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Zhang P, Xu Q, Zhu R. Vitamin D and allergic diseases. Front Immunol 2024; 15:1420883. [PMID: 39026686 PMCID: PMC11254667 DOI: 10.3389/fimmu.2024.1420883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2024] [Accepted: 06/24/2024] [Indexed: 07/20/2024] Open
Abstract
In recent years, the relationship between vitamin D and allergic diseases has received widespread attention. As a fat-soluble vitamin, vitamin D plays a crucial role in regulating the immune system and may influence the onset and progression of diseases such as atopic dermatitis, allergic rhinitis, and asthma. To understand the underlying mechanisms, we have summarized the current research on the association between vitamin D and allergic diseases. We also discuss the impact of vitamin D on the immune system and its role in the course of allergic diseases, particularly focusing on how vitamin D supplementation affects the treatment outcomes of these conditions. We aim to provide a theoretical basis and practical guidance for optimizing the management and treatment of allergic diseases by modulating vitamin D levels.
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Affiliation(s)
- Panyu Zhang
- Department of Allergy, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Qingxiu Xu
- Department of Allergy, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Rongfei Zhu
- Department of Allergy, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Institute of Allergy and Clinical Immunology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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2
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Warren CM, Bartell TR. Sociodemographic inequities in food allergy: Insights on food allergy from birth cohorts. Pediatr Allergy Immunol 2024; 35:e14125. [PMID: 38656700 DOI: 10.1111/pai.14125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Revised: 03/18/2024] [Accepted: 03/21/2024] [Indexed: 04/26/2024]
Abstract
A large and growing corpus of epidemiologic studies suggests that the population-level burden of pediatric FA is not equitably distributed across major sociodemographic groups, including race, ethnicity, household income, parental educational attainment, and sex. As is the case for more extensively studied allergic disease states such as asthma and atopic dermatitis epidemiologic data suggest that FA may be more prevalent among certain populations experiencing lower socioeconomic status (SES), particularly those with specific racial and ethnic minority backgrounds living in highly urbanized regions. Emerging data also indicate that these patients may also experience more severe FA-related physical health, psychosocial, and economic outcomes relating to chronic disease management. However, many studies that have identified sociodemographic inequities in FA burden are limited by cross-sectional designs that are subject to numerous biases. Compared with cross-sectional study designs or cohorts established later in life, birth cohorts offer advantages relative to other study designs when investigators seek to understand causal relationships between exposures occurring during the prenatal or postnatal period and the atopic disease status of individuals later in life. Numerous birth cohorts have been established across recent decades, which include evaluation of food allergy-related outcomes, and a subset of these also have measured sociodemographic variables that, together, have the potential to shed light on the existence and possible etiology of sociodemographic inequities in food allergy. This manuscript reports the findings of a comprehensive survey of the current state of this birth cohort literature and draws insights into what is currently known, and what further information can potentially be gleaned from thoughtful examination and further follow-up of ongoing birth cohorts across the globe.
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Affiliation(s)
- Christopher M Warren
- Center for Food Allergy and Asthma Research, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Tami R Bartell
- Center for Food Allergy and Asthma Research, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
- Patrick M. Magoon Institute for Healthy Communities, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois, USA
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3
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Molani-Gol R, Rafraf M. Maternal vitamin D in pregnancy and infant's gut microbiota: a systematic review. Front Pediatr 2023; 11:1248517. [PMID: 37915988 PMCID: PMC10617198 DOI: 10.3389/fped.2023.1248517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 09/26/2023] [Indexed: 11/03/2023] Open
Abstract
Background An infant's gut microbiome plays a vital role in their health, and various factors can impact their gut microbiota composition. This review aimed to summarize the current knowledge regarding the associations between maternal prenatal supplementation with vitamin D and the composition of infants' gut microbiota. Method A comprehensive systematic search was done on Web of Science, Scopus, PubMed, ScienceDirect, and Google Scholar databases without date restrictions until December 2022 using relevant keywords. All relevant original articles in English were eligible for the present review. Results Eight articles (two mice, three randomized clinical trials, and three cohort studies) were included in this review. The included mice studies reported that maternal prenatal vitamin D supplementation significantly affects the offspring's gut microbiome composition (such as enhancing the abundance of colonic Bacteroides). Moreover, the included cohort studies revealed a significant association between maternal supplementation with vitamin D during pregnancy and the infant's gut microbiome. However, one-third of clinical trials indicated that vitamin D levels in utero could influence the colonization of the microbial community in the infant's gut. Conclusion The findings of this review revealed that maternal vitamin D supplementation during pregnancy was linked to an infant's gut microbiome and could impact their gut microbiota composition. However, more studies are warranted to confirm these results.
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Affiliation(s)
- Roghayeh Molani-Gol
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
- Nutrition Research Center, Department of Community Nutrition, Faculty of Nutrition and Food Science, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Maryam Rafraf
- Nutrition Research Center, Department of Community Nutrition, Faculty of Nutrition and Food Science, Tabriz University of Medical Sciences, Tabriz, Iran
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4
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Lou F, Zhang Y, Xu A, Gao T. Transcriptional responses of liver and spleen in Lota lota to polyriboinosinic polyribocytidylic acid. Front Immunol 2023; 14:1272393. [PMID: 37901224 PMCID: PMC10611466 DOI: 10.3389/fimmu.2023.1272393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Accepted: 09/26/2023] [Indexed: 10/31/2023] Open
Abstract
Introduction The cultured Lota lota can meet the market demand in the context of the decline of wild resources, but the disease in the high-density culture process also deserves attention. Therefore, understanding the immune regulation mechanisms of L. lota will be the basis for obtaining high benefits in artificial culture. Methods To explore the viral response mechanism of L. lota, RNA-seq was applied to identify the transcriptomic changes of the liver and spleen in L. lota by poly (I:C) stress. Results The DEGs (liver: 2186 to 3123; spleen 1542 to 2622) and up-regulated genes (liver: 1231 to 1776; spleen 769 to 1502) in the liver and spleen increased with the prolongation (12h to 48h) of poly (I:C)-stimulation time. This means L. lota needs to mobilize more functional genes in response to longer periods of poly (I:C)-stimulation. Despite the responses of L. lota to poly (I:C) showed tissue-specificity, we hypothesized that both liver and spleen of L. lota can respond to poly (I:C) challenge may be through promoting apoptosis of DNA-damaged cells, increasing the activity of immune-enhancing enzymes, and increasing energy supply based on DEGs annotation information. Conclusions Our results demonstrate the transcriptional responses of L. lota to poly (I:C)-stimulation, and these data provide the first resource on the genetic regulation mechanisms of L. lota against viruses. Furthermore, the present study can provide basic information for the prevention of viral diseases in L. lota artificial culture process.
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Affiliation(s)
- Fangrui Lou
- School of Ocean, Yantai University, Yantai, Shandong, China
| | - Yuan Zhang
- CAS Key Laboratory of Tropical Marine Bio-resources and Ecology, South China Sea Institute of Oceanology Chinese Academy of Sciences, Guangzhou, China
| | - Anle Xu
- Fishery College, Zhejiang Ocean University, Zhoushan, Zhejiang, China
| | - Tianxiang Gao
- Fishery College, Zhejiang Ocean University, Zhoushan, Zhejiang, China
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5
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Zeng R, Li Y, Shen S, Qiu X, Chang CL, Koplin JJ, Perrett KP, Dharmage SC, Lodge CJ, Lowe AJ. Is antenatal or early-life vitamin D associated with eczema or food allergy in childhood? A systematic review. Clin Exp Allergy 2023; 53:511-525. [PMID: 36648071 DOI: 10.1111/cea.14281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 12/20/2022] [Accepted: 12/23/2022] [Indexed: 01/18/2023]
Abstract
OBJECTIVE To summarise the associations between antenatal or early-life blood vitamin D and the development of eczema/food allergy in childhood. DESIGN A systematic review and meta-analyses were conducted to synthesize the published literature. Two reviewers independently performed the study selection and data extraction on Covidence. We assessed the risk of bias for observational studies by using the Newcastle-Ottawa Scale and the Cochrane Risk of Bias tool for clinical trials. The certainty of the evidence was assessed using Grading of Recommendations, Assessment, Development and Evaluations (GRADE). DATA SOURCES We systematically searched PubMed and Embase from inception and April 2022. ELIGIBILITY CRITERIA Human studies that investigated prospective associations between antenatal or early-life blood vitamin D levels, dietary intake or supplementation and childhood eczema/food allergy. RESULTS Forty-three articles including six randomised controlled trials (RCTs) were included. Four RCTs of vitamin D supplementation during pregnancy showed no evidence of an effect on the incidence of eczema (pooled odds ratio [OR] = 0.85; 0.67-1.08, I2 = 6.7%, n = 2074). Three RCTs reported null associations between supplementation in pregnancy/infancy and food allergy. From six cohort studies, increasing cord blood vitamin D levels were associated with reduced prevalence of eczema at/close to age one (OR per 10 nmol/L increase = 0.89; 0.84-0.94, I2 = 0%, 2025 participants). We found no evidence of an association between maternal antenatal or infant vitamin D level or dietary intake and the development of food allergy or eczema in offspring. CONCLUSIONS We found an association between higher vitamin D levels in cord blood and reduced risk of eczema in cohort studies. Further trials with maternal and infant supplementation are needed to confirm if vitamin D supplementation can effectively prevent eczema or food allergy in childhood. SYSTEMATIC REVIEW REGISTRATION PROSPERO, No. CRD42013005559.
