Vitamin D, innate immunity and outcomes in community acquired pneumonia
Vitamin D, innate immunity and outcomes in community acquired pneumonia
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DOI：
10.1111/j.1440-1843.2011.01924.x
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发表时间：
2011-05-01
期刊：
影响因子：
6.9
通讯作者：
Hancox, Robert J.
中科院分区：
文献类型：
--
作者：
Leow, Leong;Simpson, Talia;Hancox, Robert J.
背景和目的：维生素 D 调节抗菌肽 cathelicidin 和 β-defensin-2 的产生，这两种肽在针对感染的先天免疫反应中发挥着重要作用。我们假设，维生素 D 缺乏可能与这些肽水平较低以及因社区获得性肺炎入院的患者预后较差有关。方法：在由 112 名冬季社区获得性肺炎入院患者组成的前瞻性队列中，研究了死亡率与 25-羟基维生素 D、抗菌肽和 β-防御素-2 血清水平之间的关联。结果： 严重的 25-羟基维生素 D 缺乏 (< 30 nmol/L) 在该人群中很常见 (15%)，与具有足够 25-羟基维生素 D (> 50 nmol/L) 的患者相比，与较高的 30 天死亡率相关（比值比 12.7，95% 置信区间：2.2-73.3，P = 0.004）。这些关联不能用年龄、合并症或急性疾病严重程度的差异来解释。虽然导管素和 β-防御素-2 水平均不能预测死亡率，但导管素水平较低时死亡率有增加的趋势 (P = 0.053)。抗菌肽和 β-防御素 2 水平均与 25-羟基维生素 D 相关。结论：25-羟基维生素 D 缺乏与冬季因社区获得性肺炎入院的患者死亡率增加相关。与我们的假设相反，25-羟基维生素 D 水平与导管素或 β-防御素-2 水平无关。
Background and objective: Vitamin D regulates the production of the antimicrobial peptides cathelicidin and beta-defensin-2, which play an important role in the innate immune response to infection. We hypothesized that vitamin D deficiency would be associated with lower levels of these peptides and worse outcomes in patients admitted to hospital with community acquired pneumonia.Methods: Associations between mortality and serum levels of 25-hydroxyvitamin D, cathelicidin and beta-defensin-2 were investigated in a prospective cohort of 112 patients admitted with community acquired pneumonia during winter.Results: Severe 25-hydroxyvitamin D deficiency (< 30 nmol/L) was common in this population (15%) and was associated with a higher 30-day mortality compared with patients with sufficient 25-hydroxyvitamin D (> 50 nmol/L) (odds ratio 12.7, 95% confidence interval: 2.2-73.3, P = 0.004). These associations were not explained by differences in age, comorbidities, or the severity of the acute illness. Neither cathelicidin nor beta-defensin-2 levels predicted mortality, although there was a trend towards increased mortality with lower cathelicidin (P = 0.053). Neither cathelicidin nor beta-defensin-2 levels correlated with 25-hydroxyvitamin D.Conclusions: 25-hydroxyvitamin D deficiency is associated with increased mortality in patients admitted to hospital with community acquired pneumonia during winter. Contrary to our hypothesis, 25-hydroxyvitamin D levels were not associated with levels of cathelicidin or beta-defensin-2.