Unit:
Faculty of MedicineLibrary of the School of Health Sciences
Dissertation committee:
Αλεξάνδρα Σολδάτου, Αναπληρώτρια Καθηγήτρια, Ιατρική Σχολή, ΕΚΠΑ
Δημήτριος Γουργιώτης, Ομότιμος Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Μαρία Τσολιά, Καθηγήτρια, Ιατρική Σχολή, ΕΚΠΑ
Παρασκευή Ξεπαπαδάκη, Αναπληρώτρια, Ιατρική Σχολή, ΕΚΠΑ
Λυδία Κόσσυβα, Αναπληρώτρια Καθηγήτρια Παιδιατρικής, Τμήμα Ιατρικής, ΕΚΠΑ
Νικόλαος Σπυρίδης, Αναπληρωτής Καθηγητής, Ιατρική Σχολή, ΕΚΠΑΑ
Μαργαρίτης Αυγέρης, Αναπληρωτής Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Original Title:
Η συσχέτιση των επιπέδων βιταμίνης D και αντιμικροβιακών πεπτιδίων με τη βαρύτητα της βρογχιολίτιδας
Translated title:
Association between vitamin D and antimicrobial peptides levels with the severity of bronchiolitis
Summary:
Introduction: Antimicrobial peptides (AMPs) are short and generally positively charged oligopeptides with potent antiviral properties, expressed in a wide variety of human tissues. Recent laboratory studies have shown that vitamin D plays a vital role in up-regulating the expression of antimicrobial peptides, in the sight of infection. Furthermore, vitamin D may also modulate cytokine production during periods of infection, suppressing inflammation, and, thereby, reducing the severity of viral lower respiratory tract infections.
Objective: Τo investigate the association of serum vitamin D and nasal secretion antimicrobial peptides levels with the severity of acute bronchiolitis.
Study design: We conducted a prospective single pediatric tertiary care center cohort study of inpatients aged 0-18 months with a first episode of acute bronchiolitis from November 1st 2014 to April 30th 2017. Disease severity was determined by the length of hospitalization and supplemental hospital data. Qualitative measurements included serum 25(OH)D and nasal secretion LL-37 and β-defensin-2 levels. Correlations were examined with the Mann-Whitney and Kruskal-Wallis criteria for qualitative and the correlation coefficient Spearman's rho for quantitative factors. Multiple linear and logarithmic regression were performed in order to adjust for confounding factors.
Results: The study population consisted of 153 infants and toddlers with mean age 3.6 months (SD: 2.8). No association was found between serum 25(OH)D and AMPs nasal secretions levels. Serum 25(OH)D and nasal secretion β-defensin-2 levels were not associated with the severity of bronchiolitis. In contrast, LL-37 levels were inversely associated with the length of hospitalization (rho=-0.340, p=0.001), the need for medication use (p=0.001), as well as the duration of oxygen supplementation (rho =-0.339, p=0.001) and intravenous fluid administration (rho=-0.323, p=0.001). This association remained significant after adjustment for potential confounders.
Conclusion: A significant association between LL-37 nasal secretions levels with the severity of acute bronchiolitis was found in hospitalized infants and toddlers. The role of LL-37 in the pathogenesis of bronchiolitis merits further investigation.
Main subject category:
Health Sciences
Keywords:
cathelicidin, LL-37, β-defensin-2, innate immunity, respiratory syncytial virus
Number of references:
634
File:
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ΔΙΑΤΡΙΒΗ.pdf
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