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Endocrine, Metabolic & Immune Disorders - Drug Targets

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ISSN (Print): 1871-5303
ISSN (Online): 2212-3873

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Clinical Trial

The Effect of Vitamin D Supplementation on Clinical Outcomes of Asthmatic Children with Vitamin D Insufficiency

Author(s): Rasoul N. Kalmarzi, Sivan Ahmadi, Ramesh Rahehagh, Asadollah Fathallahpour, Behzad Khalafi, Hajar Kashefi, Daem Roshani, Rama N. Zaryan, Shilan Mohamadi and Wesam Kooti*

Volume 20, Issue 1, 2020

Page: [149 - 155] Pages: 7

DOI: 10.2174/1871530319666190426161809

Price: $65

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.

Keywords: Vitamin D, Asthma, Children, Insufficiency, Clinical Outcomes, Iran.

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Graphical Abstract

[1]
Nasiri Kalmarzi, R.; Zamani, A.; Fathallahpour, A.; Ghaderi, E.; Rahehagh, R.; Kooti, W. The relationship between serum levels of vitamin D with asthma and its symptom severity: A case-control study. Allergol. Immunopathol. (Madr.), 2016, 44(6), 547-555.
[http://dx.doi.org/10.1016/j.aller.2016.04.016] [PMID: 27477034]
[2]
Subbarao, P.; Mandhane, P.J.; Sears, M.R. Asthma: epidemiology, etiology and risk factors. CMAJ, 2009, 181(9), E181-E190.
[http://dx.doi.org/10.1503/cmaj.080612] [PMID: 19752106]
[3]
Foroutan, P.; Zarezadeh, Y.; Choobdarian, H.; Faridi, A.; Azadi, N.A.; Boshagh, M.A. Comparison of Epstein - Barr virus Antibodies in the serum of patients with Multiple Sclerosis and normal people in Sanandaj, Iran. Int. J. Biomed. Public Health., 2018, 1(3), 127-131.
[4]
Asher, I.; Pearce, N. Global burden of asthma among children. Int. J. Tuberc. Lung Dis., 2014, 18(11), 1269-1278.
[http://dx.doi.org/10.5588/ijtld.14.0170] [PMID: 25299857]
[5]
Hsu, J.; Qin, X.; Beavers, S.F.; Mirabelli, M.C. Asthma-Related School Absenteeism, Morbidity, and Modifiable Factors. Am. J. Prev. Med., 2016, 51(1), 23-32.
[http://dx.doi.org/10.1016/j.amepre.2015.12.012] [PMID: 26873793]
[6]
Nasiri, K.R.; Hamedi, R.; Nasirian, R.; Farsani, M.; Kashefi, H.; Khalafi, B. Association of Body Mass Index with Asthma Severity and Pulmonary Function among Asthmatic Children. I. J. P., 2016, 4(9), 3551-3559.
[7]
Nasiri, K.R.; Shekari, A.; Tajik, M.; Ataee, P.; Homagostar, G.; Roshani, D.; Ghobadidana, V.; Nili, S. The Prevalence of Asthma Symptoms in Elementary and Middle School Students in Kurdistan Province, the West of Iran. I. J. P., 2016, 4(2), 1323-1330.
[8]
Hansdottir, S.; Monick, M.M.; Hinde, S.L.; Lovan, N.; Look, D.C.; Hunninghake, G.W. Respiratory epithelial cells convert inactive vitamin D to its active form: potential effects on host defense. J. Immunol., 2008, 181(10), 7090-7099.
[http://dx.doi.org/10.4049/jimmunol.181.10.7090] [PMID: 18981129]
[9]
Hansdottir, S.; Monick, M.M.; Lovan, N.; Powers, L.; Gerke, A.; Hunninghake, G.W. Vitamin D decreases respiratory syncytial virus induction of NF-kappaB-linked chemokines and cytokines in airway epithelium while maintaining the antiviral state. J. Immunol., 2010, 184(2), 965-974.
