A Case-control Study of Urinary Tract Infection, ۲۵‑hydroxyvitamin D Status and Associated Inflammatory and Regulatory Responses

Background: Vitamin D plays a key role in the modulation of numerous immune functions against infectious agents. We aimed to explore the association between serum ۲۵‑hydroxyvitamin D (۲۵[OH] D) levels and cytokine responses, along with hematological changes, in patients with urinary tract infection (UTI). Materials and Methods: Vitamin D level, cytokines (interferon [IFN]−γ, interleukin [IL]−۴, IL−۶, IL–۱۰, IL−۱۷A, tumor necrosis factor [TNF]−α, and transforming growth factor [TGF]−β), hematological indices (neutrophil-to-lymphocyte ratio [NLR], monocyte-to-lymphocyte ratio [MLR], neutrophil-to-monocyte ratio [NMR], platelet-to-lymphocyte ratio [PLR], and mean platelet volume [MPV]), C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR) were evaluated in a case-control human study included ۶۵ patients and ۴۵ controls. Results: Among the enhanced cytokine levels in patients, the cytokines IFN-γ, IL-۱۷A, and IL-۱۰ had a significant association with ۲۵(OH)D, but not IL-۶, TNF-α, and TGF-β. The IL-۴ levels remained unchanged. By comparing hematological indices, we found the association of increased NLR and MLR with ۲۵(OH)D and the cytokines IFN-γ and IL-۱۷A, along with a decrease in the PLR without showing such an association. The NMR did not show any significant difference. The platelet count showed an association with IL-۶, IL-۱۷A, and TGF-β, but the association of MPV with ۲۵(OH)D was significant. The ESR results exhibited statistically non-significant differences. CRP elevation was directly associated with IL-۶ and IL-۱۷A, but not with ۲۵(OH)D. Conclusion: ۲۵(OH)D-mediated inflammatory cytokine milieu might alter the proportion and function of peripheral blood cells in a regulated manner to support bacterial clearance which needs further studies to be validated.

کلیدواژه ها:

Cytokine ، Inflammation ، Leukocytes ، Platelets ، Urinary Tract Infection ، Vitamin D