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Grund JC, Krammer S, Yang Z, Mitländer H, Rauh M, Zirlik S, Kiefer A, Zimmermann T, Rieker RJ, Geppert CI, Papadopoulos NG, Finotto S. Vitamin D 3 resolved human and experimental asthma via B lymphocyte-induced maturation protein 1 in T cells and innate lymphoid cells. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. GLOBAL 2023; 2:100099. [PMID: 37779516 PMCID: PMC10510005 DOI: 10.1016/j.jacig.2023.100099] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 02/15/2023] [Accepted: 03/04/2023] [Indexed: 10/03/2023]
Abstract
Background Vitamin D3 (VitD3) is known to have immunomodulatory functions, and VitD3 deficiency is associated with more severe asthma. Objective We aimed to assess the immunoregulatory effects of VitD3 food supplementation on asthma manifestation, with particular focus on T cells and type 2 innate lymphoid cells. Methods Preschool children and adult asthmatic cohorts were analyzed in the context of VitD3 supplementation and serum levels. In a murine model of ovalbumin-induced asthma, effects of diet VitD3 sufficiency and deficiency on T cells and type 2 innate lymphoid cells immune mechanisms were investigated. Results We found less severe and better-controlled asthma phenotypes along with reduced need for steroid medication in preschool children and asthmatic adults with VitD3 supplementation. VitD3 serum levels correlated with B lymphocyte-induced maturation protein 1 (Blimp-1) expression in blood peripheral mononuclear cells. VitD3-supplement-fed mice showed decreased asthmatic traits, with a decrease in IgE serum levels, reduced airway mucus, and increased IL-10 production by lung cells. Furthermore, we discovered an upregulation of effector T cells and Blimp-1+ lung tissue-resident memory T cells as well as induction of anti-inflammatory Blimp-1+ lung innate lymphoid cells producing IL-10. Conclusion Supplementing VitD3 resulted in amelioration of clinical asthma manifestations in human studies as well as in experimental allergic asthma, indicating that VitD3 shifts proinflammatory immune responses to anti-inflammatory immune responses via upregulating Blimp-1 in lung innate lymphoid cells and tissue-resident memory cells.
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Affiliation(s)
- Janina C. Grund
- Department of Molecular Pneumology, Universitätsklinikum Erlangen, Erlangen, Germany
| | - Susanne Krammer
- Department of Molecular Pneumology, Universitätsklinikum Erlangen, Erlangen, Germany
| | - Zuqin Yang
- Department of Molecular Pneumology, Universitätsklinikum Erlangen, Erlangen, Germany
| | - Hannah Mitländer
- Department of Molecular Pneumology, Universitätsklinikum Erlangen, Erlangen, Germany
| | - Manfred Rauh
- Department of Clinical Laboratories, Universitätsklinikum Erlangen, Erlangen, Germany
| | - Sabine Zirlik
- I Medical Clinic, Universitätsklinikum Erlangen, Erlangen, Germany
| | - Alexander Kiefer
- Department of Allergy and Pneumology of the Children’s Hospital, Universitätsklinikum Erlangen, Erlangen, Germany
| | - Theodor Zimmermann
- Department of Allergy and Pneumology of the Children’s Hospital, Universitätsklinikum Erlangen, Erlangen, Germany
| | - Ralf J. Rieker
- Institute of Pathology, Friedrich-Alexander-University Erlangen-Nürnberg, Universitätsklinikum Erlangen, Erlangen, Germany
- Comprehensive Cancer Center Erlangen-EMN (CCC ER-EMN), Erlangen
| | - Carol I. Geppert
- Institute of Pathology, Friedrich-Alexander-University Erlangen-Nürnberg, Universitätsklinikum Erlangen, Erlangen, Germany
- Comprehensive Cancer Center Erlangen-EMN (CCC ER-EMN), Erlangen
| | - Nikolaos G. Papadopoulos
- Allergy and Clinical Immunology Unit, 2nd Pediatric Clinic, National and Kapodistrian University of Athens, Athens, Greece
- Centre for Respiratory Medicine & Allergy, Division of Infection, Immunity & Respiratory Medicine, University of Manchester, Manchester, United Kingdom
| | - Susetta Finotto
- Department of Molecular Pneumology, Universitätsklinikum Erlangen, Erlangen, Germany
- Comprehensive Cancer Center Erlangen-EMN (CCC ER-EMN), Erlangen
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Musa S, Dergaa I, Bachiller V, Saad HB. Global Implications of COVID-19 Pandemic on Adults' Lifestyle Behavior: The Invisible Pandemic of Noncommunicable Disease. Int J Prev Med 2023; 14:15. [PMID: 37033280 PMCID: PMC10080576 DOI: 10.4103/ijpvm.ijpvm_157_21] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2021] [Accepted: 09/07/2022] [Indexed: 04/11/2023] Open
Abstract
COVID-19 pandemic, with its subsequent lockdown and mobility restriction is a public health emergency that has obliged substantial modifications in daily routines and lifestyle of people worldwide. The drastic measures of social isolation and home confinement has impacted to a great extent the physical and psychological health. The resultant abrupt in lifestyle-related behavior such as physical inactivity, unhealthy dietary habit, sleep disturbance, stress, tobacco use, and alcohol intake, is directly linked to the rising global burden of non-communicable disease. This review aims at gaining a rich and extensive understanding of the potential negative impact triggered by COVID-19 on lifestyle-related behaviors that will influence long-term physical and mental wellbeing. Electronic database search was conducted on PubMed, ScienceDirect, Google Scholar, and Scopus from January 1, 2020 to March 15, 2021. Data related to COVID-19 impact on lifestyle habits were extracted from these studies. Articles were included if meeting the inclusion criteria (i.e., assessed the impact of COVID-19 on physical inactivity and sedentary behavior, dietary habits, sleep, mental health, vitamin D, and substance use among adults. Further search was conducted to address these behavioral changes among athletes. While physical isolation is a necessary public health measure to protect the population, outcomes of this review indicate that in light of adverse lifestyle changes brought by the pandemic, noncommunicable disease remains a critical concern. Hence, adopting healthy lifestyle behavior is essentially important especially during the current time to boost immunity and reduce the risk of COVID-19 infection. Recognizing the pandemic collateral effects offers a forward-looking perspective to guide the government and health authorities in planning prevention and control programs that focus on resilient and sustainable behavioral change.
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Affiliation(s)
- Sarah Musa
- Department of Preventative Health, Primary Health Care Corporation, Doha, Qatar
- Address for correspondence: Dr. Sarah Musa, Primary Health Care Corporation (PHCC), Doha P.O. Box 26555, Qatar. E-mail:
| | - Ismail Dergaa
- Department of Preventative Health, Primary Health Care Corporation, Doha, Qatar
| | - Veronica Bachiller
- Department of Preventative Health, Primary Health Care Corporation, Doha, Qatar
| | - Helmi Ben Saad
- Farhat HACHED Hospital, University of Sousse, Faculty of Medicine of Sousse, Sousse, Tunisia
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El‐Heis S, D’Angelo S, Curtis EM, Healy E, Moon RJ, Crozier SR, Inskip H, Cooper C, Harvey NC, Godfrey KM. Maternal antenatal vitamin D supplementation and offspring risk of atopic eczema in the first 4 years of life: evidence from a randomized controlled trial. Br J Dermatol 2022; 187:659-666. [PMID: 35763390 PMCID: PMC9804289 DOI: 10.1111/bjd.21721] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 06/14/2022] [Accepted: 06/26/2022] [Indexed: 01/05/2023]
Abstract
BACKGROUND Evidence linking prenatal maternal vitamin D supplementation with the offspring's risk of atopic eczema is inconsistent, with most data coming from observational studies. OBJECTIVES To examine the influence of maternal cholecalciferol supplementation during pregnancy on the risk of atopic eczema in the offspring at ages 12, 24 and 48 months. METHODS Within the UK Maternal Vitamin D Osteoporosis Study (MAVIDOS) double-blind, randomized placebo-controlled trial, we examined the relationship of maternal vitamin D supplementation during pregnancy with offspring atopic eczema at ages 12, 24 and 48 months. In MAVIDOS, pregnant women were allocated to either cholecalciferol 1000 IU per day or matched placebo, taken from around 14 weeks' gestation until delivery, with the primary outcome of neonatal whole-body bone mineral content. The prevalence of atopic eczema in the offspring was ascertained at ages 12 (n = 635), 24 (n = 610) and 48 (n = 449) months, based on the UK Working Party criteria for the definition of atopic dermatitis. The trial was registered with ISRCTN (82927713) and EudraCT (2007-001716-23). RESULTS The characteristics of mothers and offspring were similar between the intervention and placebo groups, apart from longer breastfeeding duration in the intervention group. Adjusting for breastfeeding duration, offspring of mothers who received cholecalciferol 1000 IU daily had a lower odds ratio (OR) of atopic eczema at age 12 months [OR 0·55, 95% confidence interval (CI) 0·32-0·97, P = 0·04]; this effect weakened and was not statistically significant at ages 24 months (OR 0·76, 95% CI 0·47-1·23) or 48 months (OR 0·75, 95% CI 0·37-1·52). The statistical interaction of intervention and breastfeeding duration in relation to eczema at age 12 months was not significant (P = 0·41), but stratification showed reduced infantile eczema risk in the intervention group for infants breastfed for ≥ 1 month (OR 0·48, 95% CI 0·24-0·94, P = 0·03) but not in those breastfed for < 1 month (OR 0·80, 95% CI 0·29-2·17, P = 0·66). CONCLUSIONS Our data provide the first randomized controlled trial evidence of a protective effect of antenatal cholecalciferol supplementation on the risk of infantile atopic eczema, with the effect potentially being via increased breast milk cholecalciferol levels. The findings support a developmental influence on atopic eczema, and point to a potentially modifiable perinatal influence on atopic eczema. What is already known about this topic? There are currently no antenatal interventions proven to reduce the incidence of infantile atopic eczema in the general population. However, observational studies have led to speculation that antenatal vitamin D supplementation may be beneficial.
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Affiliation(s)
- Sarah El‐Heis
- Medical Research Council Lifecourse Epidemiology CentreUniversity of SouthamptonSouthamptonUK
| | - Stefania D’Angelo
- Medical Research Council Lifecourse Epidemiology CentreUniversity of SouthamptonSouthamptonUK
| | - Elizabeth M. Curtis
- Medical Research Council Lifecourse Epidemiology CentreUniversity of SouthamptonSouthamptonUK
| | - Eugene Healy
- Dermatopharmacology, Faculty of MedicineUniversity of SouthamptonSouthamptonUK
| | - Rebecca J. Moon
- Medical Research Council Lifecourse Epidemiology CentreUniversity of SouthamptonSouthamptonUK
| | - Sarah R. Crozier
- Medical Research Council Lifecourse Epidemiology CentreUniversity of SouthamptonSouthamptonUK
- NIHR Applied Research Collaboration WessexSouthampton Science Park, Innovation CentreSouthamptonUK
| | - Hazel Inskip
- Medical Research Council Lifecourse Epidemiology CentreUniversity of SouthamptonSouthamptonUK
- NIHR Nutrition Biomedical Research CentreUniversity of Southampton and University Hospital Southampton NHS Foundation TrustSouthamptonUK
| | - Cyrus Cooper
- Medical Research Council Lifecourse Epidemiology CentreUniversity of SouthamptonSouthamptonUK
- NIHR Nutrition Biomedical Research CentreUniversity of Southampton and University Hospital Southampton NHS Foundation TrustSouthamptonUK
- NIHR Musculoskeletal Biomedical Research UnitUniversity of OxfordOxfordUK
| | - Nicholas C. Harvey
- Medical Research Council Lifecourse Epidemiology CentreUniversity of SouthamptonSouthamptonUK
- NIHR Nutrition Biomedical Research CentreUniversity of Southampton and University Hospital Southampton NHS Foundation TrustSouthamptonUK
| | - Keith M. Godfrey
- Medical Research Council Lifecourse Epidemiology CentreUniversity of SouthamptonSouthamptonUK
- NIHR Nutrition Biomedical Research CentreUniversity of Southampton and University Hospital Southampton NHS Foundation TrustSouthamptonUK
- Developmental SciencesUniversity of SouthamptonSouthamptonUK
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Asthma and Vitamin D Deficiency: Occurrence, Immune Mechanisms, and New Perspectives. J Immunol Res 2022; 2022:6735900. [PMID: 35874901 PMCID: PMC9307373 DOI: 10.1155/2022/6735900] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 06/06/2022] [Accepted: 06/24/2022] [Indexed: 12/13/2022] Open
Abstract
Asthma, as a chronic inflammatory condition of the airways, has a considerable prevalence among children. Vitamin D might play a role in asthma pathogenesis by affecting the development of the lung, regulating the immune responses, and remodeling of airway smooth muscle (ASM). Study results on the association between the serum level of vitamin D and asthma severity have suggested a converse relationship between lower vitamin D levels and more severe clinical courses. However, they are not consistent in these findings and have shown insignificant correlations, as well. The possible effects of vitamin D on asthma have led researchers to consider this vitamin a potential prophylactic and therapeutic tool for managing children with variant degrees of asthma. Adding vitamin D to the routine corticosteroid therapy of asthmatic children is another field of interest that has shown promising results. In this narrative review study, we aim to elaborate on the existing knowledge on the role of vitamin D in asthma pathogenesis and prognosis, explain the controversies that exist on the effectiveness of treating patients with vitamin D supplements, and make a general conclusion about how vitamin D actually is linked to asthma in children.