[http://dx.doi.org/10.4049/jimmunol.0902840] [PMID: 20008294]
[10]
Litonjua, A.A. Childhood asthma may be a consequence of vitamin D deficiency. Curr. Opin. Allergy Clin. Immunol., 2009, 9(3), 202-207.
[http://dx.doi.org/10.1097/ACI.0b013e32832b36cd] [PMID: 19365260]
[11]
Ginde, A.A.; Sutherland, E.R. Vitamin D in asthma: panacea or true promise? J. Allergy Clin. Immunol., 2010, 126(1), 59-60.
[http://dx.doi.org/10.1016/j.jaci.2010.05.030] [PMID: 20620566]
[12]
Hoxha, M.; Zoto, M.; Deda, L.; Vyshka, G. Vitamin D and its role as a protective factor in allergy. Int. Sch. Res. Notices, 2014. 2014951946
[http://dx.doi.org/10.1155/2014/951946] [PMID: 27382613]
[13]
Camargo, C.A., Jr; Rifas-Shiman, S.L.; Litonjua, A.A.; Rich-Edwards, J.W.; Weiss, S.T.; Gold, D.R.; Kleinman, K.; Gillman, M.W. Maternal intake of vitamin D during pregnancy and risk of recurrent wheeze in children at 3 y of age. Am. J. Clin. Nutr., 2007, 85(3), 788-795.
[http://dx.doi.org/10.1093/ajcn/85.3.788] [PMID: 17344501]
[14]
Hall, S.C.; Agrawal, D.K. Vitamin D and bronchial asthma: an overview of data from the past 5 years. Clin. Ther., 2017, 39(5), 917-929.
[http://dx.doi.org/10.1016/j.clinthera.2017.04.002] [PMID: 28449868]
[15]
Holick, M.F. Vitamin D deficiency. N. Engl. J. Med., 2007, 357(3), 266-281.
[http://dx.doi.org/10.1056/NEJMra070553] [PMID: 17634462]
[16]
Kaaviyaa, A.T.; Krishna, V.; Arunprasath, T.S.; Ramanan, P.V. Vitamin D deficiency as a factor influencing asthma control in children. Indian Pediatr., 2018, 55(11), 969-971.
[http://dx.doi.org/10.1007/s13312-018-1420-3] [PMID: 30587645]
[17]
Bugadze, L.; Manjavidze, N.; Jorjoliani, L. Asthma control status and lung function in relation to vitamin d level in children with bronchial asthma. Georgian Med. News, 2018, 283(283), 115-118.
[PMID: 30516505]
[18]
Agrawal, T.; Gupta, G.K.; Agrawal, D.K. Vitamin D supplementation reduces airway hyperresponsiveness and allergic airway inflammation in a murine model. Clin. Exp. Allergy, 2013, 43(6), 672-683.
[PMID: 23711130]
[19]
de Groot, J.C.; van Roon, E.N.; Storm, H.; Veeger, N.J.; Zwinderman, A.H.; Hiemstra, P.S.; Bel, E.H.; ten Brinke, A. Vitamin D reduces eosinophilic airway inflammation in nonatopic asthma. J. Allergy Clin. Immunol., 2015, 135(3), 670-5.e3.
[http://dx.doi.org/10.1016/j.jaci.2014.11.033] [PMID: 25617224]
[20]
Salas, N.M.; Luo, L.; Harkins, M.S. Vitamin D deficiency and adult asthma exacerbations. J. Asthma, 2014, 51(9), 950-955.
[http://dx.doi.org/10.3109/02770903.2014.930883] [PMID: 24926743]
[21]
Korn, S.; Hübner, M.; Jung, M.; Blettner, M.; Buhl, R. Severe and uncontrolled adult asthma is associated with vitamin D insufficiency and deficiency. Respir. Res., 2013, 14, 25.
[http://dx.doi.org/10.1186/1465-9921-14-25] [PMID: 23432854]
[22]
Fawzy, M.S.; Elgazzaz, M.G.; Ibrahim, A.; Hussein, M.H.; Khashana, M.S.; Toraih, E.A. Association of group-specific component exon 11 polymorphisms with bronchial asthma in children and adolescents. Scand. J. Immunol., 2019, 89(3)e12740
[PMID: 30548492]
[23]