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Affiliation(s)
- Rong Zeng
- Allergy and Lung Health Unit, Melbourne School of Population and Global Health, University of Melbourne, Carlton, Victoria, Australia
| | - Yusi Li
- Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Songying Shen
- Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Research in Structural Birth Defect Disease, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
- Guangdong Provincial Clinical Research Center for Child Health, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Xiu Qiu
- Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Research in Structural Birth Defect Disease, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
- Guangdong Provincial Clinical Research Center for Child Health, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
- Department of Women's Health, Guangdong Provincial Key Clinical Specialty of Woman and Child Health, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Chia-Lun Chang
- Allergy and Lung Health Unit, Melbourne School of Population and Global Health, University of Melbourne, Carlton, Victoria, Australia
| | - Jennifer J Koplin
- Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia
- Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Centre for Food and Allergy Research, Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - Kirsten P Perrett
- Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia
- Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Centre for Food and Allergy Research, Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Department of Allergy & Immunology, Royal Children's Hospital, Parkville, Victoria, Australia
| | - Shyamali C Dharmage
- Allergy and Lung Health Unit, Melbourne School of Population and Global Health, University of Melbourne, Carlton, Victoria, Australia
- Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Centre for Food and Allergy Research, Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - Caroline J Lodge
- Allergy and Lung Health Unit, Melbourne School of Population and Global Health, University of Melbourne, Carlton, Victoria, Australia
- Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Centre for Food and Allergy Research, Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - Adrian J Lowe
- Allergy and Lung Health Unit, Melbourne School of Population and Global Health, University of Melbourne, Carlton, Victoria, Australia
- Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Centre for Food and Allergy Research, Murdoch Children's Research Institute, Parkville, Victoria, Australia
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Sanguesa J, Marquez S, Bustamante M, Sunyer J, Iniguez C, Vioque J, Rodriguez LSM, Jimeno-Romero A, Torrent M, Casas M, Vrijheid M. Prenatal Vitamin D Levels Influence Growth and Body Composition until 11 Years in Boys. Nutrients 2023; 15:2033. [PMID: 37432159 DOI: 10.3390/nu15092033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 04/12/2023] [Accepted: 04/19/2023] [Indexed: 07/12/2023] Open
Abstract
BACKGROUND Gestational vitamin D levels may influence offspring growth and modulate adipogenesis. Findings from prospective studies are inconsistent, and few have evaluated the persistence of these associations into late childhood. OBJECTIVE To examine the association between prenatal vitamin D levels and growth and adiposity in late childhood. METHODS We included 2027 mother-child pairs from the INMA birth cohort. 25-hydroxyvitamin D3 (vitamin D3) levels were measured in serum at 13 weeks of pregnancy. Sex- and age-specific body mass index z-scores were calculated at 7 and 11 years, overweight was defined as z-score ≥ 85th percentile, and body fat mass was measured at 11 years. Z-score body mass index (zBMI) trajectories from birth to 11 years were identified using latent class growth analysis. RESULTS The prevalence of vitamin D3 deficiency (<20 ng/mL) was 17.5%, and around 40% of the children had overweight at both ages. Associations between vitamin D levels and outcomes differed by sex. In boys, maternal vitamin D3 deficient status was associated with higher zBMI, higher fat mass percentage, higher odds of being overweight, and with an increased risk of belonging to lower birth size followed by accelerated BMI gain trajectory. In girls no associations were observed. CONCLUSION Our results support a sex-specific programming effect of early pregnancy vitamin D3 levels on offspring body composition into late childhood observed in boys.
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Affiliation(s)
- Julia Sanguesa
- ISGlobal, 08036 Barcelona, Spain
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain
- Universitat Pompeu Fabra (UPF), 08002 Barcelona, Spain
| | - Sandra Marquez
- ISGlobal, 08036 Barcelona, Spain
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain
- Universitat Pompeu Fabra (UPF), 08002 Barcelona, Spain
| | - Mariona Bustamante
- ISGlobal, 08036 Barcelona, Spain
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain
- Universitat Pompeu Fabra (UPF), 08002 Barcelona, Spain
| | - Jordi Sunyer
- ISGlobal, 08036 Barcelona, Spain
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain
- Universitat Pompeu Fabra (UPF), 08002 Barcelona, Spain
| | - Carmen Iniguez
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain
- Department of Statistics and Operational Research, Universitat de València, 46010 València, Spain
| | - Jesus Vioque
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain
- Alicante Institute for Health and Biomedical Research (ISABIAL-FISABIO Foundation), 03010 Alicante, Spain
- Nutritional Epidemiology Unit, University Miguel Hernandez, 03202 Elche, Spain
| | - Loreto Santa-Marina Rodriguez
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain
- Biodonostia Health Research Institute, Group of Environmental Epidemiology and Child Development, 20014 San Sebastian, Spain
- Ministry of Health of the Basque Government, SubDirectorate for Public Health and Addictions of Gipuzkoa, 20010 San Sebastian, Spain
| | - Alba Jimeno-Romero
- Biodonostia Health Research Institute, Group of Environmental Epidemiology and Child Development, 20014 San Sebastian, Spain
- Preventive Medicine and Public Health Department, University of the Basque Country, 48940 Leioa, Spain
| | - Matias Torrent
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain
- IB-SALUT, Area de Salud de Menorca, Menorca, Spain
| | - Maribel Casas
- ISGlobal, 08036 Barcelona, Spain
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain
- Universitat Pompeu Fabra (UPF), 08002 Barcelona, Spain
| | - Martine Vrijheid
- ISGlobal, 08036 Barcelona, Spain
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain
- Universitat Pompeu Fabra (UPF), 08002 Barcelona, Spain
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Alcantara Galvão A, de Andrade Belitardo EMM, de Araújo Sena F, Santos JM, de Oliveira Costa GN, Feitosa CA, Fiaccone RL, Cruz ÁA, Barreto ML, Figueiredo CA, Alcantara-Neves NM. Serum 25-hydroxyvitamin D deficiency is associated with atopy, and sex may be an effect modifier of its association with asthma in teenagers from northeast Brazil. Pediatr Pulmonol 2023; 58:297-305. [PMID: 36263459 DOI: 10.1002/ppul.26200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Revised: 09/03/2022] [Accepted: 10/08/2022] [Indexed: 01/11/2023]
Abstract
OBJECTIVE Sufficient vitamin D (25-hydroxyvitamin D [25(OH)D]) serum levels are associated with decreased asthma symptoms. Our aim was to investigate associations between vitamin D and atopy, asthma, asthma severity, and asthma phenotypes in Brazilian teenagers. METHODS This cross-sectional study involved 942 individuals (11-19 years old) engaged in an asthma cohort. The ISAAC questionnaire was employed to diagnosis asthma and asthma severity. Serum allergen-specific immunoglobulin E (sIgE) was measured by ImmunoCap and serum 25(OH)D was measured by ELISA. We calculated the correlation between sIgE and 25(OH)D. We used multivariate logistic regression analysis to assess associations of interest. RESULTS We found that 25(OH)D deficiency was positively associated with atopy (OR 1.45, confidence interval [CI] 1.05-2.00) and high levels of this vitamin negatively correlated with sIgE to Dermatophagoides pteronyssinus (r = -0.11, p = 0.019). The average 25(OH)D serum level was 27.0 ± 9.5 ng/ml; 366 individuals (38.8%) had a sufficient level. There was no association between 25(OH)D and asthma, asthma severity or asthma phenotypes in the population. However, sex was a possible effect modifier of the association between vitamin D and asthma: insufficiency in asthmatic women (86%) was higher than in asthmatic men (42%), and there was an association between insufficient vitamin D levels and greater asthma risk only in women (OR = 3.06, 95% CI 1.16-8.07). CONCLUSION We have shown that vitamin D deficiency was associated with greater risk of atopy in both sexes and vitamin D insufficiency was associated with asthma only in women. There was no association between vitamin D levels and asthma phenotypes or asthma severity.