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Aziz DA, Abbas A, Viquar W, Munawar Hussain A. Association of vitamin D levels and asthma exacerbations in children and adolescents: Experience from a tertiary care center. Monaldi Arch Chest Dis 2022; 93. [PMID: 35608518 DOI: 10.4081/monaldi.2022.2230] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Accepted: 05/11/2022] [Indexed: 01/19/2023] Open
Abstract
The role of vitamin D as an immunosuppressant and anti-inflammatory has been studied previously for different pathologies in different populations globally. Relationships between serum vitamin D levels and its effect on asthma exacerbations in the adolescent asthma population are not well studied in this region. Therefore, this study was conducted to determine the vitamin D status in pediatric and adolescent asthma patients, and its association with asthma exacerbations. A retrospective study was conducted at The Aga Khan University Hospital from 2016 to 2020. Children and adolescents who were diagnosed and admitted with acute asthma exacerbations and who had at least one measurement of 25 hydroxy-vitamin D (25 OHD) were included in the study. Serum vitamin D levels were documented for enrolled patients and their past 2-year data was analyzed for asthma exacerbations, mean length of stay per admission, and admission plus length of stay at High Dependency Unit. 114 patients were included in the study. 41 patients (35.96%) were found to be vitamin D deficient, 38 patients (33.3%) were vitamin D insufficient, and 35 patients (30.7%) were labeled as vitamin D sufficient. The average number of exacerbations per year was significantly high in vitamin D deficient group (2.82±1.11) in comparison with insufficient (2.05±0.92) and sufficient groups (1.37±0.59) (p<0.001). Vitamin D deficiency is related to an increased number of annual asthma exacerbations, length of stay per admission, and admission into High Dependency Unit (HDU).
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Affiliation(s)
- Danish Abdul Aziz
- Department of Pediatrics and Child Health, Aga Khan University Hospital, Karachi.
| | - Aiza Abbas
- Medical College, Aga Khan University, Karachi.
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Al-Zayadneh E, Alnawaiseh NA, Ajarmeh S, Altarawneh AH, Albataineh EM, AlZayadneh E, Shatanawi A, Alzayadneh EM. Vitamin D deficiency in children with bronchial asthma in southern Jordan: a cross-sectional study. J Int Med Res 2021; 48:300060520974242. [PMID: 33284716 PMCID: PMC7724425 DOI: 10.1177/0300060520974242] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Objectives To assess serum 25-hydroxycholecalciferol (25-OH vitamin D) levels in
Jordanian children with bronchial asthma, and to examine correlations
between 25-OH vitamin D levels and asthma severity and control. Methods A cross-sectional study was conducted at the Paediatric Chest Clinic,
Al-Karak Governmental Hospital, Southern Jordan, between May 2015 and
February 2016. Serum 25-hydroxyvitamin D level was determined in children
aged 1–14 years diagnosed with bronchial asthma (6–14 years) or recurrent
wheezing episodes (<6 years). Asthma severity was determined based on the
Global Initiative for Asthma assessment, the Asthma Control Test, and the
Childhood Asthma Control Test. Demographic and clinical characteristics were
compared between patients with low and normal 25-OH vitamin D levels, and
correlations between asthma severity and 25-OH vitamin D level were
assessed. Results Out of 98 included children, 25-OH vitamin D levels were deficient and
insufficient in 41 (41.8%) and 34 (34.7%) children, respectively. Only 23
(23.5%) had sufficient 25-OH vitamin D levels. A significant correlation was
found between severity of asthma symptoms and 25-OH vitamin D
deficiency. Conclusion 25-OH vitamin D deficiency is highly prevalent in Jordanian children with
bronchial asthma and correlates significantly with asthma severity.
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Affiliation(s)
- Enas Al-Zayadneh
- Department of Paediatrics, School of Medicine, The University of Jordan, Amman, Jordan
| | - Nedal Awad Alnawaiseh
- Department of Public Health, School of Medicine, University of Mutah, Al-Karak, Jordan
| | - Salma Ajarmeh
- Department of Paediatrics, School of Medicine, University of Mutah, Al-Karak, Jordan
| | - Areej Hamed Altarawneh
- Department of Obstetrics, Gynaecology and Woman's Health, Ministry of Health, Al-Karak, Jordan
| | - Eman M Albataineh
- Department of Microbiology and Immunology, School of Medicine, University of Mutah, Al-Karak, Jordan
| | - Eyas AlZayadneh
- Department of Paediatrics, Faculty of Medicine, The Hashemite University, Zarqa, Jordan
| | - Alia Shatanawi
- Department of Pharmacology, School of Medicine, The University of Jordan, Amman, Jordan
| | - Ebaa M Alzayadneh
- Department of Physiology and Biochemistry, School of Medicine, The University of Jordan, Amman, Jordan
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7
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Vitamin D and Microbiota: Is There a Link with Allergies? Int J Mol Sci 2021; 22:ijms22084288. [PMID: 33924232 PMCID: PMC8074777 DOI: 10.3390/ijms22084288] [Citation(s) in RCA: 40] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 04/11/2021] [Accepted: 04/19/2021] [Indexed: 12/12/2022] Open
Abstract
There is increasing recognition of the importance of both the microbiome and vitamin D in states of health and disease. Microbiome studies have already demonstrated unique microbial patterns in systemic autoimmune diseases such as inflammatory bowel disease, rheumatoid arthritis, and systemic lupus erythematosus. Dysbiosis also seems to be associated with allergies, in particular asthma, atopic dermatitis, and food allergy. Even though the effect of vitamin D supplementation on these pathologies is still unknown, vitamin D deficiency deeply influences the microbiome by altering the microbiome composition and the integrity of the gut epithelial barrier. It also influences the immune system mainly through the vitamin D receptor (VDR). In this review, we summarize the influence of the microbiome and vitamin D on the immune system with a particular focus on allergic diseases and we discuss the necessity of further studies on the use of probiotics and of a correct intake of vitamin D.
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Isaia G, Diémoz H, Maluta F, Fountoulakis I, Ceccon D, di Sarra A, Facta S, Fedele F, Lorenzetto G, Siani AM, Isaia G. Does solar ultraviolet radiation play a role in COVID-19 infection and deaths? An environmental ecological study in Italy. THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 757:143757. [PMID: 33272604 PMCID: PMC7678486 DOI: 10.1016/j.scitotenv.2020.143757] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 11/09/2020] [Accepted: 11/10/2020] [Indexed: 05/21/2023]
Abstract
A significantly stronger impact in mortality and morbidity by COVID-19 has been observed in the northern Italian regions compared to the southern ones. The reasons of this geographical pattern might involve several concurrent factors. The main objective of this work is to investigate whether any correlations exist between the spatial distribution of COVID-19 cases and deaths in the different Italian regions and the amount of solar ultraviolet (UV) radiation at the Earth's surface. To this purpose, in this environmental ecological study a mixed-effect exponential regression was built to explain the incidence of COVID-19 based on the environmental conditions, and demographic and pathophysiologic factors. Observations and estimates of the cumulative solar UV exposure have been included to quantify the amount of radiation available e.g., for pre-vitamin D3 synthesis or SARS-CoV-2 inactivation by sunlight. The analysis shows a significant correlation (p-value <5 × 10-2) between the response variables (death percentage, incidence of infections and positive tests) and biologically effective solar UV radiation, residents in nursing homes per inhabitant (NHR), air temperature, death percentage due to the most frequent comorbidities. Among all factors, the amount of solar UV radiation is the variable contributing the most to the observed correlation, explaining up to 83.2% of the variance of the COVID-19 affected cases per population. While the statistical outcomes of the study do not directly entail a specific cause-effect relationship, our results are consistent with the hypothesis that solar UV radiation impacted on the development of the infection and on its complications, e.g. through the effect of vitamin D on the immune system or virus inactivation by sunlight. The analytical framework used in this study, based on commonly available data, can be easily replicated in other countries and geographical domains to identify possible correlations between exposure to solar UV radiation and the spread of the pandemic.
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Affiliation(s)
- Giancarlo Isaia
- Department of Medical Sciences, University of Turin, Italy; Academy of Medicine of Turin, Italy.
| | - Henri Diémoz
- Regional Environmental Protection Agency (ARPA), Valle d'Aosta, Italy
| | - Francesco Maluta
- Department of Industrial Chemistry, University of Bologna, Italy
| | | | - Daniela Ceccon
- Provincial Environmental Protection Agency (APPA), Bolzano, Italy
| | - Alcide di Sarra
- Italian Agency for New Technologies, Energy and Sustainable Economic Development (ENEA), Italy
| | - Stefania Facta
- Regional Environmental Protection Agency (ARPA), Piemonte, Italy
| | | | | | | | - Gianluca Isaia
- Geriatrics and Metabolic Bone Diseases, AOU Città della Salute e della Scienza of Turin, Italy
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van Brakel L, Mensink RP, Wesseling G, Plat J. Nutritional Interventions to Improve Asthma-Related Outcomes through Immunomodulation: A Systematic Review. Nutrients 2020; 12:nu12123839. [PMID: 33339167 PMCID: PMC7765612 DOI: 10.3390/nu12123839] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 12/09/2020] [Accepted: 12/11/2020] [Indexed: 12/20/2022] Open
Abstract
Asthma is a chronic inflammatory disease of the airways, characterized by T-helper (Th) 2 inflammation. Current lifestyle recommendations for asthma patients are to consume a diet high in fruits and vegetables and to maintain a healthy weight. This raises the question of whether other nutritional interventions may also improve asthma-related outcomes and whether these changes occur via immunomodulation. Therefore, we systematically reviewed studies that reported both asthma-related outcomes as well as immunological parameters and searched for relations between these two domains. A systematic search identified 808 studies, of which 28 studies met the inclusion criteria. These studies were divided over six nutritional clusters: herbs, herbal mixtures and extracts (N = 6); supplements (N = 4); weight loss (N = 3); vitamin D3 (N = 5); omega-3 long-chain polyunsaturated fatty acids (LCPUFAs) (N = 5); and whole-food approaches (N = 5). Fifteen studies reported improvements in either asthma-related outcomes or immunological parameters, of which eight studies reported simultaneous improvements in both domains. Two studies reported worsening in either asthma-related outcomes or immunological parameters, of which one study reported a worsening in both domains. Promising interventions used herbs, herbal mixtures or extracts, and omega-3 LCPUFAs, although limited interventions resulted in clinically relevant results. Future studies should focus on further optimizing the beneficial effects of nutritional interventions in asthma patients, e.g., by considering the phenotypes and endotypes of asthma.
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Affiliation(s)
- Lieve van Brakel
- Department of Nutrition and Movement Sciences, NUTRIM (School of Translational Research in Metabolism), Maastricht University Medical Center, 6200 MD Maastricht, The Netherlands
| | - Ronald P Mensink
- Department of Nutrition and Movement Sciences, NUTRIM (School of Translational Research in Metabolism), Maastricht University Medical Center, 6200 MD Maastricht, The Netherlands
| | - Geertjan Wesseling
- Department of Respiratory Medicine, Maastricht University Medical Center, 6200 MD Maastricht, The Netherlands
| | - Jogchum Plat
- Department of Nutrition and Movement Sciences, NUTRIM (School of Translational Research in Metabolism), Maastricht University Medical Center, 6200 MD Maastricht, The Netherlands
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Kalmarzi RN, Ahmadi S, Rahehagh R, Fathallahpour A, Khalafi B, Kashefi H, Roshani D, Zaryan RN, Mohamadi S, Kooti W. The Effect of Vitamin D Supplementation on Clinical Outcomes of Asthmatic Children with Vitamin D Insufficiency. Endocr Metab Immune Disord Drug Targets 2020; 20:149-155. [PMID: 31942850 DOI: 10.2174/1871530319666190426161809] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2019] [Revised: 03/01/2019] [Accepted: 03/04/2019] [Indexed: 01/08/2023]
Abstract
BACKGROUND The extensive impacts of vitamin D on the immune system has gathered the attention of scholars in last years. In this regard, studies about vitamin D and incidence of asthma have showed various results. The aim of this study was to evaluate the effect of vitamin D supplements on clinical outcomes in asthmatic children with vitamin D insufficiency. MATERIALS & METHODS This before-after interventional study was conducted on all asthmatic children who attended the Be'sat Hospital, Iran. Serum levels of 25(OH)D, asthma severity and pulmonary function tests before and after therapeutic prescription of vitamin D were evaluated. Serum levels of 25(OH)D were measured by enzyme-linked immunosorbent assay. RESULTS The mean age of the samples was 10.69±9.78 years and 39 subjects (57.4%) were male. The primary mean level of serum 25(OH)D (18.21±8.22, ng/mL) has significantly (p<0.05) increased after treatment (35.45±9.35, ng/mL). Also, asthma severity, forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC), and FEV1/FVC indicators were significantly (p<0.05) increased after treatment. CONCLUSION We can conclude that therapeutic prescription of vitamin D is very effective in improving the clinical status of asthmatic children.
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Affiliation(s)
- Rasoul N Kalmarzi
- Lung Diseases and Allergy Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Sivan Ahmadi
- Student Research Committee, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | | | - Asadollah Fathallahpour
- Lung Diseases and Allergy Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Behzad Khalafi
- Lung Diseases and Allergy Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Hajar Kashefi
- Student Research Committee, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Daem Roshani
- Social Determinants of Health Research Center, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Rama N Zaryan
- Lung Diseases and Allergy Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Shilan Mohamadi
- Lung Diseases and Allergy Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Wesam Kooti
- Lung Diseases and Allergy Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
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11
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Tutuncu M, Tutuncu M. The effect of vitamin D on restless legs syndrome: prospective self-controlled case study. Sleep Breath 2020; 24:1101-1106. [DOI: 10.1007/s11325-019-01984-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2019] [Revised: 11/18/2019] [Accepted: 11/22/2019] [Indexed: 12/13/2022]
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12
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Yousfi N, Bragazzi NL, Briki W, Zmijewski P, Chamari K. The COVID-19 pandemic: how to maintain a healthy immune system during the lockdown - a multidisciplinary approach with special focus on athletes. Biol Sport 2020; 37:211-216. [PMID: 32879542 PMCID: PMC7433333 DOI: 10.5114/biolsport.2020.95125] [Citation(s) in RCA: 55] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 05/08/2020] [Accepted: 05/12/2020] [Indexed: 12/28/2022] Open
Abstract
On January 31, 2020, the World Health Organization (WHO) declared the outbreak of a novel coronavirus responsible for an infection termed COVID-19 as a global public health emergency. To slow the spread of the coronavirus, countries around the world have been implementing various measures, including school and institutional closures, lockdown and targeted quarantine for suspected infected individuals. More than a third of the world's population have been home confined less than 4 months after the start of the outbreak. The present article aims to advise healthy individuals and athletes who are in lockdown regarding their lifestyle in order to keep healthy, safe and fit. The advice contained in the present article could apply to anyone aiming at remaining in good physical and mental health while forced to undergo lockdown, quarantine, or limited movement (movement control order). Boosting the immune system is crucial during such periods for confined people and especially for confined athletes. Specific recommendations must be followed concerning boosting the immune system through physiological and psychological management. This article analyses the available scientific evidence in order to recommend a practical approach, focusing on nutrition, intermittent fasting or caloric restriction, vitamin D insufficiency, sleep pattern, exercise, and psychodynamic aspects as factors impacting the immune system and human health in general.
