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Is There A Relationship Between Urinary Tract Infections and Vitamin D and Cathelicidin Levels?: A Cross-Sectional Observational Study From the Pediatric Emergency Department

Year 2024, Volume: 18 Issue: 3, 174 - 180, 13.05.2024
https://doi.org/10.12956/tchd.1366493

Abstract

Objective: Cathelicidin is a crucial antibacterial peptide that is produced in the urinary system and is induced by vitamin D. In order to distinguish between lower and upper urinary tract infections (UTIs), the association between cathelicidin levels and vitamin D levels was examined in this study.

Material and Methods: We analyzed complete blood count, biochemistry profile, C reactive protein (CRP), 25 hydroxyvitamin D, serum cathelicidin levels of pre-treatment children aged 0-18 years who were diagnosed with a UTI in the Pediatric Emergency Room.

Results: A total of 72 children (36 healthy and 36 patients) were included in the study. The mean age of the participants was 83.8±66.22 months, with 40 (56%) female and 32 (44%) male. Our patient group had higher white blood cell, neutrophil, and CRP levels than our control group (p=0.050). There was no significant difference in cathelicidin levels (5.7±3.7; 9.6±10.9; p=0.810) or vitamin D levels (23.3±9.5; 25.9±12.5; p=0.795) between patients with lower and upper UTI. We found a positive correlation between vitamin D and cathelicidin levels in the control group (r=0.346, p=0.030). There was no statistically significant difference in cathelicidin levels between patients with upper UTI and the control group (p=0.054).

Conclusion: Although there was no significant relationship between vitamin D and cathelicidin levels in children with urinary tract infections, a weak but positive correlation exists between vitamin D and cathelisidin in healthy children.

Thanks

Dear Editor; We wish to submit an original research article entitled “Types of urinary tract infections and the relationship between Vitamin D and cathelisidin:A study from the pediatric emergency department.” for consideration by Turkish Journal of Pediatric Disease. We confirm that this work is original and has not been published elsewhere, nor is it currently under consideration for publication elsewhere. Cathelicidin is an antimicrobial agent that eliminates intracellular mycobacteria and also plays a regulatory role in various processes of the autophagy pathway to increase the fusion of mycobacterial phagosomes with autophagosomes and autolysosomes. In this study cathelicidin and vitamin D levels in pediatric patients diagnosed with upper or lower urinary tract infections before treatment were compared with healthy controls to determine the relationship between urinary tract infection type and severity. Although it could not be proven in our study, the serum cathelicidin levels of patients with UTI and even upper UTI may be higher than healthy children. We have no conflicts of interest to disclose. Please address all correspondence concerning this manuscript to me at dr_alper_cicek@hotmail.com Thank you for your consideration of this manuscript. Sincerely, Alper Çiçek, MD Health Science University, Tepecik Education and Training Hospital, Pediatric Emergency Department İzmir, Turkey