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Affiliation(s)
| | | | - Flávia de Araújo Sena
- Instituto de Ciências da Saúde, Universidade Federal da Bahia (UFBA), Salvador, Brazil
| | - Juliana M Santos
- Instituto de Ciências da Saúde, Universidade Federal da Bahia (UFBA), Salvador, Brazil
| | | | - Caroline A Feitosa
- Instituto de Saúde Coletiva, Universidade Federal da Bahia (UFBA), Salvador, Brazil.,Escola Baiana de Medicina e Saúde Pública, Salvador, Brazil
| | - Rosemeire L Fiaccone
- Instituto de Matemática e Estatística, Universidade Federal da Bahia, Salvador, Brazil
| | - Álvaro A Cruz
- ProAR, Faculdade de Medicina, Universidade Federal da Bahia, (UFBA), Salvador, Brazil
| | - Maurício L Barreto
- Instituto de Saúde Coletiva, Universidade Federal da Bahia (UFBA), Salvador, Brazil.,Centro de Integração de Dados e Conhecimentos Para a Saúde (CIDACS), Fiocruz, Brazil
| | - Camila A Figueiredo
- Instituto de Ciências da Saúde, Universidade Federal da Bahia (UFBA), Salvador, Brazil
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Sangüesa J, Sunyer J, Garcia-Esteban R, Abellan A, Esplugues A, Garcia-Aymerich J, Guxens M, Irizar A, Júlvez J, Luque-García L, Rodríguez-Dehli AC, Tardón A, Torrent M, Vioque J, Vrijheid M, Casas M. Prenatal and child vitamin D levels and allergy and asthma in childhood. Pediatr Res 2022; 93:1745-1751. [PMID: 36057646 DOI: 10.1038/s41390-022-02256-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Revised: 07/27/2022] [Accepted: 07/29/2022] [Indexed: 11/09/2022]
Abstract
BACKGROUND Early-life vitamin D deficiency may impair immune system development contributing to allergy and asthma onset. Findings from prospective studies are inconsistent. OBJECTIVE To examine whether maternal and child vitamin D levels are associated with allergic and asthma-related symptoms throughout childhood in a Spanish birth cohort. METHODS 25-Hydroxyvitamin D3 (25(OH)D3) levels were measured in the serum of pregnant women (N = 2525) and children (N = 803). Information on allergic and asthma-related symptoms was obtained from repeated questionnaires from 1 to 9 years. RESULTS A total of 19% of mothers and 24% of children had deficient 25(OH)D3 levels (<20 ng/ml). Higher child 25(OH)D3 levels at 4 years were associated with lower odds of atopic eczema from 4 to 9 years (adjusted odds ratio = 0.90; 95% CI = 0.84-0.97 per 5 ng/ml). Higher maternal and child 25(OH)D3 levels were associated with a lower prevalence of late-onset wheezing at the limit of statistical significance (adjusted relative risk ratio (RRRadj) = 0.86; 95% CI = 0.74-1.00 and RRRadj = 0.76; 95% CI = 0.58-1.02 per 5 ng/ml, respectively). All the remaining associations were null. CONCLUSION Child 25(OH)D3 levels at pre-school age are associated with a reduced odds of atopic eczema in later childhood and both maternal and child levels may reduce the prevalence of late-onset wheezing. IMPACT In this Spanish birth cohort, with a total of 19% of mothers and 24% of children with deficient levels of vitamin D, higher child vitamin D at 4 years of age was associated with reduced odds of atopic eczema up to 9 years. There was also some evidence that higher maternal and child vitamin D levels reduced the prevalence of late-onset wheezing. Although these findings need replication, they may imply optimal vitamin D levels at pre-school age to prevent atopic eczema.
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Affiliation(s)
- Júlia Sangüesa
- ISGlobal, Barcelona, Spain.,Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain.,Universitat Pompeu Fabra (UPF), Barcelona, Spain
| | - Jordi Sunyer
- ISGlobal, Barcelona, Spain.,Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain.,Universitat Pompeu Fabra (UPF), Barcelona, Spain
| | - Raquel Garcia-Esteban
- ISGlobal, Barcelona, Spain.,Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain.,Universitat Pompeu Fabra (UPF), Barcelona, Spain
| | - Alicia Abellan
- ISGlobal, Barcelona, Spain.,Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain.,Universitat Pompeu Fabra (UPF), Barcelona, Spain.,Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
| | - Ana Esplugues
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain.,Facultat d'Infermeria i Podologia, Universitat de València, Valencia, Spain.,Unidad Mixta de Investigación en Epidemiología y Salud Ambiental, FISABIO-Universitat Jaume I-Universitat de València, Valencia, Spain
| | - Judith Garcia-Aymerich
- ISGlobal, Barcelona, Spain.,Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain.,Universitat Pompeu Fabra (UPF), Barcelona, Spain
| | - Mònica Guxens
- ISGlobal, Barcelona, Spain.,Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain.,Universitat Pompeu Fabra (UPF), Barcelona, Spain.,Department of Child and Adolescent Psychiatry, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands
| | - Amaia Irizar
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain.,Public Health Department of Gipuzkoa, San Sebastián, Spain.,Health Research Institute BIODONOSTIA, San Sebastián, Spain
| | - Jordi Júlvez
- ISGlobal, Barcelona, Spain.,Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain.,Universitat Pompeu Fabra (UPF), Barcelona, Spain.,Pere Virgili Health Research Institute (IISPV), Hospital Universitari Sant Joan de Reus, Reus (Tarragona), Spain
| | - Leire Luque-García
- Department of Preventive Medicine and Public Health, Faculty of Medicine, University of the Basque Country (UPV/EHU), Leioa, 48940, Spain
| | - Ana Cristina Rodríguez-Dehli
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain.,Hospital San Agustín, Servicio de Salud del Principado de Asturias (SESPA), Avilés, Asturias, Spain
| | - Adonina Tardón
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain.,IUOPA, University of Oviedo, Health Research Institute of Asturias, ISPA, Asturias, Spain
| | - Maties Torrent
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain.,Area de Salud de Menorca, IB-SALUT, Menorca, Spain
| | - Jesús Vioque
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain.,Institute for Health and Biomedical Research ISABIAL-UMH, Alicante, Spain.,Nutritional Epidemiology Unit, University Miguel Hernandez, Elche-Alicante, Spain
| | - Martine Vrijheid
- ISGlobal, Barcelona, Spain.,Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain.,Universitat Pompeu Fabra (UPF), Barcelona, Spain
| | - Maribel Casas
- ISGlobal, Barcelona, Spain. .,Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain. .,Universitat Pompeu Fabra (UPF), Barcelona, Spain.
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9
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Rueter K, Siafarikas A, Palmer DJ, Prescott SL. Pre- and Postnatal Vitamin D Status and Allergy Outcomes in Early Childhood. Biomedicines 2022; 10:biomedicines10050933. [PMID: 35625670 PMCID: PMC9139153 DOI: 10.3390/biomedicines10050933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2022] [Revised: 04/01/2022] [Accepted: 04/06/2022] [Indexed: 11/16/2022] Open
Abstract
The dramatic increase in the prevalence of allergic disease in recent decades reflects environmental and behavioural changes that have altered patterns of early immune development. The very early onset of allergic diseases points to the specific vulnerability of the developing immune system to environmental changes and the development of primary intervention strategies is crucial to address this unparalleled burden. Vitamin D is known to have immunomodulatory functions. While allergic disease is multifactorial, associations with reduced sunlight exposure have led to the hypothesis that suboptimal vitamin D levels during critical early periods may be one possible explanation. Interventions to improve vitamin D status, especially in early life, may be the key to allergic disease prevention.
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Affiliation(s)
- Kristina Rueter
- School of Medicine, The University of Western Australia, 35 Stirling Highway, Crawley 6009, Australia; (A.S.); (D.J.P.); (S.L.P.)
- Department of Immunology, Perth Children’s Hospital, 15 Hospital Avenue, Nedlands 6009, Australia
- inVIVO Planetary Health, Group of the Worldwide Universities Network (WUN), 6010 Park Ave, West New York, NJ 07093, USA
- Correspondence:
| | - Aris Siafarikas
- School of Medicine, The University of Western Australia, 35 Stirling Highway, Crawley 6009, Australia; (A.S.); (D.J.P.); (S.L.P.)
- Telethon Kids Institute, The University of Western Australia, 15 Hospital Avenue, Nedlands 6009, Australia
- Department of Endocrinology, Perth Children’s Hospital, 15 Hospital Avenue, Nedlands 6009, Australia
- Institute for Health Research, University of Notre Dame, Fremantle 6160, Australia
| | - Debra J. Palmer
- School of Medicine, The University of Western Australia, 35 Stirling Highway, Crawley 6009, Australia; (A.S.); (D.J.P.); (S.L.P.)
