Low vitamin D in sinusitis with polyps

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and also in allergic fungal rhinosinusitis.Note that, in this article, low vitamin D means (25-OH-D3) < 32 ng/ml.----------Clin Exp Immunol. 2011 Mar 14. doi: 10.1111/j.1365-2249.2011.04325.x. [Epub ahead of print]Vitamin D(3) correlates inversely with systemic dendritic cell numbers and bone erosion in chronic rhinosinusitis with nasal polyps and allergic fungal rhinosinusitis.Mulligan JK, Bleier BS, O'Connell B, Mulligan RM, Wagner C, Schlosser RJ.Division of Rhinology & Sinus Surgery, Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina Ralph H. VA Medical Center Division of Neonatology, Department of Pediatrics, Medical University of South Carolina, ton, SC Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA, USA.AbstractVitamin D(3) (VD(3) ) is a steroid hormone that regulates bone health and numerous aspects of immune function and may play a role in respiratory health. We hypothesized that T helper type 2 (Th2) disorders, chronic rhinosinusitis with nasal polyps (CRSwNP) and allergic fungal rhinosinusitis (AFRS) would have VD(3) deficiencies, resulting in increased mature dendritic cells (DCs) and bone erosion. We conducted a retrospective study examining VD(3) levels in patients with AFRS (n = 14), CRSwNP (n = 9), chronic rhinosinusitis without nasal polyps (CRSsNP) (n = 20) and cerebrospinal fluid leak repair (non-diseased controls) (n = 14) at time of surgery. Circulating immune cell levels were determined by immunostaining and flow cytometric analysis. Plasma VD(3) and immune regulatory factors (granulocyte-macrophage colony-stimulating factor and prostaglandin E(2) ) were measured by enzyme-linked immunosorbent assay. It was observed that CRSwNP and AFRS demonstrated increased circulating DCs, while chronic rhinosinusitis without nasal polyps displayed increased circulating macrophages. CRSwNP and AFRS were to found to have insufficient levels of VD(3) which correlated inversely with circulating numbers of mature DCs, DC regulatory factors and bone erosion. CRSsNP displayed no change in circulating DC numbers or VD(3) status compared to control, but did display increased numbers of circulating macrophages that was independent of VD(3) status. Lastly, VD(3) deficiency was associated with more severe bone erosion. Taken together, these results suggest support a role for VD(3) as a key player in the immunopathology of CRSwNP and AFRS.