Santos, H.L.B.S.; Silva, S.S.E.; Paula, E.; Pereira-Ferrari, L.; Mikami, L.; Riedi, C.A.; Chong-Neto, H.J.; Rosário, N.A. Vitamin D receptor gene mutations anD Vitamin D serum leVels in asthmatic chilDren. Rev. Paul. Pediatr., 2018, 36(3), 269-274.
[http://dx.doi.org/10.1590/1984-0462/;2018;36;3;00016] [PMID: 30066819]
[24]
Mirzakhani, H.; Carey, V.J.; Zeiger, R.; Bacharier, L.B.; O’Connor, G.T.; Schatz, M.X.; Laranjo, N.; Weiss, S.T.; Litonjua, A.A. Impact of parental asthma, prenatal maternal asthma control, and vitamin D status on risk of asthma and recurrent wheeze in 3-year-old children. Clin. Exp. Allergy, 2019, 49(4), 419-429.
[http://dx.doi.org/10.1111/cea.13320] [PMID: 30461089]
[25]
Busse, W.W.; Lemanske, R.F., Jr; Gern, J.E. Role of viral respiratory infections in asthma and asthma exacerbations. Lancet, 2010, 376(9743), 826-834.
[http://dx.doi.org/10.1016/S0140-6736(10)61380-3] [PMID: 20816549]
[26]
Jolliffe, D.A.; Griffiths, C.J.; Martineau, A.R. Vitamin D in the prevention of acute respiratory infection: systematic review of clinical studies. J. Steroid Biochem. Mol. Biol., 2013, 136, 321-329.
[http://dx.doi.org/10.1016/j.jsbmb.2012.11.017] [PMID: 23220552]
[27]
Bergman, P.; Lindh, A.U.; Björkhem-Bergman, L.; Lindh, J.D. Vitamin D and Respiratory Tract Infections: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. PLoS One, 2013, 8(6)e65835
[http://dx.doi.org/10.1371/journal.pone.0065835] [PMID: 23840373]
[28]
Charan, J.; Goyal, J.P.; Saxena, D.; Yadav, P. Vitamin D for prevention of respiratory tract infections: A systematic review and meta-analysis. J. Pharmacol. Pharmacother., 2012, 3(4), 300-303.
[http://dx.doi.org/10.4103/0976-500X.103685] [PMID: 23326099]
[29]
Lange, N.E.; Litonjua, A.; Hawrylowicz, C.M.; Weiss, S. Vitamin D, the immune system and asthma. Expert Rev. Clin. Immunol., 2009, 5(6), 693-702.
[http://dx.doi.org/10.1586/eci.09.53] [PMID: 20161622]
[30]
Chambers, E.S.; Nanzer, A.M.; Richards, D.F.; Ryanna, K.; Freeman, A.T.; Timms, P.M.; Martineau, A.R.; Griffiths, C.J.; Corrigan, C.J.; Hawrylowicz, C.M. Serum 25-dihydroxyvitamin D levels correlate with CD4(+)Foxp3(+) T-cell numbers in moderate/severe asthma. J. Allergy Clin. Immunol., 2012, 130(2), 542-544.
[http://dx.doi.org/10.1016/j.jaci.2012.04.022] [PMID: 22656048]
[31]
Heine, G.; Niesner, U.; Chang, H.D.; Steinmeyer, A.; Zügel, U.; Zuberbier, T.; Radbruch, A.; Worm, M. 1,25-dihydroxyvitamin D(3) promotes IL-10 production in human B cells. Eur. J. Immunol., 2008, 38(8), 2210-2218.
[http://dx.doi.org/10.1002/eji.200838216] [PMID: 18651709]
[32]
Laird, E.; McNulty, H.; Ward, M.; Hoey, L.; McSorley, E.; Wallace, J.M.; Carson, E.; Molloy, A.M.; Healy, M.; Casey, M.C.; Cunningham, C.; Strain, J.J. Vitamin D deficiency is associated with inflammation in older Irish adults. J. Clin. Endocrinol. Metab., 2014, 99(5), 1807-1815.
[http://dx.doi.org/10.1210/jc.2013-3507] [PMID: 24606079]
[33]
Ma, Y.H.; Zhou, Y.L.; Yue, C.Y.; Zhang, G.H.; Deng, L.; Xie, G.H.; Xu, W.P.; Shen, L.S. Vitamin D deficiency contributes to the reduction and impaired function of naïve CD45RA+ regulatory T cell in chronic heart failure. J. Immunol. Res., 2015. 2015547697
[http://dx.doi.org/10.1155/2015/547697] [PMID: 25984539]