- Telethon Kids Institute, The University of Western Australia, 15 Hospital Avenue, Nedlands 6009, Australia
| | - Susan L. Prescott
- School of Medicine, The University of Western Australia, 35 Stirling Highway, Crawley 6009, Australia; (A.S.); (D.J.P.); (S.L.P.)
- Department of Immunology, Perth Children’s Hospital, 15 Hospital Avenue, Nedlands 6009, Australia
- inVIVO Planetary Health, Group of the Worldwide Universities Network (WUN), 6010 Park Ave, West New York, NJ 07093, USA
- Telethon Kids Institute, The University of Western Australia, 15 Hospital Avenue, Nedlands 6009, Australia
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10
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Adams SN, Adgent MA, Gebretsadik T, Hartman TJ, Vereen S, Ortiz C, Tylavsky FA, Carroll KN. Prenatal vitamin D levels and child wheeze and asthma. J Matern Fetal Neonatal Med 2021; 34:323-331. [PMID: 30983439 PMCID: PMC6824925 DOI: 10.1080/14767058.2019.1607286] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Revised: 03/25/2019] [Accepted: 04/10/2019] [Indexed: 01/22/2023]
Abstract
Background: Maternal vitamin D status during pregnancy may influence lung development and risk of childhood wheeze and asthma. We investigated the relationship between prenatal vitamin D and child asthma in a racially diverse cohort with a high burden of vitamin D insufficiency and child asthma.Materials and methods: We included mother-child dyads in the prenatal Conditions Affecting Neurocognitive Development and Learning in Early Childhood (CANDLE) cohort (2006-2011, Shelby County, Tennessee). Maternal plasma vitamin D [25(OH)D] was measured from second trimester (n = 1091) and delivery specimens (n = 907). At age 4-6 years, we obtained parent report of current child wheeze (symptoms within the past 12 months) and asthma (physician diagnosis and/or medication or symptoms within the past 12 months). We used multivariable logistic regression to assess associations of 25(OH)D and child wheeze/asthma, including an interaction term for maternal race.Results: Median second trimester 25(OH)D levels were 25.1 and 19.1 ng/ml in White (n = 366) and Black women (N = 725), respectively. We detected significant interactions by maternal race for second-trimester plasma 25(OH)D and child current wheeze (p = .014) and asthma (p = .011). Odds of current wheeze and asthma decreased with increasing 25(OH)D in dyads with White mothers and increased in dyads with Black mothers, e.g. adjusted odds ratio (95% confidence interval) for asthma: 0.63 (0.36-1.09) and 1.41 (1.01-1.97) per interquartile range (15-27 ng/ml 25[OH]D) increase, respectively. At delivery, protective associations in White dyads were attenuated.Conclusion: We detected effect modification by maternal race in associations between prenatal 25(OH)D and child wheeze/asthma. Further research in racially diverse populations is needed.
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Affiliation(s)
- Sarah N. Adams
- Division of Allergy and Immunology, Department of Medicine, Vanderbilt University Medical Center
| | - Margaret A. Adgent
- Division of General Pediatrics, Department of Pediatrics, Vanderbilt University Medical Center
| | | | - Terryl J. Hartman
- Department of Epidemiology, Rollins School of Public Health, Emory University
| | - Shanda Vereen
- Division of General Pediatrics, Department of Pediatrics, Vanderbilt University Medical Center
| | - Christina Ortiz
- Division of Allergy and Immunology, Department of Medicine, Vanderbilt University Medical Center
| | - Frances A Tylavsky
- Department of Preventive Medicine, University of Tennessee Health Science Center
| | - Kecia N. Carroll
- Division of General Pediatrics, Department of Pediatrics, Vanderbilt University Medical Center
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11
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Sitarik AR, Arora M, Austin C, Bielak LF, Eggers S, Johnson CC, Lynch SV, Kyun Park S, Hank Wu KH, Yong GJM, Cassidy-Bushrow AE. Fetal and early postnatal lead exposure measured in teeth associates with infant gut microbiota. ENVIRONMENT INTERNATIONAL 2020; 144:106062. [PMID: 32871381 PMCID: PMC7572588 DOI: 10.1016/j.envint.2020.106062] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Revised: 08/11/2020] [Accepted: 08/17/2020] [Indexed: 05/18/2023]
Abstract
BACKGROUND Lead (Pb) is an environmentally ubiquitous heavy metal associated with a wide range of adverse health effects in children. Both lead exposure and the early life microbiome- which plays a critical role in human development-have been linked to similar health outcomes, but it is unclear if the adverse effects of lead are partially driven by early life gut microbiota dysbiosis. The objective of this study was to examine the association between in utero and postnatal lead levels (measured in deciduous baby teeth) and early life bacterial and fungal gut microbiota in the first year of life. METHODS Data from the Wayne County Health, Environment, Allergy and Asthma Longitudinal Study (WHEALS) birth cohort were analyzed. Tooth lead levels during the 2nd and 3rd trimesters and postnatally (<1 year of age) were quantified using high-resolution microspatial mapping of dentin growth rings. Early life microbiota were measured in stool samples collected at approximately 1 and 6 months of age, using both 16S rRNA (bacterial) and ITS2 (fungal) sequencing. Of the 1,258 maternal-child pairs in WHEALS, 146 had data on both tooth metals and early life microbiome. RESULTS In utero tooth lead levels were significantly associated with gut fungal community composition at 1-month of age, where higher levels of 2nd trimester tooth lead was associated with lower abundances of Candida and Aspergillus and higher abundances of Malassezia and Saccharomyces; 3rd trimester lead was also associated with lower abundances of Candida. Though lead did not significantly associate with the overall structure of the infant gut bacterial community, it associated with the abundance of some specific bacterial taxa, including the increased abundance of Collinsella and Bilophila and a decreased abundance of Bacteroides taxa. CONCLUSIONS The observed associations between lead exposure and infant gut microbiota could play a role in the impact of lead on childhood development. Given the paucity of research examining these associations in humans-particularly for fungal microbiota-further investigation is needed.
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Affiliation(s)
- Alexandra R Sitarik
- Department of Public Health Sciences, Henry Ford Health System, Detroit, USA.
| | - Manish Arora
- Senator Frank R Lautenberg Environmental Health Sciences Laboratory, Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York City, USA.
| | - Christine Austin
- Senator Frank R Lautenberg Environmental Health Sciences Laboratory, Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York City, USA.
| | | | - Shoshannah Eggers
- Senator Frank R Lautenberg Environmental Health Sciences Laboratory, Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York City, USA.
| | - Christine C Johnson
- Department of Public Health Sciences, Henry Ford Health System, Detroit, USA.
| | - Susan V Lynch
- Division of Gastroenterology, Department of Medicine, University of California, San Francisco, USA.
| | - Sung Kyun Park
- Department of Epidemiology, University of Michigan, Ann Arbor, USA; Department of Environmental Health Sciences, University of Michigan, Ann Arbor, USA.
| | - Kuan-Han Hank Wu
- Department of Public Health Sciences, Henry Ford Health System, Detroit, USA.
| | - Germaine J M Yong
- Division of Gastroenterology, Department of Medicine, University of California, San Francisco, USA.
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12
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Kassem Z, Sitarik A, Levin AM, Lynch SV, Havstad S, Fujimura K, Kozyrskyj A, Ownby DR, Johnson CC, Yong GJM, Wegienka G, Cassidy-Bushrow AE. Maternal and cord blood vitamin D level and the infant gut microbiota in a birth cohort study. Matern Health Neonatol Perinatol 2020; 6:5. [PMID: 33101701 PMCID: PMC7576815 DOI: 10.1186/s40748-020-00119-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Accepted: 10/08/2020] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Mounting evidence suggests both vitamin D and the early life gut microbiome influence childhood health outcomes. However, little is known about how these two important exposures are related. We aimed to examine associations between plasma 25-hydroxyvitamin D (25[OH]D) levels during pregnancy or at delivery (cord blood) and infant gut microbiota. METHODS Maternal and cord blood 25[OH]D levels were assessed in a sample of pregnant women. Compositional analyses adjusted for race were run on the gut microbiota of their offspring at 1 and 6 months of age. RESULTS Mean prenatal 25(OH)D level was 25.04 ± 11.62 ng/mL and mean cord blood 25(OH)D level was 10.88 ± 6.77 ng/mL. Increasing prenatal 25(OH)D level was significantly associated with decreased richness (p = 0.028) and diversity (p = 0.012) of the gut microbiota at 1 month of age. Both prenatal and cord 25(OH)D were significantly associated with 1 month microbiota composition. A total of 6 operational taxonomic units (OTUs) were significantly associated with prenatal 25(OH)D level (four positively and two negatively) while 11 OTUs were significantly associated with cord 25(OH)D (10 positively and one negatively). Of these, OTU 93 (Acinetobacter) and OTU 210 (Corynebacterium), were consistently positively associated with maternal and cord 25(OH)D; OTU 64 (Ruminococcus gnavus) was positively associated with prenatal 25(OH)D but negatively associated with cord 25(OH)D. CONCLUSIONS Prenatal maternal and cord blood 25(OH)D levels are associated with the early life gut microbiota. Future studies are needed to understand how vitamin D and the microbiome may interact to influence child health.
