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Roberts G. Inheritance and the sunshine vitamin. Clin Exp Allergy 2019; 47:602-603. [PMID: 28449333 DOI: 10.1111/cea.12932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- G Roberts
- Clinical and Experimental Sciences and Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, UK.,NIHR Southampton Respiratory Biomedical Research Unit, University Hospital Southampton NHS Foundation Trust, Southampton, UK.,The David Hide Asthma and Allergy Research Centre, St Mary's Hospital, Isle of Wight, UK
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Mirzakhani H, Carey VJ, Zeiger R, Bacharier LB, O’Connor GT, Schatz MX, Laranjo N, Weiss ST, Litonjua AA. Impact of parental asthma, prenatal maternal asthma control, and vitamin D status on risk of asthma and recurrent wheeze in 3-year-old children. Clin Exp Allergy 2019; 49:419-429. [PMID: 30461089 PMCID: PMC6438751 DOI: 10.1111/cea.13320] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2018] [Revised: 10/04/2018] [Accepted: 11/07/2018] [Indexed: 12/13/2022]
Abstract
BACKGROUND While familial clustering of asthma is known, few studies have reported on the relative roles of paternal and maternal asthma and the role of maternal asthma control in pregnancy on the risk for asthma in the child. OBJECTIVE We aimed to investigate the relative roles of paternal asthma, maternal asthma, and maternal asthma control during pregnancy on the risk of asthma or recurrent wheeze in 3-year-old children and how prenatal and cord blood vitamin D status might affect this risk. METHODS Data from 806 women, their partners (biologic fathers of the infants), and their children participated in the Vitamin D Antenatal Asthma Reduction Trail (VDAART, clinicaltrials.gov identification number NCT00920621) were used for this cohort analysis. The parental report of physician-diagnosed asthma or recurrent wheeze in offspring was the main outcome. Weibull regression models for interval-censored event times were used to estimate the main variables of interests and additional covariates on the outcome. RESULTS The highest risk was observed among children with both parents being asthmatic relative to non-asthmatic parents (aHR = 2.30, 95% CI: 1.35-3.84), and less so if only the mother was asthmatic (aHR = 1.70, 95% CI: 1.17-2.40). In the subset of children born to asthmatic mothers, the risk for asthma was higher in those who were born to mothers whose asthma was uncontrolled (aHR = 1.60, 95% CI: 1.02-2.54). Children whose mothers had sufficient vitamin D status (25Hydroxyvitamin D ≥ 30 ng/mL) at early and late pregnancy and had cord blood vitamin D sufficiency demonstrated a lower risk of asthma/recurrent wheeze than children who had insufficient cord blood vitamin D status at birth (aHR = 0.47, 95% CI: 0.27-0.83). CONCLUSION AND CLINICAL RELEVANCE Careful attention to maternal asthma control, monitoring vitamin D status, and correcting insufficiency at early pregnancy and maintaining the sufficiency status throughout pregnancy have potential preventive roles in offspring asthma or recurrent wheeze.
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Affiliation(s)
- Hooman Mirzakhani
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
| | - Vincent J. Carey
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
| | - Robert Zeiger
- Department of Allergy and Research and Evaluation, Kaiser Permanente Southern California Region, San Diego and Pasadena, California
| | - Leonard B. Bacharier
- Division of Pediatric Allergy, Immunology and Pulmonary Medicine, Department of Pediatrics, Washington University, St. Louis, Missouri
| | - George T. O’Connor
- Pulmonary Center, Department of Medicine, Boston Medical Center, Boston University, Boston, Massachusetts
| | - Michael X. Schatz
- Department of Allergy and Research and Evaluation, Kaiser Permanente Southern California Region, San Diego and Pasadena, California
| | - Nancy Laranjo
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
| | - Scott T. Weiss
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
- Partners Center for Personalized Medicine, Partners Health Care, Boston, MA
| | - Augusto A. Litonjua
- Division of Pediatric Pulmonary Medicine, Department of Pediatrics, Golisano Children’s Hospital at Strong, University of Rochester Medical Center, Rochester, NY
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Kim HB. Modifiable prenatal environmental factors for the prevention of childhood asthma. ALLERGY ASTHMA & RESPIRATORY DISEASE 2019; 7:179. [DOI: 10.4168/aard.2019.7.4.179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2019] [Revised: 05/11/2019] [Accepted: 05/14/2019] [Indexed: 09/01/2023]
Affiliation(s)
- Hyo-Bin Kim
- Department of Pediatrics, Inje University Sanggye Paik Hospital, Seoul, Korea
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Karpinski P, Skiba P, Kosinska M, Rosiek-Biegus M, Królewicz E, Blin N, Meese E, Panaszek B, Nittner-Marszalska M, Sasiadek MM. Genome-wide analysis of gene expression after one year of venom immunotherapy. Immunol Lett 2018; 204:23-28. [DOI: 10.1016/j.imlet.2018.10.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Revised: 09/28/2018] [Accepted: 10/08/2018] [Indexed: 11/28/2022]
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Weidmann E, Samadi N, Klems M, Heiden D, Seppova K, Ret D, Untersmayr E. Mouse Chow Composition Influences Immune Responses and Food Allergy Development in a Mouse Model. Nutrients 2018; 10:nu10111775. [PMID: 30453476 PMCID: PMC6266012 DOI: 10.3390/nu10111775] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2018] [Revised: 11/06/2018] [Accepted: 11/07/2018] [Indexed: 12/29/2022] Open
Abstract
Our diet is known to substantially influence the immune response not only by support of mucosal barriers but also via direct impact on immune cells. Thus, it was of great interest to compare the immunological effect of two mouse chows with substantial differences regarding micro-, macronutrient, lipid and vitamin content on the food allergic response in our previously established mouse model. As the two mouse chows of interest, we used a soy containing feed with lower fatty acid (FA) amount (soy-containing feed) and compared it to a soy free mouse chow (soy-free feed) in an established protocol of oral immunizations with Ovalbumin (OVA) under gastric acid suppression. In the animals receiving soy-containing feed, OVA-specific IgE, IgG1, IgG2a antibody levels were significantly elevated and food allergy was evidenced by a drop of body temperature after oral immunizations. In contrast, mice on soy-free diet had significantly higher levels of IL-10 and were protected from food allergy development. In conclusion, soy-containing feed was auxiliary during sensitizations, while soy-free feed supported oral tolerance development and food allergy prevention.
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Affiliation(s)
- Eleonore Weidmann
- Institute of Pathophysiology and Allergy Research, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, 1090 Vienna, Austria.
| | - Nazanin Samadi
- Institute of Pathophysiology and Allergy Research, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, 1090 Vienna, Austria.
| | - Martina Klems
- Institute of Pathophysiology and Allergy Research, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, 1090 Vienna, Austria.
| | - Denise Heiden
- Institute of Pathophysiology and Allergy Research, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, 1090 Vienna, Austria.
| | - Klara Seppova
- Institute of Pathophysiology and Allergy Research, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, 1090 Vienna, Austria.
| | - Davide Ret
- Institute of Pathophysiology and Allergy Research, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, 1090 Vienna, Austria.
- Division of Macromolecular Chemistry, Institute of Applied Synthetic Chemistry, Vienna University of Technology, 1060 Vienna, Austria.
| | - Eva Untersmayr
- Institute of Pathophysiology and Allergy Research, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, 1090 Vienna, Austria.
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Park S, Lee MG, Hong SB, Lim CM, Koh Y, Huh JW. Effect of vitamin D deficiency in Korean patients with acute respiratory distress syndrome. Korean J Intern Med 2018; 33:1129-1136. [PMID: 29914229 PMCID: PMC6234412 DOI: 10.3904/kjim.2017.380] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2017] [Accepted: 02/01/2018] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND/AIMS Vitamin D modulates innate and adaptive immune responses, and vitamin D deficiency is associated with increased mortality in hospitalized patients with pneumonia. We evaluated the prevalence of vitamin D deficiency in Korean patients with acute respiratory distress syndrome (ARDS) and its effect on the clinical outcomes of ARDS. METHODS We retrospectively analyzed the data of 108 patients who had a measured serum level of 25-hydroxy vitamin D3 (25(OH)D3) at the time of diagnosis with ARDS. The clinical outcomes were evaluated based on 25(OH)D3 levels of 20 ng/mL and stratified by quartiles of 25(OH)D3 levels. RESULTS The mean age of patients was 59.4 years old; 77 (71.3%) were male. Vitamin D deficiency was found in 103 patients (95.4%). The mean 25(OH)D3 level was 8.3 ± 7.0 ng/mL. Neither in-hospital mortality (40.0% vs. 68.0%) nor 6-month mortality (40.0% vs. 71.8%) significantly differed between groups. There were no significant differences in 25(OH)D3 level between survivors (8.1 ± 7.6 ng/mL) and non-survivors (8.5 ± 6.8 ng/mL, p = 0.765). There were no trends toward a difference in mortality among quartiles of 25(OH)D3 levels. However, 25(OH)D3 levels were inversely related with length of hospital stay and intensive care unit stay among in-hospital survivors. CONCLUSION Vitamin D deficiency was prevalent in Korean patients with ARDS. However, levels of vitamin D were not associated with mortality. A large, prospective study is needed to evaluate the effects of vitamin D deficiency on clinical outcomes of ARDS.
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Affiliation(s)
- Sojung Park
- Department of Pulmonary, Allergy, and Critical Care Medicine, Hallym University Dongtan Sacred Heart Hospital, Hwaseong, Korea
| | - Min Gi Lee
- Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Sang-Bum Hong
- Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Chae-Man Lim
- Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Younsuck Koh
- Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jin Won Huh
- Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
- Correspondence to Jin Won Huh, M.D. Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Korea Tel: +82-2-3010-3985 Fax: +82-2-3010-6968 E-mail:
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Zhang X, Chen X, Weirauch MT, Zhang X, Burleson JD, Brandt EB, Ji H. Diesel exhaust and house dust mite allergen lead to common changes in the airway methylome and hydroxymethylome. ENVIRONMENTAL EPIGENETICS 2018; 4:dvy020. [PMID: 30090644 PMCID: PMC6063278 DOI: 10.1093/eep/dvy020] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/04/2018] [Revised: 06/01/2018] [Accepted: 06/22/2018] [Indexed: 05/28/2023]
Abstract
Exposures to diesel exhaust particles (DEP) from traffic and house dust mite (HDM) allergens significantly increase risks of airway diseases, including asthma. This negative impact of DEP and HDM may in part be mediated by epigenetic mechanisms. Beyond functioning as a mechanical barrier, airway epithelial cells provide the first line of immune defense towards DEP and HDM exposures. To understand the epigenetic responses of airway epithelial cells to these exposures, we exposed human bronchial epithelial cells to DEP and HDM and studied genome-wide 5-methyl-cytosine (5mC) and 5-hydroxy-methylcytosine (5hmC) at base resolution. We found that exposures to DEP and HDM result in elevated TET1 and DNMT1 expression, associated with 5mC and 5hmC changes. Interestingly, over 20% of CpG sites are responsive to both exposures and changes in 5mC at these sites negatively correlated with gene expression differences. These 5mC and 5hmC changes are located in genes and pathways related to oxidative stress responses, epithelial function and immune cell responses and are enriched for binding sites of transcription factors (TFs) involved in these pathways. Histone marks associated with promoters, enhancers and actively transcribed gene bodies were associated with exposure-induced DNA methylation changes. Collectively, our data suggest that exposures to DEP and HDM alter 5mC and 5hmC levels at regulatory regions bound by TFs, which coordinate with histone marks to regulate gene networks of oxidative stress responses, epithelial function and immune cell responses. These observations provide novel insights into the epigenetic mechanisms that mediate the epithelial responses to DEP and HDM in airways.
