Association between Vitamin D Level, Vitamin D Receptor Gene Polymorphisms, and Cathelicidin Level to Acute Lower Respiratory Infections, and the Picture of Exon 2-Vitamin D Receptor Gene Polymorphisms in Children under 5 years old

Ida Bagus Subanada; I. Made Bakta; I. Wayan Bikin Suryawan; Putu Astawa; Bagus Komang Satriyasa

doi:10.3889/oamjms.2020.4352

Authors

Ida Bagus Subanada Department of Pediatric, School of Medicine, Universitas Udayana, Sanglah General Hospital, Denpasar, Bali, Indonesia
I. Made Bakta Department of Internal Medicine, School of Medicine, Universitas Udayana, Sanglah General Hospital, Denpasar, Bali, Indonesia
I. Wayan Bikin Suryawan Department of Pediatric, Wangaya Hospital Denpasar, Bali, Indonesia
Putu Astawa Department of Orthopaedic, School of Medicine, Universitas Udayana, Sanglah General Hospital Denpasar, Bali, Indonesia
Bagus Komang Satriyasa Department of Pharmacology, School of Medicine, Universitas Udayana Denpasar, Bali, Indonesia

DOI:

https://doi.org/10.3889/oamjms.2020.4352

Keywords:

acute lower respiratory infections, vitamin D level, VDR gene polymorphism, cathelicidin level, children under five

Abstract

BACKGROUND: Acute lower respiratory infections (ALRIs) are infectious diseases with high morbidity and mortality in children under five. There are several factors associated with ALRIs (bronchiolitis or pneumonia) that have been established. In recent years, Vitamin D level, Vitamin D receptor (VDR) gene polymorphism, and cathelicidin level are also associated with ALRIs. Until now, there was no VDR gene other than Fok1 identified at the exon 2-VDR gene.

OBJECTIVE: The objective of this study was to establish whether Vitamin D deficiency, ff genotype-Fok1 VDR gene polymorphism, and low levels of cathelicidin are risk factors of ALRIs and to determine the pictures of exon 2-VDR genes polymorphisms in children under five.

METHODS: A matched case–control study was conducted in children under the age of five. There were 35 subjects who suffered from bronchiolitis or pneumonia and 35 healthy subjects as a control group. These groups were matched based on age and gender, and the children originated from the same neighborhood. Level of 25(OH) D, exon 2-VDR genes sequencing, and level of cathelicidin were investigated. Data were analyzed by the Chi-square test or Fisher exact test and logistic regression with a significant level of p < 0.05.

RESULTS: This study found that Vitamin D deficiency and low levels of cathelicidin were risk factors of ALRIs (odds ratio [OR] = 5.82 [95% confidence interval [CI] = 1.71–19.89], p = 0.005 and OR = 4.07 [95% CI = 1.10–15.12], p = 0.036, respectively), while ff genotype-Fok1 VDR gene polymorphism was not (OR = 1.12 [95% CI = 0.26–4.86], p = 1.000). Fok1 VDR gene polymorphism was the picture of exon 2-VDR gene polymorphisms.

CONCLUSION: It is concluded that Vitamin D deficiency and low levels of cathelicidin are risk factors, but ff genotype-Fok1 VDR gene polymorphism is not a risk factor of ALRIs. Fok1 VDR gene polymorphism is the picture of exon 2-VDR genes polymorphisms.

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