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Vit D deficiency is a possible risk factor in ARS

  • Rhinology
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Abstract

Vitamin D deficiency is effective in the development of acute rhinosinusitis and prolongation of inflammation by increasing inflammation in the sinonasal epithelium. Vitamin D deficiency is important in the development of bone barriers that prevent the complication of acute rhinosinusitis. Although Vitamin D levels may be a variable risk factor for various respiratory tract disorders, there are limited data on the role in sinonasal infections. Our aim was to investigate the association of 25-hydroxy-vitamin D (25OHD) levels with acute rhinosinusitis (ARS) and preseptal cellulitis complications. The type of the study is prospective case–control study. Fifteen patients in the pediatric age group with ARS-induced preseptal cellulitis complication were identified as Group 1, fifteen patients with ARS and without complication were identified as Group 2, and fifteen healthy volunteers were identified as Group 3. Serum 25OHD levels (nmol/l) were measured in addition to routine blood tests at the first admission of patients participating in the study. Statistical analysis was performed between groups. The ages of the cases ranged from 1 to 14 years with a mean of 5.62 ± 3.42 years. 55.6% of the cases (n = 25) were male; 44.4% (n = 20) were female children. As a result of classification in which vitamin D levels were compared with normal values, there was a statistically significant difference according to the presence of ARS (Group-1 and Group 2) and absence of ARS (Group-3) (p < 0.05). A statistically significant difference was also found between Group 1 and Group-3 (p < 0.05). Statistically significant difference between Group 1 and Group 3 suggests that lack of vitamin D predisposes to the complication of preseptal cellulitis. Comparison of Group 1 and 2 with Group 3 (normal subjects) suggests that Vit D has a protective effect against developing sinusitis.

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References

  1. Shapiro DJ, Gonzales R, Cabana MD, Hersh AL (2011) National trends in visit rates and antibiotic prescribing for children with acute sinusitis. Pediatrics 127:28–34

    Article  PubMed  Google Scholar 

  2. DeMuri GP, Wald ER (2012) Clinical practice. Acute bacterial sinusitis in children. N Engl J Med 367:1128–1134

    Article  CAS  PubMed  Google Scholar 

  3. American Academy of Pediatrics (2001) Subcommittee on Management of Sinusitis and Committee on Quality Improvement. Clinical practice guideline: management of sinusitis. Pediatrics 108:798–808

    Article  Google Scholar 

  4. Chandler JR, Langenbrunner DJ, Stevens ER (1970) The pathogenesis of orbital complications in acute sinusitis. Laryngoscope 80:1414–1428

    Article  CAS  PubMed  Google Scholar 

  5. Wright ED, Frenkiel S (2005) Infectious adult rhinosinusitis: etiology, diagnosis, and management principles. J Otolaryngol 34:S7–S13

    Article  PubMed  Google Scholar 

  6. Mulligan JK, Nagel W, O’Connell B et al (2014) Cigarette smoke exposure is associated with vitamin D3 deficiencies in patients with chronic rhinosinusitis. J Allergy Clin Immunol 134:342–349

    Article  CAS  PubMed  Google Scholar 

  7. Baeke F, Takiishi T, Korf H et al (2010) Vitamin D: modulator of the immune system. Curr Opin Pharmacol 10:482–496

    Article  CAS  PubMed  Google Scholar 

  8. Taylor CE, Camargo CA Jr (2010) Impact of micronutrients on respiratory infections. Nutr Rev 69:259–269

    Article  Google Scholar 

  9. Cannell JJ, Vieth R, Umhau JC et al (2006) Epidemic influenza and vitamin D. Epidemiol Infect 134:1129–1140

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  10. Fokkens WJ et al (2012) EPOS 2012: European position paper on rhinosinusitis and nasal polyps 2012. A summary for otorhinolaryngologists. Rhinology 50(1):1–12

    PubMed  Google Scholar 

  11. Adams JS, Hewison M (2008) Unexpected actions of vitamin D: new perspectives on the regulation of innate and adaptive immunity. Nat Clin Pract Endocrinol Metab 4:80–90