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Affiliation(s)
- Xue Zhang
- Pyrosequencing Lab for Genomic and Epigenomic Research
- Division of Human Genetics
| | | | - Matthew T Weirauch
- Center for Autoimmune Genomics and Etiology
- Divisions of Biomedical Informatics and Developmental Biology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Xiang Zhang
- Genomics, Epigenomics and Sequencing Core, University of Cincinnati, Cincinnati, OH, USA
| | - J D Burleson
- Division of Asthma Research, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
| | - Eric B Brandt
- Division of Asthma Research, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
| | - Hong Ji
- Pyrosequencing Lab for Genomic and Epigenomic Research
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
- Division of Asthma Research, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
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Morgan KA, Mann EH, Young AR, Hawrylowicz CM. ASTHMA - comparing the impact of vitamin D versus UVR on clinical and immune parameters. Photochem Photobiol Sci 2018; 16:399-410. [PMID: 28092390 DOI: 10.1039/c6pp00407e] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
The incidence of asthma has increased markedly since the 1960s and is currently estimated to affect more than 300 million individuals worldwide. A number of environmental factors are implicated in asthma pathogenesis, one of which is vitamin D. Vitamin D deficiency is a global health concern and has increased in parallel with asthma incidence. Epidemiological studies report associations between low vitamin D status, assessed as circulating levels of 25-hydroxyvitamin D, with asthma incidence, severity, exacerbations and responses to treatment. This has led to clinical studies to test whether increasing the levels of vitamin D improves asthma management. Despite being highly variable in dosing regimens, design and outcomes, meta-analyses suggest overall positive outcomes with respect to reduced asthma exacerbations and steroid requirements. The primary mechanism for increasing vitamin D levels in the body is through exposure of the skin to the ultraviolet B (UVB) component of ultraviolet radiation (UVR), most commonly from sun exposure. However, only a limited number of studies investigating the impact of UVR on the asthmatic response have been performed; these generally report on the impact of latitude as a surrogate of sun exposure, or address this in animal models. To the best of our knowledge no comprehensive trials to assess the impact of UVB radiation on asthma outcomes have been performed. Within this review we discuss observational and clinical studies in this field, and innate and adaptive immune mechanisms through which UVR and vitamin D may impact respiratory health, and asthma. We highlight the heterogeneity of asthmatic disease, which is likely to impact upon the efficacy of interventional studies, and briefly overview more recent findings relating to the impact of vitamin D/UVR on the development of asthma.
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Affiliation(s)
- Kylie A Morgan
- MRC and Asthma UK Centre in Allergic Mechanisms of Asthma, King's College London, UK. and NIHR Health Protection Research Unit in Health Impact of Environmental Hazards, King's College London, UK and St John's Institute of Dermatology, Division of Genetics and Molecular Medicine, King's College London, UK
| | - Elizabeth H Mann
- MRC and Asthma UK Centre in Allergic Mechanisms of Asthma, King's College London, UK.
| | - Antony R Young
- NIHR Health Protection Research Unit in Health Impact of Environmental Hazards, King's College London, UK and St John's Institute of Dermatology, Division of Genetics and Molecular Medicine, King's College London, UK
| | - Catherine M Hawrylowicz
- MRC and Asthma UK Centre in Allergic Mechanisms of Asthma, King's College London, UK. and NIHR Health Protection Research Unit in Health Impact of Environmental Hazards, King's College London, UK
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Lee-Sarwar K, Litonjua AA. As You Eat It: Effects of Prenatal Nutrition on Asthma. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. IN PRACTICE 2018; 6:711-718. [PMID: 29412180 PMCID: PMC5948171 DOI: 10.1016/j.jaip.2018.01.026] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/12/2017] [Revised: 01/08/2018] [Accepted: 01/10/2018] [Indexed: 02/08/2023]
Abstract
Asthma most frequently develops early in life, and increased recognition of the role of lifestyle and environmental factors in asthma susceptibility raises the possibility that dietary exposures during pregnancy may influence the risk of asthma in offspring. This review discusses the latest evidence with regard to the effect of diet during pregnancy on childhood asthma risk, including potential mechanisms, outcomes of randomized clinical trials, and results from observational studies. Vitamin D and polyunsaturated fatty acid intake during pregnancy are highlighted as areas with large and growing bodies of literature to support a potential role in prenatal modulation of subsequent asthma risk. Several other nutritional interventions are under active investigation, and recommendations regarding dietary modifications during pregnancy will likely need to be personalized based on factors such as maternal smoking and genetic variants. Although nutrition during pregnancy is uniquely challenging to investigate, and definitive recommendations cannot be made without additional high-quality evidence and knowledge regarding long-term effects of interventions, the modifiable nature of the diet and sizeable potential reduction of morbidity supports ongoing research to determine how to optimize nutrition during pregnancy to prevent asthma in offspring.
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Affiliation(s)
- Kathleen Lee-Sarwar
- Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital and Harvard Medical School, Boston, Mass
| | - Augusto A Litonjua
- Division of Pediatric Pulmonary Medicine, Golisano Children's Hospital at University of Rochester Medical Center, Rochester, NY.
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Hufnagl K, Jensen-Jarolim E. Vitamin A and D in allergy: from experimental animal models and cellular studies to human disease. ALLERGO JOURNAL 2018. [DOI: 10.1007/s15007-018-1579-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Nasiri-Kalmarzi R, Abdi M, Hosseini J, Babaei E, Mokarizadeh A, Vahabzadeh Z. Evaluation of 1,25-dihydroxyvitamin D3 pathway in patients with chronic urticaria. QJM 2018; 111:161-169. [PMID: 29165650 DOI: 10.1093/qjmed/hcx223] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2017] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Previous studies showed the role of vitamin D (Vit D) on the progression of chronic urticaria. To the best of our knowledge, there are no other results regarding the contribution of single nucleotide polymorphisms (SNPs) in the vitamin D receptor (VDR) and vitamin D binding protein (VDBP) genes in chronic urticaria (CU). AIM In the present study, we investigated the Vit pathway and the association between VDR and VDBP gene polymorphisms and CU risk in Iranian population. METHODS All participating individuals in the present study were evaluated for serum Vit D and VDBP concentration VDR rs1544410 and rs2228570 and VDBP rs7041using a polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) analysis. The associations of studied analytes and three SNPs with clinical and laboratory outcomes were investigated in CU patients. RESULTS Patients with CU showed lower Vit D compared to controls (19.26 ± 1.26 vs. 31.72 ± 7.14 ng/ml, P-value = 0.006). There was a significant correlation between Vit D levels and urticaria activity score. Serum VDBP was significantly higher in CU patients than controls (1317.3 ± 183.71 vs. 395.77 ± 12.96 µg/ml, P-value <0.0001) and had a positive correlation to progression of CU. The A allele of this polymorphism might be a potential risk factor for progression of CU [odds ratio 4.3434, 95% confidence interval (1.7331-10.8852), Z-statistic = 3.133, P-value = 0.0017]. CONCLUSION In summary, this study demonstrated that change in Vit D pathway in the level of gene or protein may be a risk factor for progression of CU.
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Affiliation(s)
- R Nasiri-Kalmarzi
- Cellular and Molecular Research Center, Kurdistan University of Medical Sciences, Sanandaj, Iran
- Department of Pediatrics, Faculty of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - M Abdi
- Cellular and Molecular Research Center, Kurdistan University of Medical Sciences, Sanandaj, Iran
- Department of Clinical Biochemistry, Faculty of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - J Hosseini
- Cellular and Molecular Research Center, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - E Babaei
- Cellular and Molecular Research Center, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - A Mokarizadeh
- Cellular and Molecular Research Center, Kurdistan University of Medical Sciences, Sanandaj, Iran
- Department of Research and Development, Asia Jivan Teb Science-based Company, Sanandaj, Iran
| | - Z Vahabzadeh
- Department of Clinical Biochemistry, Faculty of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran
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Mirzakhani H, Carey VJ, McElrath TF, Laranjo N, O'Connor G, Iverson RE, Lee-Parritz A, Strunk RC, Bacharier LB, Macones GA, Zeiger RS, Schatz M, Hollis BW, Litonjua AA, Weiss ST. The Association of Maternal Asthma and Early Pregnancy Vitamin D with Risk of Preeclampsia: An Observation From Vitamin D Antenatal Asthma Reduction Trial (VDAART). THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. IN PRACTICE 2018; 6:600-608.e2. [PMID: 28923490 PMCID: PMC5843492 DOI: 10.1016/j.jaip.2017.07.018] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/03/2017] [Revised: 06/28/2017] [Accepted: 07/14/2017] [Indexed: 12/29/2022]
Abstract
BACKGROUND Maternal asthma, uncontrolled asthma, and low vitamin D levels during pregnancy have been individually linked to increased risk of preeclampsia. OBJECTIVE To investigate the association of history of physician-diagnosed asthma and uncontrolled asthma status during pregnancy with the risk of preeclampsia and the effects of early pregnancy vitamin D concentrations on this relationship. METHODS A total of 816 subjects with available pregnancy outcome data and risk factors of interest were analyzed. A group of experienced obstetricians and gynecologists from 3 study centers validated the preeclampsia diagnoses. Vitamin D was measured using the DiaSorin method at 10 to 18 weeks of gestation. The Pregnancy-Asthma Control Test was used to assess asthma control during pregnancy. Criterion-based stepwise variable selection algorithm was applied to investigate the relationships of risk factors of interest (history of asthma diagnosis, uncontrolled asthma during pregnancy, and vitamin D) to preeclampsia. RESULTS The incidence of preeclampsia was not related to the presence of asthma diagnosis (8.9% with vs 7.4% without). The adjusted odds of preeclampsia controlled for maternal serum 25-hydroxyvitamin D (25OHD) concentrations was higher for women with a higher proportion of uncontrolled asthma months per visit during pregnancy (adjusted odds ratio, 3.55; 95% CI, 1.15-13.0). Adjusting for asthma control status during pregnancy, an additional decrease in the associated preeclampsia risk by 7% was observed for a 10-unit (ng/mL) increase in early pregnancy 25OHD levels (adjusted odds ratio10-unit, 0.60; 95% CI, 0.43-0.82) as compared with the previous risk estimate of preeclampsia associated with low maternal 25OHD unadjusted for asthma control status. CONCLUSIONS Uncontrolled asthma during pregnancy is associated with an increased risk of preeclampsia. Early pregnancy 25OHD contributes to the association of uncontrolled asthma status with preeclampsia.
