The effect of vitamin D on the course of chronic lung disease in children

Background. The effect of vitamin D (VD) on the regulation of the immune response due to its powerful anti-inflammatory potential is of particular interest. The effect of the active metabolite VD on cell nuclei has been proven, determining the gene level of regulation. The nongenic mechanism of influence on plasma membranes is being actively studied. Taking into account the diversity of VD interference on the system of active and passive immunity, it is important to determine the phenotypic characteristics of diseases, including the group of chronic lung diseases (CLD) in the context of VD status. Objective. Evaluation of the effect of VD level on the course of CLD in children. Methods. 98 children with CLD were examined. All patients were divided into two main subgroups. The first subgroup (n=42) consisted of children with primary CLD. The second group was presented by patients with lung diseases formed either on the background of malformations (n=10) or as a result of hereditary diseases: cystic fibrosis (n=34), primary immunodeficiencies (n=12). The diagnoses were verified on the basis of the data of a comprehensive examination, taking into account medical history and clinical data, according to the classification of clinical forms of bronchopulmonary diseases in children. Regardless of the nosological form, all patients underwent determination of blood serum total hydroxycalciferol level using ELISA. Results. A comparative analysis of the frequency of bronchopulmonary exacerbations in children with CLD revealed that with VD deficiency, the frequency of increase in the severity of clinical manifestations was significantly more often recorded - up to 3-4 times a year, while with reference VD values - no more than 2 timed a year. VD deficiency was associated with risk of severe exacerbations, while with reference values, moderate exacerbations prevailed. Pulmonary function parameters were statistically significantly correlated with serum VD levels. The mixed nature of the microbiota was noted with VD deficiency in both groups, however, in patients with hereditary diseases it was more common (63.5 and 12.5%, respectively). Conclusion. The results of study determined that the serum calcidiol concentration is able to influence the phenotypic characteristics of CLD due to genomic and non-genomic mechanisms of regulation of chronic inflammation. A correlation between VD status, frequency and severity of exacerbations, the nature of the respiratory tract microbiota, as well as the pulmonary function parameters was found. It was noted that the VD deficiency in the blood serum is directly related to an increase in clinical manifestations and a decrease in pulmonary flow rate parameters according to instrumental methods of diagnosis.

chronic lung disease, vitamin D