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Introduction. Currently, there are insufficient studies to demonstrate the effect of vitamin D status on the production of proinflammatory cytokines in children with allergic diseases, which precipitated this study.Aim. To analyse interferon-γ, interleukin-17A and 33 profiles in children with asthma according to serum calcidiol levels before and during cholecalciferol subsidies.Materials and methods. A total of 71 children aged 3 to 18 years were examined: 51 patients with asthma and 20 children in the control group. A 3-month cholecalciferol course at a prophylactic dose specified in the national program was prescribed to all children. 25(OH)D, interferon-γ, interleukin-17A and 33 levels were twice determined in the examined children.Results and discussion. Median 25(OH)D levels in patients with asthma did not reach the levels of healthy children either before or after cholecalciferol subsidies at prophylactic doses. Vitamin D intake led to a decrease in interferon-γ levels in healthy children from 3.07 [2.29; 4.81] pg/ml to 2.18 [1.74; 3.45] pg/ml (p < 0.05). In patients with asthma, such changes were not detected in the initial population, however, after cholecalciferol subsidies their interferon-γ levels were significantly higher than those in healthy children: 3.11 [0.89; 5.0] pg/ml and 2.18 [1.74; 3.45] pg/ml, respectively (p < 0.05). Assessment results of interleukin-17A levels in children with asthma showed that the median cytokine levels were significantly higher before the cholecalciferol subsidies than after them: 2.03 [0.1; 10.01] pg/ml and 0.96 [0.1; 12.87] pg/ml, respectively (p = 0.03). The median interleukin-17A levels in children with asthma were significantly higher than in healthy children, both before and during the cholecalciferol subsidies. The median interleukin-33 levels were significantly higher in children with asthma as compared to healthy children, both before and during vitamin D subsidies.Conclusion. Our results suggest that cholecalciferol has a modulatory effect on interferon-γ and interleukin-17A in patients with asthma. Interleukin-33 levels did not change significantly in children with asthma on cholecalciferol.
Introduction. Currently, there are insufficient studies to demonstrate the effect of vitamin D status on the production of proinflammatory cytokines in children with allergic diseases, which precipitated this study.Aim. To analyse interferon-γ, interleukin-17A and 33 profiles in children with asthma according to serum calcidiol levels before and during cholecalciferol subsidies.Materials and methods. A total of 71 children aged 3 to 18 years were examined: 51 patients with asthma and 20 children in the control group. A 3-month cholecalciferol course at a prophylactic dose specified in the national program was prescribed to all children. 25(OH)D, interferon-γ, interleukin-17A and 33 levels were twice determined in the examined children.Results and discussion. Median 25(OH)D levels in patients with asthma did not reach the levels of healthy children either before or after cholecalciferol subsidies at prophylactic doses. Vitamin D intake led to a decrease in interferon-γ levels in healthy children from 3.07 [2.29; 4.81] pg/ml to 2.18 [1.74; 3.45] pg/ml (p < 0.05). In patients with asthma, such changes were not detected in the initial population, however, after cholecalciferol subsidies their interferon-γ levels were significantly higher than those in healthy children: 3.11 [0.89; 5.0] pg/ml and 2.18 [1.74; 3.45] pg/ml, respectively (p < 0.05). Assessment results of interleukin-17A levels in children with asthma showed that the median cytokine levels were significantly higher before the cholecalciferol subsidies than after them: 2.03 [0.1; 10.01] pg/ml and 0.96 [0.1; 12.87] pg/ml, respectively (p = 0.03). The median interleukin-17A levels in children with asthma were significantly higher than in healthy children, both before and during the cholecalciferol subsidies. The median interleukin-33 levels were significantly higher in children with asthma as compared to healthy children, both before and during vitamin D subsidies.Conclusion. Our results suggest that cholecalciferol has a modulatory effect on interferon-γ and interleukin-17A in patients with asthma. Interleukin-33 levels did not change significantly in children with asthma on cholecalciferol.
Background/Objectives: Vitamin D is essential for bone health, immune function, and overall well-being. Numerous ecological, observational, and prospective studies, including randomized controlled clinical trials (RCTs), report an inverse association between higher serum 25-hydroxyvitamin D [25(OH)D; calcifediol] levels in various conditions, including cardiovascular disease, metabolic disorders such as diabetes and obesity, susceptibility to infection-related complications, autoimmune diseases, and all-cause mortality. Results: Vitamin D operates through two distinct systems. The endocrine system comprises the renal tubular cell-derived circulatory calcitriol, which primarily regulates calcium homeostasis and muscular functions. In contrast, intracellularly generated calcitriol in peripheral target cells is responsible for intracrine/paracrine system signaling and calcitriol–vitamin D receptor-mediated genomic effects. Government-appointed committees and health organizations have developed various clinical practice guidelines for vitamin D supplementation and management. However, these guidelines heavily relied on the 2011 Institute of Medicine (IoM) report, which focused solely on the skeletal effects of vitamin D, ignoring other body systems. Thus, they do not represent maintaining good overall health and aspects of disease prevention. Additionally, the IoM report was intended as a public health recommendation for the government and is not a clinical guideline. Discussion: New country- and regional-specific guidelines must focus on healthy nations through disease prevention and reducing healthcare costs. They should not be restricted to bone effect and must encompass all extra-skeletal benefits. Nevertheless, due to misunderstandings, medical societies and other governments have used faulty IoM report as a foundation for creating vitamin D guidelines. Consequently, they placed disproportionate emphasis on bone health while largely overlooking its benefits for other bodily systems, making current guidelines, including 2024, the Endocrine Society less applicable to the public. As a result, the utility of published guidelines has been significantly reduced for clinical practice and RCTs that designed on bone-centric are generate misleading information and remain suboptimal for public health and disease prevention. Conclusions: This review and its recommendations address the gaps in current vitamin D clinical practice guidelines and propose a framework for developing more effective, country and region-specific recommendations that capture the extra-skeletal benefits of vitamin D to prevent multiple diseases and enhance public health.
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