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

• Published in: PloS one Vol. 12; no. 2; p. e0172350
• Main Authors: Elenius, Varpu, Palomares, Oscar, Waris, Matti, Turunen, Riitta, Puhakka, Tuomo, Rückert, Beate, Vuorinen, Tytti, Allander, Tobias, Vahlberg, Tero, Akdis, Mübeccel, Camargo, Carlos A., Akdis, Cezmi A., Jartti, Tuomas
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 24.02.2017; Public Library of Science (PLoS)
• Subjects: Acids; Adolescent; Adult; Allergens; Allergens - blood; Allergens - immunology; Allergic rhinitis; Allergies; Allergy; Anti-inflammatory agents; Antimicrobial Cationic Peptides - blood; Antimicrobial peptides; Asthma; Atopy; Biology and Life Sciences; Child; Cytokines; Eczema; Education; Female; Forkhead Transcription Factors - blood; Foxp3 protein; GATA-3 protein; Gene expression; Health aspects; Hospitals; Humans; Hypersensitivity; Hypersensitivity - blood; Hypersensitivity - virology; Immune response; Immune system; Immunity, Innate - immunology; Immunoassay; Immunoglobulin E; Immunoglobulin E - blood; Immunoglobulin E - immunology; Immunological tolerance; Immunomodulation; Inflammation; Innate immunity; Interferon-gamma - blood; Interleukin 10; Interleukin 13; Interleukin 17; Interleukin-1 - blood; Interleukin-17 - blood; Lymphocytes T; Male; Medicine and Health Sciences; Nasopharynx; Nuclear Receptor Subfamily 1, Group F, Member 3 - blood; Otolaryngology; Palatine Tonsil - immunology; Palatine Tonsil - surgery; Palatine Tonsil - virology; Patients; Pediatrics; Peptides; Physical sciences; Polymerase chain reaction; Pregnancy; Respiratory Tract Infections - blood; Respiratory Tract Infections - immunology; Respiratory Tract Infections - virology; Rhinitis; Risk factors; Studies; Systematic review; T cells; Throat surgery; Tocopherol; Tonsillectomy; Tonsils; Transcription factors; Virology; Viruses; Vitamin A; Vitamin A - blood; Vitamin D; Vitamin D - blood; Vitamin deficiency; Vitamin E; Vitamin E - blood; Vitamins; Young Adult; α-Interferon; β-Interferon; γ-Interferon; Sweden; Netherlands; United States > US; Massachusetts; Finland; Switzerland; Germany
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0172350

Tonsils 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. 110 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-α, IFN-β, IFN-γ, IL-10, IL-13, IL-17, IL-28, IL-29, IL-37, TGF-β, FOXP3, GATA3, RORC2 and Tbet in tonsils were analyzed by quantitative RT-PCR. The 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-γ 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). Vitamin 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.