A1 Refereed original research article in a scientific journal

The relationship of serum vitamins A, D, E and LL-37 levels with allergic status, tonsillar virus detection and immune response




AuthorsVarpu Elenius, Oscar Palomares, Matti Waris, Riitta Turunen, Tuomo Puhakka, Beate Rückert, Tytti Vuorinen, Tobias Allander, Tero Vahlberg, Mübeccel Akdis, Carlos A. Camargo Jr, Cezmi A. Akdis, Tuomas Jartti

PublisherPUBLIC LIBRARY SCIENCE

Publication year2017

JournalPLoS ONE

Journal name in sourcePLOS ONE

Journal acronymPLOS ONE

Article numberARTN e0172350

Volume12

Issue2

Number of pages13

ISSN1932-6203

DOIhttps://doi.org/10.1371/journal.pone.0172350

Self-archived copy’s web addresshttps://research.utu.fi/converis/portal/detail/Publication/19292342


Abstract
BackgroundTonsils have an active role in immune defence and inducing and maintaining tolerance to allergens. Vitamins A, D, and E, and antimicrobial peptide LL-37 may have immunomodulatory effects. We studied how their serum levels were associated with allergy status, intratonsillar/nasopharyngeal virus detection and intratonsillar expression of T cell-and innate immune response-specific cytokines, transcription factors and type I/II/III interferons in patients undergoing tonsillectomy.Methods110 elective tonsillectomy patients participated. Serum levels of vitamins A, 25(OH)D, and E, LL-37 and allergen-specific IgE as well as nasopharyngeal/intratonsillar respiratory viruses were analyzed. The mRNA expression of IFN-alpha, IFN-beta, IFN-gamma, IL-10, IL-13, IL-17, IL-28, IL-29, IL-37, TGF-beta, FOXP3, GATA3, RORC2 and Tbet in tonsils were analyzed by quantitative RT-PCR.ResultsThe median age of the patients was 16 years (range 3-60), 28% of subjects had atopy, and 57% carried >= 1 respiratory virus in nasopharynx. Detection of viruses decreased by age. Higher vitamin A levels showed borderline significance with less viral detection (P = 0.056). Higher 25(OH) D was associated with less allergic rhinitis and atopy (P < 0.05) and higher vitamin E with less self-reported allergy (P < 0.05). In gene expression analyses, 25(OH)D was associated with higher IL-37, vitamin A with higher IFN-gamma and vitamin E with less IL-28 (P < 0.05). LL-37 was associated with less FOXP3, RORC2 and IL-17 in tonsils (P < 0.05).ConclusionsVitamin D and E levels were associated with less allergic disorders. Vitamin A was linked to antiviral and vitamin D with anti-inflammatory activity. LL-37 and was linked to T regulatory cell effects.

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