References

  • Mailhot G, White JH. Vitamin D and Immunity in Infants and Children. Nutrients 2020;12:1233.
  • Al-Khalidi B, Kimball SM, Rotondi MA, Ardern CI. Standardized serum 25-hydroxyvitamin D concentrations are inversely associated with cardiometabolic disease in U.S. adults: a cross-sectional analysis of NHANES, 2001-2010. Nutr J 2017;16:16.
  • Science M, Maguire JL, Russell ML, Smieja M, Walter SD, Loeb M. Low serum 25-hydroxyvitamin D level and risk of upper respiratory tract infection in children and adolescents. Clin Infect Dis 2013;57:392-7.
  • Riverin BD, Maguire JL, Li P. Vitamin D Supplementation for Childhood Asthma: A Systematic Review and Meta-Analysis. PLoS One 2015;10:e0136841.
  • Liu X, Arguelles L, Zhou Y, Wang G, Chen Q, Tsai HJ, et al. Longitudinal trajectory of vitamin D status from birth to early childhood in the development of food sensitization. Pediatr Res 2013;74:321-6.
  • Tekin M, Konca C, Celik V, Almis H, Kahramaner Z, Erdemir A, et al. The Association between Vitamin D Levels and Urinary Tract Infection in Children. Horm Res Paediatr 2015;83:198-203.
  • Yuk JM, Shin DM, Lee HM, CS Yang, HS Jin, KK Kim, et al. Vitamin D3 induces autophagy in human monocytes/macrophages via cathelicidin. Cell Host Microbe 2009;6:231-43.
  • Li A, Zhang W, Zhang H, Yi B. Vitamin D/vitamin D receptor, autophagy and inflammation relevant diseases. Zhong Nan Da Xue Xue Bao Yi Xue Ban 2017;42:979-85.
  • White JH. Emerging Roles of Vitamin D-Induced Antimicrobial Peptides in Antiviral Innate Immunity. Nutrients 2022;14:284.
  • Avila EE. Functions of Antimicrobial Peptides in Vertebrates. Curr Protein Pept Sci 2017;18:1098-119.
  • Weichhart T, Haidinger M, Hörl WH, Säemann MD. Current concepts of molecular defence mechanisms operative during urinary tract infection. Eur J Clin Invest 2008;38 Suppl 2:29-38.
  • Ching C, Schwartz L, Spencer JD, Becknell B. Innate immunity and urinary tract infection. Pediatr Nephrol 2020;35:1183-92.
  • Chromek M, Slamová Z, Bergman P, Kovács L, Podracká L, Ehrén I, et al. The antimicrobial peptide cathelicidin protects the urinary tract against invasive bacterial infection. Nat Med 2006;12:636-41.
  • Kai-Larsen Y, Lüthje P, Chromek M, Peters V, Wang X, Holm A, et al. Uropathogenic Escherichia coli modulates immune responses and its curli fimbriae interact with the antimicrobial peptide LL-37. PLoS Pathog 2010;6:e1001010.
  • Asadi Karam MR, Habibi M, Bouzari S. Urinary tract infection: Pathogenicity, antibiotic resistance and development of effective vaccines against Uropathogenic Escherichia coli. Mol Immunol 2019;108:56-67.
  • Balighian E, Burke M. Urinary Tract Infections in Children. Pediatr Rev 2018;39:3-12.
  • Leung AKC, Wong AHC, Leung AAM, Hon KL. Urinary Tract Infection in Children. Recent Pat Inflamm Allergy Drug Discov 2019;13:2-18.
  • Korbel L, Howell M, Spencer JD. The clinical diagnosis and management of urinary tract infections in children and adolescents. Paediatr Int Child Health 2017;37:273-9.
  • Morello W, La Scola C, Alberici I, Montini G. Acute pyelonephritis in children. Pediatr Nephrol 2016;31:1253-65.
  • Tullus K, Shaikh N. Urinary tract infections in children. Lancet 2020;395:1659-68.
  • Zhang H, Yang J, Lin L, Huo B, Dai H, He Y. Diagnostic value of serum procalcitonin for acute pyelonephritis in infants and children with urinary tract infections: an updated meta-analysis. World J Urol 2016;34:431-41.
  • Shaikh KJ, Osio VA, Leeflang MM, Shaikh N. Procalcitonin, C-reactive protein, and erythrocyte sedimentation rate for the diagnosis of acute pyelonephritis in children. Cochrane Database Syst Rev 2020;9:CD009185.
  • Schmidt B, Copp HL. Work-up of Pediatric Urinary Tract Infection. Urol Clin North Am 2015;42:519-26.
  • Spencer JD, Schwaderer AL, Becknell B, Watson J, Hains DS. The innate immune response during urinary tract infection and pyelonephritis. Pediatr Nephrol 2014;29:1139-49.
  • Danka ES, Hunstad DA. Cathelicidin augments epithelial receptivity and pathogenesis in experimental Escherichia coli cystitis. J Infect Dis 2015;211:1164-73.
  • Övünç Hacıhamdioğlu D, Altun D, Hacıhamdioğlu B, Çekmez F, Aydemir G, Kul M, et al. The Association between Serum 25-Hydroxy Vitamin D Level and Urine Cathelicidin in Children with a Urinary Tract Infection. J Clin Res Pediatr Endocrinol 2016;8:325-9.
  • Georgieva V, Kamolvit W, Herthelius M, Lüthje P, Brauner A, Chromek M. Association between vitamin D, antimicrobial peptides and urinary tract infection in infants and young children. Acta Paediatr 2019;108:551-6.
  • Kafle S, Basnet AK, Karki K, Thapa Magar M, Shrestha S, Yadav RS. Association of Vitamin D Deficiency With Pulmonary Tuberculosis: A Systematic Review and Meta-Analysis. Cureus 2021;13:e17883.
  • Dao CN, Patel P, Overton ET, Rhame F, Pals SL, Johnson C, et al. Low vitamin D among HIV-infected adults: prevalence of and risk factors for low vitamin D Levels in a cohort of HIV-infected adults and comparison to prevalence among adults in the US general population. Clin Infect Dis 2011;52:396-405.
  • Fujita K, Ito Y, Oguma T, Mio T, Niimi A, Hirai T. Association between Mycobacterium avium complex lung disease and serum vitamin D status, antimicrobial peptide levels, and bone mineral density. Medicine (Baltimore) 2018;97(38):e12463.
  • Thursfield RM, Naderi K, Leaver N, Rosenthal M, Alton EWFW, Bush A, et al. Children with cystic fibrosis demonstrate no respiratory immunological, infective or physiological, consequences of vitamin D deficiency. J Cyst Fibros 2018;17:657-65.
  • Serré J, Mathyssen C, Ajime TT, Korf H, Maes K, Heulens N, et al. Airway infection with Nontypeable Haemophilus influenzae is more rapidly eradicated in vitamin D deficient mice. J Steroid Biochem Mol Biol 2019;187:42-51.

