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Vitamin D, high-sensitivity C-reactive protein, and airway hyperresponsiveness in infants with recurrent respiratory
Anette M Määttä1, Anne Kotaniemi-Syrjänen1, Kristiina Malmström1
1Skin and Allergy Hospital, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.
Insights
Vitamin D insufficiency in infants may contribute to airway hyperresponsiveness and eosinophilia. Low vitamin D levels were observed in infants with both conditions, suggesting a link to troublesome lung symptoms.
Area of Science:
- Pediatric Pulmonology
- Immunology
- Nutritional Science
Background:
- Vitamin D insufficiency is potentially linked to T-cell dysfunction, contributing to inflammatory conditions like asthma and atopy.
- The specific role of vitamin D in early childhood low-grade systemic inflammation and airway hyperresponsiveness (AHR) remains unclear.
Purpose of the Study:
- To investigate the association between vitamin D insufficiency, elevated serum high-sensitivity C-reactive protein (hs-CRP), and AHR in infants presenting with respiratory symptoms.
Main Methods:
- Seventy-nine infants with lower respiratory tract symptoms underwent lung function tests, including bronchial methacholine challenge.
- Skin prick tests, serum 25-hydroxyvitamin D (S-25-OHD), hs-CRP, total immunoglobulin E, and blood eosinophil counts were analyzed.
Main Results:
- Infants with both blood eosinophilia and AHR exhibited the lowest S-25-OHD levels (P = .035).
- Vitamin D insufficiency was most prevalent in infants with both eosinophilia and AHR (P = .041).
- Seasonal variations showed lower S-25-OHD during autumn-winter compared to spring-summer (P = .026).
Conclusions:
- Vitamin D insufficiency may be a contributing factor to eosinophilia and AHR in infants with persistent respiratory issues.
- Low-grade systemic inflammation, indicated by hs-CRP, appears uncommon in early childhood wheezing and is not associated with vitamin D levels or AHR.
Background:
Vitamin D insufficiency might be associated with biased T-cell responses resulting in inflammatory conditions such as atopy and asthma. Little is known about the role of vitamin D in low-grade systemic inflammation and airway hyperresponsiveness (AHR) in young children.
Objective:
To evaluate whether vitamin D insufficiency and increased serum high-sensitivity C-reactive protein (hs-CRP) are linked to AHR in symptomatic infants.
Methods:
Seventy-nine infants with recurrent or persistent lower respiratory tract symptoms underwent comprehensive lung function testing and a bronchial methacholine challenge test. In addition, skin prick tests were performed and serum 25-hydroxyvitamin D (S-25-OHD), hs-CRP, total immunoglobulin E, and blood eosinophil levels were determined.
Results:
S-25-OHD was lowest in infants with blood eosinophilia and AHR (n = 10) compared with those with eosinophilia only (n = 6) or AHR only (n = 50) or those with neither (n = 13; P = .035). Moreover, vitamin D insufficiency (S-25-OHD <50 nmol/L) was most common in infants with blood eosinophilia and AHR (P = .041). Serum hs-CRP was lower in infants with recurrent physician-diagnosed wheezing (P = .048) and in those with blood eosinophilia (P = .015) than in infants without these characteristics and was not associated with S-25-OHD or AHR. S-25-OHD levels were significantly lower (median 54 nmol/L) during the autumn-winter season than in the spring-summer season (median 63 nmol/L; P = .026).
Conclusion:
Vitamin D insufficiency could underlie eosinophilia and AHR in infants with troublesome lung symptoms, whereas hs-CRP-mediated low-grade systemic inflammation is rare in early childhood wheezing.
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