ESPN 50th Annual Meeting

ESPN 2017


 
The association between vitamin D status, antimicrobial peptides and urinary tract infection in small children
VALYA GEORGIEVA 1 WITCHUDA KAMOLVIT 2 MARIA HERTHELIUS 1 PETRA LÜTHJE 2 ANNELIE BRAUNER 2 MILAN CHROMEK 1

1- DIVISION OF PAEDIATRICS, DEPARTMENT OF CLINICAL SCIENCE, INTERVENTION AND TECHNOLOGY, KAROLINSKA INSTITUTET AND KAROLINSKA UNIVERSITY HOSPITAL, STOCKHOLM, SWEDEN
2- DIVISION OF CLINICAL MICROBIOLOGY, DEPARTMENT OF MICROBIOLOGY, TUMOR AND CELL BIOLOGY, KAROLINSKA INSTITUTET AND KAROLINSKA UNIVERSITY HOSPITAL, STOCKHOLM, SWEDEN
 
Introduction:

Vitamin D stimulates production of cathelicidin and β-defensin-2, endogenous antimicrobial peptides, expressed in the urinary tract. Both peptides are active against most common uropathogens. We sought to study vitamin D, cathelicidin and β-defensin-2 levels in children with urinary tract infection (UTI) and healthy controls. 

Material and methods:

 The study is a cross-sectional study of 77 children under 2 years of age with UTI, and of a control group of 46 healthy children. Serum vitamin D (25-OH cholecalciferol) levels were measured by direct competitive electro-chemiluminescence immunoassay (ECLIA), and plasma cathelicidin and β-defensin-2 concentrations were analyzed by ELISA. Samples were taken two months after the UTI in the study group and during a random hospital visit in the control group.

Results:

 The mean±SD serum vitamin D level in the UTI group was 80.8±21,2 nmol/l vs. 101,1±33 nmol/l in the control group, which is a significant difference (p=0.0003). Children with UTI also had significantly lower plasma cathelicidin and β-defensin-2 levels (medians 33.6 ng/ml and 208.1 pg/ml, respectively) as compared with healthy children (medians 53.8 ng/ml and 394.0 pg/ml, respectively, p<0.0001 for both cathelicidin and β-defensin-2).

Conclusions:

Low serum vitamin D levels and low levels of antimicrobial peptides cathelicidin and β-defensin-2 in plasma are significantly associated with urinary tract infection in small children. Vitamin D deficiency may prove to be a risk factor for urinary tract infection. Moreover, supplementation with vitamin D may become a new prophylactic strategy for recurrent UTIs.