Vitamin D and respiratory tract infections in childhood.
Vitamin D and respiratory tract infections in childhood.
复制标题
DOI：
10.1186/s12879-015-1196-1
复制
发表时间：
2015-10-28
影响因子：
3.7
通讯作者：
Lelii M
中科院分区：
文献类型：
--
作者：
Esposito S;Lelii M
呼吸道感染仍然是儿童发病和死亡的最重要原因之一。一些研究表明，维生素D缺乏与生殖道感染风险增加有关，补充维生素D已被提议作为预防儿童生殖道感染的可能措施。本综述的主要目的是总结目前文献中关于维生素D与儿童生殖道感染之间联系的证据。最近的几项研究表明，维生素D具有不同的免疫调节特性，与儿童期RTI的风险相关。在这方面，了解维生素D缺乏和不足的定义以及何时以及如何治疗这种情况非常重要。不幸的是，没有达成共识，尽管认为至少10 ng/mL的25-羟基胆钙化醇（25[OH]D）水平对促进骨矿化和钙稳态是必要的，并且认为20 ng/mL和50 ng/mL之间的浓度足以提供免疫调节作用。现有数据支持维生素D缺乏在儿童结核病、复发性急性中耳炎和严重细支气管炎风险中的作用，而需要进一步研究来证实儿童复发性咽扁桃体炎、急性鼻窦炎和社区获得性肺炎的相关性。维持足够的维生素D状态可能是预防某些RTI的有效且廉价的方法，但补充方案尚未明确定义。需要进一步的临床试验来确定与RTI风险增加相关的25（OH）D浓度，并根据RTI的类型确定最佳的维生素D补充方案，同时考虑维生素D受体多态性。
Respiratory tract infections (RTIs) remain among of the most important causes of morbidity and mortality among children. Several studies have associated vitamin D deficiency with an increased risk of RTIs, and vitamin D supplementation has been proposed as a possible preventive measure against RTIs in children. The main aim of this review is to summarize the current evidence from the literature about the link between vitamin D and RTIs in children. Several recent studies have shown that vitamin D has different immunomodulatory properties associated with the risk of RTIs in childhood. In this regard, it is very important to understand the definition of deficiency and insufficiency of vitamin D and when and how to treat this condition. Unfortunately, there is no consensus, although a level of at least 10 ng/mL 25-hydroxycholecalciferol (25[OH]D) is thought to be necessary to promote bone mineralization and calcium homeostasis, and a concentration between 20 ng/mL and 50 ng/mL is considered adequate to provide an immunomodulatory effect. Available data support a role for vitamin D deficiency in the risk of pediatric tuberculosis, recurrent acute otitis media, and severe bronchiolitis, whereas further studies are needed to confirm an association in children with recurrent pharyngotonsillitis, acute rhinosinusitis and community-acquired pneumonia. Maintenance of adequate vitamin D status may be an effective and inexpensive prophylactic method against some RTIs, but the supplementation regimen has not been clearly defined. Further clinical trials are needed to determine the 25(OH)D concentrations associated with an increased risk of RTIs and optimal vitamin D supplementation regimen according to the type of RTI while also taking into consideration vitamin D receptor polymorphisms.