Çocuklarda Yineleyen Tonsillofarenjitte D Vitamininin Rolü

Yıl 2012, , 132 - 138, 01.07.2012

İsmail Yıldız Emine Ünüvar Ümit Zeybek Bahar Toptaş Canan Cacina Sadık Toprak Ayşe Kılıç Salih Aydın

https://doi.org/10.5222/j.child.2012.132

Öz

Amaç: Çocuklarda yineleyen tonsillofarenjitin etiyolojisi tam olarak belli değildir. Çocukluk çağı çoğu hastalıkta olduğu gibi etiyolojisi multifaktöriyeldir. Bu çalışmada amacımız yineleyen tonsillifarenjitte D vitaminin rolünü saptamaktır. Yineleyen tonsillifarenjitli çocuklarda serum 25-OH D vitamini düzeyi ve vitamin D reseptör polimorfizmi çalışıldı. Gereç ve Yöntemler: Yaşları 2-10 arasında değişen yineleyen tonsillofarenjitli 84 vaka çalışma grubunu, sağlıklı 71 vaka kontrol grubunu oluşturdu. Serum 25-OH D vitamin düzeyleri ELİZA yöntemi, vitamin D reseptör polimorfizmleri Apa I, Taq I, Fok I PCR yöntemi ile belirlendi. Serum 25-OH D vitamin düzeyi 50 nmol/L altındaki düzeyler düşük olarak kabul edildi. Her iki grupta vitamin D reseptör polimorfizmleri karşılaştırılı.Bulgular: Çalışma grubunun ortalama yaşı 5.6±2.4 yaş, kontrol grubunun ortalama yaşı 6.1±2.7 yaş saptandı. Çalışma grubunda ortalama serum 25-OH D vitamin düzeyi 142.7±68.1 nmol/L, kontrol grubununda 192.3±56.1 nmol/L saptandı. Bu fark istatistiksel açıdan anlamlıydı p

Anahtar Kelimeler

Çocuk, vitamin D, infeksiyon, tonsillit

The Role of Vitamin D in Children with Recurrent Tonsillopharyngitis

Öz

Aim: The exact etiology of recurrent tonsillopharyngitis in children is not clear. Recurrent tonsillitis in children has multifactorial etiology like most of the diseases in childhood. In this study, our aim was to determine the potential role of vitamin D in recurrent tonsillitis by measuring serum 25-OH vitamin D levels and determining the vitamin D receptor polymorphism among children with recurrent tonsillitis.Material and Methods: Eighty-four children with recurrent tonsillitis and seventy-one healthy children aging between 2 and 10 years were enrolled in this study. Serum 25-OH vitamin D level was measured with ELISA and vitamin D receptor gene polymorphism Apa 1, Taq 1, Fok 1 was determined by PCR. Serum 25-OH vitamin D level below 50 nmol/L was accepted as vitamin D deficiency. The vitamin D receptor gene polymorphism in each group was compared.Results: The mean age was 5.6±2.4 and 6.1±2.7 years in the study and control groups, respectively. The average serum 25-OH vitamin D level was 142.7±68.1 nmol/L in the study group and 192.3±56.1 nmol/L in the control group. There was a significant difference between the groups p