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Affiliation(s)
- Hooman Mirzakhani
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, Mass; Harvard Medical School, Boston, Mass
| | - Vincent J Carey
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, Mass; Harvard Medical School, Boston, Mass
| | - Thomas F McElrath
- Harvard Medical School, Boston, Mass; Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Brigham and Women's Hospital, Boston, Mass
| | - Nancy Laranjo
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, Mass
| | - George O'Connor
- Department of Medicine, Boston Medical Center, Boston University, Boston, Mass
| | - Ronald E Iverson
- Department of Medicine, Boston Medical Center, Boston University, Boston, Mass
| | - Aviva Lee-Parritz
- Department of Obstetrics and Gynecology, Boston Medical Center, Boston University, Boston, Mass
| | - Robert C Strunk
- Division of Pediatric Allergy, Immunology and Pulmonary Medicine, Department of Pediatrics, Washington University, St Louis, Mo
| | - Leonard B Bacharier
- Division of Pediatric Allergy, Immunology and Pulmonary Medicine, Department of Pediatrics, Washington University, St Louis, Mo
| | - George A Macones
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Washington University, St Louis, Mo
| | - Robert S Zeiger
- Department of Allergy and Research and Evaluation, Kaiser Permanente Southern California Region, San Diego and Pasadena, Calif
| | - Michael Schatz
- Department of Allergy and Research and Evaluation, Kaiser Permanente Southern California Region, San Diego and Pasadena, Calif
| | - Bruce W Hollis
- Department of Pediatrics, University of South Carolina College of Medicine, Charleston, SC
| | - Augusto A Litonjua
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, Mass; Harvard Medical School, Boston, Mass; Division of Pulmonary and Critical Care Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, Mass
| | - Scott T Weiss
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, Mass; Harvard Medical School, Boston, Mass; Partners Center for Personalized Medicine, Partners Health Care, Boston, Mass.
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Vitamin A and D in allergy: from experimental animal models and cellular studies to human disease. ACTA ACUST UNITED AC 2018; 27:72-78. [PMID: 29707474 PMCID: PMC5910477 DOI: 10.1007/s40629-018-0054-2] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2017] [Accepted: 01/22/2018] [Indexed: 12/28/2022]
Abstract
Introduction Vitamins A and D are able to modulate innate and adaptive immune responses and may therefore influence the development and the course of allergic diseases. Materials and methods This article reviews the current evidence for the experimental effects of vitamins A and D in vivo in animal models and on immune cells in vitro, and discusses their translational implication. A systematic literature search over the last 10 years was performed using MEDLINE and PubMed databases. Results Deficiencies of vitamin A or vitamin D in mouse models of allergic asthma seem to exacerbate allergic symptoms along with enhanced lung inflammation and Th2 cytokine production. In contrast, supplementation regimes especially with vitamin D were able to attenuate symptoms in therapeutic mouse models. The active metabolites retinoic acid (RA) and 1,25-dihydroxyvitamin D3 (VD3) induced tolerogenic dendritic cells (DCs) and up-regulated T‑regulatory cells in the allergic sensitization phase, which likely contributes to tolerance induction. Additionally, RA and VD3 maintained the stability of eosinophils and mast cells in the effector phase, thereby reducing allergic mediator release. Thus, both active vitamin metabolites RA and VD3 are able to influence allergic immune responses at several immunological sites. Conclusion Animal studies predict that vitamin A and D may also be attractive players in the control of allergy in humans. Whether these experimental observations can be translated to the human situation remains open, as results from clinical trials are controversial.
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Vereen S, Kocak M, Potukuchi PK, Hartman TJ, Tylavsky F, Carroll KN. The association of maternal prenatal vitamin D levels and child current wheeze. Ann Allergy Asthma Immunol 2018; 120:98-99. [PMID: 29162316 PMCID: PMC5791544 DOI: 10.1016/j.anai.2017.10.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2017] [Revised: 09/19/2017] [Accepted: 10/04/2017] [Indexed: 12/23/2022]
Affiliation(s)
- Shanda Vereen
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Mehmet Kocak
- Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, Tennessee
| | - Praveen K Potukuchi
- Division of Nephrology, University of Tennessee Health Science Center, Memphis,Tennessee
| | - Terryl J Hartman
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Frances Tylavsky
- Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, Tennessee
| | - Kecia N Carroll
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee.
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Correlation between serum vitamin D status and immunological changes in children affected by gastrointestinal food allergy. Allergol Immunopathol (Madr) 2018; 46:39-44. [PMID: 28757197 DOI: 10.1016/j.aller.2017.03.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2017] [Revised: 03/19/2017] [Accepted: 03/30/2017] [Indexed: 01/02/2023]
Abstract
BACKGROUND Low vitamin D status is linked to increased incidence of food allergy and intestinal inflammation. Whether vitamin D status is associated with immunological changes in children with gastrointestinal food allergy (GFA) remains unclear. METHODS Forty-nine GFA children (aged 2-11 years old) were enrolled in this study. Serum 25-hydroxyvitamin D (25OHD) level, total immunoglobulin E (IgE), specific IgE against allergens, circulating regulatory T lymphocytes (Tregs), and blood eosinophil numbers were measured. RESULTS Levels of serum 25OHD in the GFA children ranged 35.5-156.4nmol/L, with a mean value similar to that of the healthy controls. Compared to those with normal 25OHD (≥75nmol/L), GFA children with low 25OHD (<75nmol/L) had increased total IgE (84% vs. 54%, P<0.05), persistent blood eosinophilia (56% vs. 25%, P<0.05), and delayed resolution of symptoms after food allergen elimination (odds ratio 3.51, 95% CI 1.00-12.36, P<0.05). Among the GFA children with elevated total IgE, those with low 25OHD had lower circulatory Tregs (8.79±2.4% vs. 10.21±1.37%, P<0.05), higher total IgE (1197.5±1209.8 vs. 418.5±304.6kU/L, P<0.05), and persistent eosinophilia (0.61±0.52 vs. 0.31±0.15×109cells/L, P<0.05) compared to those with normal 25OHD. In addition, serum 25OHD concentrations inversely correlated with total IgE (R=-0.434, P<0.05), and positively with Treg population (R=0.356, P<0.05). CONCLUSION Low serum vitamin D status correlates with stronger allergic immune response in GFA children.
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66
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Ariaee N, Zarei S, Mohamadi M, Jabbari F. Amelioration of patients with chronic spontaneous urticaria in treatment with vitamin D supplement. Clin Mol Allergy 2017; 15:22. [PMID: 29299028 PMCID: PMC5740857 DOI: 10.1186/s12948-017-0078-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2017] [Accepted: 12/08/2017] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Spontaneous urticaria is a common allergic skin condition affecting 0.5-1% of individuals and may burden on health care expenditure or may be associated with remarkable morbidity. AIM In this study, we measured the effect of vitamin D supplementation in patients with a diagnosis of CSU. Furthermore, quality of life and cytokine changes were evaluated. METHODS The clinical trial was conducted on 20 patients with idiopathic chronic urticaria. Vitamin D was administered orally for 8 weeks and disease activity was measured pre- and post-treatment using USS and DLQI. On the other hand expressions of IL-17, IL-10, Foxp3, and TGF-β by Real-time RT-PCR were assessed. RESULTS USS questionnaire showed that severity of idiopathic urticaria after the intervention, which compared with the first day reached a significant 55% reduction. The DLQI quality of life questionnaire 2 months after treatment showed 55% improvement. Along with the significant improvement of clinical symptoms, use of vitamin D increase FOXP3 gene expression and downregulation of IL-10, TGF-B, and FOXP3, IL-17, but these changes were not statistically significant. LIMITATION These might happen due to lack of enrolled population in the investigation. CONCLUSION Vitamin D can be used along with standard medical care and it's a safe and cost-effective method for the treatment of chronic urticaria with deficiency of vitamin D.
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Affiliation(s)
- Nazila Ariaee
- Allergy Research Center, Ghaem Hospital, Mashhad University of Medical Sciences, Shariati Square, Mashhad, Iran
| | - Shima Zarei
- Allergy Research Center, Ghaem Hospital, Mashhad University of Medical Sciences, Shariati Square, Mashhad, Iran
| | - Mojgan Mohamadi
- Allergy Research Center, Ghaem Hospital, Mashhad University of Medical Sciences, Shariati Square, Mashhad, Iran
| | - Farahzad Jabbari
- Allergy Research Center, Ghaem Hospital, Mashhad University of Medical Sciences, Shariati Square, Mashhad, Iran
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67
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Nwaru BI, Hadkhale K, Hämäläinen N, Takkinen HM, Ahonen S, Ilonen J, Toppari J, Niemelä O, Haapala AM, Veijola R, Knip M, Virtanen SM. Vitamin D intake during the first 4 years and onset of asthma by age 5: A nested case-control study. Pediatr Allergy Immunol 2017; 28:641-648. [PMID: 28815786 DOI: 10.1111/pai.12773] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/13/2017] [Indexed: 12/15/2022]
Abstract
BACKGROUND Early-life vitamin D intake has been linked to asthma risk in childhood, but the role of longitudinal vitamin D exposure has not been previously evaluated. We investigated the association between vitamin D intake during the first 4 years of life and asthma risk by age 5. METHODS Within a Finnish population-based birth cohort, 182 incident asthma cases were matched to 728 controls on sex, genetic risk for type 1 diabetes, delivery hospital, and time of birth. Vitamin D intake was assessed by age-specific 3 day food records. Parents completed a validated version of the International Study of Asthma and Allergies in Childhood questionnaire at 5 years. RESULTS At 3 months, supplements were the main source of vitamin D intake; intake from foods increased from 3 months on, mainly from fortified milk products. Vitamin D intake at each specific age was associated with an increased risk of any asthma, atopic, and non-atopic asthma, but only intake at 1 and 2 years was statistically significantly associated with asthma. Longitudinal vitamin D intake was associated with an increased risk of asthma (OR 1.24; 95%CI 1.00-1.53). CONCLUSIONS Increased vitamin D intake in childhood, particularly intake at 1 and 2 years of age, may increase risk of childhood asthma. This might reflect a true effect or residual confounding by lifestyle or environmental factors. Repeated assessment of vitamin D intake allowed evaluation of the longitudinal and age-dependent impact of vitamin D on the risk of asthma. Further longitudinal studies are required to confirm or question these findings.