[34]
Sutherland, E.R.; Goleva, E.; Jackson, L.P.; Stevens, A.D.; Leung, D.Y. Vitamin D levels, lung function, and steroid response in adult asthma. Am. J. Respir. Crit. Care Med., 2010, 181(7), 699-704.
[http://dx.doi.org/10.1164/rccm.200911-1710OC] [PMID: 20075384]
[35]
Creed, T.J.; Lee, R.W.; Newcomb, P.V.; di Mambro, A.J.; Raju, M.; Dayan, C.M. The effects of cytokines on suppression of lymphocyte proliferation by dexamethasone. J. Immunol., 2009, 183(1), 164-171.
[http://dx.doi.org/10.4049/jimmunol.0801998] [PMID: 19542427]
[36]
Saramäki, A.; Diermeier, S.; Kellner, R.; Laitinen, H.; Vaïsänen, S.; Carlberg, C. Cyclical chromatin looping and transcription factor association on the regulatory regions of the p21 (CDKN1A) gene in response to 1alpha,25-dihydroxyvitamin D3. J. Biol. Chem., 2009, 284(12), 8073-8082.
[http://dx.doi.org/10.1074/jbc.M808090200] [PMID: 19122196]
[37]
Poon, A.H.; Mahboub, B.; Hamid, Q. Vitamin D deficiency and severe asthma. Pharmacol. Ther., 2013, 140(2), 148-155.
[http://dx.doi.org/10.1016/j.pharmthera.2013.06.006] [PMID: 23792089]
[38]
Majak, P.; Olszowiec-Chlebna, M.; Smejda, K.; Stelmach, I. Vitamin D supplementation in children may prevent asthma exacerbation triggered by acute respiratory infection. J. Allergy Clin. Immunol., 2011, 127(5), 1294-1296.
[http://dx.doi.org/10.1016/j.jaci.2010.12.016] [PMID: 21315433]
[39]
Li, F.; Peng, M.; Jiang, L.; Sun, Q.; Zhang, K.; Lian, F.; Litonjua, A.A.; Gao, J.; Gao, X. Vitamin D deficiency is associated with decreased lung function in Chinese adults with asthma. Respiration, 2011, 81(6), 469-475.
[http://dx.doi.org/10.1159/000322008] [PMID: 21124013]
[40]
Samaha, H.M.S.; Elsaid, A.R. NasrEldin, E. Vitamin D and markers of airway inflammation in asthma. Egypt. J. Chest Dis. Tuberc., 2015, 64(4), 779-783.
[http://dx.doi.org/10.1016/j.ejcdt.2015.03.027]
[41]
Afzal, S.; Lange, P.; Bojesen, S.E.; Freiberg, J.J.; Nordestgaard, B.G. Plasma 25-hydroxyvitamin D, lung function and risk of chronic obstructive pulmonary disease. Thorax, 2014, 69(1), 24-31.
[http://dx.doi.org/10.1136/thoraxjnl-2013-203682] [PMID: 23908128]
[42]
Black, P.N.; Scragg, R. Relationship between serum 25-hydroxyvitamin d and pulmonary function in the third national health and nutrition examination survey. Chest, 2005, 128(6), 3792-3798.
[http://dx.doi.org/10.1378/chest.128.6.3792] [PMID: 16354847]
[43]
Banerjee, A.; Damera, G.; Bhandare, R.; Gu, S.; Lopez-Boado, Y.; Panettieri, R., Jr; Tliba, O. Vitamin D and glucocorticoids differentially modulate chemokine expression in human airway smooth muscle cells. Br. J. Pharmacol., 2008, 155(1), 84-92.
[http://dx.doi.org/10.1038/bjp.2008.232] [PMID: 18552877]
[44]
Sakurai, R.; Shin, E.; Fonseca, S.; Sakurai, T.; Litonjua, A.A.; Weiss, S.T.; Torday, J.S.; Rehan, V.K. 1alpha,25(OH)2D3 and its 3-epimer promote rat lung alveolar epithelial-mesenchymal interactions and inhibit lipofibroblast apoptosis. Am. J. Physiol. Lung Cell. Mol. Physiol., 2009, 297(3), L496-L505.
[http://dx.doi.org/10.1152/ajplung.90539.2008] [PMID: 19574420]

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