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Affiliation(s)
- Narimen Yousfi
- Tunisian Research Laboratory “Sport Performance Optimisation”, National Center of Medicine and Science in Sport, Tunis, Tunisia
- High Institute of Sport and Physical Education, Ksar-Saïd, Manouba University. Tunis, Tunisia
| | - Nicola Luigi Bragazzi
- Laboratory for Industrial and Applied Mathematics (LIAM), Department of Mathematics and Statistics, York University, Toronto, ON, Canada
- Postgraduate School of Public Health, Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy
| | - Walid Briki
- Sport Science Program, College of Arts and Sciences, Qatar University, Doha, Qatar
| | - Piotr Zmijewski
- Jozef Pilsudski University of Physical Education in Warsaw, 00-809 Warsaw, Poland
| | - Karim Chamari
- ASPETAR, Qatar Orthopaedic and Sports Medicine Hospital, Doha, Qatar
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Soto JR, Anthias C, Madrigal A, Snowden JA. Insights Into the Role of Vitamin D as a Biomarker in Stem Cell Transplantation. Front Immunol 2020; 11:966. [PMID: 32582151 PMCID: PMC7295104 DOI: 10.3389/fimmu.2020.00966] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2019] [Accepted: 04/24/2020] [Indexed: 12/19/2022] Open
Abstract
Vitamin D was discovered 100 years ago and since then multiple studies have consistently proved its effect on bone health and mineral metabolism. Further research has also explored its so-called "non-classical" biological effects, encompassing immune regulation and control of cell proliferation and differentiation. Vitamin D downregulates pro-inflammatory immune cells and subsequently their cytokine production, while enhancing the anti-inflammatory subsets, thus mediating inflammation and fostering a more tolerogenic environment. Its biological action is exerted through the vitamin D receptor, a nuclear receptor that mediates gene transcription and is expressed in most cells from the innate and adaptive immunity. Owing to its immune-modulatory properties, its role in cancer pathophysiology, hematology disorders and stem cell transplantation has also been investigated. Vitamin D deficiency causes immune imbalance and cytokine dysregulation, contributing to some autoimmune diseases. In the hematopoietic stem cell transplant setting this could lead to complications such as acute and chronic graft-versus-host disease, ultimately impacting transplant outcomes. Other factors have also been linked to this, including specific polymorphisms of the vitamin D receptor in both stem cell donors and recipients. Nevertheless, studies thus far have shown conflicting results and the use of vitamin D or its receptor as biomarkers has not been validated yet, therefore there are no evidence-based consensus guidelines to guide clinicians in their day-to-day practice. To gain more insight in this topic, we have reviewed the existent literature and gathered the current evidence. This is an overview of the role of serum vitamin D and its receptor as biomarkers for clinical outcomes in patients undergoing hematopoietic stem cell transplantation. Further prospective studies with larger cohorts are warranted to validate the viability of using serum vitamin D, and its receptor, as biomarkers in potential stem cell donors and patients, to identify those at risk of post-transplant complications and enable early therapeutic interventions.
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Affiliation(s)
- Jose Ros Soto
- Anthony Nolan Research Institute, Royal Free Hospital and University College London, London, United Kingdom
| | - Chloe Anthias
- Anthony Nolan Research Institute, Royal Free Hospital and University College London, London, United Kingdom
- Department of Haemato-Oncology, The Royal Marsden Hospital, Sutton, United Kingdom
| | - Alejandro Madrigal
- Anthony Nolan Research Institute, Royal Free Hospital and University College London, London, United Kingdom
| | - John A. Snowden
- Department of Haematology, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, United Kingdom
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Third Trimester Vitamin D Status Is Associated With Birth Outcomes and Linear Growth of HIV-Exposed Uninfected Infants in the United States. J Acquir Immune Defic Syndr 2020; 81:336-344. [PMID: 31021992 DOI: 10.1097/qai.0000000000002041] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
BACKGROUND Vitamin D status in pregnancy may influence the risk of prematurity, birth size, and child postnatal growth, but few studies have examined the relationship among pregnant women living with HIV. METHODS We conducted a prospective cohort study of 257 HIV-infected mothers and their HIV-exposed uninfected infants who were enrolled in the 2009-2011 nutrition substudy of the Surveillance Monitoring for ART Toxicities (SMARTT) study. HIV-infected pregnant women had serum 25-hydroxyvitamin D (25(OH)D) assessed in the third trimester of pregnancy, and their infants' growth and neurodevelopment were evaluated at birth and approximately 1 year of age. RESULTS The mean third trimester serum 25(OH)D concentration was 35.4 ± 14.2 ng/mL with 15% of women classified as vitamin D deficient (<20 ng/mL) and 21% as insufficient (20-30 ng/mL). In multivariable models, third trimester vitamin D deficiency and insufficiency were associated with -273 g [95% confidence interval (CI): -450 to -97] and -203 g (95% CI: -370 to -35) lower birth weights compared with vitamin D sufficient women, respectively. Maternal vitamin D deficiency was also associated with shorter gestation (mean difference -0.65 weeks; 95% CI: -1.22 to -0.08) and lower infant length-for-age z-scores at 1 year of age (mean difference: -0.65; 95% CI: -1.18 to -0.13). We found no association of vitamin D status with infant neurodevelopment at 1 year of age. CONCLUSION Third trimester maternal vitamin D deficiency was associated with lower birth weight, shorter length of gestation, and reduced infant linear growth. Studies and trials of vitamin D supplementation in pregnancy for women living with HIV are warranted.
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Kuti BP, Kuti DK. Relationship between serum 25-hydroxyvitamin D and inflammatory cytokines in Nigerian children with asthma. J Asthma 2020; 58:604-613. [PMID: 31914352 DOI: 10.1080/02770903.2020.1712726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Background: Childhood asthma involves a network of mutually interacting inflammatory mediators and cytokines. The influence of serum vitamin D (an immunomodulatory agent) on these cytokines is poorly understood. This study sets out to determine the relationship between serum T-helper cells type 1 cytokines (Interleukins ILs-1β, 2, 6, 8 and 10), type 2 cytokines (ILs 3, 4,5,9,13), ILs-12, 17 and 25-hydroxyvitamin D (25-OHD) in Nigerian children with asthma.Methods: Children with physician-diagnosed asthma and non-asthmatics aged 2-15 years were consecutively recruited at a tertiary center in Nigeria. Serum 25-OHD and cytokines were assayed using chromatography method and association between these parameters determined.Results: A total of 180 children (90 for each group; mean age 7.5 ± 3.9 years; M:F 1.9:1) were recruited. Fifty-six (76.7%) asthmatics had mild intermittent form and symptoms were sub-optimally controlled in 16 (21.9%). The mean (SD) serum Vitamin D was lower in children with asthma (38.8 ± 17.0 ng/ml vs. 45.5 ± 16.6 ng/ml vs. p = 0.023). Also more proportion of children with asthma had suboptimal serum vitamin D level (26.0% vs. 8.8%; p = 0.022). Deficient vitamin D state was associated with higher serum Th1 and Th2 cytokines compared to insufficient state, but the highest cytokine levels were observed in normal vitamin D state. There was significant positive correlation between serum vitamin D and Th1 cytokines IL-2 and IL-8 as well as Th2 cytokines (ILs-3, 4, 5 and 9), but negative correlation with IL-13Conclusions: Serum Vitamin D and cytokines were lower in a sample of Nigerian children with asthma than controls. Vitamin D status was not related to asthma severity and control. Serum 25-OHD seems to have a non-linear relationship with Th1 and Th2 cytokines in Nigerian asthmatics.
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Affiliation(s)
- Bankole Peter Kuti
- Department of Paediatrics, Wesley Guild Hospital, Ilesa, Nigeria.,Department of Paediatrics and Child Health, Obafemi Awolowo University, Ile-Ile, Nigeria
| | - Demilade K Kuti
- Department of Paediatrics, Wesley Guild Hospital, Ilesa, Nigeria
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Liu J, Dong YQ, Yin J, Yao J, Shen J, Sheng GJ, Li K, Lv HF, Fang X, Wu WF. Meta-analysis of vitamin D and lung function in patients with asthma. Respir Res 2019; 20:161. [PMID: 31590675 PMCID: PMC6781357 DOI: 10.1186/s12931-019-1072-4] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Accepted: 05/13/2019] [Indexed: 12/27/2022] Open
Abstract
Background There is growing literature suggesting a link between vitamin D and asthma lung function, but the results from systematic reviews are conflicting. We conducted this meta-analysis to investigate the relation between serum vitamin D and lung function in asthma patients. Methods Major databases, including OVID, MEDLINE, Web of Science and PUBMED, were searched until 10th October 2018. All published observational studies related to vitamin D and asthma were extracted. All meta-analyses were performed using Review Manager 5.3.5. Results This quantitative synthesis found that asthma patients with low vitamin D levels had lower forced expiratory volume In 1 s (FEV1) (mean difference (MD) = − 0.1, 95% CI = − 0.11 to − 0.08,p < 0.01;I2 = 49%, p = 0.12) and FEV1% (MD = − 10.02, 95% CI = − 11 to − 9.04, p < 0.01; I2 = 0%, p = 0.82) than those with sufficient vitamin D levels. A positive relation was found between vitamin D and FEV1 (r = 0.12, 95% CI = 0.04 to 0.2, p = 0.003; I2 = 59%,p = 0.01), FEV1% (r = 0.19, 95% CI = 0.13 to 0.26, p < 0.001; I2 = 42%, p = 0.11), forced vital capacity (FVC) (r = 0.17, 95% CI = 0.00 to 0.34, p = 0.05; I2 = 60%, p = 0.04), FEV1/FVC (r = 0.4, 95% CI = 0.3 to 0.51, p < 0.001; I2 = 48%, p = 0.07), and the asthma control test (ACT) (r = 0.33, 95% CI = 0.2 to 0.47, p < 0.001; I2 = 0%, p = 0.7). Subgroup analysis indicated that the positive correlation between vitamin D and lung function remained significant in both children and adults. Conclusions Our meta-analysis suggested that serum vitamin D levels may be positively correlated with lung function in asthma patients. Future comprehensive studies are required to confirm these relations and to elucidate potential mechanisms.
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Affiliation(s)
- Jian Liu
- Department of Intensive Care Unit, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, China
| | - Yong-Quan Dong
- Department of Respiratory Disease, Yinzhou No. 2 Hospital, Ningbo, Zhejiang Province, China
| | - Jie Yin
- Department of Medical Oncology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, China
| | - Jian Yao
- Department of Emergency, People's Hospital of Jinyun County, LiuShui, Zhejiang Province, China
| | - Jie Shen
- Department of Medical Oncology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, China
| | - Guo-Jie Sheng
- Department of Intensive Care Unit, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, China
| | - Kun Li
- Department of Intensive Care Unit, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, China
| | - Hai-Feng Lv
- Department of Intensive Care Unit, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, China
| | - Xing Fang
- Department of Intensive Care Unit, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, China
| | - Wei-Fang Wu
- Department of Intensive Care Unit, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, China.
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Th17 cells in Bulgarian children with chronic obstructive lung diseases. Allergol Immunopathol (Madr) 2019; 47:227-233. [PMID: 30262413 DOI: 10.1016/j.aller.2018.07.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Revised: 07/08/2018] [Accepted: 07/19/2018] [Indexed: 02/08/2023]
Abstract
INTRODUCTION AND OBJECTIVES Th17 lymphocytes are now widely believed to be critical in various chronic pulmonary diseases. However, there is still a small number of investigations regarding children. We aimed to assess the percentage of Th17 lymphocytes and IL-17A in peripheral blood of children with chronic obstructive lung diseases. PATIENTS AND METHODS We included a total of 42 children: 20 with bronchial asthma (BA), 12 with cystic fibrosis (CF) and 10 healthy children without a history of allergies, aged 4-17 years. Th17 cells (CD3+CD4+CD161+CCR6+) were determined in peripheral blood by flow cytometry. The concentration of serum IL-17A was measured by ELISA. RESULTS The BA patients had a significantly higher percentage of Th17 (12.40±1.16%) compared to the CF children (7.64±0.87%, p=0.0035) and healthy (7.25±0.45%, p=0.008). Stratifying the BA group, we found higher levels of Th17 in patients with severe BA (p=0.03), whereas patients with moderate BA had Th17 cells close to those in CF and healthy children. We found that patients with better control of BA had Th17 closer to those with CF (p=0.98) than BA children with poor control (p<0.001) (post hoc, Bonferroni correction). CF patients with concomitant P. aeruginosa infection showed slightly higher percentages of Th17 cells than those without infection (8.08±3.09% vs. 6.25±2.42%, p=0.294). CONCLUSIONS The percentage of Th17 cells was significantly increased in the peripheral blood of children with severe BA compared to the children with moderate BA, which suggests that the former could possibly benefit from future target therapies.
