Vitamin D levels in asthmatic patients with and without allergic bronchopulmonary aspergillosis

Agarwal, Ritesh; Sehgal, Inderpaul Singh; Dhooria, Sahajal; Aggarwal, Ashutosh N.; Sachdeva, Naresh; Bhadada, Sanjay Kumar; Garg, Mandeep; Behera, Digambar; Chakrabarti, Arunaloke

doi:10.1111/myc.12744

Cited by 11 publications

(7 citation statements)

References 22 publications

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“…While a few studies have demonstrated a prevalence of vitamin D deficiency in allergic aspergillosis [9,23], none have evaluated the association between vitamin D deficiency and CPA. We found a high prevalence (65%) of vitamin D deficiency in subjects with CPA.…”

Section: Discussionmentioning

confidence: 99%

“…The interand intra-assay coefficient of variation was 13.1% and 6.8%, respectively. We defined vitamin D (25[OH]D3) levels ≥30 ng/mL, 21-29 ng/mL, and <20 ng/mL as normal, insufficient, and deficient, respectively [9,17].…”

Section: Study Proceduresmentioning

confidence: 99%

“…Vitamin D, a non-essential vitamin primarily involved in bone metabolism, has also been demonstrated to have immunomodulatory effects by enhancing innate and adaptive immunity [7,8]. Vitamin D modulates the Th1, Th2, and Th17 immune responses [9], and upregulates the regulatory T cells [7,10]. Vitamin D also promotes the clearance of Aspergillus [8,10].…”

Section: Introductionmentioning

confidence: 99%

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Prevalence of Vitamin D Deficiency in Treatment-Naïve Subjects with Chronic Pulmonary Aspergillosis

Sehgal

Dhooria

Prasad

et al. 2020

JoF

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The association of vitamin D deficiency in the pathogenesis of invasive and allergic pulmonary aspergillosis is known. Whether vitamin D deficiency is prevalent in chronic pulmonary aspergillosis (CPA) remains unknown. We evaluated the prevalence of vitamin D deficiency in subjects with CPA. We compared the clinicoradiological features, microbiology, the immunological response, and the severity of CPA in those with or without vitamin D deficiency. We measured plasma vitamin D levels in 230 consecutive treatment-naïve subjects with CPA and 78 controls (28 with prior tuberculosis (TB); 50 healthy controls). We defined vitamin D deficiency as 25(OH)D3 level <20 ng/mL. The mean (95% confidence intervals (CI)) levels of plasma vitamin D levels were 19.5 (17.6–21.4), 18.6 (13.9–23.3), and 15.3 (12.6–17.9) ng/mL in subjects with CPA, diseased controls, and healthy controls, respectively; and the levels were not different between the groups. The prevalence of vitamin D deficiency in subjects with CPA was 65% (n = 150) and was also not different between healthy (70%) or diseased (61%) controls. We did not find any difference in the clinicoradiological features, microbiology, immunological response, and severity of CPA between vitamin D sufficient and deficient groups. The prevalence of vitamin D deficiency is high in subjects with CPA, albeit similar to controls. Vitamin D deficiency does not affect the disease severity in subjects with CPA.

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Section: Discussionmentioning

confidence: 99%

Section: Study Proceduresmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Prevalence of Vitamin D Deficiency in Treatment-Naïve Subjects with Chronic Pulmonary Aspergillosis

Sehgal

Dhooria

Prasad

et al. 2020

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“…Unlike CF, the prevalence of vitamin D deficiency has been shown to be similar in asthmatic patients with and without ABPA . We had hypothesised that supraphysiological doses of vitamin D could be beneficial in reversing Th2 inflammation seen in patients with ABPA.…”

Section: Discussionmentioning

confidence: 99%

A randomised trial of vitamin D in acute‐stage allergic bronchopulmonary aspergillosis complicating asthma

Dodamani

Muthu

Thakur

et al. 2019

Mycoses

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Summary Vitamin D has been demonstrated to have an immunomodulatory role in cystic fibrosis with allergic bronchopulmonary aspergillosis (ABPA). Herein, we evaluate supplemental vitamin D in acute‐stage ABPA complicating asthma. Thirty subjects were randomised to receive either prednisolone (n = 15, control) or prednisolone and oral vitamin D (n = 15, intervention arm). Serum vitamin D levels were significantly higher in the intervention versus the control arm, following therapy. The mean decline in total IgE at 2 months (primary outcome) was 10% higher in the intervention arm than the control arm; however, this was not statistically significant (48.6% vs 38.1%, P = 0.27). The percentage decline in total IgE after 4 and 6 months of randomisation was also similar in the two arms. There was no difference in asthma exacerbations (0 vs 2, intervention vs control; P = 0.16). No ABPA exacerbation occurred in either arm. The other outcomes including the Th2 (IL‐4, IL‐6 and IL‐10) and Th17 (IL‐17) cytokine levels were similar in the two groups. None of the participants experienced hypervitaminosis D. There was no significant improvement in the clinical or immunological outcomes following vitamin D supplementation. A larger trial is required to ascertain the role of vitamin D in ABPA complicating asthma [Clinicaltrials.gov: NCT03133299].

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“…In ABPA, several defects in innate and adaptive immunity have been identified that lead to persistence of A. fumigatus and a distorted immune response Table II 3 35 36 37 38 39 40 41 . Vitamin D deficiency has been proposed as a pathogenetic factor in ABPA complicating CF 42 43 ; however, its role in ABPA complicating asthma is uncertain 44 45 .…”

Section: Pathogenesis Of Abpamentioning

confidence: 99%

Allergic bronchopulmonary aspergillosis

Agarwal

Sehgal

Dhooria

et al. 2020

Indian Journal of Medical Research

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Allergic bronchopulmonary aspergillosis (ABPA) is an inflammatory disease caused by immunologic reactions initiated against Aspergillus fumigatus colonizing the airways of patients with asthma and cystic fibrosis. The common manifestations include treatment-resistant asthma, transient and fleeting pulmonary opacities and bronchiectasis. It is believed that globally there are about five million cases of ABPA, with India alone accounting for about 1.4 million cases. The occurrence of ABPA among asthmatic patients in special clinics may be as high as 13 per cent. Thus, a high degree of suspicion for ABPA should be entertained while treating a patient with bronchial asthma, particularly in specialized clinics. Early diagnosis and appropriate treatment can delay (or even prevent) the onset of bronchiectasis, which suggests that all patients of bronchial asthma should be screened for ABPA, especially in chest clinics. The current review summarizes the recent advances in the pathogenesis, diagnosis and management of ABPA.

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Vitamin D levels in asthmatic patients with and without allergic bronchopulmonary aspergillosis

Cited by 11 publications

References 22 publications

Prevalence of Vitamin D Deficiency in Treatment-Naïve Subjects with Chronic Pulmonary Aspergillosis

Prevalence of Vitamin D Deficiency in Treatment-Naïve Subjects with Chronic Pulmonary Aspergillosis

A randomised trial of vitamin D in acute‐stage allergic bronchopulmonary aspergillosis complicating asthma

Allergic bronchopulmonary aspergillosis

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