İdrar Yolu Enfeksiyonları ile D vitamini ve Katelisidin Düzeyleri Arasında Bir İlişki Var mı?: Çocuk Acil servisinden Kesitsel Gözlemsel Bir Çalışma

Year 2024, Volume: 18 Issue: 3, 174 - 180, 13.05.2024
https://doi.org/10.12956/tchd.1366493

Abstract

Amaç: Katelisidin, üriner sistemde üretilen ve D vitamini tarafından indüklenen önemli bir antibakteriyel peptittir. Bu çalışmada alt ve üst idrar yolu enfeksiyonlarını (İYE) ayırt etmek için katelisidin düzeyleri ile D vitamini düzeyleri arasındaki ilişki incelenmiştir

Gereç ve Yöntemler: Çocuk Acil Servisinde idrar yolu enfeksiyonu tanısı alan 0-18 yaş arası tedavi öncesi çocukların tam kan sayımı, biyokimya profili, C reaktif protein (CRP), prokalsitonin, 25 hidroksivitamin D ve serum katelisidin düzeylerini analiz ettik.

Bulgular: Çalışmaya toplam 72 çocuk (36 sağlıklı ve 36 hasta) dahil edildi. Katılımcıların yaş ortalaması 83.8±66.22 ay olup, 40’ı (%) kadın, 32’si (%) erkektir. Hasta grubumuzun beyaz küre, nötrofil ve CRP düzeyleri kontrol grubumuza göre daha yüksekti (p=0.050). Alt ve üst İYE’li hastalar arasında katelisidin düzeyleri (5.7±3.7, 9.6±10.9; p=0.810) veya D vitamini düzeyleri (23.3±9.5, 25.9±12.5; p=0.795) açısından anlamlı fark yoktu. Kontrol grubunda D vitamini ile katelisidin düzeyleri arasında pozitif korelasyon bulduk (r:346, p=0.030). Üst İYE’li hastalar ile kontrol grubu arasında katelisidin düzeyleri açısından istatistiksel olarak anlamlı fark yoktu (p=0.054).

Sonuç: İdrar yolu enfeksiyonu olan çocuklarda D vitamini ile katelisidin düzeyleri arasında anlamlı bir ilişki bulunmazken, sağlıklı çocuklarda D vitamini ile katelisidin arasında zayıf fakat pozitif bir ilişki bulunmaktadır.