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Mensink-Bout SM, van Meel ER, de Jongste JC, Voortman T, Reiss IK, De Jong NW, Jaddoe VWV, Duijts L. Maternal and neonatal 25-hydroxyvitamin D concentrations and school-age lung function, asthma and allergy. The Generation R Study. Clin Exp Allergy 2019; 49:900-910. [PMID: 30866115 PMCID: PMC6850458 DOI: 10.1111/cea.13384] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Revised: 01/29/2019] [Accepted: 02/25/2019] [Indexed: 12/27/2022]
Abstract
BACKGROUND Vitamin D deficiency in early life might affect the developing lung and immune system, and subsequently influence the risk of asthma and allergy in later life. OBJECTIVE We examined the associations of 25-hydroxyvitamin D concentrations in mid-gestation and at birth with lung function, asthma, inhalant allergic sensitization and inhalant allergy at school-age. METHODS This study among 4951 children and their mothers was embedded in a population-based prospective cohort in Rotterdam, the Netherlands. Maternal venous blood samples in mid-gestation and umbilical cord blood samples at birth were used to determine 25-hydroxyvitamin D concentrations. At age 10 years, lung function was measured by spirometry, current asthma and physician-diagnosed inhalant allergy by questionnaire, and inhalant allergic sensitization by skin prick tests. We used multivariable regression models to examine associations. RESULTS Higher 25-hydroxyvitamin D concentrations in mid-gestation were associated with a higher forced vital capacity (FVC), but a lower forced expiratory volume in 1 second/FVC (FEV1 /FVC) and a lower forced expiratory flow after exhaling 75% of FVC (FEF75 ) (Z-score differences [95% CI] 0.02 [0.00, 0.03], -0.02 [-0.03, -0.01] and -0.01 [-0.03, -0.00], respectively, per 10 nmol/L 25-hydroxyvitamin D), but not with asthma. Furthermore, higher 25-hydroxyvitamin D concentrations in mid-gestation were associated with an increased risk of inhalant allergy (Odds Ratio [95% CI] 1.07 [1.02, 1.12]), but not with inhalant allergic sensitization. After additional adjustment for child's 25-hydroxyvitamin D concentrations at the age of 6 years, only the associations of 25-hydroxyvitamin D concentrations in mid-gestation with FEV1 /FVC and FEF75 remained. We did not find consistent associations of 25-hydroxyvitamin D concentrations at birth with respiratory or allergy outcomes. CONCLUSION AND CLINICAL RELEVANCE Our results suggest that maternal 25-hydroxyvitamin D concentrations in mid-gestation may influence lung development. The clinical implications of the observed associations remain unclear.
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Affiliation(s)
- Sara M Mensink-Bout
- The Generation R Study Group, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.,Department of Pediatrics, Division of Respiratory Medicine and Allergology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Evelien R van Meel
- The Generation R Study Group, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.,Department of Pediatrics, Division of Respiratory Medicine and Allergology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Johan C de Jongste
- Department of Pediatrics, Division of Respiratory Medicine and Allergology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Trudy Voortman
- Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Irwin K Reiss
- Department of Pediatrics, Division of Neonatology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Nicolette W De Jong
- Department of Internal Medicine, Division of Allergology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Vincent W V Jaddoe
- The Generation R Study Group, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.,Department of Pediatrics, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Liesbeth Duijts
- Department of Pediatrics, Division of Respiratory Medicine and Allergology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.,Department of Pediatrics, Division of Neonatology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
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Rajaram M, Selvarajan S, Neelamegan R, Kamalanathan S, Gunaseelan V, Xavier AS, Das S, Karthikeyan V, Saka V, Chandrasekaran A. Effects of genetic polymorphisms in Vitamin D metabolic pathway on Vitamin D level and asthma control in South Indian patients with bronchial asthma. Lung India 2019; 36:483-491. [PMID: 31670295 PMCID: PMC6852217 DOI: 10.4103/lungindia.lungindia_23_19] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Objectives: The study was designed to evaluate the single-nucleotide polymorphisms (SNPs) of genes involved in Vitamin D actions (rs2228570) and metabolic pathways (rs2248137 and rs10766197) and their associations with serum 25-hydroxy Vitamin D (25(OH)D) level and asthma control in South Indian patients with bronchial asthma. Materials and Methods: One hundred and two patients of South Indian origin with bronchial asthma either naive to inhaled corticosteroids (ICSs) or not receiving ICS for ≥1 month were included and were treated with ICS (beclomethasone 200 μg twice daily) for 8 weeks. One hundred and one unrelated healthy South Indians were used as controls. Pulmonary function test and fractional exhaled nitric oxide were used to assess asthma control. Serum 25(OH)D levels (chemiluminescence immunoassay) and SNPs in Vitamin D pathway (real-time polymerase chain reaction) were assessed. The associations of SNPs and serum 25(OH)D with asthma control was determined using linear regression. All analyses were performed using SPSS (version 19) and “SNPStats.” P < 0.05 was considered as statistically significant. Results: Vitamin D receptor (VDR) polymorphism (rs2228570) was found to be protective against asthma (P = 0.022), while there were no significant associations between the other two SNPs and asthma. Similarly, poor correlation and insignificant associations between the SNPs and serum 25(OH)D levels were observed in both cases and controls. There were also insignificant associations between the SNPs and asthma control. Conclusion: VDR polymorphism (rs2228570) was found to be protective against asthma in South Indians, while other genes involved in the metabolic pathway of Vitamin D did not show associations with asthma.
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Affiliation(s)
- Manju Rajaram
- Department of Pulmonary Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Sandhiya Selvarajan
- Department of Clinical Pharmacology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Revathy Neelamegan
- Department of Pharmacology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Sadishkumar Kamalanathan
- Department of Endocrinology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | | | - Alphienes Stanley Xavier
- Department of Clinical Pharmacology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Saibal Das
- Department of Clinical Pharmacology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Vignesh Karthikeyan
- Centre for Biotechnology, Cell Signaling Laboratory, Anna University, Chennai, Tamil Nadu, India
| | - Vinodkumar Saka
- Department of Pulmonary Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Adithan Chandrasekaran
- Department of Clinical Pharmacology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
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The effects of vitamin D in pregnancy. GINECOLOGIA.RO 2019. [DOI: 10.26416/gine.24.2.2019.2372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
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Vitamin D: is it important in haematopoietic stem cell transplantation? A review. Bone Marrow Transplant 2018; 54:810-820. [PMID: 30401967 DOI: 10.1038/s41409-018-0377-0] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2018] [Revised: 09/28/2018] [Accepted: 10/12/2018] [Indexed: 12/17/2022]
Abstract
Vitamin D has effects on several body systems, from well-established role in bone metabolism to emerging effects on the immune system. Increasing evidence supports an immunomodulatory effect including inhibition of the pro-inflammatory lymphocyte subsets while enhancing their anti-inflammatory counterpart, in favour of a more tolerogenic status. Vitamin D deficiency is increasingly recognised in association with autoimmune and inflammatory diseases, also with evidence from the field of asthma where vitamin D supplementation may overcome steroid resistance. In the HSCT setting, vitamin D deficiency has been variably associated with increased complications, including graft-versus-host disease (GvHD), with a potential impact on survival outcomes. In this review we provide an overview and critical appraisal of the current literature of the role of vitamin D (and its deficiency) in relation to immunity in both allogeneic and autologous HSCT settings. We conclude that the evidence base is mixed, but a greater understanding of the role of vitamin D in relation to immune reconstitution following HSCT is warranted. Given its potential benefits, its inexpensive cost and favourable side effect profile, consideration of vitamin D levels and its supplementation could be easily incorporated into prospective studies in GvHD, including clinical trials of novel therapeutics, supportive care and biomarkers.
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Vitamin D: Immunomodulatory Aspects. J Clin Gastroenterol 2018; 52 Suppl 1, Proceedings from the 9th Probiotics, Prebiotics and New Foods, Nutraceuticals and Botanicals for Nutrition & Human and Microbiota Health Meeting, held in Rome, Italy from September 10 to 12, 2017:S86-S88. [PMID: 30300262 DOI: 10.1097/mcg.0000000000001112] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Vitamin D is a group of liposoluble prohormones consisting of 5 different vitamins, the most important forms being vitamin D2 and vitamin D3. The ergocalciferol (vitamin D2) is less efficacious and derives from irradiated fungi, while colecalciferol (vitamin D3), derived from cholesterol, is synthesized via ultraviolet B rays in animal organisms. Only the ultraviolet B rays (290 to 315 nm) portion of the solar ray photolyzes 7-dehydrocholesterol in the skin to previtamin D3, which is converted subsequently to vitamin D3. Moreover, the skin makes little vitamin D from the sun at latitudes above 37 degrees north or below 37 degrees south of the equator. Calcidiol [25(OH)D] is the more stable metabolite of vitamin D in serum and the best indicator of the vitamin D status. Optimal values range are >30 ng/mL. Calcitriol [1,25(OH)2D] is the active hormone form of vitamin D. The 1,25(OH)2D binds to its nuclear receptor (vitamin D receptor), expressed in many tissues, regulating the expression of genes involved in calcium metabolism, cell differentiation, apoptosis, and immunity. About immunity, calcitriol stimulates innate immune responses by enhancing the chemotactic and phagocytotic responses of macrophages as well as the production of antimicrobial peptides. 1,25(OH)2D strongly enhances production of interleukine-10 by stimulating T regulatory cells and inhibiting Th1 and Th17 cell differentiation. Furthermore, several studies suggest that lower 25(OH)D serum levels are associated with an increased risk of respiratory infection at all ages in a dose-response manner.
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Vitamin D and associated perinatal-neonatal outcomes among extremely low-birth-weight infants. J Perinatol 2018; 38:1318-1323. [PMID: 30108343 DOI: 10.1038/s41372-018-0203-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Revised: 08/03/2018] [Accepted: 08/06/2018] [Indexed: 11/08/2022]
Abstract
OBJECTIVE To evaluate vitamin D inadequacy among extremely low-birth-weight (ELBW, <1000 g) infants and the association between circulating vitamin D concentrations and perinatal-neonatal outcomes. STUDY DESIGN Prospective cohort study of ELBW infants in the neonatal ICU. Blood was collected within the first 3 days after birth after obtaining informed consent. Circulating 25-hydroxyvitamin D concentrations (25(OH)D) were quantified using liquid chromatography-tandem mass spectroscopy and classified as vitamin D deficient, insufficient, or adequate ( < 20, 20-30, or > 30 ng/mL, respectively). Associations between 25(OH)D and perinatal-neonatal outcomes were determined by multivariable regression, adjusted for covariates that differ in the bivariate analysis. RESULTS Of the 60 ELBW infants enrolled, 13 (22%) were vitamin D deficient, 15 (25%) were insufficient, and 32 (53%) were adequate. 25(OH)D levels were positively associated with fetal growth restriction and prolonged rupture of the membranes. CONCLUSIONS Vitamin D inadequacy was frequent among ELBW infants. Circulating vitamin D concentrations were significantly associated with perinatal outcomes in this contemporary cohort.
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Al-Daghri NM, Al-Attas OS, Yakout SM, Alnaami AM, Wani K, Alokail MS. The association of serum 25-OH vitamin D with asthma in Saudi adults. Medicine (Baltimore) 2018; 97:e12286. [PMID: 30200174 PMCID: PMC6133535 DOI: 10.1097/md.0000000000012286] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
The study aimed to assess the differences and associations of serum 25 (OH)D levels in Saudi adults with and without asthma. A total of 1070 Saudi adults aged 22 to 28 years (359 with known asthma and 711 matched nonasthmatic controls) were selected randomly from the Riyadh Cohort, Saudi Arabia. Serum 25(OH)D serum levels were measured. Asthma diagnosis was taken from questionnaires. In all participants, 359 (33.6%) were known asthmatic and 711 (66.5%) were nonasthmatic. The overall incidence of vitamin D deficiency (serum 25(OH)D <25 nmol/L) was 29.6% in controls and 35.6% in asthma group (P = .01). The asthma group have a significantly lower serum 25(OH)D than the control group (P = .01) but lost significance after adjusting for age, body mass index (BMI), and sex. Nonasthmatic and asthmatic females had a higher incidence of vitamin D deficiency (33% and 46%) than nonasthmatic and asthmatic males (17% and 33%). Vitamin D deficiency is significantly high among Saudi adults with asthma, but more so among women. Whether vitamin D deficiency exacerbates asthma attack remains to be proven in this population.
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Affiliation(s)
- Nasser M. Al-Daghri
- Biomarkers Research Program
- Prince Mutaib Chair for Biomarkers of Osteoporosis, Biochemistry Department, College of Science, King Saud University, Riyadh, Kingdom of Saudi Arabia
| | - Omar S. Al-Attas
- Biomarkers Research Program
- Prince Mutaib Chair for Biomarkers of Osteoporosis, Biochemistry Department, College of Science, King Saud University, Riyadh, Kingdom of Saudi Arabia
| | - Sobhy M. Yakout
- Biomarkers Research Program
- Prince Mutaib Chair for Biomarkers of Osteoporosis, Biochemistry Department, College of Science, King Saud University, Riyadh, Kingdom of Saudi Arabia
| | - Abdullah M. Alnaami
- Biomarkers Research Program
- Prince Mutaib Chair for Biomarkers of Osteoporosis, Biochemistry Department, College of Science, King Saud University, Riyadh, Kingdom of Saudi Arabia
| | - Kaiser Wani
- Biomarkers Research Program
- Prince Mutaib Chair for Biomarkers of Osteoporosis, Biochemistry Department, College of Science, King Saud University, Riyadh, Kingdom of Saudi Arabia
| | - Majed S. Alokail
- Biomarkers Research Program
- Prince Mutaib Chair for Biomarkers of Osteoporosis, Biochemistry Department, College of Science, King Saud University, Riyadh, Kingdom of Saudi Arabia
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25
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Abstract
Vitamin D exerts several immunological functions in addition to its homeostatic functions on calcium and bone metabolism. Current data show that relative vitamin D deficiency (< 75 nmol/l 25-hydroxyvitamin D) as well as acquired seasonal vitamin D deficiency (< 50 nmol/l) are frequent in Germany. As confirmed by our own data, UV exposure plays a major role for maintenance of vitamin D status, e.g., in patients with UV-triggered diseases, vitamin D deficiency is more frequent, even throughout the year. The beneficial impact of vitamin D on immune functions is highlighted by epidemiologic, genetic, and experimental evidence. In the past years, numerous publications have presented associations between vitamin D deficiency, on the one hand, and severity and prevalence of allergic asthma in children and adults, on the other hand.
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Restimulia L, Pawarti DR, Ekorini HM. The Relationship between Serum Vitamin D Levels with Allergic Rhinitis Incidence and Total Nasal Symptom Score in Allergic Rhinitis Patients. Open Access Maced J Med Sci 2018; 6:1405-1409. [PMID: 30159065 PMCID: PMC6108797 DOI: 10.3889/oamjms.2018.247] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Revised: 05/23/2018] [Accepted: 05/25/2018] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Allergic diseases and vitamin D deficiency were found to have a relationship. However, there was limited number of studies on the relationship between vitamin D with allergic rhinitis (AR) and total nasal symptom scores (TNSS), particularly in determining the cut-off points of serum vitamin D levels which correlated to AR. AIM As this particular study has never been conducted in Indonesia, the main objective of this study was to investigate this issue. METHODS The research was conducted at Dr Soetomo Hospital, Surabaya in January 2017. A group of 30 subjects were recruited using consecutive sampling. Levels of serum vitamin D were measured using electrochemiluminescence immunoassay (ECLIA) method while the total nasal symptom scores were obtained by accumulating all the nasal symptoms. Data of serum vitamin D levels and TNSS were analysed statistically with the Pearson correlation test. RESULTS It was found that the mean of serum 25(OH) vitamin D levels (9.13 ng/mL) of the AR group was significantly lower than the non-AR group (26.22 ng/mL) (P = 0.000). The vitamin D cut-off points which correlated to AR was about 12.83 ng/mL (sensitivity = 80%; specificity = 100%). A Pearson correlation test found a strong, negative correlation between vitamin D levels and TNSS (P = 0.000; r = -0.800). CONCLUSION There was a strong, negative correlation between serum vitamin D levels with AR and TNSS. The cut-off points of serum vitamin D levels correlated to AR were approximately12.83 ng/mL. Thus, further research needs to be conducted.