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Affiliation(s)
- Bright I Nwaru
- Faculty of Social Sciences/Health, University of Tampere, Tampere, Finland.,Asthma UK Centre for Applied Research, Centre for Medical Informatics, Usher Institute of Population Health Sciences and Informatics, The University of Edinburgh, Edinburgh, UK.,Krefting Research Centre, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Kishor Hadkhale
- Faculty of Social Sciences/Health, University of Tampere, Tampere, Finland
| | - Niina Hämäläinen
- Faculty of Social Sciences/Health, University of Tampere, Tampere, Finland
| | - Hanna-Mari Takkinen
- Faculty of Social Sciences/Health, University of Tampere, Tampere, Finland.,Nutrition Unit, National Institute for Health and Welfare, Department of Public Health Solutions, Helsinki, Finland
| | - Suvi Ahonen
- Faculty of Social Sciences/Health, University of Tampere, Tampere, Finland.,Nutrition Unit, National Institute for Health and Welfare, Department of Public Health Solutions, Helsinki, Finland.,The Science Center of Pirkanmaa Hospital District, Tampere, Finland
| | - Jorma Ilonen
- Immunogenetics Laboratory, University of Turku, Turku, Finland.,Department of Clinical Microbiology, University of Eastern Finland, Joensuu, Finland
| | - Jorma Toppari
- Department of Physiology, Department of Pediatrics, Institute of Biomedicine, University of Turku, Turku University Hospital, Turku, Finland
| | - Onni Niemelä
- Department of Laboratory Medicine, Seinäjoki Central Hospital and University of Tampere, Tampere, Finland
| | - Anna-Maija Haapala
- Faculty of Medicine, University of Tampere and Fimlab Ltd, Pirkanmaa Hospital District, Tampere, Finland
| | - Riitta Veijola
- Department of Pediatrics, PEDEGO Research Unit, Medical Research Center, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Mikael Knip
- Center for Child Health Research, University of Tampere and Tampere University Hospital, Tampere, Finland.,Folkhälsan Research Center, Helsinki, Finland.,Children's Hospital, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland.,Research Programs Unit, Diabetes and Obesity, University of Helsinki, Helsinki, Finland
| | - Suvi M Virtanen
- Faculty of Social Sciences/Health, University of Tampere, Tampere, Finland.,Nutrition Unit, National Institute for Health and Welfare, Department of Public Health Solutions, Helsinki, Finland.,The Science Center of Pirkanmaa Hospital District, Tampere, Finland.,Center for Child Health Research, University of Tampere and Tampere University Hospital, Tampere, Finland
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Castano R, Yucesoy B, Johnson VJ, Castellanos L, Cartier A. Inflammatory proteins in nasal lavage of workers exposed to occupational agents. Clin Exp Allergy 2017; 47:1566-1573. [DOI: 10.1111/cea.13039] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2017] [Revised: 08/04/2017] [Accepted: 09/02/2017] [Indexed: 12/26/2022]
Affiliation(s)
- R. Castano
- Department of Otolaryngology; Hôpital du Sacré-Coeur de Montréal; Montreal QC Canada
- Research Center; Axe Maladies Chroniques; Hôpital du Sacré-Coeur de Montréal; Montreal QC Canada
| | - B. Yucesoy
- Formerly of the Health Effects Laboratory Division; CDC/NIOSH; Morgantown WV USA
| | - V. J. Johnson
- Burleson Research Technologies, Inc.; Morrisville NC USA
| | - L. Castellanos
- Research Center; Axe Maladies Chroniques; Hôpital du Sacré-Coeur de Montréal; Montreal QC Canada
| | - A. Cartier
- Department of Chest Medicine; Hôpital du Sacré-Coeur de Montréal; Montreal QC Canada
- Research Center; Axe Maladies Chroniques; Hôpital du Sacré-Coeur de Montréal; Montreal QC Canada
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69
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Blighe K, Chawes BL, Kelly RS, Mirzakhani H, McGeachie M, Litonjua AA, Weiss ST, Lasky-Su JA. Vitamin D prenatal programming of childhood metabolomics profiles at age 3 y. Am J Clin Nutr 2017; 106:1092-1099. [PMID: 28835366 PMCID: PMC5611786 DOI: 10.3945/ajcn.117.158220] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2017] [Accepted: 07/18/2017] [Indexed: 12/28/2022] Open
Abstract
Background: Vitamin D deficiency is implicated in a range of common complex diseases that may be prevented by gestational vitamin D repletion. Understanding the metabolic mechanisms related to in utero vitamin D exposure may therefore shed light on complex disease susceptibility.Objective: The goal was to analyze the programming role of in utero vitamin D exposure on children's metabolomics profiles.Design: First, unsupervised clustering was done with plasma metabolomics profiles from a case-control subset of 245 children aged 3 y with and without asthma from the Vitamin D Antenatal Asthma Reduction Trial (VDAART), in which pregnant women were randomly assigned to vitamin D supplementation or placebo. Thereafter, we analyzed the influence of maternal pre- and postsupplement vitamin D concentrations on cluster membership. Finally, we used the metabolites driving the clustering of children to identify the dominant metabolic pathways that were influential in each cluster.Results: We identified 3 clusters of children characterized by 1) high concentrations of fatty acids and amines and low maternal postsupplement vitamin D (mean ± SD; 27.5 ± 11.0 ng/mL), 2) high concentrations of amines, moderate concentrations of fatty acids, and normal maternal postsupplement vitamin D (34.0 ± 14.1 ng/mL), and 3) low concentrations of fatty acids, amines, and normal maternal postsupplement vitamin D (35.2 ± 15.9 ng/mL). Adjusting for sample storage time, maternal age and education, and both child asthma and vitamin D concentration at age 3 y did not modify the association between maternal postsupplement vitamin D and cluster membership (P = 0.0014). Maternal presupplement vitamin D did not influence cluster membership, whereas the combination of pre- and postsupplement concentrations did (P = 0.03).Conclusions: Young children can be clustered into distinct biologically meaningful groups by their metabolomics profiles. The clusters differed in concentrations of inflammatory mediators, and cluster membership was influenced by in utero vitamin D exposure, suggesting a prenatal programming role of vitamin D on the child's metabolome. This trial was registered at clinicaltrials.gov as NCT00920621.
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Affiliation(s)
- Kevin Blighe
- Channing Division of Network Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA; and
| | - Bo L Chawes
- Channing Division of Network Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA; and,Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Rachel S Kelly
- Channing Division of Network Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA; and
| | - Hooman Mirzakhani
- Channing Division of Network Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA; and
| | - Michael McGeachie
- Channing Division of Network Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA; and
| | - Augusto A Litonjua
- Channing Division of Network Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA; and
| | - Scott T Weiss
- Channing Division of Network Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA; and
| | - Jessica A Lasky-Su
- Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA; and
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70
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Souto Filho JTD, de Andrade AS, Ribeiro FM, Alves PDAS, Simonini VRF. Impact of vitamin D deficiency on increased blood eosinophil counts. Hematol Oncol Stem Cell Ther 2017; 11:25-29. [PMID: 28830802 DOI: 10.1016/j.hemonc.2017.06.003] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2017] [Accepted: 06/26/2017] [Indexed: 01/21/2023] Open
Abstract
OBJECTIVE/BACKGROUND Vitamin D has been increasingly recognized as an immunomodulatory agent. Its deficiency has been associated with immune-mediated diseases such as asthma, rhinitis, and atopic dermatitis. These allergic conditions are dependent on T-helper type 2 (Th2) cells secreting interleukins, overproduction of immunoglobulin E (IgE), and eosinophil activation. We investigated the association between serum vitamin D levels and blood absolute eosinophil count. METHODS We carried out a cross-sectional study of 669 men and women referred to a clinical pathology laboratory who underwent 25-hydroxyvitamin D testing and complete blood count analysis on the same day. RESULTS Vitamin D levels were stratified into four ranges: severely deficient (<10ng/mL), deficient (≥10ng/mL and <20ng/mL), insufficient (≥20ng/mL and <30ng/mL), or sufficient (≥30ng/mL). The mean/median eosinophil count in the four groups was 267/254cells/μL, 245/238cells/μL, 191/159cells/μL, and 182/146cells/μL, respectively, (p=.001). The difference was significant between the severe deficiency group and each of the other three groups (p=.012, p=.002, and p=.001, respectively). There was no statistical difference among the four groups in terms of total leukocyte counts (p=.151), neutrophils (p=.177), or lymphocytes (p=.582). CONCLUSION Vitamin D deficiency was associated with higher blood eosinophil count. These results support the possible role of vitamin D in the eosinophil immune response.
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Affiliation(s)
- João Tadeu Damian Souto Filho
- Faculdade de Medicina de Campos, Campos dos Goytacazes, Rio de Janeiro, Brazil; Instituto Federal de Educação, Ciência e Tecnologia Fluminense, Campos dos Goytacazes, Rio de Janeiro, Brazil.
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71
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Kutluğ S, Kılıç M, Bilgici B, Paksu Ş, Yıldıran A, Sancak R. An evaluation of vitamin D levels in children with seasonal allergic rhinitis during pollen season. Pediatr Allergy Immunol 2017; 28:446-451. [PMID: 28452068 DOI: 10.1111/pai.12728] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/23/2017] [Indexed: 12/15/2022]
Abstract
BACKGROUND Serum vitamin D levels have not been studied in children with seasonal allergic rhinitis (SAR). The aim of this study was to evaluate the vitamin D levels of children with SAR and to compare them to levels in healthy children during pollen season. METHODS This study was conducted in 100 children with SAR and 100 healthy controls. Clinical and laboratory evaluations and vitamin D analyses of all the participants were performed between the months of April and July. Pollen sensitization was detected in the patient group using a skin prick test. 25(OH)D3 levels were compared between the patient and control groups. Associations among the patient 25(OH)D3 levels and their demographic, clinical, and laboratory characteristics were analyzed. RESULTS Overall, 72% of the patients were male, the median age was 12.35 years (range: 6-17.8 years), and the median body mass index value was 19.15 (range: 13.6-27.8). There were no differences between the patients and healthy controls in terms of gender, age, or body mass index. The mean levels of 25(OH)D3 (20.78±6) in patients were higher than those of the controls (17.92±4). In the patient group, no associations were found among 25(OH)D3 levels, demographic characteristics, atopy test results, atopy history, severity of rhinitis, and the total four symptoms score (all P>.05). CONCLUSIONS During pollen season, children with SAR may have higher vitamin D levels than healthy controls. The presence of asthma and/or atopic dermatitis in addition to SAR did not change this result.
