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Published on: August 7, 2017
Bronchial Reactivity, Inflammatory and Allergic Parameters, and Vitamin D Levels in Children With Asthma
Husein Dabbah1, Ronen Bar Yoseph2, Galit Livnat2
1Department of Pediatrics, Galilee Medical Center, Nahariya, Israel, and the Faculty of Medicine in the Galilee, Bar-Ilan University, Safed, Israel. h_dabbah@rambam.health.gov.il.
Insights
This study found no link between vitamin D levels and asthma severity or allergic markers in children. Further research is needed to clarify the relationship between vitamin D, asthma, and allergies.
Area of Science:
- Pediatric Allergy and Immunology
- Respiratory Medicine
- Nutritional Science
Background:
- Low vitamin D levels may be associated with increased asthma prevalence and severity.
- Investigating vitamin D's role in pediatric asthma requires controlling for confounding factors.
- This study focused on non-obese children with asthma not on anti-inflammatory treatment.
Purpose of the Study:
- To assess the correlation between serum vitamin D levels and asthma markers in children.
- To evaluate the relationship between vitamin D and airway hyper-responsiveness.
- To examine vitamin D's association with airway inflammation and allergy markers.
Main Methods:
- Recruited non-obese children aged 6-18 with asthma, excluding those on anti-inflammatory treatment.
- Performed spirometry with methacholine challenge, measured fractional exhaled nitric oxide (FENO), serum vitamin D, IgE, blood eosinophils, and C-reactive protein.
- Primary endpoint: correlation between vitamin D and methacholine response; Secondary endpoint: correlation with FENO, inflammatory markers, and allergy.
Main Results:
- Included 71 children with asthma (median age 12.5 years).
- Median vitamin D level was 23 ng/mL.
- No significant correlation was observed between vitamin D levels and airway hyper-responsiveness, FENO, inflammatory markers, IgE, eosinophils, or allergic rhinitis/atopic dermatitis frequency.
Conclusions:
- In this cohort of pediatric asthma patients, vitamin D levels did not correlate with airway reactivity, inflammation, or allergy.
- The etiological relationship between vitamin D, asthma, and allergies remains to be elucidated.
- Further investigation is warranted to clarify the complex interplay between vitamin D and respiratory conditions.
Background:
A low serum vitamin D level may represent a marker of other perplexing factors that may lead to increased asthma prevalence and severity. Our aim was to assess the correlation between vitamin D levels and asthma and allergy markers in a subgroup of children with fewer confounding factors.
Methods:
Non-obese children (6-18 y old) with asthma who were not receiving anti-inflammatory treatment were recruited. Subjects underwent spirometry with a methacholine challenge test, and fractional exhaled nitric oxide (FENO), serum vitamin D levels, total immunoglobulin E (IgE) levels, blood eosinophil counts, and high-sensitivity C-reactive protein levels were determined. The primary end point was the correlation between vitamin D level and airway hyper-responsiveness as assessed by a methacholine challenge test. The secondary end point was the correlation between vitamin D level and FENO, systemic inflammatory markers, and allergy.
Results:
Seventy-one children with asthma (25 females, 35%; 12.5 ± 3.6 y of age) were included. The median vitamin D level was 23 ng/mL (range of 6-48.5, mean of 23.02 ± 7.74), the median IgE level was 305 IU/mL (range of 4.3-4,240), the median provocational concentration of methacholine that produced a 20% decrease in FEV1 was 1.1 mg/mL (range of 0-13.9), and the median FENO was 26.5 ppb (range of 3.6-285). No correlation was found between vitamin D level and response to the methacholine challenge test, FENO, high-sensitivity C-reactive protein levels, IgE levels, eosinophil counts, and frequency of allergic rhinitis or atopic dermatitis.
Conclusions:
In our group of children with asthma, no correlation was found between the level of vitamin D and the degree of airway reactivity, airway inflammation, and allergy. The cause-and-effect relationship between vitamin D, asthma, and allergy should be further clarified. (ClinicalTrials.gov registration NCT01287455).
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