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Affiliation(s)
- Lia Restimulia
- Department of Otorhinolaryngology Head and Neck Surgery, Faculty of Medicine, Airlangga University, Jl. Prof. Dr Moestopo No. 47, Surabaya 60132, Indonesia
| | - Dwi Reno Pawarti
- Department of Otorhinolaryngology Head and Neck Surgery, Faculty of Medicine, Airlangga University, Jl. Prof. Dr Moestopo No. 47, Surabaya 60132, Indonesia
| | - Haris Mayaguyang Ekorini
- Department of Otorhinolaryngology Head and Neck Surgery, Faculty of Medicine, Airlangga University, Jl. Prof. Dr Moestopo No. 47, Surabaya 60132, Indonesia
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Morgan KA, Mann EH, Young AR, Hawrylowicz CM. ASTHMA - comparing the impact of vitamin D versus UVR on clinical and immune parameters. Photochem Photobiol Sci 2018; 16:399-410. [PMID: 28092390 DOI: 10.1039/c6pp00407e] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
The incidence of asthma has increased markedly since the 1960s and is currently estimated to affect more than 300 million individuals worldwide. A number of environmental factors are implicated in asthma pathogenesis, one of which is vitamin D. Vitamin D deficiency is a global health concern and has increased in parallel with asthma incidence. Epidemiological studies report associations between low vitamin D status, assessed as circulating levels of 25-hydroxyvitamin D, with asthma incidence, severity, exacerbations and responses to treatment. This has led to clinical studies to test whether increasing the levels of vitamin D improves asthma management. Despite being highly variable in dosing regimens, design and outcomes, meta-analyses suggest overall positive outcomes with respect to reduced asthma exacerbations and steroid requirements. The primary mechanism for increasing vitamin D levels in the body is through exposure of the skin to the ultraviolet B (UVB) component of ultraviolet radiation (UVR), most commonly from sun exposure. However, only a limited number of studies investigating the impact of UVR on the asthmatic response have been performed; these generally report on the impact of latitude as a surrogate of sun exposure, or address this in animal models. To the best of our knowledge no comprehensive trials to assess the impact of UVB radiation on asthma outcomes have been performed. Within this review we discuss observational and clinical studies in this field, and innate and adaptive immune mechanisms through which UVR and vitamin D may impact respiratory health, and asthma. We highlight the heterogeneity of asthmatic disease, which is likely to impact upon the efficacy of interventional studies, and briefly overview more recent findings relating to the impact of vitamin D/UVR on the development of asthma.
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Affiliation(s)
- Kylie A Morgan
- MRC and Asthma UK Centre in Allergic Mechanisms of Asthma, King's College London, UK. and NIHR Health Protection Research Unit in Health Impact of Environmental Hazards, King's College London, UK and St John's Institute of Dermatology, Division of Genetics and Molecular Medicine, King's College London, UK
| | - Elizabeth H Mann
- MRC and Asthma UK Centre in Allergic Mechanisms of Asthma, King's College London, UK.
| | - Antony R Young
- NIHR Health Protection Research Unit in Health Impact of Environmental Hazards, King's College London, UK and St John's Institute of Dermatology, Division of Genetics and Molecular Medicine, King's College London, UK
| | - Catherine M Hawrylowicz
- MRC and Asthma UK Centre in Allergic Mechanisms of Asthma, King's College London, UK. and NIHR Health Protection Research Unit in Health Impact of Environmental Hazards, King's College London, UK
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28
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Han YY, Forno E, Boutaoui N, Canino G, Celedón JC. Vitamin D insufficiency, T H2 cytokines, and allergy markers in Puerto Rican children with asthma. Ann Allergy Asthma Immunol 2018; 121:497-498.e1. [PMID: 29909056 DOI: 10.1016/j.anai.2018.06.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2018] [Revised: 06/06/2018] [Accepted: 06/07/2018] [Indexed: 02/06/2023]
Affiliation(s)
- Yueh-Ying Han
- Division of Pediatric Pulmonary Medicine Children's Hospital of Pittsburgh of UPMC University of Pittsburgh Pittsburgh, Pennsylvania
| | - Erick Forno
- Division of Pediatric Pulmonary Medicine Children's Hospital of Pittsburgh of UPMC University of Pittsburgh Pittsburgh, Pennsylvania
| | - Nadia Boutaoui
- Division of Pediatric Pulmonary Medicine Children's Hospital of Pittsburgh of UPMC University of Pittsburgh Pittsburgh, Pennsylvania
| | - Glorisa Canino
- Behavioral Sciences Research Institute University of Puerto Rico San Juan, Puerto Rico
| | - Juan C Celedón
- Division of Pediatric Pulmonary Medicine Children's Hospital of Pittsburgh of UPMC University of Pittsburgh Pittsburgh, Pennsylvania.
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Saggese G, Vierucci F, Prodam F, Cardinale F, Cetin I, Chiappini E, de’ Angelis GL, Massari M, Miraglia Del Giudice E, Miraglia Del Giudice M, Peroni D, Terracciano L, Agostiniani R, Careddu D, Ghiglioni DG, Bona G, Di Mauro G, Corsello G. Vitamin D in pediatric age: consensus of the Italian Pediatric Society and the Italian Society of Preventive and Social Pediatrics, jointly with the Italian Federation of Pediatricians. Ital J Pediatr 2018; 44:51. [PMID: 29739471 PMCID: PMC5941617 DOI: 10.1186/s13052-018-0488-7] [Citation(s) in RCA: 121] [Impact Index Per Article: 20.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2017] [Accepted: 04/16/2018] [Indexed: 02/07/2023] Open
Abstract
Vitamin D plays a pivotal role in the regulation of calcium-phosphorus metabolism, particularly during pediatric age when nutritional rickets and impaired bone mass acquisition may occur.Besides its historical skeletal functions, in the last years it has been demonstrated that vitamin D directly or indirectly regulates up to 1250 genes, playing so-called extraskeletal actions. Indeed, recent data suggest a possible role of vitamin D in the pathogenesis of several pathological conditions, including infectious, allergic and autoimmune diseases. Thus, vitamin D deficiency may affect not only musculoskeletal health but also a potentially wide range of acute and chronic conditions. At present, the prevalence of vitamin D deficiency is high in Italian children and adolescents, and national recommendations on vitamin D supplementation during pediatric age are lacking. An expert panel of the Italian Society of Preventive and Social Pediatrics reviewed available literature focusing on randomized controlled trials of vitamin D supplementation to provide a practical approach to vitamin D supplementation for infants, children and adolescents.
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Affiliation(s)
- Giuseppe Saggese
- Department of Clinical and Experimental Medicine, Section of Paediatrics, University of Pisa, Pisa, Italy
| | | | - Flavia Prodam
- Division of Pediatrics, Department of Health Sciences, Interdisciplinary Research Center of Autoimmune Diseases (IRCAD), University of Piemonte Orientale, Novara, Italy
| | - Fabio Cardinale
- Pediatric Unit, Division of Pulmonology, Allergy, and Immunology, AOU Policlinico-Giovanni XXIII, Bari, Italy
| | - Irene Cetin
- Department of Mother and Child, Hospital Luigi Sacco, University of Milano, Milan, Italy
| | - Elena Chiappini
- Pediatric Infectious Disease Unit, Department of Health Sciences, University of Florence, Anna Meyer Children’s University Hospital, Florence, Italy
| | - Gian Luigi de’ Angelis
- Gastroenterology and Digestive Endoscopy Unit and Clinical Paediatrics Unit, Department of Paediatrics and Maternal Medicine, University of Parma Hospital Trust, Parma, Italy
| | - Maddalena Massari
- Department of Mother and Child, Hospital Luigi Sacco, University of Milano, Milan, Italy
| | - Emanuele Miraglia Del Giudice
- Department of Woman, Child and General and Specialist Surgery, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Michele Miraglia Del Giudice
- Department of Woman, Child and General and Specialist Surgery, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Diego Peroni
- Department of Clinical and Experimental Medicine, Section of Paediatrics, University of Pisa, Pisa, Italy
| | - Luigi Terracciano
- Pediatric Primary Care, National Pediatric Health Care System, Milan, Italy
| | | | - Domenico Careddu
- Pediatric Primary Care, National Pediatric Health Care System, Novara, Italy
| | - Daniele Giovanni Ghiglioni
- Pediatric Highly Intensive Care Unit, Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Gianni Bona
- Division of Pediatrics, University of Piemonte Orientale, Novara, Italy
| | - Giuseppe Di Mauro
- Pediatric Primary Care, National Pediatric Health Care System, Caserta, Italy
| | - Giovanni Corsello
- Department of Sciences for Health Promotion and Mother and Child Care, Neonatal Intensive Care Unit, AOUP, University of Palermo, Palermo, Italy
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30
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Lee RU, Won SH, Hansen C, Crum-Cianflone NF. 25-hydroxyvitamin D, influenza vaccine response and healthcare encounters among a young adult population. PLoS One 2018; 13:e0192479. [PMID: 29425250 PMCID: PMC5806853 DOI: 10.1371/journal.pone.0192479] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2017] [Accepted: 01/24/2018] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Influenza causes significant morbidity and mortality; the pandemic in 2009-2010 was a reminder of the potential for novel strains and antigenic changes. Studies have shown that vitamin D deficiency may be associated with poor vaccine immunogenicity, therefore we sought to determine if there was a correlation between 25-hydroxyvitamin D [25(OH)D] and influenza vaccine response. METHODS A retrospective observational study was conducted among young, healthy military members to evaluate the association between total 25(OH)D levels with post influenza vaccination antibody titers and healthcare encounters during the 2009-10 influenza season. Univariate analyses were performed to evaluate whether 25(OH)D levels are associated with baseline characteristics and post-vaccination antibody responses. Multivariable logistic regression models were utilized to determine the associations between antibody responses and 25(OH)D levels adjusting for possible confounders. RESULTS A total of 437 subjects were studied. Most participants were young adults (91% were 18-39 years of age), 50% were male, and 56% resided in the southern U.S. Overall, 152 (34.8%) were vitamin D deficient, 167 (38.2%) insufficient, and 118 (27.0%) with normal 25(OH)D levels. There were no demographic differences by 25(OH)D category. Only 224 (51.3%) demonstrated a seroprotective anti-influenza post-vaccination titer, which did not vary by categorical 25(OH)D levels [vitamin D deficient vs. normal: OR 1.10 (0.68-1.78) and insufficient vs. normal: OR 1.25 (0.78-2.01)] or continuous vitamin D levels [OR 0.98 (0.84-1.15)]. There were also no associations with increased influenza like illnesses, respiratory diagnoses and healthcare encounters between the vitamin D groups. CONCLUSION Vitamin D insufficiency and deficiency were highly prevalent despite evaluating a young, healthy adult population. There were no significant associations between 25(OH)D levels and post-vaccination antibody titers to influenza vaccine. Further studies are required to discover strategies to improve vaccine efficacy as well as to determine the role of 25(OH)D in vaccine immunity.
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Affiliation(s)
- Rachel U. Lee
- Division of Allergy and Immunology, Department of Internal Medicine, Naval Medical Center San Diego, San Diego, CA
- * E-mail:
| | - Seung Hyun Won
- Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, MD
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD
| | - Christian Hansen
- Operational Infectious Disease Department, Naval Health Research Center, San Diego, CA
| | - Nancy F. Crum-Cianflone
- Division of Infectious Disease, Department of Internal Medicine, Scripps Mercy Hospital, San Diego, CA
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31
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Jerzyńska J, Stelmach W, Rychlik B, Majak P, Podlecka D, Woicka-Kolejwa K, Stelmach I. Clinical and immunological effects of vitamin D supplementation during the pollen season in children with allergic rhinitis. Arch Med Sci 2018; 14:122-131. [PMID: 29379542 PMCID: PMC5778420 DOI: 10.5114/aoms.2016.61978] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2016] [Accepted: 05/29/2016] [Indexed: 12/27/2022] Open
Abstract
INTRODUCTION Vitamin D deficiency has been proposed as a potential contributing factor in patients with allergic diseases. We compared the clinical and immunological effects of vitamin D supplementation to placebo during the pollen season in children with allergic rhinitis. MATERIAL AND METHODS Thirty-eight children aged 5-12, sensitive to grass pollen, participated in a prospective, randomized, double-blind, placebo-controlled trial. Children received either vitamin D 1000 IU daily supplementation or placebo. We studied symptoms/medication score, lung function, exhaled nitric oxide concentration (FENO), methacholine bronchial provocation test and serum level of 25(OH)D, as well as; CD4+CD25+Foxp3+ cells, TLR4, IL-1, IL-6, TNF and the IL-10 and transforming growth factor β1 (TGF-β1) levels in cell culture supernatants. RESULTS Vitamin D therapy was effective in reduction of the symptoms/medication score (p = 0.0371). In vitamin D group an increase in the CD4+CD25+Foxp3+ cells (7.06 vs. 10.5%; p = 0.0013) and serum 25(OH)D concentration (49.6 vs. 96.6 ng/ml; p = 0.0001) and in control group an increase in FENO (15.6 vs. 21 ppb; p = 0.0331) and serum 25(OH)D level were observed (82.9 vs. 100.3 ng/ml; p = 0.0003).We revealed a higher increase from baseline in the percentage of CD4+CD25+Foxp3+ cells in the vitamin D group compared to the control group (p = 0.0058). A significant correlation between CD4+CD25+Foxp3+ cell induction and FENO reduction in the vitamin D group was observed (p = 0.0217). CONCLUSIONS Vitamin D 1000 IU as a supplementary treatment of grass pollen allergy in children with allergic rhinitis during the pollen season significantly reduced the symptoms/medication score. The study revealed an immunological effect of vitamin D.