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Affiliation(s)
- Zeinab Kassem
- Department of Public Health Sciences, Henry Ford Hospital, 1 Ford Place, 5C, Detroit, MI 48202 USA
| | - Alexandra Sitarik
- Department of Public Health Sciences, Henry Ford Hospital, 1 Ford Place, 5C, Detroit, MI 48202 USA
| | - Albert M. Levin
- Department of Public Health Sciences, Henry Ford Hospital, 1 Ford Place, 5C, Detroit, MI 48202 USA
| | - Susan V. Lynch
- Department of Medicine, University of California, San Francisco, CA USA
| | - Suzanne Havstad
- Department of Public Health Sciences, Henry Ford Hospital, 1 Ford Place, 5C, Detroit, MI 48202 USA
| | - Kei Fujimura
- Department of Medicine, University of California, San Francisco, CA USA
| | - Anita Kozyrskyj
- Department of Pediatrics, University of Alberta, Alberta, Canada
| | - Dennis R. Ownby
- Division of Allergy and Clinical Immunology, Department of Pediatrics, Georgia Regents University, Augusta, GA USA
| | - Christine Cole Johnson
- Department of Public Health Sciences, Henry Ford Hospital, 1 Ford Place, 5C, Detroit, MI 48202 USA
- Center for Urban Responses to Environmental Stressors, Wayne State University, Detroit, MI USA
| | | | - Ganesa Wegienka
- Department of Public Health Sciences, Henry Ford Hospital, 1 Ford Place, 5C, Detroit, MI 48202 USA
- Center for Urban Responses to Environmental Stressors, Wayne State University, Detroit, MI USA
| | - Andrea E. Cassidy-Bushrow
- Department of Public Health Sciences, Henry Ford Hospital, 1 Ford Place, 5C, Detroit, MI 48202 USA
- Center for Urban Responses to Environmental Stressors, Wayne State University, Detroit, MI USA
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13
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Chen Y, Lyu J, Xia Y, Zhu J, Tong S, Ying Y, Qu J, Li S. Effect of maternal sleep, physical activity and screen time during pregnancy on the risk of childhood respiratory allergies: a sex-specific study. Respir Res 2020; 21:230. [PMID: 32883301 PMCID: PMC7650521 DOI: 10.1186/s12931-020-01497-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Accepted: 08/27/2020] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Early life exposure in the uterus had a long-term effect on children's health. As the prevalence of allergies is increasing with a remarkable sex difference, very few studies have traced back to their early origins. We sought to investigate if maternal behavioral exposure, herein sleep, physical activity, and screen time during pregnancy is associated with childhood respiratory allergies. The sex difference would be examined. METHODS Six thousand two hundred thirty-six mother-child pairs from Shanghai Children Allergy Study (SCAS) were enrolled, The International Study of Asthma and Allergies in Childhood questionnaire was adopted to evaluate respiratory allergic diseases. RESULTS 14.6, 16.2, and 21.0% of children had asthma, wheeze, and allergic rhinitis, respectively. Maternal short sleep duration, lack of physical activity, and too much screen exposure during pregnancy could increase the risk of childhood respiratory allergies, however, the significance was found only in males. Moreover, a dose-response trend was clearly shown, any two of the three combined could increase the risk (OR,1.921; 95% CI,1.217-3.033), and the coexistence of all three further amplified the risk (OR,2.412; 95% CI,1.489-3.906). The findings can be verified in allergen test subgroup and each single type of respiratory allergies in most cases. CONCLUSIONS Maternal unhealthy behaviors during pregnancy could increase the risk of childhood respiratory allergies with a dose-response pattern. Males were more susceptible to the association. The identification of modifiable maternal risk behaviors lies in the emphasis of intervention in early life to face up increasing childhood allergies.
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Affiliation(s)
- Yiting Chen
- School of Public Health, Shanghai Jiao Tong University School of Medicine, 227 South Chongqing Road, Huangpu District, Shanghai, 200025, China
| | - Jiajun Lyu
- School of Public Health, Shanghai Jiao Tong University School of Medicine, 227 South Chongqing Road, Huangpu District, Shanghai, 200025, China
| | - Yuanqing Xia
- School of Public Health, Shanghai Jiao Tong University School of Medicine, 227 South Chongqing Road, Huangpu District, Shanghai, 200025, China
| | - Jianzhen Zhu
- School of International and Public Affairs, Shanghai Jiao Tong University, Shanghai, China
| | - Shilu Tong
- School of Public Health, Shanghai Jiao Tong University School of Medicine, 227 South Chongqing Road, Huangpu District, Shanghai, 200025, China.,Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,School of Public Health and Social Work, Queensland University of Technology, Brisbane, Australia
| | - Yong Ying
- Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jiajie Qu
- Shanghai Municipal Education Commission, 100 Dagu Road, Huangpu District, Shanghai, 200003, China.
| | - Shenghui Li
- School of Public Health, Shanghai Jiao Tong University School of Medicine, 227 South Chongqing Road, Huangpu District, Shanghai, 200025, China. .,MOE-Shanghai Key Laboratory of Children's Environmental Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
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14
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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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15
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Milliken S, Allen RM, Lamont RF. The role of antimicrobial treatment during pregnancy on the neonatal gut microbiome and the development of atopy, asthma, allergy and obesity in childhood. Expert Opin Drug Saf 2019; 18:173-185. [PMID: 30739516 DOI: 10.1080/14740338.2019.1579795] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
INTRODUCTION The use of antibiotics prenatally, during pregnancy, or neonatally may have adverse effects on the neonatal gut microbiome, and adversely affect the development of the infant immune system, leading to childhood atopy, asthma, allergy and obesity. AREAS COVERED Vaginal eubiosis and dysbiosis from molecular-based, cultivation-independent techniques, and how this affects the neonatal gut microbiome and early development of the immune system, the association between maternal antibiotics and the beneficial role of vitamin D in the development of atopy, asthma, allergy and obesity, efforts to reduce the use of antibiotics in pregnancy and therapeutic interventions such as vaginal 'seeding', probiotics, breastfeeding and neonatal dietary supplementation. EXPERT OPINION Currently available research gives insufficient attention to confounding variables. There remains uncertainty as to whether it is relevant that the mother suffered from the same condition as the purported infant outcome variable, for which she may have received antibiotics. In most studies, there is a lack of control for the number of antibiotic courses administered, the timing of use, the use of broad spectrum or narrow range antibiotics, the indication for antibiotics, the dose-dependent nature of the effect, the class of antibiotics used, or a varying degree of risk.
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Affiliation(s)
- Sarah Milliken
- a Department of Obstetrics and Gynaecology, Simpsons Centre for Reproductive Health , Royal Infirmary of Edinburgh , Edinburgh , UK
| | - Ruridh M Allen
- b Department of Gastroenterology, Division of Medicine , Royal Infirmary of Edinburgh , Edinburgh , UK
| | - Ronald F Lamont
- c Division of Surgery , University College London, Northwick Park Institute of Medical Research Campus , London , UK.,d Institute of Clinical Research , University of Southern Denmark , Odense , Denmark
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16
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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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17
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Hennessy Á, Hourihane JO, Malvisi L, Irvine AD, Kenny LC, Murray DM, Kiely ME. Antenatal vitamin D exposure and childhood eczema, food allergy, asthma and allergic rhinitis at 2 and 5 years of age in the atopic disease-specific Cork BASELINE Birth Cohort Study. Allergy 2018; 73:2182-2191. [PMID: 30085352 DOI: 10.1111/all.13590] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Revised: 07/19/2018] [Accepted: 07/31/2018] [Indexed: 12/24/2022]
Abstract
BACKGROUND Prospective studies of antenatal and infant vitamin D exposure and atopic disease from extensively characterised, disease-specific, maternal-infant cohorts with gold standard analysis of vitamin D status and clinically validated atopic outcomes are lacking. This study aimed to investigate associations between intrauterine vitamin D status and atopic outcomes in an extensively characterised, disease-specific, maternal-infant cohort. METHODS Circulating 25-hydroxyvitamin D (25(OH)D) was measured in maternal sera at 15 weeks of gestation (n = 1537) and umbilical cord blood (n = 1050) using a CDC-accredited LC-MS/MS platform, and the association with clinically validated atopic disease outcomes (eczema, food allergy, asthma, allergic rhinitis) at 2 and 5 years was explored using multivariable logistic regression. RESULTS Persistent eczema in the first 2 years of life was present in 5% of infants. Food allergy at 2 years was confirmed in 4%. The prevalence of aeroallergen sensitisation at 2 years was 8%. Asthma at 5 years was reported in 15% and allergic rhinitis in 5% of 5-year-olds. There were no significant differences in the distributions of maternal 25(OH)D at 15 weeks of gestation (mean [SD] 58.4 [26.2] and 58.5 [26.1] nmol/L) and cord 25(OH)D concentrations (mean [SD] 35.2 [17.8] and 35.4 [18.3] nmol/L) between children with and without atopic disease. Neither maternal (aOR [95% CI]: 1.02 [0.97, 1.08], P = 0.450) nor cord 25(OH)D (aOR [95% CI]: 1.00 [0.91, 1.09], P = 0.991) were significant predictors of atopic disease outcomes in fully adjusted models. CONCLUSION These data in a disease-specific cohort with prospectively collected, validated atopic outcomes do not support an association between antenatal exposure to vitamin D and atopic disease outcomes in childhood.
