STUDY OF THE ASSOCIATION OF VITAMIN D AND ITS RECEPTOR WITH AUTOIMMUNE HEPATITIS
autoimmune hepatitis, vitamin D, inflammation, pediatric patients.
Autoimmune hepatitis (AIH) is a severe liver disease that affects children and adults worldwide. It develops in genetically susceptible individuals when an environmental trigger leads to an autoimmune response directed to liver auto antigens. This response involves the cells of the immune system, cytokines and auto antibodies. In recent years, the immunomodulatory activity of vitamin D has been studied. The association of this vitamin with autoimmune diseases has been investigated, since it acts in the regulatory pathways that prevent and improve inflammation and immunity. Thus, the present study aimed to evaluate the association of vitamin D and its receptor (VDR) with autoimmune hepatitis, by assessing the nutritional status of vitamin D and the expression of the genes encoding VDR and cytokines (IL- 6 and IL-10) in children and adolescents with AIH. Thus, 28 volunteers (14 patients diagnosed with AIH - Case Group and 14 without the disease - Control Group) were included in the study. Peripheral blood was collected by venipuncture to assess the general metabolic status (biochemical parameters), quantification of 25 (OH) vitamin D and extraction of mRNA (for later quantification of VDR, IL6 and IL10 gene expressions). It was observed that the majority of patients with AIH are female with an average age of 15 years. Regarding the biochemical parameters, increased activities of AST (aspartate aminotransferase), ALT (alanine aminotransferase), GGT (gamma glutamyl transferase), ALP (alkaline phosphatase) and LDH (lactate dehydrogenase) were found for patients with AIH when compared to controls. Regarding vitamin D, there was a high frequency (71%) of individuals with values below the recommended in patients with AIH, while none of the individuals in the control group had values below the recommended. Thus, it can be concluded that patients in the case group presented with a characteristic profile of patients with compensated AIH and that vitamin D may be associated with the development of the disease.