Öz

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.

Anahtar Kelimeler: acil, pediatri, üriner sistem enfeksiyonu, Vitamin D, Katelisidin

Referanslar

  1. Mailhot G, White JH. Vitamin D and Immunity in Infants and Children. Nutrients 2020;12:1233.
  2. 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.
  3. 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.
  4. Riverin BD, Maguire JL, Li P. Vitamin D Supplementation for Childhood Asthma: A Systematic Review and Meta-Analysis. PLoS One 2015;10:e0136841.
  5. 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.
  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.
  7. 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.
  8. 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.
  9. White JH. Emerging Roles of Vitamin D-Induced Antimicrobial Peptides in Antiviral Innate Immunity. Nutrients 2022;14:284.
  10. Avila EE. Functions of Antimicrobial Peptides in Vertebrates. Curr Protein Pept Sci 2017;18:1098-119.
  11. 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.
  12. Ching C, Schwartz L, Spencer JD, Becknell B. Innate immunity and urinary tract infection. Pediatr Nephrol 2020;35:1183-92.
  13. 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.
  14. 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.
  15. 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.
  16. Balighian E, Burke M. Urinary Tract Infections in Children. Pediatr Rev 2018;39:3-12.
  17. Leung AKC, Wong AHC, Leung AAM, Hon KL. Urinary Tract Infection in Children. Recent Pat Inflamm Allergy Drug Discov 2019;13:2-18.
  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.
  19. Morello W, La Scola C, Alberici I, Montini G. Acute pyelonephritis in children. Pediatr Nephrol 2016;31:1253-65.
  20. Tullus K, Shaikh N. Urinary tract infections in children. Lancet 2020;395:1659-68.
  21. 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.
  22. 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.
  23. Schmidt B, Copp HL. Work-up of Pediatric Urinary Tract Infection. Urol Clin North Am 2015;42:519-26.
  24. 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.
  25. Danka ES, Hunstad DA. Cathelicidin augments epithelial receptivity and pathogenesis in experimental Escherichia coli cystitis. J Infect Dis 2015;211:1164-73.
  26. 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.
  27. 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.
  28. 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.
  29. 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.
  30. 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.
  31. 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.
  32. 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.

Telif hakkı ve lisans

Nasıl atıf yapılır

1.
Çiçek A, Elibol P, Basok BI, Orbatu D, Berksoy E, Alaygut D, et al. İdrar Yolu Enfeksiyonları ile D vitamini ve Katelisidin Düzeyleri Arasında Bir İlişki Var mı?: Çocuk Acil servisinden Kesitsel Gözlemsel Bir Çalışma. Turk J Pediatr Dis [Internet]. 2024 May 13 [cited 2025 May 25];18(3):174-80. Available from: https://turkjpediatrdis.org/article/view/1045