25(OH)D3 levels in children with allergic rhinoconjunctivitis

Amaç: Bu prospektif çalışmada alerjik rinokonjonktivitli (ARK) çocuklarda serum D vitamini [serum 25(OH)D3 düzeyleri] düzeylerini araştırdık. Yöntem: Alerjik rinokonjonktivitli 61 çocuk (çalışma grubu) ve 61 sağlıklı çocuk (kontrol grubu) çalışmaya dahil edildi. Çalışma grubu, deri iğneleme testinde en azından bir aktif etkene karşı alerjikti. D vitamini [25(OH)D3] düzeyleri için Toplam 5 Semptom Skoru (T5SS) elde edildi, total eozinofil sayımları ve total IgE ölçümleri yapıldı. Bulgular: Alerjik rinokonjonktivit grubunda rinore, aksırma, nazal konjesyon ve nazal kaşıntı semptomlarının her biri için ortanca T5SS skoru 1.00 idi. ARK grubunda total eozinofil sayısı ve total IgE değerleri de kontrol grubuna göre daha yüksekti. Kontrol grubuna göre ARK grubunda ailevi atopi daha yüksek ve güneşe maruziyet daha düşüktü. ARK grubunda serum 25(OH)D3 düzeyleri (ortanca: 15.80 ng/ml) kontrol grubuna göre anlamlı derece daha düşüktü (18.40 ng/ml). D vitamini düzeylerinin yeterli veya yetersiz olma durumu ele alındığında kontrol grubundaki çocukların %57.4'ü ve çalışma grubundaki çocukların ise %80.3'ünde D vitamini eksikliği mevcuttu. Çalışma grubunda güneş ışığına maruziyet yeterli değildi ve ailevi atopi mevcuttu. Yeterince güneş ışığı alan çocuklarda serum 25(OH)D3 düzeylerinin daha yüksek olduğu saptandı. Ailevi atopisi olan çocuklarda total IgE ve total eozinofil sayıları da artmıştı. Sonuç: Alerjik rinokonjonktivitli çocuklarda D vitamini düzeylerinin daha düşük olduğu sonucuna vardık. D vitamini düzeylerini yükseltmek ve böylece ARK riskini azaltmak çin çocukların yeterince güneş ışığı almasını öneriyoruz.

Alerjik rinokonjonktivitli çocuklarda 25(OH)D3 düzeyleri

Objective: In this prospective study, we investigated the serum vitamin D levels [serum 25(OH)D3 levels] in children with allergic rhinoconjunctivitis (ARC). Methods: Sixty-one children with allergic rhinoconjunctivitis (study group) and 61 healthy children (control group) were included into the study. The children in the study group had an allergy against at least one active agent at skin-prick test; a total of 5 Symptoms Score (T5SS) was obtained for vitamin D [25(OH)D3] levels. Total eosinophil counts and total IgE measurement were performed. Results: In ARC group, median of T5SS scores was 1.00 for each of the rhinorrhea, sneezing, nasal congestion and nasal pruritis items. In ARC group, total eosinophil count and total IgE values were also higher than the control group. In ARC group, familial atopy was higher, and sunlight exposure was lower than the control group. Serum 25(OH)D3 levels of the ARC group (median: 15.80 ng/ml) were significantly lower than the control group (18.40 ng/ml). Considering the vitamin D levels being as sufficient/or deficient; it was deficient in 80.3% of the children in the study group and in 57.4% of the children in the control group. In the study group, sunlight exposure was insufficient; and familial atopy was present. In children with sufficient sunlight exposure, serum 25(OH)D3 levels were detected as higher. In children with familial atopy, total IgE and total eosinophil counts also increased. Conclusion: We concluded that vitamin D levels were lower in children with ARC. We recommend children to expose sunlight sufficiently to increase vitamin D levels; and therefore reduce the risk of allergic rhino-conjunctivitis.