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Affiliation(s)
- Joanna Jerzyńska
- Departament of Pediatrics and Allergy, Medical University of Lodz, N. Copernicus Hospital, Lodz, Poland
| | - Włodzimierz Stelmach
- Departament of Social and Preventive Medicine, Medical University of Lodz, Lodz, Poland
| | - Błażej Rychlik
- Departament of Molecular Biophysics, University of Lodz, Lodz, Poland
| | - Paweł Majak
- Departament of Internal Medicine, Asthma and Allergy, Medical University of Lodz, Lodz, Poland
| | - Daniela Podlecka
- Departament of Pediatrics and Allergy, Medical University of Lodz, N. Copernicus Hospital, Lodz, Poland
| | - Katarzyna Woicka-Kolejwa
- Departament of Pediatrics and Allergy, Medical University of Lodz, N. Copernicus Hospital, Lodz, Poland
| | - Iwona Stelmach
- Departament of Pediatrics and Allergy, Medical University of Lodz, N. Copernicus Hospital, Lodz, Poland
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Janeva-Jovanovska E, Dokic D, Jovkovska-Kaeva B, Breskovska G, Goseva Z, Minov J, Trajkov D, Dimitrova-Genadieva M, Zafirovska-Ivanovska B. Relationship between Vitamin D, Inflammation and Lung Function In Patients with Severe Uncontrolled Asthma. Open Access Maced J Med Sci 2017; 5:899-903. [PMID: 29362615 PMCID: PMC5771291 DOI: 10.3889/oamjms.2017.190] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2017] [Revised: 11/03/2017] [Accepted: 11/04/2017] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Recently epidemiological studies showed that low vitamin D is linked to airway hyperresponsiveness, decreased lung function, poor asthma control, and steroid-resistant asthma. AIM We investigated the relationship between Vitamin D, inflammation with circulating IL-33 and lung function in 30 patients with severe uncontrolled asthma. MATERIALS AND METHODS The study included 30 patients with severe uncontrolled asthma. In each of them were measured serum levels of IL-33 and Vitamin D by the ELISA method. The pulmonary function is measured by basic spirometry parameters, FEV1. The results were statistically elaborated according to the Pearson's Correlation Tests. RESULTS The results showed statistically insignificant correlation between Vitamin D and IL-33, and Vitamin D with FEV1 (Vit.D/IL-33; r = 0.11323, p = 0.551); (Vit.D/FEV1; r = -0.1005; p = 0.597) Correlation between IL-33 and FEV1 is negative but statistically significant (IL-33/FEV1; r = -0.5248; p = 0.003). CONCLUSION Because there are little studies about the link between vitamin D and asthma, further research to clarify the mechanism how vitamin D control the activity of CD4+ T cells and the related Th2-type cytokines in the parthenogenesis of asthma.
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Affiliation(s)
- Elena Janeva-Jovanovska
- PHI University Clinic of Pulmonology and Allergy, Faculty of Medicine, Ss Cyril and Methodius University of Skopje, Skopje, Republic of Macedonia
| | - Dejan Dokic
- PHI University Clinic of Pulmonology and Allergy, Faculty of Medicine, Ss Cyril and Methodius University of Skopje, Skopje, Republic of Macedonia
| | - Biserka Jovkovska-Kaeva
- PHI University Clinic of Pulmonology and Allergy, Faculty of Medicine, Ss Cyril and Methodius University of Skopje, Skopje, Republic of Macedonia
| | - Gorica Breskovska
- PHI University Clinic of Pulmonology and Allergy, Faculty of Medicine, Ss Cyril and Methodius University of Skopje, Skopje, Republic of Macedonia
| | - Zlatica Goseva
- PHI University Clinic of Pulmonology and Allergy, Faculty of Medicine, Ss Cyril and Methodius University of Skopje, Skopje, Republic of Macedonia
| | - Jordan Minov
- Institute for Occupational Health of RM - Faculty of Medicine, Ss Cyril and Methodius University of Skopje, Skopje, Republic of Macedonia
| | - Dejan Trajkov
- Institute of Immunobiology and Human Genetics, Faculty of Medicine, Ss Cyril and Methodius University of Skopje, Skopje, Republic of Macedonia
| | - Magdalena Dimitrova-Genadieva
- PHI University Clinic of Gastroenterohepatology, Faculty of Medicine, Ss Cyril and Methodius University of Skopje, Skopje, Republic of Macedonia
| | - Beti Zafirovska-Ivanovska
- Institute of Epidemiology and Biostatistics, Faculty of Medicine, Ss Cyril and Methodius University of Skopje, Skopje, Republic of Macedonia
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33
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Nwaru BI, Hadkhale K, Hämäläinen N, Takkinen HM, Ahonen S, Ilonen J, Toppari J, Niemelä O, Haapala AM, Veijola R, Knip M, Virtanen SM. Vitamin D intake during the first 4 years and onset of asthma by age 5: A nested case-control study. Pediatr Allergy Immunol 2017; 28:641-648. [PMID: 28815786 DOI: 10.1111/pai.12773] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/13/2017] [Indexed: 12/15/2022]
Abstract
BACKGROUND Early-life vitamin D intake has been linked to asthma risk in childhood, but the role of longitudinal vitamin D exposure has not been previously evaluated. We investigated the association between vitamin D intake during the first 4 years of life and asthma risk by age 5. METHODS Within a Finnish population-based birth cohort, 182 incident asthma cases were matched to 728 controls on sex, genetic risk for type 1 diabetes, delivery hospital, and time of birth. Vitamin D intake was assessed by age-specific 3 day food records. Parents completed a validated version of the International Study of Asthma and Allergies in Childhood questionnaire at 5 years. RESULTS At 3 months, supplements were the main source of vitamin D intake; intake from foods increased from 3 months on, mainly from fortified milk products. Vitamin D intake at each specific age was associated with an increased risk of any asthma, atopic, and non-atopic asthma, but only intake at 1 and 2 years was statistically significantly associated with asthma. Longitudinal vitamin D intake was associated with an increased risk of asthma (OR 1.24; 95%CI 1.00-1.53). CONCLUSIONS Increased vitamin D intake in childhood, particularly intake at 1 and 2 years of age, may increase risk of childhood asthma. This might reflect a true effect or residual confounding by lifestyle or environmental factors. Repeated assessment of vitamin D intake allowed evaluation of the longitudinal and age-dependent impact of vitamin D on the risk of asthma. Further longitudinal studies are required to confirm or question these findings.
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Affiliation(s)
- Bright I Nwaru
- Faculty of Social Sciences/Health, University of Tampere, Tampere, Finland.,Asthma UK Centre for Applied Research, Centre for Medical Informatics, Usher Institute of Population Health Sciences and Informatics, The University of Edinburgh, Edinburgh, UK.,Krefting Research Centre, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Kishor Hadkhale
- Faculty of Social Sciences/Health, University of Tampere, Tampere, Finland
| | - Niina Hämäläinen
- Faculty of Social Sciences/Health, University of Tampere, Tampere, Finland
| | - Hanna-Mari Takkinen
- Faculty of Social Sciences/Health, University of Tampere, Tampere, Finland.,Nutrition Unit, National Institute for Health and Welfare, Department of Public Health Solutions, Helsinki, Finland
| | - Suvi Ahonen
- Faculty of Social Sciences/Health, University of Tampere, Tampere, Finland.,Nutrition Unit, National Institute for Health and Welfare, Department of Public Health Solutions, Helsinki, Finland.,The Science Center of Pirkanmaa Hospital District, Tampere, Finland
| | - Jorma Ilonen
- Immunogenetics Laboratory, University of Turku, Turku, Finland.,Department of Clinical Microbiology, University of Eastern Finland, Joensuu, Finland
| | - Jorma Toppari
- Department of Physiology, Department of Pediatrics, Institute of Biomedicine, University of Turku, Turku University Hospital, Turku, Finland
| | - Onni Niemelä
- Department of Laboratory Medicine, Seinäjoki Central Hospital and University of Tampere, Tampere, Finland
| | - Anna-Maija Haapala
- Faculty of Medicine, University of Tampere and Fimlab Ltd, Pirkanmaa Hospital District, Tampere, Finland
| | - Riitta Veijola
- Department of Pediatrics, PEDEGO Research Unit, Medical Research Center, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Mikael Knip
- Center for Child Health Research, University of Tampere and Tampere University Hospital, Tampere, Finland.,Folkhälsan Research Center, Helsinki, Finland.,Children's Hospital, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland.,Research Programs Unit, Diabetes and Obesity, University of Helsinki, Helsinki, Finland
| | - Suvi M Virtanen
- Faculty of Social Sciences/Health, University of Tampere, Tampere, Finland.,Nutrition Unit, National Institute for Health and Welfare, Department of Public Health Solutions, Helsinki, Finland.,The Science Center of Pirkanmaa Hospital District, Tampere, Finland.,Center for Child Health Research, University of Tampere and Tampere University Hospital, Tampere, Finland
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34
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Flexeder C, Thiering E, Koletzko S, Berdel D, Lehmann I, von Berg A, Hoffmann B, Bauer CP, Heinrich J, Schulz H. Higher serum 25(OH)D concentrations are associated with improved FEV1 and FVC in adolescence. Eur Respir J 2017; 49:49/4/1601804. [DOI: 10.1183/13993003.01804-2016] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2016] [Accepted: 01/11/2017] [Indexed: 12/29/2022]
Abstract
Vitamin D plays a role in the development of the immune system and the lung, as well as in airway remodelling. Therefore, this study investigated the association between serum 25-hydroxyvitamin D (25(OH)D) concentrations and spirometric lung function parameters at age 15 years.In the German birth cohorts GINIplus and LISAplus, lung function testing by spirometry and 25(OH)D measurements were performed during the 15-year follow-up examinations. Valid lung function measurements pre- and/or post-bronchodilation and serum 25(OH)D concentrations, which were adjusted for the date of blood sampling to account for seasonal variability, were available for 2607 adolescents. Associations between 25(OH)D concentrations and spirometric parameters were analysed using generalised additive models adjusted for confounding factors.Serum 25(OH)D concentrations were significantly associated with forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1) and FEV1/FVC measured before bronchodilation after adjustment for potential confounders: FEV1 increased by 10 mL (95% CI 2–17), FVC by 20 mL (95% CI 12–28) and FEV1/FVC decreased by 0.177% (95% CI −0.286 to −0.067) per 10 nmol·L−1 increase in 25(OH)D concentrations. Flow rates (forced expiratory flow rates at 25, 50 and 75% of exhaled FVC (FEF25, FEF50, FEF75) and mean flow rate between 25 and 75% of FVC (FEF25–75)) were not associated with vitamin D. Similar associations were observed for lung function parameters measured after bronchodilation.Vitamin D concentrations are positively associated with volume-related lung function parameters pre- and post-bronchodilation, suggesting structural changes in peripheral airways.
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35
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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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Beyhan-Sagmen S, Baykan O, Balcan B, Ceyhan B. Association Between Severe Vitamin D Deficiency, Lung Function and Asthma Control. Arch Bronconeumol 2017; 53:186-191. [PMID: 28320552 DOI: 10.1016/j.arbres.2016.09.010] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2016] [Revised: 09/05/2016] [Accepted: 09/07/2016] [Indexed: 12/30/2022]
Abstract
INTRODUCTION To examine the relationship between severe vitamin D deficiency, asthma control, and pulmonary function in Turkish adults with asthma. METHODS One hundred six asthmatic patients underwent pulmonary function tests skin prick test, peripheral blood eosinophil counts, IgE, body mass index and vitamin D levels were determined. Patients were divided into 2 subgroups according to vitamin D levels (vitamin D level<10ng/ml and vitamin D level≥10 ng/ml). Asthma control tests were performed. RESULTS The mean age of subgroup i (vitamin D level<10) was 37±10 and the mean age of subgroup ii (vitamin D level≥10ng/ml) was 34±8. Sixty-six percent of patients had severe vitamin D deficiency (vitamin D level<10 ng/ml). There was a significant trend towards lower absolute FEV1 (L) values in patients with lower vitamin D levels (P=.001). Asthma control test scores were significantly low in the severe deficiency group than the other group (P=.02). There were a greater number of patients with uncontrolled asthma (asthma control test scores<20) in the severe vitamin D deficiency group (P=.040). Patients with severe vitamin D deficiency had a higher usage of inhaled corticosteroids than the group without severe vitamin D deficiency (P=.015). There was a significant trend towards lower absolute FEV1 (L) (P=.005, r=.272) values in patients with lower vitamin D levels. Vitamin D levels were inversely related with body mass index (P=.046). CONCLUSION The incidence of severe vitamin D deficiency was high in adult Turkish asthmatics. In addition, lower vitamin D levels were associated with poor asthma control and decreased pulmonary function.
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Affiliation(s)
- Seda Beyhan-Sagmen
- Department of Pulmonolgy and Intensive care, Faculty of Medicine, Marmara University , Estambul, Turquía.
| | - Ozgur Baykan
- Department of Pulmonolgy and Intensive care, Faculty of Medicine, Marmara University , Estambul, Turquía
| | - Baran Balcan
- Department of Pulmonolgy and Intensive care, Faculty of Medicine, Marmara University , Estambul, Turquía
| | - Berrin Ceyhan
- Department of Pulmonolgy and Intensive care, Faculty of Medicine, Marmara University , Estambul, Turquía
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37
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Kim YR, Seo SC, Yoo Y, Choung JT. Are children with asthma in South Korea also associated with vitamin D deficiency? ENVIRONMENTAL HEALTH AND TOXICOLOGY 2017; 32:e2017005. [PMID: 28231689 PMCID: PMC5480427 DOI: 10.5620/eht.e2017005] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/02/2016] [Accepted: 01/18/2017] [Indexed: 06/06/2023]
Abstract
Recently, epidemiologic studies have shown that the lack of serum vitamin D levels may be associated with high asthma prevalence, but its effect is still controversial, depending on season, area, and food consumption. We aimed to examine the association of serum vitamin D levels with the prevalence of pediatric asthma in Korea. A total of 80 children (50 asthmatic children and 30 healthy controls) aged 6-14 years were participated in this study. Serum vitamin D levels were measured and compared between the two groups. Moreover, the relationship of serum vitamin D levels with results of pulmonary function test and environmental factors (lifestyle habits and residential factors) collected by a questionnaire survey were examined in asthmatic patients. Serum vitamin D levels in asthmatic children (16.63±4.20 ng/mL) were significantly lower than that in healthy controls (24.24±6.76 ng/mL) (p<0.05). Also, we found that the prevalence of asthma increase to 0.79-fold (odds ratio, 0.79; 95% confidence interval, 0.71 to 0.88; p<0.001) as serum vitamin D level is 1 ng/mL decreases. The increased time spent in outdoor could affect the increases of serum vitamin D levels significantly. However, no associations of serum vitamin D with pulmonary function and residential environmental factors (i.e., housing type, living floor, and indoor activity time) were observed. Our findings suggest that serum vitamin D levels were also associated with pediatric asthma in Korea. Moreover, management of serum vitamin D level in asthmatic children would be a promising approach for preventing exaggeration of their severity.