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Affiliation(s)
- Seyhan Kutluğ
- Department of Pediatrics, Division of Pediatric Allergy and Immunology, Faculty of Medicine, Ondokuz Mayıs University, Samsun, Turkey
| | - Mehtap Kılıç
- Department of Pediatrics, Division of Pediatric Allergy and Immunology, Mehmet Aydın Training and Research Hospital, Samsun, Turkey
| | - Birşen Bilgici
- Department of Biochemistry, Faculty of Medicine, Ondokuz Mayıs University, Samsun, Turkey
| | - Şule Paksu
- Department of Pediatrics, Ondokuz Mayıs University, Samsun, Turkey
| | - Alişan Yıldıran
- Department of Pediatrics, Division of Pediatric Allergy and Immunology, Faculty of Medicine, Ondokuz Mayıs University, Samsun, Turkey
| | - Recep Sancak
- Department of Pediatrics, Division of Pediatric Allergy and Immunology, Faculty of Medicine, Ondokuz Mayıs University, Samsun, Turkey
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Alansari K, Davidson BL, Yousef KI, Mohamed ANH, Alattar I. Rapid vs Maintenance Vitamin D Supplementation in Deficient Children With Asthma to Prevent Exacerbations. Chest 2017; 152:527-536. [PMID: 28651793 DOI: 10.1016/j.chest.2017.06.021] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2017] [Revised: 06/13/2017] [Accepted: 06/15/2017] [Indexed: 10/19/2022] Open
Abstract
BACKGROUND Whether vitamin D reduces clinically important exacerbations of childhood asthma remains uncertain. We compared rapid to maintenance vitamin D repletion analyzed by baseline vitamin D level. METHODS Children presenting to the ED with moderate-to-severe asthma exacerbations and vitamin D levels ≤ 25 ng/mL underwent masked randomization, and then open dosing to either IM+oral (the latter daily) therapy or daily oral-only therapy, and were followed for 12 months. The primary outcome was patient-initiated unplanned visits for asthma exacerbations, examined two ways: cumulative proportions with an exacerbation, and average exacerbation frequency. As this was a nutrient study, we analyzed treatment groups by quartile of baseline vitamin D level, collecting repeat levels and clinical observations at 3, 6, 9, and 12 months after enrollment. RESULTS One hundred and sixteen patients in the IM+oral cohort vs 115 in the oral-only cohort had similar mean (SD) baseline levels: 15.1 (5.4) vs 15.8 (5.2) ng/mL (range, 3-25 ng/mL). There was no difference in the primary outcome over the entire 12-month observation period. However, rapid IM+oral supplementation significantly reduced unplanned visits for asthma exacerbations for children with baseline levels of 3 to 11 ng/mL during the initial 3 months: the relative exacerbation rate for the IM+oral cohort compared with the oral-only cohort at 3 months was 0.48 (95% CI, 0.28-0.89; P = .008); average exacerbation frequency per child analysis, relative rate 0.36 (95% CI, 0.13-0.87; P = .017). Otherwise, there were no significant differences between groups. CONCLUSIONS Rapid compared to maintenance vitamin D supplementation for children with the lowest levels resulted in short- but not long-term reduction in asthma exacerbations.
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Affiliation(s)
- Khalid Alansari
- Division of Pediatric Emergency Medicine, Department of Pediatrics, Hamad Medical Corporation, Doha, Qatar; Division of Pediatric Emergency Medicine, Department of Pediatrics, Sidra Medical and Research Centre, Doha, Qatar; Weill Cornell Medical College in Qatar, Doha, Qatar
| | - Bruce L Davidson
- Pulmonary and Critical Care Medicine Division, University of Washington School of Medicine, Seattle, WA.
| | - Khalid Ibrahim Yousef
- Division of Pediatric Emergency Medicine, Department of Pediatrics, Hamad Medical Corporation, Doha, Qatar
| | - Abdel Nasser H Mohamed
- Division of Pediatric Emergency Medicine, Department of Pediatrics, Hamad Medical Corporation, Doha, Qatar
| | - Imad Alattar
- Division of Pediatric Emergency Medicine, Department of Pediatrics, Hamad Medical Corporation, Doha, Qatar
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Asthma control status in pregnancy, body mass index, and maternal vitamin D levels. J Allergy Clin Immunol 2017; 140:1453-1456.e7. [PMID: 28606587 DOI: 10.1016/j.jaci.2017.03.053] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2016] [Revised: 03/10/2017] [Accepted: 03/31/2017] [Indexed: 01/21/2023]
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74
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Saranz RJ, Lozano A, Lozano NA, Ponzio MF, Cruz ÁA. Subclinical lower airways correlates of chronic allergic and non-allergic rhinitis. Clin Exp Allergy 2017; 47:988-997. [PMID: 28421631 DOI: 10.1111/cea.12938] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
The upper and lower airways behave as a physiological and pathophysiological unit. Subclinical lower airways abnormalities have been described in patients with rhinitis without asthma. These are expressed as bronchial hyperreactivity, abnormalities in lung function and bronchial inflammation, likely as a result of the same phenomenon with systemic inflammatory impact that reaches both the nose and the lungs, which for unknown reasons does not always have a full clinical expression. Patients with rhinitis are at increased risk of developing asthma; therefore, most authors suggest a careful clinical evaluation and monitoring of these patients, especially if symptoms related to inflammation in the lower airways are observed. Although current treatments, such as H1-antihistamines, intranasal steroids and allergen immunotherapy, are quite effective for the management of rhinitis, it is difficult to prove their capacity to prevent asthma among subjects with rhinitis. Evidence showing that the treatment of rhinitis has a favourable impact on indicators of bronchial hyperreactivity and inflammation among subjects that have no symptoms of asthma is more frequently described. In this review, we address the frequency and characteristics of lower airway abnormalities in subjects with rhinitis, both in paediatric and adult populations, their likely predictive value for the development of asthma and the possibilities for therapeutic intervention that could modify the risk of subjects with rhinitis towards presenting asthma.
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Affiliation(s)
- R J Saranz
- Allergy and Immunology Division, Clínica Universitaria Reina Fabiola, Facultad de Medicina Universidad Católica de Córdoba, Córdoba, Argentina
| | - A Lozano
- Allergy and Immunology Division, Clínica Universitaria Reina Fabiola, Facultad de Medicina Universidad Católica de Córdoba, Córdoba, Argentina
| | - N A Lozano
- Allergy and Immunology Division, Clínica Universitaria Reina Fabiola, Facultad de Medicina Universidad Católica de Córdoba, Córdoba, Argentina
| | - M F Ponzio
- INICSA-CONICET, Cátedra de Fisiología Humana, Facultad de Ciencias Médicas, Universidad Nacional de Córdoba, Córdoba, Argentina
| | - Á A Cruz
- ProAR-Nucleo de Excelência em Asma da Universidade Federal da Bahia, and CNPq, Salvador, Brazil
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Flexeder C, Thiering E, Koletzko S, Berdel D, Lehmann I, von Berg A, Hoffmann B, Bauer CP, Heinrich J, Schulz H. Higher serum 25(OH)D concentrations are associated with improved FEV1 and FVC in adolescence. Eur Respir J 2017; 49:49/4/1601804. [DOI: 10.1183/13993003.01804-2016] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2016] [Accepted: 01/11/2017] [Indexed: 12/29/2022]
Abstract
Vitamin D plays a role in the development of the immune system and the lung, as well as in airway remodelling. Therefore, this study investigated the association between serum 25-hydroxyvitamin D (25(OH)D) concentrations and spirometric lung function parameters at age 15 years.In the German birth cohorts GINIplus and LISAplus, lung function testing by spirometry and 25(OH)D measurements were performed during the 15-year follow-up examinations. Valid lung function measurements pre- and/or post-bronchodilation and serum 25(OH)D concentrations, which were adjusted for the date of blood sampling to account for seasonal variability, were available for 2607 adolescents. Associations between 25(OH)D concentrations and spirometric parameters were analysed using generalised additive models adjusted for confounding factors.Serum 25(OH)D concentrations were significantly associated with forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1) and FEV1/FVC measured before bronchodilation after adjustment for potential confounders: FEV1 increased by 10 mL (95% CI 2–17), FVC by 20 mL (95% CI 12–28) and FEV1/FVC decreased by 0.177% (95% CI −0.286 to −0.067) per 10 nmol·L−1 increase in 25(OH)D concentrations. Flow rates (forced expiratory flow rates at 25, 50 and 75% of exhaled FVC (FEF25, FEF50, FEF75) and mean flow rate between 25 and 75% of FVC (FEF25–75)) were not associated with vitamin D. Similar associations were observed for lung function parameters measured after bronchodilation.Vitamin D concentrations are positively associated with volume-related lung function parameters pre- and post-bronchodilation, suggesting structural changes in peripheral airways.
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76
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Vitamin D and Bronchial Asthma: An Overview of Data From the Past 5 Years. Clin Ther 2017; 39:917-929. [PMID: 28449868 DOI: 10.1016/j.clinthera.2017.04.002] [Citation(s) in RCA: 65] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2017] [Revised: 04/03/2017] [Accepted: 04/04/2017] [Indexed: 11/23/2022]
Abstract
PURPOSE Vitamin D is a potent immunomodulator capable of dampening inflammatory signals in several cell types involved in the asthmatic response. Its deficiency has been associated with increased inflammation, exacerbations, and overall poor outcomes in patients with asthma. Given the increase in the prevalence of asthma over the past few decades, there has been enormous interest in the use of vitamin D supplementation as a potential therapeutic option. Here, we critically reviewed the most recent findings from in vitro studies, animal models, and clinical trials regarding the role of vitamin D in treating bronchial asthma. METHODS Using the key terms [Vitamin D, asthma, clinical trials, in vivo and in vitro studies], the [PubMed, Google Scholar] databases were searched for [clinical trials, original research articles, meta-analyses, and reviews], English-language articles published from [2012] to the present. Articles that were [Articles that did not meet these criteria were excluded] excluded from the analysis. FINDINGS Several studies have found that low serum levels of vitamin D (< 20 ng/mL) are associated with increased exacerbations, increased airway inflammation, decreased lung function, and poor prognosis in asthmatic patients. Results from in vitro and in vivo studies in animals and humans have suggested that supplementation with vitamin D may ameliorate several hallmark features of asthma. However, the findings obtained from clinical trials are controversial and do not unequivocally support a beneficial role of vitamin D in asthma. Largely, interventional studies in children, pregnant women, and adults have primarily found little to no effect of vitamin D supplementation on improved asthma symptoms, onset, or progression of the disease. This could be related to the severity of the disease process and other confounding factors. IMPLICATIONS Despite the conflicting data obtained from clinical trials, vitamin D deficiency may influence the inflammatory response in the airways. Further studies are needed to determine the exact mechanisms by which vitamin D supplementation may induce antiinflammatory effects.
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Chirumbolo S, Bjørklund G, Sboarina A, Vella A. The Role of Vitamin D in the Immune System as a Pro-survival Molecule. Clin Ther 2017; 39:894-916. [PMID: 28438353 DOI: 10.1016/j.clinthera.2017.03.021] [Citation(s) in RCA: 69] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2017] [Revised: 03/30/2017] [Accepted: 03/31/2017] [Indexed: 02/07/2023]
Abstract
PURPOSE Vitamin D is a fascinating and attractive molecule that has gained particular attention in medicine in recent years. Its immunomodulatory and anti-inflammatory potential might resemble the activity of many nature-derived molecules (eg, flavonoids), but its role in biology was selected during a long evolutionary pathway to dampen the damaging effect of cell stress response and of the immune reaction. In this sense, this molecule can be considered an ancient hormone that serves, in its primary role, as a pro-survival agent. The goal of this review was to elucidate this topic. METHODS The article reviews current literature on the field, focusing on issues regarding the role of vitamin D in immunity. FINDINGS Vitamin D participates in the survival machinery used by the cell, and in particular it plays a major role in synchronizing calcium oscillatory signaling to allow cell autophagy or apoptosis during a stress response. IMPLICATIONS Vitamin D should be better highlighted in its molecular action and vitamin D receptor genomics to conceive a more suited therapeutic supplementation protocol in clinics.