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  12. Kankova M, Luini W, Pedrazzoni M et al (1991) Impairment of cytokine production in mice fed a vitamin D3-deficient diet. Immunology 73:466–471

    CAS  PubMed  PubMed Central  Google Scholar 

  13. Fabri M, Stenger S, Shin DM et al (2011) Vitamin D is required for IFN-gamma-mediated antimicrobial activity of human macrophages. Sci Transl Med. 3:104ra102

    Article  PubMed  PubMed Central  Google Scholar 

  14. Liu PT, Stenger S, Tang DH et al (2007) Cutting edge: vitamin D-mediated human antimicrobial activity against Mycobacterium tuberculosis is dependent on the induction of cathelicidin. J Immunol 179:2060–2063

    Article  CAS  PubMed  Google Scholar 

  15. da Silva FP, Machado MC (2012) Antimicrobial peptides: clinical relevance and therapeutic implications. Peptides 36:308–314

    Article  Google Scholar 

  16. Dürr UH, Sudheendra US, Ramamoorthy A (2006) LL-37, the only human member of the cathelicidin family of antimicrobial peptides. Biochim Biophys Acta 1758:1408–1425

    Article  PubMed  Google Scholar 

  17. Tollin M, Bergman P, Svenberg T et al (2003) Antimicrobial peptides in the first line defence of human colon mucosa. Peptides 24:523–530

    Article  CAS  PubMed  Google Scholar 

  18. Nell MJ, Tjabringa GS, Vonk MJ et al (2004) Bacterial products increase expression of the human cathelicidin hCAP-18/LL-37 in cultured human sinus epithelial cells. FEMS Immunol Med Microbiol 42:225–231

    Article  CAS  PubMed  Google Scholar 

  19. Wang LF, Lee CH, Chien CY et al (2013) Serum 25-hydroxyvitamin D levels are lower in chronic rhinosinusitis with nasal polyposis and are correlated with disease severity in Taiwanese patients. Am J Rhinol Allergy 27:e162–e165

    Article  PubMed  Google Scholar 

  20. Pinto JM, Schneider J, Perez R et al (2008) Serum 25-hydroxyvitamin D levels are lower in urban African American subjects with chronic rhinosinusitis. J Allergy Clin Immunol 122:415–417

    Article  CAS  PubMed  Google Scholar 

  21. Schlosser RJ, Soler ZM, Schmedes GW et al (2014) Impact of vitamin D deficiency upon clinical presentation in nasal polyposis. Int Forum Allergy Rhinol 4:196–199

    Article  PubMed  Google Scholar 

  22. Mulligan JK, Bleier BS, O’Connell B et al (2011) Vitamin D3 correlates inversely with systemic dendritic cell numbers and bone erosion in chronic rhinosinusitis with nasal polyps and allergic fungal rhinosinusitis. Clin Exp Immunol 164:312–320

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  23. Sansoni ER, Sautter NB, Mace JC et al (2015) Vitamin D3 as a novel regulator of basic fibroblast growth factor in chronic rhinosinusitis with nasal polyposis. Int Forum Allergy Rhinol 5:191–196

    Article  PubMed  PubMed Central  Google Scholar 

  24. Fraczek M, Rostkowska-Nadolska B, Kusmierz D et al (2012) Vitamin D analogs decrease in vitro secretion of RANTES and enhance the effect of budesonide. Adv Med Sci 57:290–295

    Article  CAS  PubMed  Google Scholar 

  25. Sugimoto I, Hirakawa K, Ishino T et al (2007) Vitamin D3, vitamin K2, and warfarin regulate bone metabolism in human paranasal sinus bones. Rhinology 45:208–213

    PubMed  Google Scholar 

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Correspondence to Hasan Emre Koçak.

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Elbistanlı, M.S., Koçak, H.E., Güneş, S. et al. Vit D deficiency is a possible risk factor in ARS. Eur Arch Otorhinolaryngol 274, 3391–3395 (2017). https://doi.org/10.1007/s00405-017-4635-3

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  • DOI: https://doi.org/10.1007/s00405-017-4635-3

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