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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.

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



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).


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.


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.


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.


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


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