Children with cystic fibrosis demonstrate no respiratory immunological, infective or physiological, consequences of vitamin D deficiency.
Thursfield. Rebecca M RM; Naderi. Khayam K; Leaver. Neil N; Rosenthal. Mark M; Alton. Eric W F W EWFW; Bush. Andrew A; Davies. Jane C JC
Key Findings
- Vitamin D levels did not correlate with LL‑37 or HBD‑2 in airway samples
- Vitamin D‑deficient children showed no increase in airway infections or inflammation
- Lung function (FEV1) was similar whether children were vitamin D sufficient or deficient
Practical Outcomes
- For biohackers targeting LL‑37, supplementing vitamin D isn’t likely to help cystic fibrosis patients. Focus on other strategies to modulate antimicrobial peptides or address lung health. Vitamin D can still be used for its other benefits, but not for boosting LL‑37 in this context.
Summary
In kids with cystic fibrosis, having low vitamin D didn't change the levels of the antimicrobial peptide LL‑37, infection rates, inflammation, or lung function, meaning vitamin D isn’t a useful shortcut to boost this peptide in this group.
Abstract
Vitamin D has health benefits in many respiratory diseases but the evidence in CF is unclear. Induction of the antimicrobial peptides cathelicidin (LL37) and human-beta-defensin-2 (HBD-2) may be the mechanism of any benefit. We hypothesised that antimicrobial peptide levels would be decreased, and airway infection and inflammation greater, in CF children with vitamin D deficiency. The objective of the study was to explore relationships between vitamin D, LL37 and HBD-2, and airway infection, inflammation and physiology in children with CF. Bronchoalveolar lavage (BALF) and blood were obtained from children undergoing fibreoptic bronchoscopy. Serum vitamin D, BALF HBD-2 and LL37, cultured bacteria and inflammatory markers were measured. Clinical parameters were recorded. 113 patients with CF, 23 with non-CF chronic suppurative lung disease (CSLD) and 6 healthy controls were included. We found no relationship between serum vitamin D and BALF HBD-2 or LL-37. There were no differences in infective or inflammatory markers between vitamin D sufficient and deficient groups. Vitamin D deficient patients (<50 nmol/L) did not have a worse FEV<sub>1</sub> (CF: 66 (58-71)% vs. 71.5 (61-76)%, ns; non-CF CSLD: 69 (36-88)% vs. 70 (62-95)%, ns). In the first bronchoscopic study exploring this question, we demonstrate that vitamin D deficiency is not associated with immunological, infective or clinical markers of disease severity in patients with CF or CSLD.
Study Information
pubmed
2018
2018-04-07T00:00:00.000Z
10.1016/j.jcf.2018.02.011
15
31