Efeitos da vitamina D na prevenção da bronquiolite viral aguda: revisão sistemática

Angélica Maria Barba Rueda,Eduardo Mundstock,Rita Mattiello,Marcelo Comerlato Scotta,Leonardo Araújo Pinto,Rafaela Becker,Ângela De Moura,Matias Epifanio,Edgar Enrique Sarria-Icaza,Matheus Dorigatti Soldatelli

doi:10.15448/1980-6108.2015.2.20313

Abstract

Aims : Published evidence suggests that supplementation may have a protective effect on infectious disease of the lower respiratory tract. The objective of this review was to critically appraise the effects of vitamin intake in the prevention of acute bronchiolitis in children. Methods: We searched the databases MEDLINE, EMBASE, Web of Science, LILACS, and Cochrane Central Register of Controlled Trials, until December 2014. Keywords: Vitamin D OR cholecalciferol OR ergocalciferol AND bronchiolitis, viral OR bronchiolitides, OR bronchiolitides viral. Eligibility Criteria: We included studies evaluating the effect of vitamin intake in the prevention of acute bronchiolitis in young children. Studies with less than two weeks of intervention and review articles were excluded. Results: The search identified 241 articles; twenty were selected for full reading but only two were included in the systematic review, comprising 296 children. No study measured serum vitamin D. One of them was a clinical trial, where the number of episodes of acute bronchiolitis was significantly lower in children supplemented with vitamin (Group I: mean: 0.6 ± 0.7 Group II: mean: 1.4 ± 0.9; p = 0.001). The other, a case-control study, did not find a significant relationship between the occurrence of acute bronchiolitis cases and the intake of vitamin (OR 1.7 95% CI 0.7 to 4.0). Conclusions: Current scientific evidence is insufficient to prove clinical benefits of vitamin in preventing acute bronchiolitis.

Highlights

Acute viral bronchiolitis (AVB) is the most common lower respiratory tract infection (LRTI) in children up to two years of age [1,2,3]
The findings of the study by El-Mazary et al [19], in infants who lived in urban areas and with dark skin, agree with a randomized double blind study performed in 2012, with adults who had immunodeficiency, which
Rueda AMB et al – Effects of vitamin D in the prevention of acute viral bronchiolitis demonstrated that vitamin D intake reduced the risk of acute LRTI, frequent in the winter

Summary

Introduction

Acute viral bronchiolitis (AVB) is the most common lower respiratory tract infection (LRTI) in children up to two years of age [1,2,3] It is one of the main reasons for visits in pediatric emergency rooms [3,4], and it is the cause of approximately 17% of hospital admissions at this age [5,6]. The discovery of vitamin D receptors in the nucleus of cells in the immune system enabled research aimed at identifying the role of vitamin D in the homeostasis of the immune system and in disease prevention [4] Some of these studies suggested that vitamin D supplements could prevent respiratory infections such as AVB [8,9,10]. There is evidence that vitamin D activates antimicrobial function in monocytes and macrophages, helping to protect against infectious diseases and acting to keep the integrity of the innate immune system, changing the activity of T lymphocites, regulatory and natural killer cells [11,12]

Methods

Results

Conclusion