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Acta Paediatr. 2018 Jul 13. doi: 10.1111/apa.14499. [Epub ahead of print]

Association between vitamin D, antimicrobial peptides and urinary tract infection in infants and young children.

Author information

1
Department of Clinical Science, Intervention and Technology, Division of Paediatrics, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden.
2
Department of Microbiology, Tumour and Cell Biology, Division of Clinical Microbiology, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden.
3
Department of Clinical Sciences Lund, Division of Paediatrics, Lund University, Lund, Sweden.

Abstract

AIM:

Vitamin D stimulates production of the endogenous antimicrobial peptides cathelicidin and β-defensin-2, which are expressed in the urinary tract. We investigated vitamin D status and levels of cathelicidin and β-defensin-2 and their association with urinary tract infection (UTI).

METHODS:

The study included 120 children under three years of age: 76 children with UTIs and 44 otherwise healthy children with congenital hydronephrosis. Serum 25-hydroxycholecalciferol levels were measured by direct competitive electro-chemiluminescence immunoassay, and plasma cathelicidin and β-defensin-2 concentrations were analysed by enzyme-linked immunosorbent assay.

RESULTS:

We found that vitamin D insufficiency and deficiency are prevalent in young children (21%). Serum vitamin D levels negatively correlated with age and were significantly lower in girls. Levels of vitamin D positively correlated with levels of cathelicidin but not with β-defensin-2. Low concentrations of vitamin D were associated with UTIs in girls, but we did not see any correlation with the recurrence of infection at one-year follow-up.

CONCLUSION:

Vitamin D deficiency is common and may prove to be a risk factor for UTIs especially in girls. We hypothesise that adequate supplementation with vitamin D may become a way to prevent first-time UTIs.

KEYWORDS:

Antimicrobial peptides; Cathelicidin; Defensin; Urinary tract infection; Vitamin D

PMID:
30003595
DOI:
10.1111/apa.14499

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