Vitamin D3 Deficiency Increases Sinus Mucosa Dendritic Cells in Pediatric Chronic Rhinosinusitis with Nasal Polyps.

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Otolaryngol Head Neck Surg. 2012 May 24. [Epub ahead of print]
Vitamin D3 Deficiency Increases Sinus Mucosa Dendritic Cells in
Pediatric Chronic Rhinosinusitis with Nasal Polyps.
Mulligan JK, White DR, Wang EW, Sansoni SR, Moses H, Yawn RJ, Wagner
C, Casey SE, Mulligan RM, Schlosser RJ.
Source
Research Service, Ralph H. Johnson VA Medical Center, Charleston,
South Carolina, USA.
Abstract
Objective. Dendritic cells are professional antigen presenting cells,
capable of initiating Th1 or Th2 responses, and have been implicated
in the pathogenesis of a number of diseases, including sinusitis.
Vitamin D(3) is a steroid hormone that acts on dendritic cells in a
manner similar to corticosteroids. Investigators examined whether
children with allergic fungal rhinosinusitis (AFRS) or chronic
rhinosinusitis with nasal polyposis (CRSwNP) were vitamin D(3)
deficient and the relationship of vitamin D(3) deficiency to dendritic
cell infiltrate in the sinus mucosa.Setting. Tertiary care university
hospital.Study Design. Retrospective, controlled study using samples
collected from pediatric patients seen from August 2009 to July
2011.Subjects and Methods. Plasma levels of 25-hydroxy vitamin D(3)
were measured by enzyme-linked immunosorbent assay in children (≤18
years old) with AFRS, CRSwNP, or CRS without nasal polyposis (CRSsNP)
and in controls undergoing surgery for adenotonsillar hypertrophy.
Vitamin D(3) levels were confirmed using clinical diagnostic methods
for those with CRSwNP or AFRS. Tissue samples were
immunohistochemically stained for the dendritic cell marker CD209 and
the costimulatory molecules CD80 and CD86.Results. There was no
difference in mean vitamin D(3) levels between control and CRSsNP,
whereas mean CRSwNP and AFRS levels were both well below the minimum
recommended level of 30 ng/mL and significantly lower than control and
CRSsNP levels. CD209(+) dendritic cells inversely correlated with
vitamin D(3) but not costimulatory molecule expression.Conclusions.
These studies identify that children with CRSwNP or AFRS are vitamin
D(3) deficient, which may be linked to increased dendritic cell
infiltrate. These results suggest a role for vitamin D(3) as a key
player in the immunopathology of pediatric CRSwNP.