反复上呼吸道感染患儿补充维生素D后LL-37、IL-10含量变化

doi:10.3969/j.issn.1674-490X.2019.05.001

摘要/Abstract

摘要： 目的研究反复上呼吸道感染与LL-37、IL-10及维生素D的相关性。方法将64例反复呼吸道感染患儿随机分成2组,实验组给予常规治疗同时补充维生素D,对照组给予常规治疗同时给予安慰剂。随访12个月,检测治疗前基线含量和治疗12个月后血浆25-羟维生素D₃、IL-10及痰上清LL-37的变化。结果实验组与对照组比较,LL-37、IL-10及25-羟维生素D₃含量均显著增高(P<0.05),呼吸道感染次数显著下降(P<0.05)。实验组治疗12个月后25-羟维生素D₃、LL-37、IL-10均显著增高(P<0.05),呼吸道感染次数显著下降(P<0.05)。实验组治疗12个月后LL-37含量、IL-10含量、25-羟维生素D₃含量均呈正相关(P<0.05)。讨论补充维生素D有助于减少反复上呼吸道感染次数,这种作用可能与LL-37及IL-10产生增加有关。

关键词: 反复呼吸道感染, 维生素D₃, LL-37, 白介素10

Abstract: Objective To study the correlation between recurrent upper respiratory tract infection and LL-37,IL-10 and vitamin D.Methods 64 children with recurrent respiratory infection were randomly divided into two groups.The experimental group was treated in a routine way with vitamin D supplementation,while the control group was treated in a routine way with placebo.The follow-up period was 12 months.Plasma 25-hydeoxyvitamin D₃,IL-10 and sputum supernatant LL-37 at baseline before treatment and changes of them after 12 months were detected.Results Compared with the control group,the content of LL-37,IL-10 and 25-hydroxyvitamin D₃ in the experimental group were significantly increased(P<0.05),while the number of respiratory infections was decreased significantly(P<0.05).In the experimental group,the content of LL-37,IL-10 and 25-hydroxyvitamin D₃ were significantly increased after 12 months treatment(P<0.05),while the number of upper respiratory infections was decreased significantly(P<0.05).The LL-37 content,IL-10 content and 25-hydroxyvitamin D₃ content in the experimental group were positively correlated(P<0.05).Discussion Vitamin D supplementation helps to reduce the number of recurrent upper respiratory infections,which may be associated with increased production of LL-37 and IL-10.

Key words: recurrent respiratory infection, vitamin D₃, LL-37, IL-10

中图分类号:

王博玉,杨小巍,谢雪兰,石瑄,安晓肖. 反复上呼吸道感染患儿补充维生素D后LL-37、IL-10含量变化[J]. 医学研究与教育, 2019, 36(5): 1-6.

参考文献

[1] 李亚,聂鑫,崔明明.儿童反复呼吸道感染与血清维生素A、D、E水平的相关性研究[J].中国儿童保健杂志,2017,25(6):634-636.DOI: 10.11852/zgetbjzz2017-25-06-28.
[2] BERGMAN P,NORLIN A C,HANSEN S,et al.Vitamin D₃ supplementation in patients with frequent respiratory tract infections:a randomised anddouble-blind intervention study[J].BMJ Open,2012,2(6):e001663.DOI: 10.1136/bmjopen-2012-001663.
[3] 林罗娜,林立,李昌崇.Cathelicidin LL-37表达调节机制研究现状[J].国际呼吸杂志,2015,35(17):1352-1356.DOI: 10.3760/cma.i.issn.1673-436x.2015.17.018.
[4] 罗光燕,杨小琼,张芸,等.25羟维生素D₃与抗菌肽在反复上呼吸道感染中的作用研究及相关性分析[J].重庆医学,2016,45(29):4053-4058.DOI: 10.3969/j.issn.1671-8348.2016.29.007.
[5] 谭国平,陈桂良.反复上呼吸道感染T细胞亚群特点及与球蛋白的相关性[J].现代医院,2011,11(12):5-7.DOI: 10.3969/j.issn.1671-332X.2011.12.003.
[6] 刘红杰,张明谏.维生素D对小鼠严重烫伤后炎症反应的影响[D].天津:天津医科大学,2011:1-30.
[7] OLIVEIRA-BRAVO M,SANGIORGI B B,SCHIAVINATO J L,et al.LL-37 boosts immunosuppressive function of placenta-derived mesenchymal stromal cells[J].Stem Cell Res Ther,2016,7(1):189.DOI: 10.1186/s13287-016-0448-3.
[8] 王晓川,申昆玲,邓力,等.反复呼吸道感染临床诊治路径[J].中国实用儿科杂志,2016,31(10):721-725.DOI: 10.7504/ek2016100601.
[9] 中华医学会儿科学分会儿童保健学组,《中华儿科杂志》编辑委员会.儿童微量营养素缺乏防治建议[J].中华儿科杂志,2010,48(7):502-509.DOI: 10.3760/cms.j.issn.0578-1310.2010.07.006.
[10] 中华医学会儿科学分会呼吸学组,《中华儿科杂志》编辑委员会.反复呼吸道感染的临床概念和处理原则[J].中华儿科杂志,2008,46(2):108-110.DOI: 10.3321/j.issn:0578-1310.2008.02.008.
[11] 张晓丹,赵贝,李光慧,等.维生素D缺乏与感染发生的相关性及其机制研究进展[J].中国药房,2018,29(5): 710-715.DOI: 10.6039/j.issn.1001-0408.2018.05.34.
[12] 李春,叶梅.0~3岁反复上呼吸道感染患儿血清细胞因子IL-6、IL-10和TNF-α的水平及意义[J].河北医药,2017,39(1):14-16.DOI: 10.3969/j.issn.1002-7386.2017.01.003.
[13] RAGAB D,SOLIMAN D,SAMAHA D,et al.Vitamin D status and its modulatory effect on interferon gamma and interleukin-10 production by peripheral blood mononuclear cells in culture[J].Cytokine,2016,85:5-10.DOI: 10.1016/j.cyto.2016.05.024.
[14] CALVELLO R,CIANCIULLI A,NICOLARDI G,et al.Vitamin D treatment attenuates neuroinflammation and dopaminergic neurodegeneration in an animal model of Parkinson's Disease,shifting M1 to M2 microglia responses[J].J Neuroimmunepharm,2016,12(2): 327-339. DOI: 10.1007/s11481-016-9720-7.
[15] YULIIA I K,MARYNA I B.Vitamin D deficiency and immune disorders in combined endocrine pathology[J].Front Endocrinol,2018,9:1-8.DOI: 10.3389/fendo.2018.00600.
[16] RAMOS-MARTÍNEZ E,LÓPEZ-VANCELL M R,FERNÁNDEZ DE CÓRDOVA-AGUIRRE J C,et al.Reduction of respiratory infections in asthma patients supplemented with vitamin D is related to increased serum IL-10 and IFNγ levels and cathelicidin expression[J].Cytokine,2018,108:239-246.DOI: 10.1016/j.cyto.2018.01.001.
[17] 邓燕,杜先智.LL-37抑制结核分枝杆菌感染巨噬细胞炎性因子分泌的研究[J].中国免疫学杂志,2017,33(2):190-195.DOI: 10.3969/j.issn.1000-484X.2017.02.006.
[18] 凌亚.儿童维生素D钙咀嚼片与反复上呼吸道感染患儿免疫调节的相关性护理研究[J].医疗装备,2015,28(7): 158-160.DOI: 10.3969/j.issn.1002-2376.2015.07.102.