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Affiliation(s)
- Salvatore Chirumbolo
- Department of Neurological and Movement Sciences, University of Verona, Verona, Italy.
| | - Geir Bjørklund
- Council for Nutritional and Environmental Medicine, Mo i Rana, Norway
| | - Andrea Sboarina
- Department of Surgery, Dentistry, Gynaecology and Paediatrics, University of Verona, Verona, Italy
| | - Antonio Vella
- Department of Medicine-University of Verona, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
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Lee-Sarwar KA, Bacharier LB, Litonjua AA. Strategies to alter the natural history of childhood asthma. Curr Opin Allergy Clin Immunol 2017; 17:139-145. [PMID: 28079559 PMCID: PMC5664210 DOI: 10.1097/aci.0000000000000340] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
PURPOSE OF REVIEW Asthma exhibits significant heterogeneity in occurrence and severity over the lifespan. Our goal is to discuss recent evidence regarding determinants of the natural history of asthma during childhood, and review the rationale behind and status of major efforts to alter its course. RECENT FINDINGS Variations in microbial exposures are associated with risk of allergic disease, and the use of bacterial lysates may be a promising preventive strategy. Exposure to air pollution appears to be particularly damaging in prenatal and early life, and interventions to reduce pollution are feasible and result in clinical benefit. E-cigarette use may have a role in harm reduction for conventional cigarette smokers with asthma, but has undefined short-term and long-term effects that must be clarified. Vitamin D insufficiency over the first several years of life is associated with risk of asthma, and vitamin D supplementation reduces the risk of severe exacerbations. SUMMARY The identification of risk factors for asthma occurrence, persistence and severity will continue to guide efforts to alter the natural history of the disease. We have reviewed several promising strategies that are currently under investigation. Vitamin D supplementation and air pollution reduction have been shown to be effective strategies and warrant increased investigation and implementation.
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Affiliation(s)
- K A Lee-Sarwar
- aDivision of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital, Boston, Massachusetts bDivision of Pediatric Allergy, Immunology and Pulmonary Medicine, Department of Pediatrics, Washington University School of Medicine cSt Louis Children's Hospital, St Louis, Missouri dChanning Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA
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Song H, Yang L, Jia C. Maternal vitamin D status during pregnancy and risk of childhood asthma: A meta-analysis of prospective studies. Mol Nutr Food Res 2017; 61. [PMID: 27981740 DOI: 10.1002/mnfr.201600657] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2016] [Revised: 12/02/2016] [Accepted: 12/06/2016] [Indexed: 01/03/2023]
Abstract
SCOPE Mounting evidence suggests that maternal vitamin D status during pregnancy may be associated with development of childhood asthma, but the results are still inconsistent. A dose-response meta-analysis was performed to quantitatively summarize evidence on the association of maternal vitamin D status during pregnancy with the risk of childhood asthma. METHODS AND RESULTS A systematic search was conducted to identify all studies assessing the association of maternal 25-hydroxyvitamin D (25(OH)D) during pregnancy with risk of childhood asthma. The fixed or random-effect model was selected based on the heterogeneity test among studies. Nonlinear dose-response relationship was assessed by restricted cubic spline model. Fifteen prospective studies with 12 758 participants and 1795 cases were included in the meta-analysis. The pooled relative risk of childhood asthma comparing the highest versus lowest category of maternal 25(OH)D levels was 0.87 (95% confidence interval, CI, 0.75-1.02). For dose-response analysis, evidence of a U-shaped relationship was found between maternal 25(OH)D levels and risk of childhood asthma (Pnonlinearity = 0.02), with the lowest risk at approximately 70 nmol/L of 25(OH)D. CONCLUSION This dose-response meta-analysis suggested a U-shaped relationship between maternal blood 25(OH)D levels and risk of childhood asthma. Further studies are needed to confirm the association.
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Affiliation(s)
- Huihui Song
- Department of Epidemiology, School of Public Health, Shandong University, Jinan, P.R. China
| | - Lei Yang
- Department of Epidemiology, School of Public Health, Shandong University, Jinan, P.R. China
| | - Chongqi Jia
- Department of Epidemiology, School of Public Health, Shandong University, Jinan, P.R. China
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Idolazzi L, Ridolo E, Fassio A, Gatti D, Montagni M, Caminati M, Martignago I, Incorvaia C, Senna G. Periostin: The bone and beyond. Eur J Intern Med 2017; 38:12-16. [PMID: 27939043 DOI: 10.1016/j.ejim.2016.11.015] [Citation(s) in RCA: 50] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2016] [Revised: 11/26/2016] [Accepted: 11/28/2016] [Indexed: 12/21/2022]
Abstract
In recent years the relationship between bone, metabolism and many pathophysiologic mechanisms involving other organs and the immune system, was increasingly apparent. This observation concerns vitamin D, osteopontin and periostin (PO). PO is expressed in the periosteum of long bones but also in many other tissues and organs, including heart, kidney, skin and lungs, being enhanced by mechanical stress or injury. PO has a relevant physiological function in promoting injury repair in a large number of tissues. However, its overexpression was observed in different diseases characterized by inflammation, fibrosis and tumorigenesis. Here we review the current knowledge on the role of PO in physiologic and pathologic pathways of different diseases. A specific focus regards the correlation between the level of PO and lung diseases and the identification of PO also as an inflammatory key effector in asthma, strongly associated with airways eosinophilia. In fact PO seems to be a useful biomarker of "Th2-high" asthma compared to "Th2-low" asthma phenotype and a predictor of response to therapeutic agents. Currently, a growing number of studies suggests a possible role of PO as a new diagnostic marker and/or therapeutic target for different diseases and its usefulness in clinical practice should be supported and confirmed by further and larger studies.
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Affiliation(s)
- L Idolazzi
- Rheumatology Unit, Department of Medicine, University of Verona, Italy.
| | - E Ridolo
- Clinical and Experimental Medicine, University of Parma, Parma, Italy
| | - A Fassio
- Rheumatology Unit, Department of Medicine, University of Verona, Italy
| | - D Gatti
- Rheumatology Unit, Department of Medicine, University of Verona, Italy
| | - M Montagni
- Departmental Unit of Allergology, AUSL of Piacenza,, "Guglielmo da Saliceto" Hospital, Piacenza, Italy
| | - M Caminati
- Asthma Center and Allergy Unit, Verona University and General Hospital, Verona, Italy
| | - I Martignago
- Clinical and Experimental Medicine, University of Parma, Parma, Italy
| | - C Incorvaia
- Allergy/Cardiac & Pulmonary Rehabilitation, ASST Gaetano Pini/CTO, Milan, Italy
| | - G Senna
- Asthma Center and Allergy Unit, Verona University and General Hospital, Verona, Italy
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Bountouvi E, Douros K, Papadopoulou A. Can Getting Enough Vitamin D during Pregnancy Reduce the Risk of Getting Asthma in Childhood? Front Pediatr 2017; 5:87. [PMID: 28491864 PMCID: PMC5405075 DOI: 10.3389/fped.2017.00087] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2017] [Accepted: 04/07/2017] [Indexed: 12/21/2022] Open
Abstract
The worldwide increase in asthma prevalence during the last decades and the re-emergence of vitamin D deficiency in many populations hinted toward an underlying association between these two conditions. Since asthma is presented with high incidence in childhood and neonatal vitamin D stores depend on maternal vitamin levels, a possible programming effect of maternal vitamin D status during gestation was suggested. Observational and longitudinal studies on this subject led to inconclusive results with glimmer of positivity. In the randomized controlled clinical trials (RCTs) that followed, increased doses of vitamin D were tested in pregnant women being at high risk of having an asthmatic child. Although, the results of RCTs showed a potential association with asthma-related phenotypes rather than asthma per se, the low toxicity of vitamin D supplements make it tempting to speculate that pregnant women at a high risk of obtaining a child with asthma may be benefited, especially if they are vitamin D deficient.
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Affiliation(s)
- Evangelia Bountouvi
- Third Department of Pediatrics, Athens University Medical School, University General Hospital "Attikon", Athens, Greece
| | - Konstantinos Douros
- Third Department of Pediatrics, Athens University Medical School, University General Hospital "Attikon", Athens, Greece
| | - Anna Papadopoulou
- Third Department of Pediatrics, Athens University Medical School, University General Hospital "Attikon", Athens, Greece
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Tromp IIM, Franco OH, van den Hooven EH, Heijboer AC, Jaddoe VWV, Duijts L, de Jongste JC, Moll HA, Kiefte-de Jong JC. 25-Hydroxyvitamin D concentrations, asthma and eczema in childhood: The generation R study. Clin Nutr 2016; 37:169-176. [PMID: 28017448 DOI: 10.1016/j.clnu.2016.11.019] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2016] [Revised: 11/09/2016] [Accepted: 11/19/2016] [Indexed: 01/12/2023]
Abstract
BACKGROUND & AIMS A role of vitamin D in the development of respiratory and allergic disease in children remains unclear. It may be likely that vitamin D has an effect on airway inflammation, but only few studies examined the effect in children. We aimed to examine whether serum 25-hydroxyvitamin D (25(OH) vitamin D) concentrations are associated with the fraction of exhaled nitric oxide (FeNO), airway interrupter resistance (Rint), physician diagnosed asthma ever, wheezing and eczema in a population-based cohort study in 6 year old children. METHODS Serum 25(OH) vitamin D concentration was assessed in 3815 children. 25(OH) vitamin D concentrations ≥75 nmol/L were considered as sufficient, between 50 and 75 nmol/L as insufficient, and <50 nmol/L as deficient. FeNO and Rint were measured at the research center. Data on physician diagnosed asthma, wheezing, and eczema were obtained by parent-reported questionnaires. RESULTS In comparison with sufficient 25(OH) vitamin D concentration, deficient concentrations were associated with elevated FeNO of ≥25 ppb (OR: 2.54; 95% CI: 1.34-4.80). In addition, deficient and insufficient 25(OH) vitamin D concentrations were associated with a lower Rint (Z-score: -1.26; 95% CI: -1.66 to -0.85) (ß: -0.75; 95% CI: -1.08 to -0.42), and increased risks of eczema (OR: 1.65; 95% CI: 1.13-2.41) (OR: 1.44; 95% CI: 1.06-1.95). Insufficient 25(OH) vitamin D concentration were associated with a decreased risk of physician diagnosed asthma ever (OR: 0.59; 95% CI: 0.38-0.94). CONCLUSIONS Our results indicate that lower 25(OH) vitamin D levels are associated with elevated FeNO levels, but lower Rint values. Lower 25(OH) vitamin D levels are also associated with a decreased risk for asthma diagnoses but an increased risk for eczema.
