Vitamin D as an adjunctive therapy in asthma. Part 1: A review of potential mechanisms

Kerley, Conor P; Elnazir, Basil; Faul, John L.; Cormican, Liam

doi:10.1016/j.pupt.2015.02.004

Cited by 44 publications

(48 citation statements)

References 283 publications

(353 reference statements)

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“…However, the effect of vitamin D on immune and inflammatory signals may outweigh any potential shifting of Th1eTh2 balance and the majority of existing mechanistic [92] as well as observational data suggest that vitamin D repletion may be therapeutic in asthma. In fact, some authors have suggested that VDD may be responsible for the increase in allergic diseases and asthma prevalence worldwide [171,107,106].…”

Section: Is Vitamin D Detrimental In Asthma?mentioning

confidence: 99%

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Vitamin D as an adjunctive therapy in asthma. Part 2: A review of human studies

Kerley

Elnazir

Faul

et al. 2015

Pulmonary Pharmacology & Therapeutics

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This article appeared in a journal published by Elsevier. The attached copy is furnished to the author for internal non-commercial research and education use, including for instruction at the authors institution and sharing with colleagues.Other uses, including reproduction and distribution, or selling or licensing copies, or posting to personal, institutional or third party websites are prohibited. Emerging evidence suggests that VDD is associated with increased airway hyperresponsiveness, decreased pulmonary function, worse asthma control, and possibly decreased response to standard antiasthma therapy. However the effect is inconsistent with preliminary evidence from different studies suggesting vitamin D is both beneficial and detrimental to asthma genesis and severity.Current evidence suggests that supplementation with moderate doses of vitamin D may be appropriate for maintenance of bone health in asthmatics, particularly steroid users. However emerging data from an increasing number of randomized, controlled, intervention studies of vitamin D supplementation in pediatric and adult asthma are becoming available and should help determine the importance, if any of vitamin D for asthma pathogenesis.The purpose of this second of a two-part review is to review the current human literature on vitamin D and asthma, discussing the possible consequences of VDD for asthma and the potential for vitamin D repletion as adjunct therapy.

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Section: Is Vitamin D Detrimental In Asthma?mentioning

confidence: 99%

“…We will discuss the merits and limitations of each study design regarding asthma and vitamin D. However, unanswered questions remain. We have reviewed mechanisms by which vitamin D may influence asthmatic disease in part one of this two-part review [92]. Therefore, we will conclude this review with some recommendations for future research in the area.…”

mentioning

confidence: 99%

Vitamin D as an adjunctive therapy in asthma. Part 2: A review of human studies

Kerley

Elnazir

Faul

et al. 2015

Pulmonary Pharmacology & Therapeutics

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“…Although current asthma therapies control the symptoms of the disorder, there is little evidence to suggest that the current therapies affect airway remodeling [61]. Given that lower levels of serum vitamin D has been shown to be associated with increased ASM mass and AHR, worse control of asthma and increased exacerbations in children, adolescents and adults [18,20–22], vitamin D could be a potent modulator of ASM cells (Figure 2).…”

Section: Vitamin D and Airway Smooth Muscle Cell Functionmentioning

confidence: 99%

The impact of vitamin D on asthmatic human airway smooth muscle

Hall

Fischer

Agrawal

2015

Expert Review of Respiratory Medicine

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Asthma is a chronic heterogeneous disorder, which involves airway inflammation, airway hyperresponsiveness (AHR) and airway remodeling. The airway smooth muscle (ASM) bundle regulates the broncho-motor tone and plays a critical role in AHR as well as orchestrating inflammation. Vitamin D deficiency has been linked to increased severity and exacerbations of symptoms in asthmatic patients. It has been shown to modulate both immune and structural cells, including ASM cells, in inflammatory diseases. Given that current asthma therapies have not been successful in reversing airway remodeling, vitamin D supplementation as a potential therapeutic option has gained a great deal of attention. Here, we highlight the potential immunomodulatory properties of vitamin D in regulating ASM function and airway inflammation in bronchial asthma.

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“…10 Low levels of vitamin D have been associated with asthma severity and loss of control, together with recurrent exacerbations. Remodeling is an early event in asthma described as a consequence of production of mediators and growth factors by inflammatory and resident bronchial cells.…”

Section: Vitamin D Levels Lung Function and Airway Remodellingmentioning

confidence: 99%

Assessment and evaluation of vitamin D levels in patients of moderate persistent asthma: a prospective study in rural hilly area

Sood

2016

Int J Adv Med

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INTRODUCTIONVitamin D is a lipid soluble vitamin that acts as a hormone playing a pivotal role in Ca 2+ homeostasis. It acts through nuclear receptors called vitamin D receptors (VDR). The principal provitamin found in humans is 7-dehydrocholesterol, synthesized in skin. UV exposure of skin converts it to cholecalciferol (vitamin D 3 ). Further, D 3 gets converted by 25-hydroxylation in the liver to 25-OH D 3.Finally 1-α-hydroxylation takes place in the kidney (rate limiting step) and 1α, 25-(OH) 2 D 3 or calcitriol is formed.Calcitriol stimulates intestinal calcium and phosphate absorption and with its interplay with parathyroid hormone (PTH) maintains normal plasma Ca 2+ concentrations from bone mobilization through bone growth, bone resorption and remodeling. It also raises plasma Ca 2+ levels by decreasing its renal excretion and by increasing proximal tubular reabsorption.VDRs are distributed widely throughout the body and believed to be involved in the regulation of cell growth, differentiation and apoptosis as well as modulation of the immune system by influencing cytokine production and other functions. 1 ABSTRACT Background:The discovery of non-classical actions of vitamin D has opened new applications. Among these is its anti-inflammatory role in inflammatory diseases like asthma. Low levels of vitamin D have been associated with asthma severity and recurrent exacerbations. Emerging evidence suggests that vitamin D deficiency (VDD) is also associated with increased airway hyper-responsiveness, decreased pulmonary function and decreased response to standard anti-asthma therapy. Methods: In this prospective study, vitamin D levels were assessed in 50 consecutive consenting subjects of moderate persistent asthma diagnosed as per GINA guidelines. Levels were assessed in relation to exacerbations, seasonal variation in spring, rainy and winter season and lung function. Results: 62% subjects were having deficient levels of 25 (OH) Vitamin D (<20 ng/ml). None of study participant had sufficient levels of vitamin D. There was lack of seasonal effect due to variation in sun exposure in different seasons on levels of vitamin D. This study found no correlation (r=0.078) between levels of vitamin D and number of exacerbations in patients of asthma on regular treatment. In subjects groups having less and more than 3 exacerbations in nine months, difference of vitamin D levels and lung function was also statistically not significant. Conclusions: Findings of this study were consistent with HUNT study that concluded non association of low serum 25 (OH) D levels with airway obstruction. However, considerable variation in different study results with regard to seasonal, lung function and exacerbational variation underline the need for a meta-analysis in this field.

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Vitamin D as an adjunctive therapy in asthma. Part 1: A review of potential mechanisms

Cited by 44 publications

References 283 publications

Vitamin D as an adjunctive therapy in asthma. Part 2: A review of human studies

Vitamin D as an adjunctive therapy in asthma. Part 2: A review of human studies

The impact of vitamin D on asthmatic human airway smooth muscle

Assessment and evaluation of vitamin D levels in patients of moderate persistent asthma: a prospective study in rural hilly area

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