References

  • Mailhot G, White JH. Vitamin D and Immunity in Infants and Children. Nutrients 2020;12:1233.
  • Al-Khalidi B, Kimball SM, Rotondi MA, Ardern CI. Standardized serum 25-hydroxyvitamin D concentrations are inversely associated with cardiometabolic disease in U.S. adults: a cross-sectional analysis of NHANES, 2001-2010. Nutr J 2017;16:16.
  • Science M, Maguire JL, Russell ML, Smieja M, Walter SD, Loeb M. Low serum 25-hydroxyvitamin D level and risk of upper respiratory tract infection in children and adolescents. Clin Infect Dis 2013;57:392-7.
  • Riverin BD, Maguire JL, Li P. Vitamin D Supplementation for Childhood Asthma: A Systematic Review and Meta-Analysis. PLoS One 2015;10:e0136841.
  • Liu X, Arguelles L, Zhou Y, Wang G, Chen Q, Tsai HJ, et al. Longitudinal trajectory of vitamin D status from birth to early childhood in the development of food sensitization. Pediatr Res 2013;74:321-6.
  • Tekin M, Konca C, Celik V, Almis H, Kahramaner Z, Erdemir A, et al. The Association between Vitamin D Levels and Urinary Tract Infection in Children. Horm Res Paediatr 2015;83:198-203.
  • Yuk JM, Shin DM, Lee HM, CS Yang, HS Jin, KK Kim, et al. Vitamin D3 induces autophagy in human monocytes/macrophages via cathelicidin. Cell Host Microbe 2009;6:231-43.
  • Li A, Zhang W, Zhang H, Yi B. Vitamin D/vitamin D receptor, autophagy and inflammation relevant diseases. Zhong Nan Da Xue Xue Bao Yi Xue Ban 2017;42:979-85.
  • White JH. Emerging Roles of Vitamin D-Induced Antimicrobial Peptides in Antiviral Innate Immunity. Nutrients 2022;14:284.
  • Avila EE. Functions of Antimicrobial Peptides in Vertebrates. Curr Protein Pept Sci 2017;18:1098-119.
  • Weichhart T, Haidinger M, Hörl WH, Säemann MD. Current concepts of molecular defence mechanisms operative during urinary tract infection. Eur J Clin Invest 2008;38 Suppl 2:29-38.
  • Ching C, Schwartz L, Spencer JD, Becknell B. Innate immunity and urinary tract infection. Pediatr Nephrol 2020;35:1183-92.
  • Chromek M, Slamová Z, Bergman P, Kovács L, Podracká L, Ehrén I, et al. The antimicrobial peptide cathelicidin protects the urinary tract against invasive bacterial infection. Nat Med 2006;12:636-41.
  • Kai-Larsen Y, Lüthje P, Chromek M, Peters V, Wang X, Holm A, et al. Uropathogenic Escherichia coli modulates immune responses and its curli fimbriae interact with the antimicrobial peptide LL-37. PLoS Pathog 2010;6:e1001010.
  • Asadi Karam MR, Habibi M, Bouzari S. Urinary tract infection: Pathogenicity, antibiotic resistance and development of effective vaccines against Uropathogenic Escherichia coli. Mol Immunol 2019;108:56-67.
  • Balighian E, Burke M. Urinary Tract Infections in Children. Pediatr Rev 2018;39:3-12.
  • Leung AKC, Wong AHC, Leung AAM, Hon KL. Urinary Tract Infection in Children. Recent Pat Inflamm Allergy Drug Discov 2019;13:2-18.
  • Korbel L, Howell M, Spencer JD. The clinical diagnosis and management of urinary tract infections in children and adolescents. Paediatr Int Child Health 2017;37:273-9.
  • Morello W, La Scola C, Alberici I, Montini G. Acute pyelonephritis in children. Pediatr Nephrol 2016;31:1253-65.
  • Tullus K, Shaikh N. Urinary tract infections in children. Lancet 2020;395:1659-68.
  • Zhang H, Yang J, Lin L, Huo B, Dai H, He Y. Diagnostic value of serum procalcitonin for acute pyelonephritis in infants and children with urinary tract infections: an updated meta-analysis. World J Urol 2016;34:431-41.
