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https://doi.org/10.14300/mnnc.2025.20027

Pro-inflammatory cytokine and cathelicidin profiles in preterm infants receiving cholecalciferol supplementation

[Original research] [Pediatrics]
Natalia Verisokina; Leonid Klimov; Alexandr Obedin; Rashid Zhetishev; Tatiana Zheleznyakova; Natalya Zarytovskaya; Natalia Fedko; Аnna Kasyanova;

Vitamin D deficiency increases the risk of adverse infectious outcomes in newborns, particularly preterm infants. There are currently no unified clinical guidelines in Russia for the safe and adequate supplementation of vitamin D in this population. Within this study, premature newborns received oral cholecalciferol at 1000 IU/day for 21 days. Serum calcidiol concentrations, pro-inflammatory cytokines (IL-1β, IL-6, TNF-α), and cathelicidin were measured before and after supplementation. Supplementation resulted in a significant increase in median serum calcidiol levels from 18.9 [11.7; 21.9] ng/mL to 33.8 [19.8; 46.9] ng/mL (p=0.019), and the proportion of infants with sufficient vitamin D status increased to 55 % (vs 33.3 % in controls). Cholecalciferol administration led to reductions in IL-1β, IL-6, and TNF-α concentrations in 73 %, 85 %, and 91 % of cases, respectively, while cathelicidin levels increased in 78.8 % of infants. No cases of hypercalcemia or excessive calcidiol (>100 ng/mL) were observed.

Thus, oral cholecalciferol supplementation (1000 IU/day for three weeks) is effective and safe in improving vitamin D status and modulating immune response in preterm infants, and may be recommended for this population.

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Keywords: vitamin D, pro-inflammatory cytokines, cathelicidin, preterm infants