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Affiliation(s)
- Yu-Ri Kim
- Environmental Health Center for Asthma, Korea University Medical Center, Seoul, Korea
| | - Sung Chul Seo
- Department of Industrial Health, College of Applied Sciences, Catholic University of Pusan, Busan, Korea
| | - Young Yoo
- Environmental Health Center for Asthma, Korea University Medical Center, Seoul, Korea
- Department of Pediatrics, Korea University College of Medicine, Seoul, Korea
| | - Ji Tae Choung
- Environmental Health Center for Asthma, Korea University Medical Center, Seoul, Korea
- Department of Pediatrics, Korea University College of Medicine, Seoul, Korea
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38
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Ozdemir A, Dogruel D, Yilmaz O. Vitamin D Status in Infants with Two Different Wheezing Phenotypes. Indian J Pediatr 2016; 83:1386-1391. [PMID: 27345567 DOI: 10.1007/s12098-016-2184-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2016] [Accepted: 06/13/2016] [Indexed: 12/11/2022]
Abstract
OBJECTIVE To investigate vitamin D levels in patients with recurrent wheeze at early ages of childhood. METHODS In the present cross-sectional study, serum 25-hydroxy vitamin D [25 (OH)D], levels which is known as an indicator of vitamin D adequacy, was examined in infants with three or more wheezing attacks. RESULTS A total of 186 infants with recurrent wheezing were included in the study along with 118 healthy control peers. The recurrent wheezing study participants were classified into two groups according to Asthma Predictive Index (API) positivity and compared to control subjects regarding their serum vitamin D status. The API negative group had the lowest mean serum 25 (OH)D level (n = 121; 22.71 ± 10.76 ng/ml) followed by API positive group (n = 65; 24.08 ± 9.02 ng/ml) compared to healthy group (26.24 ± 11.88 ng/ml) (p < 0.05). In addition, higher vitamin D deficiency was observed in infants in API negative group (52.1 %; p < 0.01) and API positive group (38.5 %; p < 0.05) than control group (31.4 %). CONCLUSIONS Low levels of 25 (OH)D were detected in infants with two different phenotypes of recurrent wheeze. Vitamin D deficiency may play a role in the pathogenesis of infants with recurrent wheezing.
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Affiliation(s)
- Ali Ozdemir
- Pediatric Pulmonary Section, Department of Pediatrics, Mersin Children's Hospital, Halkkent, 33240, Mersin, Turkey.
| | - Dilek Dogruel
- Pediatric Allergy & Immunology Section, Department of Pediatrics, University of Baskent, Adana, Turkey
| | - Ozlem Yilmaz
- Pediatric Allergy & Immunology Section, Department of Pediatrics, Mersin Children's Hospital, Halkkent, Mersin, Turkey
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39
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Loisel DA, Du G, Ahluwalia TS, Tisler CJ, Evans MD, Myers RA, Gangnon RE, Kreiner-Møller E, Bønnelykke K, Bisgaard H, Jackson DJ, Lemanske RF, Nicolae DL, Gern JE, Ober C. Genetic associations with viral respiratory illnesses and asthma control in children. Clin Exp Allergy 2016; 46:112-24. [PMID: 26399222 DOI: 10.1111/cea.12642] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2015] [Revised: 08/04/2015] [Accepted: 08/23/2015] [Indexed: 02/07/2023]
Abstract
BACKGROUND Viral respiratory infections can cause acute wheezing illnesses in children and exacerbations of asthma. OBJECTIVE We sought to identify variation in genes with known antiviral and pro-inflammatory functions to identify specific associations with more severe viral respiratory illnesses and the risk of virus-induced exacerbations during the peak fall season. METHODS The associations between genetic variation at 326 SNPs in 63 candidate genes and 10 phenotypes related to viral respiratory infection and asthma control were examined in 226 children enrolled in the RhinoGen study. Replication of asthma control phenotypes was performed in 2128 children in the Copenhagen Prospective Study on Asthma in Childhood (COPSAC). Significant associations in RhinoGen were further validated using virus-induced wheezing illness and asthma phenotypes in an independent sample of 122 children enrolled in the Childhood Origins of Asthma (COAST) birth cohort study. RESULTS A significant excess of P values smaller than 0.05 was observed in the analysis of the 10 RhinoGen phenotypes. Polymorphisms in 12 genes were significantly associated with variation in the four phenotypes showing a significant enrichment of small P values. Six of those genes (STAT4, JAK2, MX1, VDR, DDX58, and EIF2AK2) also showed significant associations with asthma exacerbations in the COPSAC study or with asthma or virus-induced wheezing phenotypes in the COAST study. CONCLUSIONS We identified genetic factors contributing to individual differences in childhood viral respiratory illnesses and virus-induced exacerbations of asthma. Defining mechanisms of these associations may provide insight into the pathogenesis of viral respiratory infections and virus-induced exacerbations of asthma.
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Affiliation(s)
- D A Loisel
- Department of Human Genetics, University of Chicago, Chicago, IL, USA.,Department of Biology, Saint Michael's College, Colchester, VT, USA
| | - G Du
- Department of Human Genetics, University of Chicago, Chicago, IL, USA
| | - T S Ahluwalia
- COPSAC, Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, Ledreborg Allé 34, DK-2820, Copenhagen, Denmark.,Steno Diabetes Center, Gentofte, Denmark
| | - C J Tisler
- Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - M D Evans
- Department of Biostatistics and Medical Informatics, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - R A Myers
- Department of Human Genetics, University of Chicago, Chicago, IL, USA
| | - R E Gangnon
- Department of Biostatistics and Medical Informatics, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.,Department of Population Health Sciences, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - E Kreiner-Møller
- COPSAC, Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, Ledreborg Allé 34, DK-2820, Copenhagen, Denmark
| | - K Bønnelykke
- COPSAC, Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, Ledreborg Allé 34, DK-2820, Copenhagen, Denmark
| | - H Bisgaard
- COPSAC, Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, Ledreborg Allé 34, DK-2820, Copenhagen, Denmark
| | - D J Jackson
- Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - R F Lemanske
- Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.,Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - D L Nicolae
- Department of Human Genetics, University of Chicago, Chicago, IL, USA.,Department of Medicine, University of Chicago, Chicago, IL, USA.,Department of Statistics, University of Chicago, Chicago, IL, USA
| | - J E Gern
- Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - C Ober
- Department of Human Genetics, University of Chicago, Chicago, IL, USA
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40
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Kumar P. Adult pulmonary tuberculosis as a pathological manifestation of hyperactive antimycobacterial immune response. Clin Transl Med 2016; 5:38. [PMID: 27709522 PMCID: PMC5052244 DOI: 10.1186/s40169-016-0119-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2016] [Accepted: 09/09/2016] [Indexed: 12/21/2022] Open
Abstract
The intricate relationship between tuberculosis (TB) and immune system remains poorly understood. It is generally believed that weakening of the immune response against Mycobacterium tuberculosis leads to reactivation of latent infection into the active pulmonary disease. However, heterogeneous nature of TB and failure of rationally designed vaccines in clinical trials raises serious questions against the simplistic view of TB as an outcome of weakened immunity. In the wake of accumulating human TB data, it is argued here that a hyperactive antimycobacterial immune response is to blame for the pathogenesis of pulmonary TB in immunocompetent adults. Direct and indirect evidence supporting this notion is presented in this article. Revisiting the role of immune system in TB pathogenesis will pave the way for effective anti-TB vaccines.
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Affiliation(s)
- Pawan Kumar
- Special Centre for Molecular Medicine, Jawaharlal Nehru University, New Mehrauli Road, New Delhi, 110067, India.
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41
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Fort P, Salas AA, Nicola T, Craig CM, Carlo WA, Ambalavanan N. A Comparison of 3 Vitamin D Dosing Regimens in Extremely Preterm Infants: A Randomized Controlled Trial. J Pediatr 2016; 174:132-138.e1. [PMID: 27079965 PMCID: PMC4925243 DOI: 10.1016/j.jpeds.2016.03.028] [Citation(s) in RCA: 62] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2015] [Revised: 01/12/2016] [Accepted: 03/09/2016] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To determine the optimal dose of vitamin D supplementation to achieve biochemical vitamin D sufficiency in extremely low gestational age newborns in a masked randomized controlled trial. STUDY DESIGN 100 infants 23 0/7-27 6/7 weeks gestation were randomized to vitamin D intakes of placebo (n = 36), 200 IU (n = 34), and 800 IU/d (n = 30) (approximating 200, 400, or 1000 IU/d, respectively, when vitamin D routinely included in parenteral or enteral nutrition is included). The primary outcomes were serum 25-hydroxy vitamin D concentrations on postnatal day 28 and the number of days alive and off respiratory support in the first 28 days. RESULTS At birth, 67% of infants had 25-hydroxy vitamin D <20 ng/mL suggesting biochemical vitamin D deficiency. Vitamin D concentrations on day 28 were (median [25th-75th percentiles], ng/mL): placebo: 22 (13-47), 200 IU: 39 (26-57), 800 IU: 84.5 (52-99); P < .001. There were no differences in days alive and off respiratory support (median [25th-75th percentiles], days): placebo: 1 (0-11), 200 IU: 0 (0-8), and 800 IU: 0.5 (0-22); P = .63, or other respiratory outcomes among groups. CONCLUSIONS At birth, most extremely preterm infants have biochemical vitamin D deficiency. This biochemical deficiency is reduced on day 28 by supplementation with 200 IU/d and prevented by 800 IU/d. Larger trials are required to determine if resolution of biochemical vitamin D deficiency improves clinical outcomes. TRIAL REGISTRATION ClinicalTrials.gov: NCT01600430.
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Affiliation(s)
- Prem Fort
- Department of Pediatrics, University of Alabama at Birmingham, Birmingham, AL
| | - Ariel A. Salas
- Department of Pediatrics, University of Alabama at Birmingham, Birmingham, AL
| | - Teodora Nicola
- Department of Pediatrics, University of Alabama at Birmingham, Birmingham, AL
| | - Carolyne M. Craig
- Department of Pediatrics, University of Alabama at Birmingham, Birmingham, AL
| | - Waldemar A. Carlo
- Department of Pediatrics, University of Alabama at Birmingham, Birmingham, AL
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Mehta AA, Agrawal AD, Appanna V, Chaudagar KK. Vitamin D improves corticosteroid efficacy and attenuates its side-effects in an animal model of asthma. Can J Physiol Pharmacol 2016; 93:53-61. [PMID: 25429688 DOI: 10.1139/cjpp-2014-0323] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The subacute use of corticosteroids has side-effects such as glucose intolerance, dyslipidemia, anxiety, and depression, which could be halted with vitamin D, which is an immunomodulatory vitamin. Thus, we aimed to study the anti-asthmatic efficacy and side-effects profile of vitamin D, the corticosteroid dexamethasone, and their combination on ovalbumin-induced airway inflammation in rats. For this, 2 different doses of vitamin D (50 IU/kg, daily for 2 weeks, or and 60000 IU/kg, bolus dose, by intraperitoneal injection (i.p.)) were administered in combination with dexamethasone (2.5 mg/kg, i.p., for 2 weeks) prior to challenge with ovalbumin. At the end of the therapy, the asthmatic parameters such as differential white blood cell counts, serum levels of immunoglobulin E, bronchoalveolar lavaged fluid, and interleukin-5, as well as serum levels of nitric oxide were significantly increased after allergen challenges in asthmatic rats as compared with the controls. Such increases were significantly attenuated by monotherapy with vitamin D and with combination therapy of vitamin D and dexamethasone, where the combination therapy was superior to the monotherapy. Dexamethasone-induced hyperglycemia, hyperlipidemia, and behavioral abnormalities in the allergic rats were attenuated with vitamin D. The daily dose was better for controlling serum levels of immunoglobulin E than the bolus dose, whereas the bolus was superior for reducing dexamethasone-induced psychotropic abnormalities. There were no significant changes in other parameters between the daily and the bolus dose. In conclusion, a daily dose of vitamin D in combination with dexamethasone is more efficacious for treating asthma in allergic rats than monotherapy.
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Affiliation(s)
- Anita A Mehta
- a Department of Pharmacology, L.M. College of Pharmacy, Navarangpura, Ahmedabad, Gujarat 380 009, India
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43
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You MJ, Kim WK. Vitamin D serum levels and risk of asthma in children. ALLERGY ASTHMA & RESPIRATORY DISEASE 2016. [DOI: 10.4168/aard.2016.4.1.44] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Affiliation(s)
- Min Jung You
- Department of Pediatrics, Inje University Sanggyae Paik Hospital, Seoul, Korea
| | - Woo Kyung Kim
- Department of Pediatrics, Inje University Seoul Paik Hospital, Seoul, Korea
- Allergy and Respiratory Research Laboratory, Inje University College of Medicine, Seoul, Korea
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44
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Vitamin D influences asthmatic pathology through its action on diverse immunological pathways. Ann Am Thorac Soc 2015; 11 Suppl 5:S314-21. [PMID: 25525739 DOI: 10.1513/annalsats.201405-204aw] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
The prevalence of vitamin D insufficiency and deficiency has increased markedly in recent decades to current epidemic levels (Hyppönen E, et al. Am J Clin Nutr 2007;85:860-868). In parallel, there has been an increase in the incidence of a range of immune-mediated conditions ranging from cancer to autoimmune and respiratory diseases, including chronic obstructive pulmonary disease and asthma (Holick MF. N Engl J Med 2007;357:266-281; Finklea et al. Adv Nutr 2011;2:244-253). There is also an association with increased respiratory infections, which are the most common cause of asthma exacerbations (Finklea et al. Adv Nutr 2011;2:244-253). Together, this has resulted in considerable interest in the therapeutic potential of vitamin D to prevent and improve treatment of asthma and other respiratory diseases. To this end, data from clinical trials involving supplementation with active vitamin D, or more commonly a precursor, are starting to emerge. This review considers mechanisms by which vitamin D may act on the immune system to dampen inappropriate inflammatory responses in the airway while also promoting tolerance and antimicrobial defense mechanisms that collectively maintain respiratory health.
