 25(OH)D levels are significantly lower in children with cystic fibrosis and hypocholesterolemia, than in patients with normal cholesterol levels. Risk factors for the development of severe hypovitaminosis D in children with cystic fibrosis are age, physical developmental delay, exocrine pancreatic insufficiency, presence of chronicStaph. Aureusbronchopulmonary infection. Given the conducted study, the dosage of cholecalciferol in patients with cystic fibrosis should be at least 2 times higher than that in healthy children.

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Vitamin d status during winter months among children and adolescents with cystic fibrosis living in southern Russia

Klimov

Долбня

Кондратьева³

et al. 2019

Med. sov.

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Vitamin D and defensins production in infants

Захарова

Цуцаева²,

Klimov³

et al. 2020

Medicinskij sovet

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Резюме Актуальность: иммунотропные эффекты холекальциферола опосредуются витамин-D-индуцируемым синтезом антимикробных пептидов (АМП), в частности β-дефензинов. Исследований, подтверждающих влияние обеспеченности витамином D на синтез АМП, в педиатрической клинической практике крайне мало. Цель: анализ взаимосвязи между обеспеченностью витамином D и продукцией АМП и оценка влияния приема препаратов холекальциферола на синтез дефензинов у детей раннего возраста. Материалы и методы: Обследовано 108 здоровых детей в возрасте от 1 месяца до 3 лет, из которых адекватно обеспеченных витамином D (уровень кальцидиола более 30 нг/мл)-34 (31,5%), с недостаточностью (от 20 до 30 нг/мл)-40 (37,0%), дефицитом витамина D (от 10 до 20 нг/мл)-27 (25,0%) и тяжелым дефицитом (менее 10 нг/мл)-7 (6,5%) детей. При наличии гиповитаминоза D с целью коррекции назначался месячный курс холекальциферола в дозах 2000-4000 МЕ/сут, а при нормальной обеспеченности-профилактический прием 1000 МЕ/сут. Трехкратно определялись показатели 25(ОН)D, β1-и β2-дефензинов. Результаты. На естественном вскармливании показатели β1-дефензина в 2,3 раза (p<0,05), а β2-дефензина в 7,5 раза (p<0,001) превосходят таковые у детей, находящихся на искусственном вскармливании. На фоне курса коррекции уровень β1-дефензина вырос с 3,3 [2,24-5,85] пг/мл до 3,7 [2,25-6,32] пг/мл (p = 0,05), а β2-дефензина-с 240,7 [86,77-686,64] пг/мл до 514,2 [468,19-1104,98] пг/мл (р<0,001). Лечебные дозы холекальциферола способствовали более существенному приросту β1-и β2-дефензина, между суточной дозой витамина D и приростом β2-дефензина выявлена прямая корреляционная связь (r = 0,34, p<0,05). Прием профилактической дозы холекальциферола 1000 МЕ/сут в течение 6 мес сопровождался дальнейшим увеличением продукции АМП-уровень β1-дефензина вырос в 2,4 раза (р<0,001), а уровень β2-дефензина-в 2,5 раза (р<0,001) по сравнению с исходными значениями. Выводы. Прием препаратов холекальциферола у детей раннего возраста сопровождается повышением уровня β-дефензиновважнейших факторов врожденного иммунитета.

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The Role of Vitamin D Metabolite Deficiency in the Development of Structural and Functional Disorders in Coxarthrosis

Kalashnikov

Gayko

Burianov

et al. 2021

HOTP

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Summary. At present, there is a need to systematize the data of our own comprehensive research and literature in order to determine the role of active metabolites of vitamin D in the formation of structural and functional disorders (SFD) in osteoarthritis of the hip. Objective: on the basis of our own complex researches and data of literature, to determine the role of the insufficiency of vitamin D metabolites in the development of SFD in coxarthrosis. Materials and Methods. The basis for determining the role of active metabolites of vitamin D in the development of SFN in coxarthrosis was our own comprehensive studies of 506 patients with osteoarthritis of the hip and data from the literature. Results. On the basis of the theory of functional systems, a conceptual model for the development of SFD in coxarthrosis has been developed. The leading factor in the development of SFD in the rapid progression of idiopathic and dysplastic osteoarthritis of the hip is the lack of active metabolites of vitamin D. The presence of undifferentiated connective tissue dysplasia in turn causes a decrease in the absorption of provitamin D in the stomach and intestines. With a slow progression of idiopathic coxarthrosis, the leading factor in the development of these disorders is the excessive load on the hip joint. Factors of violation of biomechanical conditions and injury of the hip joint are factors of the progression of coxarthrosis of dysplastic and post-traumatic genesis. Pathogenic factors lead to functional and structural changes in systems of different levels and their elements with the development of inverted processes in the structures of the hip joint. Conclusions. Insufficiency of vitamin D metabolites on the background of undifferentiated connective tissue dysplasia leads to biochemical changes in articular cartilage and serum, affects both osteo- and chondrogenesis, leads to reduced immune status of patients and the development of clinical manifestations of rapid progression of idiopathic and dysplastic coxarthrosis. With a slow progression of idiopathic coxarthrosis, the main factor leading to the development of the above mentioned disorders is the excessive load on the hip joint. Factors of violation of biomechanical conditions and injury of the hip joint determine the development of SFD in coxarthrosis of dysplastic and post-traumatic genesis.

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Role of Vitamin D in Regulation of Immunity, Prevention and Therapy of Infectious Pediatric Diseases

Cited by 4 publications

References 30 publications

Vitamin d status during winter months among children and adolescents with cystic fibrosis living in southern Russia

Vitamin d status during winter months among children and adolescents with cystic fibrosis living in southern Russia

Vitamin D and defensins production in infants

The Role of Vitamin D Metabolite Deficiency in the Development of Structural and Functional Disorders in Coxarthrosis

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