¿Hay una asociación entre deficiencia de vitamina D y riesgo de bronquiolitis y asma bronquial en la infancia?: Una revisión crítica

Se revisa criticamente la informacion cientifica relacionada con deficiencia de vitamina D (DVD) y riesgo de infecciones respiratorias agudas bajas (IRAB) o asma bronquial en ninos. Las IRAB, en especial por virus respiratorio sincicial (VRS) estan asociadas a una alta carga de enfermedad. Al no contar aun con una vacuna para ellas, las medidas preventivas y de sosten son las mas importantes. El DVD es prevalente en todos los ambientes geograficos, con consecuencias ligadas al metabolismo de calcio y oseo, pero tambien alteraciones de la inmunidad. Hay evidencia inicial de una asociacion entre DVD y mayor riesgo de IRAB, especialmente durante los primeros meses de vida; alelos de algunos polimorfismos del receptor de vitamina D podrian asociarse a un mayor riesgo de IRAB. Este escenario cosmopolita, justifica estudiar el impacto de medidas de suplementacion de VD adaptadas a las realidades locales, a la madre durante el embarazo y/o al nino en los primeros meses de vida, que impacten sobre el riesgo de presentar IRAB y asma.(AU) We critically review the information about vitamin D deficiency (VDD) and risk of lower respiratory infections and asthma in children. Acute lower respiratory infections (ALRI), particularly those due to respiratory syncytial virus (RSV) are associated with a high burden of disease. In theabsence of a vaccine for them, prevention and support during illness are important measures to reduce the risk of acquiring the condition or decreasing its severity. VDD has been described as prevalent in all geographical environments; its consequences are linked to calcium and bone metabolism, but also to impaired immunity. Recent evidence of an association between VDD and increased risk of ALRI, especially during the first few months of life has been demonstrated; alleles of some polymorphism of vitamin D receptor may be involved in an increased risk of LRTI. It is justified to study the impact of measures of vitamin D supplementation adapted to local environments, including the appropriate doses to the mother during pregnancy and/or to the child in the first months of life, on the risk of ALRI, or asthma in later ages.(AU)