文章摘要
唐慧雅,葛许华,李 灼,赵 婧,刘 勇.婴幼儿血清维生素D水平与毛细支气管炎严重程度关系及其对肺泡上皮细胞功能的影响[J].南京医科大学学报,2019,(3):387~392
婴幼儿血清维生素D水平与毛细支气管炎严重程度关系及其对肺泡上皮细胞功能的影响
Relationship between serum vitamin D Levels and severity of bronchiolitis in infants and their effects on the function of A549 cells
投稿时间:2018-06-22  
DOI:10.7655/NYDXBNS20190315
中文关键词: 毛细支气管炎  维生素D  肺上皮细胞  组胺  VDR  CYP27B1
英文关键词: bronchiolitis  vitamin D  alveolar epithelial cells  histamine  VDR  CYP27B1
基金项目:世界健康基金会AFINS(AFINS?HOPE?2012?06)
作者单位
唐慧雅 南京医科大学附属江宁医院儿科江苏 南京 211100 
葛许华 南京医科大学附属儿童医院急诊/重症医学科江苏 南京 210008 
李 灼 南京医科大学附属儿童医院急诊/重症医学科江苏 南京 210008 
赵 婧 南京医科大学附属江宁医院儿科江苏 南京 211100 
刘 勇 南京医科大学附属儿童医院急诊/重症医学科江苏 南京 210008 
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中文摘要:
      目的:探讨婴幼儿维生素D(vitamin D,VitD)缺乏与毛细支气管炎发病及其严重性的相关性,并通过体外细胞实验,探讨VitD水平与肺泡上皮细胞的应答关系。方法:选取南京医科大学附属江宁医院2016年1月—2017年12月确诊毛细支气管炎患儿为观察组80例,按标准给予严重度评分,另选取40例健康婴儿为对照组,分别检测两组血清25?羟基维生素D[25?(OH)D]水平,探讨其与毛细支气管炎严重度评分之间的相关性,并检测两组患儿血清组胺、肿瘤坏死因子(tumor necrosis factor,TNF)?α水平,探讨其与体内VitD水平的关系。体外培养人肺泡上皮细胞A549,分A、B、C 3组,A组作为对照组始终原培养液培养,B、C组细胞予以呼吸道合胞病毒(respiratory syncytial virus,RSV)感染24 h,C组同时予以骨化三醇处理,24 h后比较3组培养液上清中组胺、TNF?α水平及3组细胞VitD受体(vitamin D receptor,VDR)、25?(OH)D ?1α羟化酶(CYP27B1)mRNA表达的差异。结果:观察组患儿体内25?(OH)D水平明显低于对照组(P<0.001),毛细支气管炎严重度评分与其体内25?(OH)D水平呈负相关(R2=0.539 8)。观察组患儿血清组胺(P<0.01)、TNF?α(P<0.05)水平较对照组明显升高。RSV感染体外培养的细胞后,B组培养液上清中组胺、TNF?α水平明显上升(P均<0.001),C组细胞VDR、CYP27B1 mRNA表达明显上升(P均<0.001)。结论:提高婴幼儿体内VitD水平可降低婴幼儿毛细支气管炎发病及减轻其严重程度,可能与高VitD水平抑制Ⅱ型肺泡上皮细胞释放炎症介质及促进VitD活化及利用能力有关。
英文摘要:
      Objective:To investigate the association between vitamin D(VitD)deficiency and the incidence and severity of bronchiolitis in infants and young children,and the relationship between VitD level and response of alveolar epithelial cells in vitro. Methods:A total of 80 children with bronchiolitis diagnosed during the period from January 2016 to December 2017 in Jiangning Hospital Affiliated to NMU were selected. Severity scores were given according to the standard. Forty healthy infants were selected as the control group. The level of 25?(OH)D was explored in relation to the severity score of bronchiolitis,and the levels of histamine and TNF?α in the two groups of children were examined to investigate the relationship between the level of VitD and in vivo VitD levels. Human alveolar epithelial cells A549 were cultured in groups A,B,and C. Group A served as the control group and were cultured in the original culture medium. Group B/C were infected with respiratory syncytial virus(RSV)for 24 hours. Group C was treated with calcitriol at the same time for 24 h. The levels of histamine and TNF?α in the culture supernatant and the differences of VitD receptor(VDR)and CYP27B1 mRNA expression in the cells of three groups were measured separately after 24 h. Results:The 25?(OH)D level in the bronchiolitis group was significantly lower than that in the healthy control group(P < 0.001). The severity score of bronchiolitis was negatively correlated with the 25?(OH)D level in vivo(R2=0.5398). The levels of serum histamine(P < 0.01)and TNF?α(P < 0.05)in the bronchiolitis group were significantly higher than those in the control group. After RSV infected cells in vitro,the levels of histamine and TNF?α in the culture supernatant of group B increased significantly(both P < 0.001). The expression of VDR and CYP27B1 mRNA in group C increased significantly(both P < 0.001). Conclusion:Increasing the VitD level in infants and young children can reduce the incidence and severity of bronchiolitis,which may be related to inhibiting inflammatory mediators released by type Ⅱ alveolar epithelial cells and promoting VitD activation and utilization.
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