  • Shaikh KJ, Osio VA, Leeflang MM, Shaikh N. Procalcitonin, C-reactive protein, and erythrocyte sedimentation rate for the diagnosis of acute pyelonephritis in children. Cochrane Database Syst Rev 2020;9:CD009185.
  • Schmidt B, Copp HL. Work-up of Pediatric Urinary Tract Infection. Urol Clin North Am 2015;42:519-26.
  • Spencer JD, Schwaderer AL, Becknell B, Watson J, Hains DS. The innate immune response during urinary tract infection and pyelonephritis. Pediatr Nephrol 2014;29:1139-49.
  • Danka ES, Hunstad DA. Cathelicidin augments epithelial receptivity and pathogenesis in experimental Escherichia coli cystitis. J Infect Dis 2015;211:1164-73.
  • Övünç Hacıhamdioğlu D, Altun D, Hacıhamdioğlu B, Çekmez F, Aydemir G, Kul M, et al. The Association between Serum 25-Hydroxy Vitamin D Level and Urine Cathelicidin in Children with a Urinary Tract Infection. J Clin Res Pediatr Endocrinol 2016;8:325-9.
  • Georgieva V, Kamolvit W, Herthelius M, Lüthje P, Brauner A, Chromek M. Association between vitamin D, antimicrobial peptides and urinary tract infection in infants and young children. Acta Paediatr 2019;108:551-6.
  • Kafle S, Basnet AK, Karki K, Thapa Magar M, Shrestha S, Yadav RS. Association of Vitamin D Deficiency With Pulmonary Tuberculosis: A Systematic Review and Meta-Analysis. Cureus 2021;13:e17883.
  • Dao CN, Patel P, Overton ET, Rhame F, Pals SL, Johnson C, et al. Low vitamin D among HIV-infected adults: prevalence of and risk factors for low vitamin D Levels in a cohort of HIV-infected adults and comparison to prevalence among adults in the US general population. Clin Infect Dis 2011;52:396-405.
  • Fujita K, Ito Y, Oguma T, Mio T, Niimi A, Hirai T. Association between Mycobacterium avium complex lung disease and serum vitamin D status, antimicrobial peptide levels, and bone mineral density. Medicine (Baltimore) 2018;97(38):e12463.
  • Thursfield RM, Naderi K, Leaver N, Rosenthal M, Alton EWFW, Bush A, et al. Children with cystic fibrosis demonstrate no respiratory immunological, infective or physiological, consequences of vitamin D deficiency. J Cyst Fibros 2018;17:657-65.
  • Serré J, Mathyssen C, Ajime TT, Korf H, Maes K, Heulens N, et al. Airway infection with Nontypeable Haemophilus influenzae is more rapidly eradicated in vitamin D deficient mice. J Steroid Biochem Mol Biol 2019;187:42-51.
There are 32 citations in total.

Details

Primary Language English
Subjects Clinical Sciences (Other)
Journal Section ORIGINAL ARTICLES
Authors

Alper Çiçek 0000-0001-5017-4525

Pelin Elibol 0000-0002-2195-7421

Banu Isbilen Basok 0000-0002-1483-997X

Dilek Orbatu 0000-0002-5716-2938

Emel Berksoy 0000-0002-6831-1353

Demet Alaygut 0000-0002-2164-4652

Oya Halıcıoğlu 0000-0002-0062-9138

Early Pub Date February 15, 2024
Publication Date May 13, 2024
Submission Date September 26, 2023
Published in Issue Year 2024 Volume: 18 Issue: 3

Cite

Vancouver Çiçek A, Elibol P, Basok BI, Orbatu D, Berksoy E, Alaygut D, Halıcıoğlu O. Is There A Relationship Between Urinary Tract Infections and Vitamin D and Cathelicidin Levels?: A Cross-Sectional Observational Study From the Pediatric Emergency Department. Türkiye Çocuk Hast Derg. 2024;18(3):174-80.


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