Original articleAsthma, lower airway diseasesThe effects of vitamin D supplementation on airway functions in mild to moderate persistent asthma
Introduction
There are no clear reasons for the increased prevalence of allergic diseases, especially asthma, in recent decades.[1], [2] Some epidemiologic studies suggest that vitamin D deficiency is associated with an increased incidence of asthma symptoms.[3], [4] Vitamin D has a critical role in corticosteroid resistance in asthma, suggesting that vitamin D may play a role in the control of asthma.5 Some studies suggest that vitamin D interacts with glucocorticoid signaling pathways5 and supplementation with the active pharmacologic form of vitamin D3 enhances dexamethasone-induced expression of interleukin (IL) 10 by T-regulatory cells.6 It has been already reported that vitamin D has several effects on the innate and adaptive immune system that might be relevant to asthma morbidity.[7], [8], [9], [10] A number of studies have concluded that low 25-hydroxy-vitamin D in mild to moderate asthma is correlated with poor asthma control, reduced lung function, reduced glucocorticoid response, more frequent exacerbations, and increased corticosteroid use.[10], [11], [12] Even though there are sufficient basic and epidemiologic studies to support a causal relationship between vitamin D and asthma, clinical data that address the effect of vitamin D supplementation on disease control and severity are limited in asthma patients. Therefore, the aim of this clinical trial was to investigate the synergistic role of vitamin D supplementation on airway functions in addition to standard asthma treatment.
Section snippets
Methods
This prospective, randomized, open-label, active controlled clinical trial was designed in an outpatient setting, and patients with mild to moderate persistent asthma 10 to 50 years old were enrolled according to inclusion and exclusion criteria. Rasool-e-Akram is a referral hospital in Tehran, and the study participants were selected from patients visited in the allergy or pulmonology clinics of the hospital. Because some interventional factors, such as skin pigmentation, diet, sun exposure
Results
A total of 130 patients who met the inclusion criteria were enrolled in this study and were randomly assigned to intervention and control groups. Age, sex, body mass index (BMI), stage of asthma (mild persistent or moderate persistent), history of atopic dermatitis, allergic rhinitis, food allergy or urticaria, serum total IgE, FEV1, ratio of FEV1 to forced vital capacity (FVC), and serum vitamin D were considered as variables for final analysis. Of 130 enrolled patients, 72 cases (55.4%) had
Discussion
Long-term inhaled corticosteroids are the main asthma controllers; however, a substantial proportion of patients do not achieve optimal asthma control despite high-dose treatment.23 In addition, many of the patients are prone to recurrent exacerbations because of common respiratory viral infections.2 Vitamin D is required for fetal lung development.24 It interacts with glucocorticoid signaling pathways.5 Investigations have found that vitamin D3 can induce expression of interleukin 10 by
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Disclosures: Authors have nothing to disclose.