Anahtar Kelimeler

Child, vitamin D, infection, tonsillitis

Kaynakça

• 1. Armstrong GL, Pinner RW. Outpatient visits for infectious diseases in the United States, 1980 through 1996. Arch Intern Med 1999;159:2531-36. http://dx.doi.org/10.1001/archinte.159.21.2531 PMid:10573043
• 2. Makela MJ, Puhakka T, Ruuskanen O, Leinonen M, Saikku P, Kimpimaki M, Blomqvist S, et al. Viruses and bacteria in the etiology of the common cold. J Clin Microbiol 1998;36:539-42. PMid:9466772 PMCid:104573
• 3. Alan L, Bisno MD. Acute pharyngitis: etiology and diagnosis. Pediatrics 1996;97:949-54.
• 4. Paradise JL, Bluestone CD, Colborn DK, Bernard BS, Rockette HE, Kurs-Lasky M. Tonsillectomy and adenotonsillectomy for recurrent throat infection in moderately affected children. Pediatrics 2002;110:7-15. http://dx.doi.org/10.1542/peds.110.1.7 PMid:12093941
• 5. Kania RE, Lamers GE, Vonk MJ, Huy PT, Hiemstra PS, Bloemberg GV, Grote JJ. Demonstration of bacterial cells and glycocalyx in biofilms on human tonsils. Arch Otolaryngol Head Neck Surg 2007;133:115-21. http://dx.doi.org/10.1001/archotol.133.2.115 PMid:17309977
• 6. Bartley J. Vitamin D, innate immunity and upper respiratory tract infection. J Laryngol Otol 2010;124:465-9. http://dx.doi.org/10.1017/S0022215109992684 PMid:20067648
• 7. Deluca HF, Cantorna MT. Vitamin D: its role and uses in immunology. FASEB J 2001;15:2579-85. http://dx.doi.org/10.1096/fj.01-0433revPMid:11726533
• 8. Van Etten E, Mathieu C. Immunregulation by 1,25-dihydroxyvitamin D3: basic concepts. J Steroid Biochem Mol Biol 2005;97:93-101. http://dx.doi.org/10.1016/j.jsbmb.2005.06.002 PMid:16046118
• 9. Zmuda JM, Cauley JA, Ferrell RE. Molecular epidemiology of vitamin D receptor gene variants. Epidemiol Rev 2000;22:203-17. http://dx.doi.org/10.1093/oxfordjournals.epirev.a018033 PMid:11218372
• 10. Valdivielso JM, Fernandez E. Vitamin D receptor polymorphisms and diseases. Clin Chim Acta 2006;371:1-12. http://dx.doi.org/10.1016/j.cca.2006.02.016 PMid:16563362
• 11. Bell NH, Morrison NA, Nguyen TV, Eisman J, Hollis BW. Apa I polymorphisms of the vitamin D receptor predict bone density of the lumbar spine and not racial difference in bone density in young men. J Lab Clin Med 2001;137:133-40. http://dx.doi.org/10.1067/mlc.2001.112095 PMid:11174470
• 12. Vogel A, Strassburg CP, Manns MP. Genetic association of vitamin D receptor polymorphisms with primary biliary chirrhosis and autoimmune hepatitis. Hepatology 2002;35:126-31. http://dx.doi.org/10.1053/jhep.2002.30084 PMid:11786968
• 13. Grant WB, Holick MF. Benefits and requirements of vitamin D for optimal health: a review. Altern Med Rev 2005;10:94- 111. PMid:15989379
• 14. Vieth R. Vitamin D supplementation, 25-hydroxyvitamin D concentrations, and safety. Am J Clin Nutr 1999;69:842-56. PMid:10232622
• 15. Adams JS, Hollis BW. Vitamin D: Synthesis, metabolism and clinical measurement. In Disorders of bone and mineral metabolism. In Disorders of bone and mineral metabolism. 2nd edition. Edited by Coe FL, Favus MJ. Philadelphia: Lippincott Williams & Wilkins; 2002: 157-174. PMid:12426913
• 16. Uitterlinden A, Fang Y, Van Meurs J, Pols H, Van Leeuwen J. Genetics and biology of vitamin D receptor polymorphisms. Gene 2004;338:143-56. http://dx.doi.org/10.1016/j.gene.2004.05.014 PMid:15315818
• 17. Selvaraj P, Chandra G, Jawahar M, Rani M, Rajeshwari D, Narayanan P. Regulatory role of vitamin D receptor gene variants of Bsm I, Apa I, Taq I, and Fok I polymorphisms on macrophage phagocytosis and pymphoproliferative response to mycobacterium tuberculosis antigen in pulmonary tuberculosis. J Clin Immunol 2004;24:423-32. http://dx.doi.org/10.1023/B:JOCI.0000040923.07879.31 PMid:15359111
• 18. Roth D, Soto G, Arenas F, Bautista C, Ortiz J, Rodriguez R, et al. Association between vitamin D receptor gene polymorphisms and response to treatment of pulmonary tuberculosis. J Infect Dis 2004;190:920-7. http://dx.doi.org/10.1086/423212 PMid:15295697
• 19. McGrath JJ, Saha S, Burne THJ, Eyles DW. A systematic review of the association between common single nucleotide polymorphisms and 25-hydroxyvitamin D concentrations. J Steroid Biochemistry and Molecular Biology 2010;121:471-7. http://dx.doi.org/10.1016/j.jsbmb.2010.03.073 PMid:20363324
• 20. Roth DE, Jones AB, Prosser C, Robinson JL, Vohra S. Vitamin D receptor polymorphisms and the risk of acute lower respiratory tract infection in early childhood. J Infect Dis 2008;197:676-80. http://dx.doi.org/10.1086/527488 PMid:18266602
• 21. Reid D, Morton R, Salkeld L, Bartley J. Vitamin D and tonsil disease- Preliminary observation. Int J Ped Otorhinolaryngol 2011;75:261-4. http://dx.doi.org/10.1016/j.ijporl.2010.11.012 PMid:21131064
• 22. Laaski I, Ruohola P, Mattilia V, Auvinen A, Vlikanin T, Pihlajamaki H. Vitamin D supplementation for the prevention of acute respiratory tract infections.A randomized doubleblinded trial amongst young Finnish men. J Infect Dis 2010;202:809-14. http://dx.doi.org/10.1086/654881 PMid:20632889
• 23. Li-Ng M, Aloia JF, Polleck S, Cunha BA, Mikhail M, Yeh J, et al. A randomized controlled trial of vitamin D3 supplementation for the prevention of symptomatic upper respiratory tract infections. Epidemiol Infect 2002;137:1396-404. http://dx.doi.org/10.1017/S0950268809002404 PMid:19296870
• 24. Aydın S, Aslan I, Yıldız I, Ağaçhan B, Toptaş B, Toprak S, Değer K, Oktay MF, Unüvar E. Vitamin D levels in children with recurrent tonsillitis. Int J Pediatr Otorhinolaryngol 2011;75:364-7. http://dx.doi.org/10.1016/j.ijporl.2010.12.006 PMid:21215466