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Affiliation(s)
- Ilse I M Tromp
- From the Generation R Study Group, The Netherlands; Departments of Pediatrics, Erasmus University, Rotterdam, The Netherlands
| | - Oscar H Franco
- Departments of Epidemiology, Erasmus University, Rotterdam, The Netherlands
| | | | - Annemieke C Heijboer
- Department of Clinical Chemistry, VU University Medical Center, Amsterdam, The Netherlands
| | - Vincent W V Jaddoe
- From the Generation R Study Group, The Netherlands; Departments of Epidemiology, Erasmus University, Rotterdam, The Netherlands; Departments of Pediatrics, Erasmus University, Rotterdam, The Netherlands
| | - Liesbeth Duijts
- Departments of Epidemiology, Erasmus University, Rotterdam, The Netherlands; Division of Respiratory Medicine, Erasmus University, Rotterdam, The Netherlands; Division of Neonatology, Erasmus University, Rotterdam, The Netherlands
| | - Johan C de Jongste
- Division of Respiratory Medicine, Erasmus University, Rotterdam, The Netherlands
| | - Henriëtte A Moll
- Departments of Pediatrics, Erasmus University, Rotterdam, The Netherlands
| | - Jessica C Kiefte-de Jong
- Departments of Epidemiology, Erasmus University, Rotterdam, The Netherlands; Global Public Health, Leiden University College, The Hague, The Netherlands; Departments of Pediatrics, Erasmus University, Rotterdam, The Netherlands.
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Global gene regulation during activation of immunoglobulin class switching in human B cells. Sci Rep 2016; 6:37988. [PMID: 27897229 PMCID: PMC5126563 DOI: 10.1038/srep37988] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2016] [Accepted: 11/03/2016] [Indexed: 02/06/2023] Open
Abstract
Immunoglobulin class switch recombination (CSR) to IgE is a tightly regulated process central to atopic disease. To profile the B-cell transcriptional responses underlying the activation of the germinal centre activities leading to the generation of IgE, naïve human B-cells were stimulated with IL-4 and anti-CD40. Gene expression and alternative splicing were profiled over 12 days using the Affymetrix Human Exon 1.0 ST Array. A total of 1,399 genes, forming 13 temporal profiles were differentially expressed. CCL22 and CCL17 were dramatically induced but followed a temporal trajectory distinct from classical mediators of isotype switching. AICDA, NFIL3, IRF4, XBP1 and BATF3 shared a profile with several genes involved in innate immunity, but with no recognised role in CSR. A transcription factor BHLHE40 was identified at the core of this profile. B-cell activation was also accompanied by variation in exon retention affecting >200 genes including CCL17. The data indicate a circadian component and central roles for the Th2 chemokines CCL22 and CCL17 in the activation of CSR.
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84
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Hollams EM, Teo SM, Kusel M, Holt BJ, Holt KE, Inouye M, De Klerk NH, Zhang G, Sly PD, Hart PH, Holt PG. Vitamin D over the first decade and susceptibility to childhood allergy and asthma. J Allergy Clin Immunol 2016; 139:472-481.e9. [PMID: 27726947 DOI: 10.1016/j.jaci.2016.07.032] [Citation(s) in RCA: 64] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2015] [Revised: 06/29/2016] [Accepted: 07/14/2016] [Indexed: 12/21/2022]
Abstract
BACKGROUND Vitamin D (25(OH)D) deficiency has been implicated as a possible risk factor for asthma development, but studies at selected time points measuring 25(OH)D levels during childhood have yielded conflicting findings. Prospective studies tracking 25(OH)D levels during the initiation phase of asthma in early childhood have not been reported. OBJECTIVE We sought to elucidate relationships between 25(OH)D levels from birth to age 10 years and susceptibility to allergic sensitization, respiratory tract infections, and asthma. METHODS Asthma-, allergy-, and respiratory tract infection-associated phenotypes (including pathogen identification) were characterized in a high-risk birth cohort. Plasma 25(OH)D concentrations were quantified at birth and at clinical follow-ups at the ages of 0.5, 1, 2, 3, 4, 5, and 10 years, and relationships with clinical outcomes were examined. RESULTS Cross-sectional analyses demonstrated inverse associations between 25(OH)D concentrations and the risk for concurrent sensitization at age 0.5, 2, and 3 years, and mixed-effects regression demonstrated inverse longitudinal associations of 25(OH)D levels with both sensitization and eczema. Multivariate regression modeling suggested that the number of 25(OH)D-deficient follow-ups was positively associated with risk for asthma/wheeze, eczema, and sensitization at 10 years; adjustment for sensitization (particularly by 2 years) in the asthma/wheeze models reduced 25(OH)D associations with these latter outcomes. 25(OH)D levels were also inversely associated with early nasopharyngeal colonization with Streptococcus species and age of first febrile lower respiratory illness, both of which are known asthma risk factors. CONCLUSION 25(OH)D deficiency in early childhood is associated with increased risk for persistent asthma, potentially through modulating susceptibility to early allergic sensitization, upper respiratory tract colonization with bacterial pathogens, or both. These relationships are only evident if 25(OH)D status is monitored prospectively and longitudinally.
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Affiliation(s)
- Elysia M Hollams
- Telethon Kids Institute, University of Western Australia, Perth, Australia
| | - Shu Mei Teo
- Centre for Systems Genomics, University of Melbourne, Melbourne, Australia; Department of Biochemistry and Molecular Biology, Bio21 Molecular Science and Biotechnology Institute, University of Melbourne, Melbourne, Australia; School of BioSciences, University of Melbourne, Melbourne, Australia
| | - Merci Kusel
- Telethon Kids Institute, University of Western Australia, Perth, Australia
| | - Barbara J Holt
- Telethon Kids Institute, University of Western Australia, Perth, Australia
| | - Kathryn E Holt
- Centre for Systems Genomics, University of Melbourne, Melbourne, Australia; Department of Biochemistry and Molecular Biology, Bio21 Molecular Science and Biotechnology Institute, University of Melbourne, Melbourne, Australia
| | - Michael Inouye
- Centre for Systems Genomics, University of Melbourne, Melbourne, Australia; School of BioSciences, University of Melbourne, Melbourne, Australia
| | | | - Guicheng Zhang
- School of Public Health, Curtin University, Perth, Australia
| | - Peter D Sly
- University of Queensland, Brisbane, Australia
| | - Prue H Hart
- Telethon Kids Institute, University of Western Australia, Perth, Australia
| | - Patrick G Holt
- Telethon Kids Institute, University of Western Australia, Perth, Australia; University of Queensland, Brisbane, Australia.
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Garn H, Bahn S, Baune BT, Binder EB, Bisgaard H, Chatila TA, Chavakis T, Culmsee C, Dannlowski U, Gay S, Gern J, Haahtela T, Kircher T, Müller-Ladner U, Neurath MF, Preissner KT, Reinhardt C, Rook G, Russell S, Schmeck B, Stappenbeck T, Steinhoff U, van Os J, Weiss S, Zemlin M, Renz H. Current concepts in chronic inflammatory diseases: Interactions between microbes, cellular metabolism, and inflammation. J Allergy Clin Immunol 2016; 138:47-56. [DOI: 10.1016/j.jaci.2016.02.046] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2015] [Revised: 02/05/2016] [Accepted: 02/25/2016] [Indexed: 12/26/2022]
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Prenatal, perinatal, and childhood vitamin D exposure and their association with childhood allergic rhinitis and allergic sensitization. J Allergy Clin Immunol 2016; 137:1063-1070.e2. [PMID: 26874366 DOI: 10.1016/j.jaci.2015.11.031] [Citation(s) in RCA: 52] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2015] [Revised: 10/30/2015] [Accepted: 11/20/2015] [Indexed: 01/18/2023]
Abstract
BACKGROUND The role of early-life vitamin D in childhood allergy is controversial. OBJECTIVE We sought to assess vitamin D exposure in early life by multiple modalities and ascertain its association with childhood allergic rhinitis and allergic sensitization. METHODS One thousand two hundred forty-eight mother-child pairs from a US prebirth cohort unselected for any disease were studied. Vitamin D exposure was assessed by measures of maternal intake during the first and second trimesters of pregnancy and serum 25-hydroxyvitamin D (25[OH]D) levels in mothers during pregnancy, cord blood, and children at school age (median age, 7.7 years; interquartile range, 1.0 years). Tests for associations between vitamin D exposure with ever allergic rhinitis, serum total IgE level, and allergen sensitization at school age were conducted. RESULTS The correlations between maternal intake of vitamin D during pregnancy and serum 25(OH)D levels in pregnant mothers, cord blood, and children at school age were weak to moderate (r = -0.03 to 0.53). Each 100 IU/d of food-based vitamin D intake during the first and second trimesters (equivalent to the amount of vitamin D in an 8-ounce serving of milk) was associated with 21% and 20% reduced odds of ever allergic rhinitis at school age (odds ratios of 0.79 [95% CI, 0.67-0.92] and 0.80 [95% CI, 0.68-0.93]), respectively. There were no associations between maternal supplemental vitamin D intake or serum 25(OH)D levels at any time point with ever allergic rhinitis. There were no associations between any vitamin D exposure and serum total IgE level or allergen sensitization at school age. CONCLUSIONS Inclusion of foods containing vitamin D in maternal diets during pregnancy may have beneficial effects on childhood allergic rhinitis.
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The Editor takes a closer look at some of this month's articles. Clin Exp Allergy 2016. [DOI: 10.1111/cea.12704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Shaik-Dasthagirisaheb Y, Conti P. Impact of vitamin D on asthma. Eur Geriatr Med 2016. [DOI: 10.1016/j.eurger.2015.10.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Hall SC, Fischer KD, Agrawal DK. The impact of vitamin D on asthmatic human airway smooth muscle. Expert Rev Respir Med 2015; 10:127-35. [PMID: 26634624 DOI: 10.1586/17476348.2016.1128326] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Asthma is a chronic heterogeneous disorder, which involves airway inflammation, airway hyperresponsiveness (AHR) and airway remodeling. The airway smooth muscle (ASM) bundle regulates the broncho-motor tone and plays a critical role in AHR as well as orchestrating inflammation. Vitamin D deficiency has been linked to increased severity and exacerbations of symptoms in asthmatic patients. It has been shown to modulate both immune and structural cells, including ASM cells, in inflammatory diseases. Given that current asthma therapies have not been successful in reversing airway remodeling, vitamin D supplementation as a potential therapeutic option has gained a great deal of attention. Here, we highlight the potential immunomodulatory properties of vitamin D in regulating ASM function and airway inflammation in bronchial asthma.
