Increased serum antimicrobial peptide LL-37 and HBD-2 combined with 25-hydroxyvitamin D3 deficiency in infants with pertussis
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Updated: Dec 1, 2025

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Published on: February 22, 2019
Sihu Chen1, Wanding Ye2, Weikun Zheng3
1Department of Paediatric Intensive Care Unit, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang 325027, China. 155190577@qq.com.
Insights
Children with pertussis often have vitamin D deficiency and higher levels of antimicrobial peptides (AMPs) like LL-37 and human beta-defensin 2 (HBD-2). Despite low vitamin D, infants maintain AMPs for fighting pertussis infection.
Area of Science:
- Pediatric Infectious Diseases
- Immunology
- Nutritional Science
Background:
- Malnutrition is common in children with serious infections.
- Vitamin D plays a role in immune response via antimicrobial peptides (AMPs).
Purpose of the Study:
- To investigate 25-hydroxyvitamin D3 [25(OH)D3] and AMPs [LL-37, human β-defensin 2 (HBD-2)] expression in infants with pertussis.
Main Methods:
- Serum levels of 25(OH)D3, LL-37, and HBD-2 were measured in 116 infants with pertussis and 50 healthy controls.
- Infants were aged 1-12 months.
Main Results:
- Pertussis patients had significantly lower serum 25(OH)D3 levels and higher vitamin D deficiency rates compared to controls.
- Serum LL-37 and HBD-2 levels were significantly elevated in pertussis patients.
- No correlation was found between 25(OH)D3 and LL-37 or HBD-2 levels.
Conclusions:
- Infants with pertussis commonly exhibit vitamin D deficiency alongside elevated LL-37 and HBD-2.
- Despite low vitamin D, infants with pertussis maintain high AMP levels to combat infection.
Introduction:
Most children with serious infection diseases suffer from malnutrition. Vitamin D participates in the immune response through endogenous antimicrobial peptides (AMPs) regulation. The aim of this study is to investigate the expression of 25-hydroxyvitamin D3 [25(OH)D3], AMPs [LL-37 and human β-defensin 2 (HBD-2)] in the children with pertussis.
Methodology:
Serum levels of 25(OH)D3, LL-37, and HBD-2 were detected in 116 children with pertussis aged at 1-12 months (67 males and 49 females). Fifty healthy infants at similar age were employed as normal controls.
Results:
The serum 25(OH)D3 levels in the children with mild (27.30 ± 5.98 ng/ml) and severe (24.40 ± 6.27 ng/ml) pertussis were significantly lower than that in the healthy group (30.16 ± 5.13 ng/ml; p <0.01). The vitamin D deficiency rates in children with mild (55.9%) and severe (78.12%) pertussis were significantly higher than that in the control group (34%; p < 0.01). The serum levels of LL-37 and HBD-2 were significantly higher in pertussis patients. Spearman rank correlation analysis did not show any correlation of 25-(OH)D3 with LL-37 or HBD-2.
Conclusions:
Most children with pertussis had vitamin D deficiency accompanied by elevated serum LL-37 and HBD-2 levels. However, the average level of 25(OH)D3 at 26.50 ng/ml in the infants with pertussis may not affect the immuno-regulatory ability; thus, the infants with pertussis still maintained a higher level of AMPs (LL-37 and HBD-2) against pertussis infection.
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