Increased serum antimicrobial peptide LL-37 and HBD-2 combined with 25-hydroxyvitamin D3 deficiency in infants with pertussis.

INTRODUCTION: Most children with serious infection diseases suffer from malnutrition. Vitamin D participates in the immune response through endogenous antimicrobial peptides (AMPs) regulation. The aim of this study is to investigate the expression of 25-hydroxyvitamin D3 [25(OH)D3], AMPs [LL-37 and human ß-defensin 2 (HBD-2)] in the children with pertussis. METHODOLOGY: Serum levels of 25(OH)D3, LL-37, and HBD-2 were detected in 116 children with pertussis aged at 1-12 months (67 males and 49 females). Fifty healthy infants at similar age were employed as normal controls. RESULTS: The serum 25(OH)D3 levels in the children with mild (27.30 ± 5.98 ng/ml) and severe (24.40 ± 6.27 ng/ml) pertussis were significantly lower than that in the healthy group (30.16 ± 5.13 ng/ml; p <0.01). The vitamin D deficiency rates in children with mild (55.9%) and severe (78.12%) pertussis were significantly higher than that in the control group (34%; p < 0.01). The serum levels of LL-37 and HBD-2 were significantly higher in pertussis patients. Spearman rank correlation analysis did not show any correlation of 25-(OH)D3 with LL-37 or HBD-2. CONCLUSIONS: Most children with pertussis had vitamin D deficiency accompanied by elevated serum LL-37 and HBD-2 levels. However, the average level of 25(OH)D3 at 26.50 ng/ml in the infants with pertussis may not affect the immuno-regulatory ability; thus, the infants with pertussis still maintained a higher level of AMPs (LL-37 and HBD-2) against pertussis infection.

[Clinical characteristics of lipid aspiration pneumonia in 16 children].

OBJECTIVE: To investigate clinical characteristics and changes of pulmonary imaging of mineral oil aspiration pneumonia in children. METHOD: The clinical features, CT findings, and effects of corticosteroid therapy were analyzed in 16 children with mineral oil aspiration pneumonia, who were hospitalized in our hospital from January 2003 to July 2013. RESULT: All patients with mineral oil aspiration pneumonia had a history of mineral oil administration.Four patients had no clinical manifestations. Ten cases presented fever, and 8 of the 10 patients had fever in 4-8 h after taking mineral oil, and the temperature was between 39-40 °C. There were wheezing in 2 cases, shortness of breath in 6 cases, cyanosis in 1 case, dyspnea in 3 cases, and moaning in 2 cases, chest pain in 1 case, headache and abnormal EEG in 1 case.Six patients had rales in lungs. Peripheral blood white cells increased in 10 cases, and C- reactive protein elevated in 7 patients. Chest CT examination showed abnormal findings in 6 children, and the earliest CT was performed within 2 h after the accident. The rest 10 children got chest X-ray, and 9 of 10 children had abnormal findings. The earliest X-ray was done within 3 h after the accident. And the remaining 1 of 10 children showed no significant changes in the first chest X-ray 2-3 h after the accident until 3 days. All of the patients received corticosteroid and antibiotic treatments, 4 cases underwent bronchoalveolar lavage, 3 patients were given albumin, 6 cases received intravenous immunoglobulin. Three cases delayed in treatment with hormone because of misdiagnosis, and 2 of them had clearly secondary infections. Twelve patients recovered completely from oil aspiration pneumonia after 8 days to 5.5 months. CONCLUSION: Oil aspiration pneumonia in children occurs in almost all cases after mineral oil aspiration. Pulmonary opacities can be found by chest CT in most patients within 24 hours after mineral oil aspiration. Corticosteroids therapy was effective for patients with exogenous lipid pneumonia, which may inhibit the inflammatory response and possible pulmonary fibrosis.