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Affiliation(s)
- Sannette C Hall
- a Department of Biomedical Science , Creighton University School of Medicine , Omaha , NE , USA
| | - Kimberly D Fischer
- b Department of Medical Microbiology and Immunology , Creighton University School of Medicine , Omaha , NE , USA
| | - Devendra K Agrawal
- a Department of Biomedical Science , Creighton University School of Medicine , Omaha , NE , USA.,b Department of Medical Microbiology and Immunology , Creighton University School of Medicine , Omaha , NE , USA.,c Department of Clinical and Translational Science , Creighton University School of Medicine , Omaha , NE , USA
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Yang J, Chen Q, Tian S, Song S, Liu F, Wang Q, Fu Z. The role of 1,25-dyhydroxyvitamin D3 in mouse liver ischemia reperfusion injury: regulation of autophagy through activation of MEK/ERK signaling and PTEN/PI3K/Akt/mTORC1 signaling. Am J Transl Res 2015; 7:2630-2645. [PMID: 26885262 PMCID: PMC4731662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2015] [Accepted: 11/18/2015] [Indexed: 06/05/2023]
Abstract
Autophagy is an important mechanism for cellular homeostasis and survival during pathologic stress conditions in the liver, such as ischemia-reperfusion injury. In this study, we hypothesized a protective role of vitamin Din hepatic IR model. The administration of vitamin D displayed significantly preserved liver function as characterized by less histological damage and reduced serum enzymes level. We found that the protective effect was associated with ameliorated oxidative stress as manifested by the increase of antioxidant capacity and decrease of lipid peroxidation. Further, increased autophagic flux after vitamin D administration was demonstrated by the increase of protein light chain 3 (LC3) conversion both in vivo and in vitro. MEK/ERK and PTEN/PI3K/Akt/mTOR were both found critically involved in vitamin D-induced autophagy. By employing intracellular ROS and cell viability assay, we further confirmed this hypothesis with the observation that inhibition either of the MEK/ERK or PTEN/PI3K/Akt/mTOR pathway partly abolished the protective effect of vitamin D-induced autophagy, while inhibiting initiation of autophagy signaling pathway by knockdown of Beclin-1 completely reversed the protection provided by vitamin D. Collectively, the present results indicate that the protective role of vitamin D in murine hepatic IR injury is autophagy dependent, which is regulated by both MEK/ERK and PTEN/PI3K/Akt/mTOR pathway.
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Affiliation(s)
- Jinghui Yang
- Department of Organ Transplantation, Shanghai Changzheng Hospital, Second Military Medical UniversityShanghai, China
| | - Qi Chen
- Department of Health Statistics, Second Military Medical UniversityShanghai, China
| | - Shiyin Tian
- Department of Health Statistics, Second Military Medical UniversityShanghai, China
| | - Shaohua Song
- Department of Organ Transplantation, Shanghai Changzheng Hospital, Second Military Medical UniversityShanghai, China
| | - Fang Liu
- Department of Organ Transplantation, Shanghai Changzheng Hospital, Second Military Medical UniversityShanghai, China
| | - Quanxing Wang
- National Key Laboratory of Medical Immunology, Second Military Medical UniversityShanghai, China
| | - Zhiren Fu
- Department of Organ Transplantation, Shanghai Changzheng Hospital, Second Military Medical UniversityShanghai, China
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Refaat B, El-Shemi AG, Ashshi A, Azhar E. Vitamin D and chronic hepatitis C: effects on success rate and prevention of side effects associated with pegylated interferon-α and ribavirin. Int J Clin Exp Med 2015; 8:10284-10303. [PMID: 26379820 PMCID: PMC4565203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2015] [Accepted: 07/01/2015] [Indexed: 06/05/2023]
Abstract
Chronic hepatitis C (CHC) is one of the most common causes of liver diseases worldwide, affecting 3% of the world population and 3 to 4 million people acquire new infection annually. Despite the recent introduction of novel antiviral drugs for the treatment of CHC, these drugs are expensive and the access to them is not an option for many patients. Hence, the traditional therapy by pegylated interferon-α (Peg-IFN-α) and ribavirin may still have a role in the clinical management of CHC especially in developing countries. However, this standard therapy is associated with several severe extra-hepatic side effects and the most common adverse events are hematological abnormalities and thyroid disorders and they could result in dose reduction and/or termination of therapy. Vitamin D has been shown to be a key regulatory element of the immune system, and its serum concentrations correlate with the severity of liver damage and the development of liver fibrosis/cirrhosis. Furthermore, supplementation with vitamin D with Peg-IFN-α based therapy for the treatment of CHC could be beneficial in increase the response rate to Peg-INF-α based therapy. Vitamin D has also been shown to regulate the thyroid functions and the process of erythropoiesis. This review appraises the data to date researching the role of vitamin D during the treatment of CHC and the potential role of vitamin D in preventing/treating Peg-IFN-α induced thyroiditis and anemia during the course of treatment.
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Affiliation(s)
- Bassem Refaat
- Department of Laboratory Medicine, Faculty of Applied Medical Sciences, Umm Al-Qura UniversityAl Abdeyah, Makkah, PO Box 7607, KSA
| | - Adel Galal El-Shemi
- Department of Laboratory Medicine, Faculty of Applied Medical Sciences, Umm Al-Qura UniversityAl Abdeyah, Makkah, PO Box 7607, KSA
- Department of Pharmacology, Faculty of Medicine, Assiut UniversityEgypt
| | - Ahmed Ashshi
- Department of Laboratory Medicine, Faculty of Applied Medical Sciences, Umm Al-Qura UniversityAl Abdeyah, Makkah, PO Box 7607, KSA
| | - Esam Azhar
- Special Infectious Agents Unit, King Fahd Medical Research Center, King Abdulaziz UniversityJeddah, KSA
- Department of Medical Laboratory Technology, Faculty of Applied Medical Sciences, King Abdulaziz UniversityJeddah, Saudi Arabia
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Niruban SJ, Alagiakrishnan K, Beach J, Senthilselvan A. Association between vitamin D and respiratory outcomes in Canadian adolescents and adults. J Asthma 2015; 52:653-61. [PMID: 25563060 DOI: 10.3109/02770903.2015.1004339] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
BACKGROUND Asthma is one of the most prevalent chronic diseases worldwide, affecting more than 200 million people. Vitamin D deficiency has been reported among individuals with asthma and might play a role in asthma exacerbations. In this cross-sectional study, we investigated the association of serum 25-hydroxy vitamin D [25(OH)D] levels and current asthma, ever asthma, and lung function. METHODS Data from 3937 subjects aged 13-69 years who participated in the Canadian Health Measures Survey - Cycle 1 were considered in this study. Serum 25(OH)D levels were categorized into ≤49 nmol/L (low), 50-74 nmol/L (moderate) and ≥75 nmol/L (high). RESULTS The proportion of subjects with current and ever asthma was greater in the lower 25(OH)D category than in moderate and high categories. After adjusting for potential confounders, subjects in the low 25(OH)D levels were more likely to have current asthma than those in the moderate levels (OR: 1.54, 95% CI: 1.01-2.36). Low 25(OH)D levels were also associated with ever asthma (OR: 2.12, 95% CI: 1.40-3.21) among those with a family history of asthma and this association was stronger in those with asthma onset before 20 years of age. High 25(OH)D levels were associated with lower mean value of FEV1/FVC ratio. No significant association was observed between 25(OH)D levels and other lung function measurements. CONCLUSION In this study, 25(OH)D levels below 50 nmol/L were associated with an increased risk of current and ever asthma. Further exploration of this relationship is needed to determine the optimal level of vitamin D in the management of asthma in adolescents and adults.
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Kerley CP, Elnazir B, Faul J, Cormican L. Vitamin D as an adjunctive therapy in asthma. Part 2: A review of human studies. Pulm Pharmacol Ther 2015; 32:75-92. [PMID: 25749414 DOI: 10.1016/j.pupt.2015.02.010] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Vitamin D deficiency (VDD) is highly prevalent worldwide, with adverse effects on bone health but also potentially other unfavorable consequences. VDD and asthma-incidence/severity share many common risk factors, including winter season, industrialization, poor diet, obesity, dark skin pigmentation, and high latitude. Multiple anatomical areas relevant to asthma contain both the enzyme responsible for producing activated vitamin D and the vitamin D receptor suggesting that activated vitamin D (1,25-dihydroxyvitamin D) may have important local effects at these sites. Emerging evidence suggests that VDD is associated with increased airway hyperresponsiveness, decreased pulmonary function, worse asthma control, and possibly decreased response to standard anti-asthma therapy. However the effect is inconsistent with preliminary evidence from different studies suggesting vitamin D is both beneficial and detrimental to asthma genesis and severity. Current evidence suggests that supplementation with moderate doses of vitamin D may be appropriate for maintenance of bone health in asthmatics, particularly steroid users. However emerging data from an increasing number of randomized, controlled, intervention studies of vitamin D supplementation in pediatric and adult asthma are becoming available and should help determine the importance, if any of vitamin D for asthma pathogenesis. The purpose of this second of a two-part review is to review the current human literature on vitamin D and asthma, discussing the possible consequences of VDD for asthma and the potential for vitamin D repletion as adjunct therapy.
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Affiliation(s)
- Conor P Kerley
- Respiratory and Sleep Diagnostics Department, Connolly Hospital, Blanchardstown, Dublin 15, Ireland; School of Medicine and Medical Sciences, University College Dublin, Belfield, Dublin 4, Ireland.
| | - Basil Elnazir
- Department of Paediatric Respiratory Medicine, The National Children's Hospital Dublin 24, Ireland.
| | - John Faul
- Respiratory and Sleep Diagnostics Department, Connolly Hospital, Blanchardstown, Dublin 15, Ireland.
| | - Liam Cormican
- Respiratory and Sleep Diagnostics Department, Connolly Hospital, Blanchardstown, Dublin 15, Ireland.
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Vitamin D as an adjunctive therapy in asthma. Part 1: A review of potential mechanisms. Pulm Pharmacol Ther 2015; 32:60-74. [PMID: 25732539 DOI: 10.1016/j.pupt.2015.02.004] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2014] [Revised: 02/04/2015] [Accepted: 02/09/2015] [Indexed: 12/24/2022]
Abstract
Vitamin D deficiency (VDD) is highly prevalent worldwide. The classical role for vitamin D is to regulate calcium absorption form the gastrointestinal tract and influence bone health. Recently vitamin D receptors and vitamin D metabolic enzymes have been discovered in numerous sites systemically supporting diverse extra-skeletal roles of vitamin D, for example in asthmatic disease. Further, VDD and asthma share several common risk factors including high latitude, winter season, industrialization, poor diet, obesity, and dark skin pigmentation. Vitamin D has been demonstrated to possess potent immunomodulatory effects, including effects on T cells and B cells as well as increasing production of antimicrobial peptides (e.g. cathelicidin). This immunomodulation may lead to asthma specific clinical benefits in terms of decreased bacterial/viral infections, altered airway smooth muscle-remodeling and -function as well as modulation of response to standard anti-asthma therapy (e.g. glucocorticoids and immunotherapy). Thus, vitamin D and its deficiency have a number of biological effects that are potentially important in altering the course of disease pathogenesis and severity in asthma. The purpose of this first of a two-part review is to review potential mechanisms whereby altering vitamin D status may influence asthmatic disease.
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Guglani L, Joseph CL. Asthma and diet: could food be thy medicine? Indian Pediatr 2015; 52:21-22. [PMID: 25638178 PMCID: PMC4864955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Affiliation(s)
- Lokesh Guglani
- Pediatric Pulmonary Division, Department of Pediatrics, Childrens Hospital of Michigan and Wayne State University School of Medicine; and #Department of Public Health Sciences, Henry Ford Health System; Detroit MI, USA.
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