Vitamin D, innate immunity and outcomes in community acquired pneumonia

Respirology. 2011 May;16(4):611-6. doi: 10.1111/j.1440-1843.2011.01924.x.

Abstract

Background and objective: Vitamin D regulates the production of the antimicrobial peptides cathelicidin and beta-defensin-2, which play an important role in the innate immune response to infection. We hypothesized that vitamin D deficiency would be associated with lower levels of these peptides and worse outcomes in patients admitted to hospital with community acquired pneumonia.

Methods: Associations between mortality and serum levels of 25-hydroxyvitamin D, cathelicidin and beta-defensin-2 were investigated in a prospective cohort of 112 patients admitted with community acquired pneumonia during winter.

Results: Severe 25-hydroxyvitamin D deficiency (<30nmol/L) was common in this population (15%) and was associated with a higher 30-day mortality compared with patients with sufficient 25-hydroxyvitamin D (>50nmol/L) (odds ratio 12.7, 95% confidence interval: 2.2-73.3, P=0.004). These associations were not explained by differences in age, comorbidities, or the severity of the acute illness. Neither cathelicidin nor beta-defensin-2 levels predicted mortality, although there was a trend towards increased mortality with lower cathelicidin (P=0.053). Neither cathelicidin nor beta-defensin-2 levels correlated with 25-hydroxyvitamin D.

Conclusions: 25-hydroxyvitamin D deficiency is associated with increased mortality in patients admitted to hospital with community acquired pneumonia during winter. Contrary to our hypothesis, 25-hydroxyvitamin D levels were not associated with levels of cathelicidin or beta-defensin-2.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acute Disease
  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Antimicrobial Cationic Peptides / blood
  • Antimicrobial Cationic Peptides / immunology
  • Cohort Studies
  • Community-Acquired Infections / blood
  • Community-Acquired Infections / immunology*
  • Community-Acquired Infections / mortality
  • Female
  • Humans
  • Immunity, Innate*
  • Male
  • Middle Aged
  • Pneumonia / blood
  • Pneumonia / immunology*
  • Pneumonia / mortality
  • Prospective Studies
  • Severity of Illness Index
  • Treatment Outcome
  • Vitamin D / blood
  • Vitamin D / immunology*
  • Vitamin D Deficiency / immunology
  • Young Adult
  • beta-Defensins / blood
  • beta-Defensins / immunology

Substances

  • Antimicrobial Cationic Peptides
  • DEFB4A protein, human
  • beta-Defensins
  • Vitamin D
  • CAP18 lipopolysaccharide-binding protein