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Affiliation(s)
- Áine Hennessy
- Cork Centre for Vitamin D and Nutrition Research; School of Food and Nutritional Sciences; University College Cork; Cork Ireland
- The Irish Centre for Fetal and Neonatal Translational Research (INFANT); University College Cork; Cork Ireland
| | - Jonathan O'B Hourihane
- The Irish Centre for Fetal and Neonatal Translational Research (INFANT); University College Cork; Cork Ireland
- Department of Paediatrics and Child Health; College of Medicine and Health; University College Cork; Cork Ireland
| | - Lucio Malvisi
- Cork Centre for Vitamin D and Nutrition Research; School of Food and Nutritional Sciences; University College Cork; Cork Ireland
- The Irish Centre for Fetal and Neonatal Translational Research (INFANT); University College Cork; Cork Ireland
| | - Alan D. Irvine
- The Irish Centre for Fetal and Neonatal Translational Research (INFANT); University College Cork; Cork Ireland
- Department of Clinical Medicine; Trinity College; Dublin Ireland
- Department of Paediatric Dermatology; Our Lady's Children's Hospital; Dublin Ireland
- National Children's Research Centre; Dublin Ireland
| | - Louise C. Kenny
- Department of Women's and Children's Health; Institute of Translational Medicine; University of Liverpool; Liverpool UK
| | - Deirdre M. Murray
- The Irish Centre for Fetal and Neonatal Translational Research (INFANT); University College Cork; Cork Ireland
- Department of Paediatrics and Child Health; College of Medicine and Health; University College Cork; Cork Ireland
| | - Mairead E. Kiely
- Cork Centre for Vitamin D and Nutrition Research; School of Food and Nutritional Sciences; University College Cork; Cork Ireland
- The Irish Centre for Fetal and Neonatal Translational Research (INFANT); University College Cork; Cork Ireland
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18
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Shen SY, Xiao WQ, Lu JH, Yuan MY, He JR, Xia HM, Qiu X, Cheng KK, Lam KBH. Early life vitamin D status and asthma and wheeze: a systematic review and meta-analysis. BMC Pulm Med 2018; 18:120. [PMID: 30029599 PMCID: PMC6053833 DOI: 10.1186/s12890-018-0679-4] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2017] [Accepted: 06/25/2018] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Vitamin D deficiency has been linked to an increased risk of asthma. This study aimed to quantify the effect of early life vitamin D status on asthma and wheeze later in life. METHODS PubMed, Embase, CINAHL, and CNKI databases, the Cochrane Central Register of Controlled Trials, and Google Scholar were searched up to July 2017. We included randomized controlled trials (RCTs) and cohort studies with vitamin D level in blood (maternal or cord or infant) or intake (maternal intake during pregnancy or infant intake) and asthma and/or wheeze. Two reviewers independently extracted data. Fixed- and random-effects models were used to summarize the risk estimates of comparisons between highest vs. lowest vitamin D categories. RESULTS Of the 1485 studies identified, three RCTs and 33 cohort studies were included. We did not include the RCTs (1619 participants) in the meta-analysis as the comparators and outcome definitions were heterogenous. Three RCTs reported a non-statistically significant effect of vitamin D supplementation during pregnancy on offspring wheeze/asthma at 3 years of age. Pooled estimates of cohort studies suggest no association between antenatal blood vitamin D levels or vitamin D intake and offspring asthma assessed either > 5 years or ≤ 5 years. The estimate for blood vitamin D remained unchanged when two studies assessing asthma in adulthood were excluded, but a significant inverse association emerged between vitamin D intake and childhood asthma. We found no association between antenatal vitamin D level and wheeze. On the other hand, vitamin D intake during pregnancy may have a protective effect against wheeze. CONCLUSIONS The pooled estimates from cohort studies show no association between antenatal blood vitamin D level and asthma/wheeze in later life. Whereas, the pooled estimates from cohort studies suggest that antenatal vitamin D intake may have an effect on childhood asthma > 5 years or childhood wheeze. The inconsistent results from studies assessing vitamin D either in blood or intake may be explained by previously reported non-linear association between blood vitamin D3 and childhood asthma. Further trials with enough power and longer follow-up time should be conducted to confirm the results.
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Affiliation(s)
- Song-Ying Shen
- Division of Birth Cohort Study, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, 9 Junsui Road, Zhujiang Newtown, Tianhe District, Guangzhou, 510623 China
| | - Wan-Qing Xiao
- Division of Birth Cohort Study, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, 9 Junsui Road, Zhujiang Newtown, Tianhe District, Guangzhou, 510623 China
| | - Jin-Hua Lu
- Division of Birth Cohort Study, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, 9 Junsui Road, Zhujiang Newtown, Tianhe District, Guangzhou, 510623 China
| | - Ming-Yang Yuan
- Division of Birth Cohort Study, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, 9 Junsui Road, Zhujiang Newtown, Tianhe District, Guangzhou, 510623 China
| | - Jian-Rong He
- Division of Birth Cohort Study, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, 9 Junsui Road, Zhujiang Newtown, Tianhe District, Guangzhou, 510623 China
| | - Hui-Min Xia
- Department of Pediatric Surgery, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Xiu Qiu
- Division of Birth Cohort Study, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, 9 Junsui Road, Zhujiang Newtown, Tianhe District, Guangzhou, 510623 China
| | - Kar Keung Cheng
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Kin Bong Hubert Lam
- Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
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Pacheco-González RM, García-Marcos L, Morales E. Prenatal vitamin D status and respiratory and allergic outcomes in childhood: A meta-analysis of observational studies. Pediatr Allergy Immunol 2018; 29:243-253. [PMID: 29444346 DOI: 10.1111/pai.12876] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/08/2018] [Indexed: 02/06/2023]
Abstract
BACKGROUND Prenatal vitamin D status may influence offspring's respiratory and allergic outcomes; however, evidence is inconclusive. A systematic review and meta-analysis were conducted on the association between 25-hydroxyvitamin D [25(OH)D] levels in maternal blood in pregnancy or cord blood at birth with the risk of offspring's respiratory and allergic conditions. METHODS Two independent researchers conducted systematic searches for observational studies published until May 2017 using defined keywords on vitamin D and health outcomes, including respiratory tract infections (RTIs), wheeze, asthma, atopic eczema, allergic rhinitis, allergic sensitization, and lung function. Random-effects meta-analyses were conducted. RESULTS A total of 34 from 547 retrieved articles were included. Increased prenatal exposure to 25(OH)D was inversely associated with risk of RTIs. Comparing the highest with the lowest category of 25(OH)D levels, the pooled odds ratio was 0.64 (95% CI 0.47, 0.87). A positive borderline association was found for lung function at school age (FEV1 z-score coefficient 0.07, 95% CI -0.01, 0.15). No associations were found for wheeze, asthma, atopic eczema, allergic rhinitis, and allergic sensitization. CONCLUSION The introduction of public health measures to tackle vitamin D status in pregnancy may reduce the burden of RTIs in offspring. Current evidence does not support an impact on asthma and allergy.
