title: Vitamin D insufficiency in neonatal hypoxic-ischemic encephalopathy.
abstract: Vitamin D has neuroprotective and immunomodulatory properties, and deficiency is associated with worse stroke outcomes. Little is known about effects of hypoxia-ischemia or hypothermia treatment on vitamin D status in neonates with hypoxic-ischemic encephalopathy (HIE). We hypothesized vitamin D metabolism would be dysregulated in neonatal HIE altering specific cytokines involved in Th17 activation, which might be mitigated by hypothermia.
  
  
  
  We analyzed short-term relationships between 25(OH) and 1,25(OH)2vitamin D, vitamin D binding protein, and cytokines related to Th17 function in serum samples from a multicenter randomized controlled trial of hypothermia 33°C for 48 h after HIE birth vs. normothermia in 50 infants with moderate to severe HIE.
  
  
  
  Insufficiency of 25(OH) vitamin D was observed after birth in 70% of infants, with further decline over the first 72 h, regardless of treatment. 25(OH) vitamin D positively correlated with anti-inflammatory cytokine IL-17E in all HIE infants. However, Th17 cytokine suppressor IL-27 was significantly increased by hypothermia, negating the IL-27 correlation with vitamin D observed in normothermic HIE infants.
  
  
  
  Serum 25(OH) vitamin D insufficiency is present in the majority of term HIE neonates and is related to lower circulating anti-inflammatory IL-17E. Hypothermia does not mitigate vitamin D deficiency in HIE.
authors.affiliation: Department of Pediatrics, Medical University of South Carolina, Charleston, South Carolina.
authors.forename: Danielle W
authors.initials: DW
authors.lastname: Lowe
authors.affiliation: Department of Pediatrics, Medical University of South Carolina, Charleston, South Carolina.
authors.forename: Bruce W
authors.initials: BW
authors.lastname: Hollis
authors.affiliation: Department of Pediatrics, Medical University of South Carolina, Charleston, South Carolina.
authors.forename: Carol L
authors.initials: CL
authors.lastname: Wagner
authors.affiliation: Department of Pediatrics, Eastern Virginia Medical School, Norfolk, Virginia.
authors.forename: Thomas
authors.initials: T
authors.lastname: Bass
authors.affiliation: Department of Pediatrics, University of Virginia, Charlottesville, Virginia.
authors.forename: David A
authors.initials: DA
authors.lastname: Kaufman
authors.affiliation: Department of Pediatrics, Albany Medical Center, Albany, New York.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Horgan
authors.affiliation: Department of Pediatrics, University of Saskatchewan, Saskatoon, Saskatchewan, Canada.
authors.forename: Laurence M
authors.initials: LM
authors.lastname: Givelichian
authors.affiliation: Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada.
authors.forename: Koravangatta
authors.initials: K
authors.lastname: Sankaran
authors.affiliation: Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada.
authors.forename: Jerome Y
authors.initials: JY
authors.lastname: Yager
authors.affiliation: Department of Pediatrics, Medical University of South Carolina, Charleston, South Carolina.
authors.forename: Lakshmi D
authors.initials: LD
authors.lastname: Katikaneni
authors.affiliation: Department of Pediatrics, Medical University of South Carolina, Charleston, South Carolina.
authors.forename: Don
authors.initials: D
authors.lastname: Wiest
authors.affiliation: Department of Pediatrics, Medical University of South Carolina, Charleston, South Carolina.
authors.forename: Dorothea
authors.initials: D
authors.lastname: Jenkins
mesh_terms: D015331:Cohort Studies; D016207:Cytokines / Q000097:blood; D005260:Female; D006801:Humans; D020925:Hypoxia-Ischemia, Brain / Q000150:complications* / Q000503:physiopathology; D007231:Infant, Newborn; D007249:Inflammation; D008297:Male; D010758:Phosphorus / Q000097:blood; D012307:Risk Factors; D058504:Th17 Cells / Q000378:metabolism; D013997:Time Factors; D016896:Treatment Outcome; D014807:Vitamin D / Q000097:blood; D014808:Vitamin D Deficiency / Q000150:complications*; D014809:Vitamin D-Binding Protein / Q000097:blood
chemical_list: D016207:Cytokines; D014809:Vitamin D-Binding Protein; D014807:Vitamin D; D010758:Phosphorus