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1. de Groot H, Brand PL, Fokkens WF, Berger MY. Allergic rhinoconjunctivitis in children. BMJ 2007;335(7627):9858.
2. Sayın İ, Cingi C, San T, Ulusoy S, Acar M. An important social problem: allergic rhinitis. J Med Updates 2013;3:915.
3. Öçalan FCA, Özcan M, Öçalan R, Yılmaz YF, Ünal A. Relationship between symptoms of allergic rhinitis and their severity with specific allergens and duration of allergic rhinitis. J Med Updates 2013;3:11621.
4. Hakansson K, Thomsen SF, Ulrik CS, Porsbjerg C, Backer V. Increase in the prevalence of rhinitis among Danish children from 1986 to 2001. Pediatr Allergy Immunol 2007;18:1549.
5. Asher MI, Montefort S, Bjorksten B, et al. Worldwide time trends in the prevalence of symptoms of asthma, allergic rhinoconjunctivitis, and eczema in childhood: ISAAC phases one and three repeat multicountry cross-sectional surveys. Lancet 2006;368:73343.
6. Bener A, Ehlayel MS, Bener HZ, Hamid Q. The impact of vitamin D deficiency on asthma, allergic rhinitis and wheezing in children: an emerging public health problem. J Family Community Med 2014;21:15461.
7. Abuzeid WM, Akbar NA, Zacharek MA. Vitamin D and chronic rhinitis. Curr Opin Allergy Clin Immunol 2012;12:137.
8. Dusso A, Brown A, Slatopolsky E. Vitamin D. Am J Physiol Renal Physiol 2005;289:F8F28.
9. Katotomichelakis M, Nikolaidis C, Makris M, et al. Alternaria and Cladosporium calendar of Western Thrace: relationship with allergic rhinitis symptoms. Laryngoscope 2015. doi: 10.1002/lary. 25594
10. Rogkakou A, Villa E, Garelli V, Canonica GW. Persistent allergic rhinitis and the XPERT Study. World Allergy Organ J 2011; 4(3 Suppl):S326.
11. Heinzerling L, Frew AJ , Bindslev-J ensen C, et al. Standard skin prik testing and sensitization to inhalant allergens across Europe survey from the GALEN network. Allergy 2005;60:1287300.
12. Uysalol M, Mutlu LC, Saracoglu GV, et al. Childhood asthma and vitamin D deficiency in Turkey: is there cause and effect relationship between them? Ital J Pediatr 2013;39:78.
13. Misra M, Pacaud D, Petryk A, Collett-Solberg PF, Kappy M; Drug and Therapeutics Committee of the Lawson Wilkins Pediatric Endocrine Society. Vitamin D deficiency in children and its management: review of current knowledge and recommenda- tions. Pediatrics 2008;122:398417.
14. Goksugur SB, Erdurmus M, Bekdas M, et al. Tear and serum vitamin D levels in children with allergic rhinoconjunctivitis. Allergol Immunopathol (Madr) 2015;43:5337.
15. Bäck O, Blomquist H K, Hernell O, Stenberg B. Does vitamin D intake during infancy promote the development of atopicallergy? Acta Derm Venereol 2009;89:2832.
16. Hyppönen E, Sovio U, Wjst M, et al. Infant vitamin D supple- mentation and allergic conditions in adulthood: northern Finland birth cohort 1966. Ann N Y Acad Sci 2004;1037:8495.
17. Nurmatov U, Devereux G, Sheikh A. Nutrients and foods for the primary prevention of asthma and allergy: systematic review and meta-analysis. J Allergy Clin Immunol 2011;127:72433.
18. Miyake Y, Tanaka K, Okubo H, Sasaki S, Arakawa M. Dairy food, calcium and vitamin D intake and prevalence of allergic disorders in pregnant Japanese women. Int J Tuberc Lung Dis 2012;16: 25561.
19. Mulligan JK, Bleier BS, OConnell B, et al. Vitamin D3 correlates inversely with systemic dendritic cell numbers and bone erosion in chronic rhinosinusitis with nasal polyps and allergic fungal rhinos- inusitis. Clin Exp Immunol 2011;164:31220.
20. Dunkin MA. Vitamin D deficiency. [cited 2015 Nov 2]. Available from: http://www.webmd.com/diet/guide/vitamin-d-deficiency