Low concentrations of serum 25-hydroxyvitamin D (25-OHD) have been associated with adverse outcomes in critically ill patients. The antimicrobial protein cathelicidin is one of the possible mediators of this effect, as its expression is regulated by vitamin D. However, the role of vitamin D in the host defense of bacterial meningitis (BM) remains unclear. We investigated the serum 25-OHD concentration in children with BM, and its association with cathelicidin concentrations in the cerebrospinal fluid (CSF) and the outcome of this disease.
Patient data were collected in 1996-2003, as part of a clinical trial on childhood BM in Latin America. The current study comprised 127 children (median age 7 months, range 2 - 147 months) with an etiologically confirmed BM, of whom a frozen serum sample was available for further analysis. Serum samples had been collected on admission, and serum 25-OHD concentrations were measured with an automated IDS-iSYS analyzer. CSF cathelicidin concentrations had previously been measured by ELISA in a subgroup of 77 patients.
The mean serum 25-OHD concentration was 100 nmol/L (standard deviation 36 nmol/L), ranging from 19 nmol/L to 251 nmol/L. No association was detected between serum 25-OHD and the CSF cathelicidin concentration. Neither patient survival nor the occurrence of neurological sequelae correlated with serum 25-OHD.
Serum 25-OHD concentrations were not associated with CSF cathelicidin concentrations in our sample of children with BM, which indicates that CSF cathelicidin synthesis in BM might be independent of circulating 25-OHD. Unlike previously reported in critically ill adults, serum 25-OHD did not relate to disease outcomes in childhood BM.
I. Roine, None
H. Viljakainen, None
S. Andersson, None
A. González Mata, None
H. Peltola, None
O. Helve, None