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Affiliation(s)
- Rosa M Pacheco-González
- Biomedical Research Institute of Murcia (IMIB-Arrixaca), Murcia, Spain.,University of Murcia, Murcia, Spain.,Virgen de la Arrixaca University Hospital, Murcia, Spain
| | - Luis García-Marcos
- Biomedical Research Institute of Murcia (IMIB-Arrixaca), Murcia, Spain.,University of Murcia, Murcia, Spain.,Virgen de la Arrixaca University Hospital, Murcia, Spain.,Red de Asma Reacciones Adversas y Alérgicas (ARADyAL), Madrid, Spain
| | - Eva Morales
- Biomedical Research Institute of Murcia (IMIB-Arrixaca), Murcia, Spain.,University of Murcia, Murcia, Spain.,Virgen de la Arrixaca University Hospital, Murcia, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
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20
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Asthma and Allergy "Epidemic" and the Role of Vitamin D Deficiency. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2018; 996:169-183. [PMID: 29124699 DOI: 10.1007/978-3-319-56017-5_14] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
The increase in asthma and allergies prevalence that has been recorded in many countries during the last decades, and the reemergence of vitamin D (VD) deficiency in many populations worldwide, renders fairly plausible the assumption of an underlying association between these two conditions and justifies the research effort invented in this issue. Indeed, there is growing body of evidence from epidemiological, laboratory, and clinical studies, suggesting that such an association does exist. The hypothesis of low levels of VD leading to compromised fetal programming and impairment of various immune functions involved in asthma and allergic disorders, stands as the most credible explanation of this presumed association. However, the evidence is not yet definite and there are some conflicting results among studies. As a consequence, no safe conclusions can be drawn yet, and more research is required in order to fully clarify the involvement of VD deficiency in the pathogenesis of asthma and allergies, and decide if VD has a role to play in the prevention and therapy of these disorders.
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21
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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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22
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Wu HY, Chen JX, Tian HQ, Zhang XL, Bian HY, Cheng L. Serum 25-hydroxyvitamin D inversely associated with blood eosinophils in patients with persistent allergic rhinitis. Asia Pac Allergy 2017; 7:213-220. [PMID: 29094019 PMCID: PMC5663749 DOI: 10.5415/apallergy.2017.7.4.213] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2017] [Accepted: 09/19/2017] [Indexed: 12/24/2022] Open
Abstract
Objective The relationship between vitamin D and allergic rhinitis (AR) remains unclear. The present study investigated their association by examining serum 25-hydroxyvitamin D (25(OH)D) levels, blood eosinophils, and the expression of vitamin D receptors (VDR) on nasal mucosa in patients with AR. Methods A total of 32 patients with persistent AR and 25 controls were enrolled in this study. Serum 25(OH)D levels were detected by enzyme-linked immunosorbent assay, and eosinophils in the peripheral blood were examined by an automated hematology system, while VDR expression on inferior turbinate mucosa was assessed by immunohistochemistry. Furthermore, the correlation of serum 25(OH)D levels with blood eosinophils in persistent AR was analyzed. Results No significant difference in serum 25(OH)D levels was detected between the AR and control groups (p = 0.371). Interestingly, the serum 25(OH)D levels of the AR group were negatively correlated with blood eosinophil count and its proportion (p = 0.019 and p = 0.010, respectively) even when adjusting confounding factors including age, sex, body mass index, and the season of blood sampling. On the other hand, no significant difference in the expression levels of VDR on nasal mucosa was found between the AR group and the control group (p = 0.231). Conclusion These results suggest that the serum 25(OH)D might be inversely associated with blood eosinophils in patients with persistent AR. However, the relationship between vitamin D and AR still requires further clarification.
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Affiliation(s)
- Hai-Yan Wu
- Department of Otorhinolaryngology, The First Affiliated Hospital, Nanjing Medical University, Nanjing 210029, Jiangsu, China.,Department of Otorhinolaryngology, Affiliated Jiangyin Hospital, Medical College of Southeast University, Jiangyin 214400, Jiangsu, China
| | - Jin-Xiang Chen
- Department of Otorhinolaryngology, Affiliated Jiangyin Hospital, Medical College of Southeast University, Jiangyin 214400, Jiangsu, China
| | - Hui-Qin Tian
- Department of Otorhinolaryngology, The First Affiliated Hospital, Nanjing Medical University, Nanjing 210029, Jiangsu, China
| | - Xiu-Ling Zhang
- Department of Otorhinolaryngology, Affiliated Jiangyin Hospital, Medical College of Southeast University, Jiangyin 214400, Jiangsu, China
| | - Hai-Yan Bian
- Department of Otorhinolaryngology, Affiliated Jiangyin Hospital, Medical College of Southeast University, Jiangyin 214400, Jiangsu, China
| | - Lei Cheng
- Department of Otorhinolaryngology, The First Affiliated Hospital, Nanjing Medical University, Nanjing 210029, Jiangsu, China.,International Centre for Allergy Research, Nanjing Medical University, Nanjing 210029, Jiangsu, China
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23
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Prenatal exposures and the development of childhood wheezing illnesses. Curr Opin Allergy Clin Immunol 2017; 17:110-115. [PMID: 28079560 DOI: 10.1097/aci.0000000000000342] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
PURPOSE OF REVIEW To critically evaluate and summarize studies published between July 2015 and June 2016 linking prenatal exposures and the onset of childhood wheezing illnesses and to discuss future research directions in this field. RECENT FINDINGS The aggregated evidence indicates a consistent detrimental effect of prenatal exposure to parental smoking, outdoor air pollution, and maternal stress on childhood wheezing illnesses. Less consistent evidence suggests an adverse impact of maternal obesity during pregnancy and prenatal exposure to antibiotics on these outcomes. There is insufficient evidence to support an association between in-utero exposure to acetaminophen or prenatal levels of specific nutrients (such as vitamin D, folic acid, or polyunsaturated fatty acids) and childhood wheezing illnesses. SUMMARY Several common potentially modifiable prenatal exposures appear to be consistently associated with childhood wheezing illnesses (e.g. parental smoking, outdoor air pollution, and maternal stress). However, the effect of many other prenatal exposures on the onset of childhood wheezing illnesses remains unclear. The existing scientific evidence from the past year does not allow us to make any new recommendations on primary prevention measures. Intervention studies will best demonstrate whether changing the prenatal environment can prevent childhood wheezing illnesses and asthma.
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Molloy J, Koplin JJ, Allen KJ, Tang MLK, Collier F, Carlin JB, Saffery R, Burgner D, Ranganathan S, Dwyer T, Ward AC, Moreno-Betancur M, Clarke M, Ponsonby AL, Vuillermin P. Vitamin D insufficiency in the first 6 months of infancy and challenge-proven IgE-mediated food allergy at 1 year of age: a case-cohort study. Allergy 2017; 72:1222-1231. [PMID: 28042676 DOI: 10.1111/all.13122] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/31/2016] [Indexed: 12/13/2022]
Abstract
BACKGROUND Ecological evidence suggests vitamin D insufficiency (VDI) due to lower ambient ultraviolet radiation (UVR) exposure may be a risk factor for IgE-mediated food allergy. However, there are no studies relating directly measured VDI during early infancy to subsequent challenge-proven food allergy. OBJECTIVE To prospectively investigate the association between VDI during infancy and challenge-proven food allergy at 1 year. METHODS In a birth cohort (n = 1074), we used a case-cohort design to compare 25-hydroxyvitamin D3 (25(OH)D3 ) levels among infants with food allergy vs a random subcohort (n = 274). The primary exposures were VDI (25(OH)D3 <50 nM) at birth and 6 months of age. Ambient UVR and time in the sun were combined to estimate UVR exposure dose. IgE-mediated food allergy status at 1 year was determined by formal challenge. Binomial regression was used to examine associations between VDI, UVR exposure dose and food allergy and investigate potential confounding. RESULTS Within the random subcohort, VDI was present in 45% (105/233) of newborns and 24% (55/227) of infants at 6 months. Food allergy prevalence at 1 year was 7.7% (61/786), and 6.5% (53/808) were egg-allergic. There was no evidence of an association between VDI at either birth (aRR 1.25, 95% CI 0.70-2.22) or 6 months (aRR 0.93, 95% CI 0.41-2.14) and food allergy at 1 year. CONCLUSIONS There was no evidence that VDI during the first 6 months of infancy is a risk factor for food allergy at 1 year of age. These findings primarily relate to egg allergy, and larger studies are required.