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45
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Mirzakhani H, Al-Garawi A, Weiss ST, Litonjua AA. Vitamin D and the development of allergic disease: how important is it? Clin Exp Allergy 2015; 45:114-25. [PMID: 25307157 DOI: 10.1111/cea.12430] [Citation(s) in RCA: 93] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Vitamin D has known effects on lung development and the immune system that may be important in the development, severity, and course of allergic diseases (asthma, eczema, and food allergy). Vitamin D deficiency is prevalent worldwide and may partly explain the increases in asthma and allergic diseases that have occurred over the last 50-60 years. In this review, we explore past and current knowledge on the effect of vitamin D on lung development and immunomodulation and present the evidence of its role in allergic conditions. While there is growing observational and experimental evidence for the role of vitamin D, well-designed and well-powered clinical trials are needed to determine whether supplementation of vitamin D should be recommended in these disorders.
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Affiliation(s)
- H Mirzakhani
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
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46
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Bar Yoseph R, Livnat G, Schnapp Z, Hakim F, Dabbah H, Goldbart A, Bentur L. The effect of vitamin D on airway reactivity and inflammation in asthmatic children: A double-blind placebo-controlled trial. Pediatr Pulmonol 2015; 50:747-53. [PMID: 24989842 DOI: 10.1002/ppul.23076] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2014] [Accepted: 05/28/2014] [Indexed: 11/11/2022]
Abstract
BACKGROUND Cross-sectional studies have reported an association of vitamin D deficiency with increased asthma prevalence and severity, and with allergies. The effect of vitamin D as sole therapy on airway hyper-reactivity (AHR) and airway inflammation has not been reported. AIM To evaluate the effect of vitamin D therapy on AHR as assessed by methacholine concentration, causing a 20% reduction in FEV1 (PC20 -FEV1 ) and fractional exhaled nitric oxide (FeNO), systemic markers of allergy and inflammation, and exhaled breath condensate cytokines. PATIENTS AND METHODS Children aged 6-18 years with a clinical diagnosis of mild asthma currently not receiving anti-inflammatory therapy and with low vitamin D levels were included in this randomized, double-blind, placebo-controlled study assessing the effect of 6 weeks of treatment with oral vitamin D 14,000 units once weekly or placebo. RESULTS Of the 39 patients included, 20 received vitamin D treatment and 19 received a placebo. Vitamin D replacement resulted in a significant increase in vitamin levels, which remained unchanged in the placebo group (P < 0.0001). There was no change in IgE, eosinophil count, high sensitivity C-reactive protein, FeNO levels or PC20 -FEV1 following treatment. Similar values of exhaled breath condensate cytokines (IL4, IL5, IL10, IL17, and γ interferon) were observed in both groups. CONCLUSIONS In our small group of children with mild asthma, no difference could be demonstrated between the effect of vitamin D and placebo, despite significant increases in vitamin D blood levels. Larger interventional studies are needed to fully explore the possible effect of vitamin D in asthma.
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Affiliation(s)
- Ronen Bar Yoseph
- Pediatric Pulmonology Unit, Meyer Children's Hospital, Rambam Health Care Campus, Haifa, Israel
| | - Galit Livnat
- Pediatric Pulmonology Unit, Meyer Children's Hospital, Rambam Health Care Campus, Haifa, Israel
| | - Zeev Schnapp
- Pediatric Pulmonology Unit, Meyer Children's Hospital, Rambam Health Care Campus, Haifa, Israel
| | - Fahed Hakim
- Pediatric Pulmonology Unit, Meyer Children's Hospital, Rambam Health Care Campus, Haifa, Israel
| | - Husein Dabbah
- Department of Pediatrics, Western Galilee Hospital, Nahariya, Israel.,Faculty of Medicine, Galilee Bar-Ilan University, Safed, Israel
| | - Aviv Goldbart
- Department of Pediatrics, Soroka University Medical Center, Beer Sheba, Israel
| | - Lea Bentur
- Pediatric Pulmonology Unit, Meyer Children's Hospital, Rambam Health Care Campus, Haifa, Israel.,Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
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47
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Niruban SJ, Alagiakrishnan K, Beach J, Senthilselvan A. Association between vitamin D and respiratory outcomes in Canadian adolescents and adults. J Asthma 2015; 52:653-61. [PMID: 25563060 DOI: 10.3109/02770903.2015.1004339] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
BACKGROUND Asthma is one of the most prevalent chronic diseases worldwide, affecting more than 200 million people. Vitamin D deficiency has been reported among individuals with asthma and might play a role in asthma exacerbations. In this cross-sectional study, we investigated the association of serum 25-hydroxy vitamin D [25(OH)D] levels and current asthma, ever asthma, and lung function. METHODS Data from 3937 subjects aged 13-69 years who participated in the Canadian Health Measures Survey - Cycle 1 were considered in this study. Serum 25(OH)D levels were categorized into ≤49 nmol/L (low), 50-74 nmol/L (moderate) and ≥75 nmol/L (high). RESULTS The proportion of subjects with current and ever asthma was greater in the lower 25(OH)D category than in moderate and high categories. After adjusting for potential confounders, subjects in the low 25(OH)D levels were more likely to have current asthma than those in the moderate levels (OR: 1.54, 95% CI: 1.01-2.36). Low 25(OH)D levels were also associated with ever asthma (OR: 2.12, 95% CI: 1.40-3.21) among those with a family history of asthma and this association was stronger in those with asthma onset before 20 years of age. High 25(OH)D levels were associated with lower mean value of FEV1/FVC ratio. No significant association was observed between 25(OH)D levels and other lung function measurements. CONCLUSION In this study, 25(OH)D levels below 50 nmol/L were associated with an increased risk of current and ever asthma. Further exploration of this relationship is needed to determine the optimal level of vitamin D in the management of asthma in adolescents and adults.
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Vitamin D and atopic dermatitis in childhood. J Immunol Res 2015; 2015:257879. [PMID: 25973433 PMCID: PMC4417995 DOI: 10.1155/2015/257879] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2014] [Accepted: 01/09/2015] [Indexed: 12/26/2022] Open
Abstract
Vitamin D features immunomodulatory effects on both the innate and adaptive immune systems, which may explain the growing evidence connecting vitamin D to allergic diseases. A wealth of studies describing a beneficial effect of vitamin D on atopic dermatitis (AD) prevalence and severity are known. However, observations linking high vitamin D levels to an increased risk of developing AD have also been published, effectively creating a controversy. In this paper, we review the existing literature on the association between AD and vitamin D levels, focusing on childhood. As of today, the role of vitamin D in AD is far from clear; additional studies are particularly needed in order to confirm the promising therapeutic role of vitamin D supplementation in childhood AD.
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Man L, Zhang Z, Zhang M, Zhang Y, li J, Zheng N, Cao Y, Chi M, Chao Y, Huang Q, Song C, Xu B. Association between vitamin D deficiency and insufficiency and the risk of childhood asthma: evidence from a meta-analysis. Int J Clin Exp Med 2015; 8:5699-5706. [PMID: 26131154 PMCID: PMC4483990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2015] [Accepted: 04/04/2015] [Indexed: 06/04/2023]
Abstract
OBJECTIVE Whether vitamin D deficiency and insufficiency are associated with childhood asthma remains unclear. Thus, we conducted a meta-analysis to summarize the evidence from epidemiological studies of vitamin D deficiency and insufficiency and the risk of childhood asthma. METHODS Pertinent studies were identified by searching of PubMed and Web of Knowledge. The random effect model was used to combine the results. Meta-regression and subgroups analyses were used to explore potential sources of between-study heterogeneity. Publication bias was estimated using Egger's regression asymmetry test. RESULTS Finally, 14 articles with 15 studies including 3424 cases for vitamin D deficiency and 9 articles with 10 studies including 2756 cases for vitamin D insufficiency were included in this meta-analysis. The relative risk (95% confidence interval) of childhood asthma risk for vitamin D deficiency was 1.684 (1.321-2.148), and the associations were significant in America and Europe. Significant association of childhood asthma between vitamin D insufficiency and childhood asthma risk was found overall [1.577 (1.230-2.023)] and the subgroups of America, Europe and Asia. No evidence of significant publication bias between vitamin D deficiency and insufficiency and childhood asthma risk were found. CONCLUSIONS Results from this meta-analysis suggested that vitamin D deficiency and insufficiency might increase the risk of childhood asthma.
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Affiliation(s)
- Lixin Man
- Department of Pediatrics, General Hospital of Jinan Military AreaChina
| | - Zhao Zhang
- Shandong Traditional Chinese Medicine UniversityChina
| | - Meng Zhang
- Shandong Traditional Chinese Medicine UniversityChina
| | - Yingying Zhang
- Department of Pediatrics, General Hospital of Jinan Military AreaChina
| | - Ju li
- Department of Pediatrics, People’s Hospital of PingyiShandong Province, China
| | - Nan Zheng
- Department of Pediatrics, General Hospital of Jinan Military AreaChina
| | - Yanhua Cao
- Department of Pediatrics, General Hospital of Jinan Military AreaChina
| | - Ming Chi
- Department of Pediatrics, General Hospital of Jinan Military AreaChina
| | - Yujin Chao
- Department of Pediatrics, General Hospital of Jinan Military AreaChina
| | - Qiuer Huang
- Department of Pediatrics, General Hospital of Jinan Military AreaChina
| | - Chunmei Song
- Department of Pediatrics, General Hospital of Jinan Military AreaChina
| | - Bo Xu
- Department of Pediatrics, General Hospital of Jinan Military AreaChina
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Chambers ES, Nanzer AM, Pfeffer PE, Richards DF, Timms PM, Martineau AR, Griffiths CJ, Corrigan CJ, Hawrylowicz CM. Distinct endotypes of steroid-resistant asthma characterized by IL-17A(high) and IFN-γ(high) immunophenotypes: Potential benefits of calcitriol. J Allergy Clin Immunol 2015; 136:628-637.e4. [PMID: 25772594 PMCID: PMC4559139 DOI: 10.1016/j.jaci.2015.01.026] [Citation(s) in RCA: 137] [Impact Index Per Article: 15.2] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2014] [Revised: 01/28/2015] [Accepted: 01/29/2015] [Indexed: 01/03/2023]
Abstract
Background A small population of patients with severe asthma does not respond to glucocorticoids (steroid resistant [SR]). They have high morbidity, highlighting an urgent need for strategies to enhance glucocorticoid responsiveness. Objective We investigated the immunologic differences between steroid-sensitive (SS) and SR asthmatic patients and the effect on immunophenotype of oral calcitriol treatment because it has been previously shown to beneficially modulate the clinical response to glucocorticoids in patients with SR asthma. Methods CD8-depleted PBMCs were isolated from 12 patients with SS and 23 patients with SR asthma and cultured for 7 days with anti-CD3 and IL-2 with or without dexamethasone. Cytokine production was assessed in supernatants by using the Cytometric Bead Array. Patients with SR asthma were subsequently randomized to oral calcitriol or placebo therapy, and identical studies were repeated. Results Patients with SR asthma produced significantly increased IL-17A and IFN-γ levels compared with those in patients with SS asthma, although it was evident that cells from individual patients might overproduce one or the other of these cytokines. Production of IL-17A was inversely and production of IL-13 was positively associated with the clinical response to prednisolone. Oral calcitriol, compared with placebo, therapy of the patients with SR asthma significantly improved dexamethasone-induced IL-10 production in vitro while suppressing dexamethasone-induced IL-17A production. This effect mirrored the previously demonstrated improvement in clinical response to oral glucocorticoids in calcitriol-treated patients with SR asthma. Conclusions IL-17Ahigh and IFN-γhigh immunophenotypes exist in patients with SR asthma. These data identify immunologic pathways that likely underpin the beneficial clinical effects of calcitriol in patients with SR asthma by directing the SR cytokine profile toward a more SS immune phenotype, suggesting strategies for identifying vitamin D responder immunophenotypes.
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Affiliation(s)
- Emma S Chambers
- MRC and Asthma UK Centre for Allergic Mechanisms in Asthma, King's College London, London, United Kingdom
| | - Alexandra M Nanzer
- MRC and Asthma UK Centre for Allergic Mechanisms in Asthma, King's College London, London, United Kingdom; Asthma UK Centre for Applied Research, Centre for Primary Care and Public Health, Blizard Institute, Queen Mary, University of London, London, United Kingdom
| | - Paul E Pfeffer
- MRC and Asthma UK Centre for Allergic Mechanisms in Asthma, King's College London, London, United Kingdom
| | - David F Richards
- MRC and Asthma UK Centre for Allergic Mechanisms in Asthma, King's College London, London, United Kingdom
| | - Peter M Timms
- Homerton University NHS Foundation Trust, London, United Kingdom
| | - Adrian R Martineau
- Asthma UK Centre for Applied Research, Centre for Primary Care and Public Health, Blizard Institute, Queen Mary, University of London, London, United Kingdom
| | - Christopher J Griffiths
- MRC and Asthma UK Centre for Allergic Mechanisms in Asthma, King's College London, London, United Kingdom; Asthma UK Centre for Applied Research, Centre for Primary Care and Public Health, Blizard Institute, Queen Mary, University of London, London, United Kingdom
| | - Christopher J Corrigan
- MRC and Asthma UK Centre for Allergic Mechanisms in Asthma, King's College London, London, United Kingdom
| | - Catherine M Hawrylowicz
- MRC and Asthma UK Centre for Allergic Mechanisms in Asthma, King's College London, London, United Kingdom.
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