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Vitamin D Supplementation and T Cell Regulation in Preterm Infants: A Randomized Controlled Trial

Hany Aly1, Lamiaa Mohsen2, Indrani Bhattacharjee1

  • 1Department of Neonatology, Cleveland Clinic Children's, Cleveland, OH.

Journal of Pediatric Gastroenterology and Nutrition
|July 24, 2019
PubMed

Insights

Higher vitamin D3 doses (800 IU/day) significantly increased T regulatory cells (Treg) in preterm infants compared to lower doses (400 IU/day). This higher dose showed no short-term side effects, suggesting potential benefits for immune development in premature infants.

Area of Science:

  • Immunology
  • Neonatology
  • Nutritional Science

Background:

  • Premature infants often have vitamin D deficiency, impacting immune system development.
  • T regulatory cells (Treg) are crucial for immune homeostasis and preventing autoimmunity.
  • The optimal vitamin D dosage for Treg modulation in preterm infants remains unclear.

Purpose of the Study:

  • To evaluate the effect of two different vitamin D3 doses on Treg cell expression in preterm infants.
  • To assess short-term morbidity and mortality outcomes associated with vitamin D supplementation.

Main Methods:

  • A double-blind randomized controlled trial involving 40 preterm infants (28-33 weeks gestational age).
  • Infants received either 400 IU/day or 800 IU/day of vitamin D3 after achieving enteral feeds.
  • Treg cell counts were measured via flow cytometry at baseline, 1 week, and 4 weeks; morbidity and mortality were also assessed.

Main Results:

  • The 800 IU/day vitamin D3 group showed a significantly greater percentage increase in Treg cells after 1 week (60% vs 1.9%) and 4 weeks (73.7% vs 1.8%) compared to the 400 IU/day group.
  • No significant differences were observed between groups in anthropometric measurements, oxygen/respiratory support duration, or mortality.
  • The low-dose group experienced a longer hospital stay (24.9 days vs 22 days).

Conclusions:

  • Oral vitamin D3 supplementation demonstrates a dose- and time-dependent effect on Treg cell percentages in preterm infants.
  • The 800 IU/day dose of vitamin D3 appears safe in the short term for this population.
  • Further research is warranted to investigate the long-term effects of vitamin D3 dosing on clinical outcomes like hospital stay duration.

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