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Affiliation(s)
- J. Molloy
- School of Medicine; Deakin University; Waurn Ponds VIC Australia
- Child Health Research Unit; Barwon Health; Geelong VIC Australia
- Murdoch Childrens Research Institute; Parkville VIC Australia
- Centre for Food and Allergy Research; Parkville VIC Australia
| | - J. J. Koplin
- Murdoch Childrens Research Institute; Parkville VIC Australia
- Centre for Food and Allergy Research; Parkville VIC Australia
- Centre for Epidemiology and Biostatistics; The University of Melbourne; Carlton VIC Australia
| | - K. J. Allen
- Murdoch Childrens Research Institute; Parkville VIC Australia
- Centre for Food and Allergy Research; Parkville VIC Australia
- Department of Paediatrics; University of Melbourne; Parkville VIC Australia
- Department of Allergy and Immunology; Royal Children's Hospital; Parkville VIC Australia
| | - M. L. K. Tang
- Murdoch Childrens Research Institute; Parkville VIC Australia
- Centre for Food and Allergy Research; Parkville VIC Australia
- Department of Paediatrics; University of Melbourne; Parkville VIC Australia
- Department of Allergy and Immunology; Royal Children's Hospital; Parkville VIC Australia
| | - F. Collier
- School of Medicine; Deakin University; Waurn Ponds VIC Australia
- Child Health Research Unit; Barwon Health; Geelong VIC Australia
- Murdoch Childrens Research Institute; Parkville VIC Australia
| | - J. B. Carlin
- Murdoch Childrens Research Institute; Parkville VIC Australia
- Centre for Epidemiology and Biostatistics; The University of Melbourne; Carlton VIC Australia
- Department of Paediatrics; University of Melbourne; Parkville VIC Australia
| | - R. Saffery
- Murdoch Childrens Research Institute; Parkville VIC Australia
| | - D. Burgner
- Murdoch Childrens Research Institute; Parkville VIC Australia
- Department of Paediatrics; University of Melbourne; Parkville VIC Australia
- Department of Paediatrics; Monash University; Clayton VIC Australia
| | - S. Ranganathan
- Murdoch Childrens Research Institute; Parkville VIC Australia
- Department of Paediatrics; University of Melbourne; Parkville VIC Australia
- Department of Respiratory Medicine; Royal Children's Hospital; Parkville VIC Australia
| | - T. Dwyer
- The George Institute for Global Health; University of Oxford; Oxford UK
| | - A. C. Ward
- School of Medicine; Deakin University; Waurn Ponds VIC Australia
| | - M. Moreno-Betancur
- Murdoch Childrens Research Institute; Parkville VIC Australia
- Department of Epidemiology and Preventive Medicine; Monash University; Melbourne VIC Australia
| | - M. Clarke
- Biological and Molecular Mass Spectrometry Facility; Centre for Microscopy, Characterisation and Analysis; University of Western Australia; Perth Western Australia 6009
| | - A. L. Ponsonby
- Murdoch Childrens Research Institute; Parkville VIC Australia
- Centre for Food and Allergy Research; Parkville VIC Australia
| | - P. Vuillermin
- School of Medicine; Deakin University; Waurn Ponds VIC Australia
- Child Health Research Unit; Barwon Health; Geelong VIC Australia
- Murdoch Childrens Research Institute; Parkville VIC Australia
- Centre for Food and Allergy Research; Parkville VIC Australia
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25
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Tian HQ, Cheng L. The role of vitamin D in allergic rhinitis. Asia Pac Allergy 2017; 7:65-73. [PMID: 28487837 PMCID: PMC5410413 DOI: 10.5415/apallergy.2017.7.2.65] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2017] [Accepted: 04/06/2017] [Indexed: 12/23/2022] Open
Abstract
Recent studies suggest that vitamin D is related to allergic rhinitis (AR). In this review, we first discuss the physiology and metabolism of vitamin D, then we review the function of vitamin D in the immune system, and above all, we highlight the current research regarding the role of vitamin D in AR. Finally, we find that there are both experimental and clinical studies showing that vitamin D is associated with AR, although the results are not consistent and even conflicting. Evidences from those clinical studies show a slightly tendency that serum vitamin D level might be inversely associated with the risk of AR. Meanwhile, it seems that gender and age may influence the relationship between vitamin D and AR. However, because of the heterogeneity in defining AR, differences in study design and so on, all these findings need to be confirmed by further studies. Additional clinical studies as well as experimental research are needed to better understand how vitamin D influences AR.
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Affiliation(s)
- Hui-Qin Tian
- Department of Otorhinolaryngology, The First Affiliated Hospital, Nanjing Medical University, Nanjing, China
| | - Lei Cheng
- Department of Otorhinolaryngology, The First Affiliated Hospital, Nanjing Medical University, Nanjing, China.,International Centre for Allergy Research, Nanjing Medical University, Nanjing, China
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26
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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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27
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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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28
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The Role of Hypoallergenic Formula and Dietary Supplements in the Prevention of Early Onset Allergic Disease. CURRENT PEDIATRICS REPORTS 2016. [DOI: 10.1007/s40124-016-0101-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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29
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du Toit G, Tsakok T, Lack S, Lack G. Prevention of food allergy. J Allergy Clin Immunol 2016; 137:998-1010. [PMID: 27059727 DOI: 10.1016/j.jaci.2016.02.005] [Citation(s) in RCA: 130] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2015] [Revised: 02/18/2016] [Accepted: 02/19/2016] [Indexed: 01/21/2023]
Abstract
The past few decades have witnessed an increase in the prevalence of IgE-mediated food allergy (FA). For prevention strategies to be effective, we need to understand the causative factors underpinning this rise. Genetic factors are clearly important in the development of FA, but given the dramatic increase in prevalence over a short period of human evolution, it is unlikely that FA arises through germline genetic changes alone. A plausible hypothesis is that 1 or more environmental exposures, or lack thereof, induce epigenetic changes that result in interruption of the default immunologic state of tolerance. Strategies for the prevention of FA might include primary prevention, which seeks to prevent the onset of IgE sensitization; secondary prevention, which seeks to interrupt the development of FA in IgE-sensitized children; and tertiary prevention, which seeks to reduce the expression of end-organ allergic disease in children with established FA. This review emphasizes the prevention of IgE-mediated FA through dietary manipulation, among other strategies; in particular, we focus on recent interventional studies in this field.
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Affiliation(s)
- George du Toit
- King's College London, King's Health Partners, MRC & Asthma UK Centre in Allergic Mechanisms of Asthma, and the Department of Paediatric Allergy, Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom
| | - Teresa Tsakok
- King's College London and St John's Institute of Dermatology, Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom
| | - Simon Lack
- Imperial College London, London, United Kingdom
| | - Gideon Lack
- King's College London, King's Health Partners, MRC & Asthma UK Centre in Allergic Mechanisms of Asthma, and the Department of Paediatric Allergy, Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom.
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30
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Quirk SK, Rainwater E, Shure AK, Agrawal DK. Vitamin D in atopic dermatitis, chronic urticaria and allergic contact dermatitis. Expert Rev Clin Immunol 2016; 12:839-47. [PMID: 27014952 DOI: 10.1586/1744666x.2016.1171143] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Vitamin D influences allergen-induced pathways in the innate and adaptive immune system, and its potential immunomodulatory role in allergic skin disorders has been explored. This comprehensive review article provides an overview of the role of vitamin D in three common dermatologic conditions: atopic dermatitis (AD), chronic urticaria, and allergic contact dermatitis (ACD). Whereas the literature regarding vitamin D and AD has resulted in mixed findings, several studies have described an inverse relationship between vitamin D levels and AD severity, and improvement in AD with vitamin D supplementation. Similarly, several studies report an inverse relationship between vitamin D levels and severity of chronic urticaria. Although current research in humans remains limited, an increased likelihood of ACD has been demonstrated in vitamin D-deficient mice. Additional well-designed clinical trials will be necessary to determine whether vitamin D supplementation should be recommended for prevention or adjuvant treatment of these common dermatologic conditions.
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Affiliation(s)
- Shannon K Quirk
- a Department of Clinical & Translational Science , Creighton University School of Medicine , Omaha , NE , USA
| | - Ellecia Rainwater
- a Department of Clinical & Translational Science , Creighton University School of Medicine , Omaha , NE , USA
| | - Anna K Shure
- a Department of Clinical & Translational Science , Creighton University School of Medicine , Omaha , NE , USA
| | - Devendra K Agrawal
- a Department of Clinical & Translational Science , Creighton University School of Medicine , Omaha , NE , USA
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31
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Maternal-Cord Blood Vitamin D Correlations Vary by Maternal Levels. J Pregnancy 2016; 2016:7474192. [PMID: 27066272 PMCID: PMC4811107 DOI: 10.1155/2016/7474192] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2015] [Accepted: 02/15/2016] [Indexed: 01/18/2023] Open
Abstract
Vitamin D levels of pregnant women and their neonates tend to be related; however, it is unknown whether there are any subgroups in which they are not related. 25-Hydroxyvitamin D [25(OH)D] was measured in prenatal maternal and child cord blood samples of participants (n = 241 pairs) in a birth cohort. Spearman correlations were examined within subgroups defined by prenatal and delivery factors. Cord blood as a percentage of prenatal 25(OH)D level was calculated and characteristics compared between those who did and did not have ≥25% and ≥50% of the maternal level and those who did and did not have a detectable 25(OH)D level. The correlation among Black children was lower than in White children. When the maternal 25(OH)D level was <15 ng/mL, the overall correlation was r = 0.16. Most children had a 25(OH)D cord blood level less than half of their mother's; 15.4% had a level that was <25% of their mother's. Winter birth and maternal level were associated with the level being less than 25%. Children with undetectable levels were more likely to be Black and less likely to be firstborn. These data suggest mothers may reduce their contribution to the fetus's 25(OH)D supply once their own level becomes low.
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