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The role of vitamin D in asthma – Source: Annals of Allergy, Asthma & Immunology, Sep 2010

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By Manbir S Sandhu, MD, Thomas B Casele, MD • www.ProHealth.com • September 9, 2010


Objective: To review the current literature on vitamin D and asthma, discussing the possible roles of vitamin D on asthma pathogenesis and the potential consequences of vitamin D deficiency.

Data Sources: PubMed database was searched from 1950 to 2009. Keywords used included asthma, vitamin D, inflammation, airway smooth muscle and cytokines.

Study Selection: Articles were selected based on relevance to the subject.

Vitamin D deficiency has been associated with epidemiologic patterns observed in the asthma epidemic. Vitamin D deficiency is more common with obesity, African American ethnicity, and westernization of countries with higher-risk populations for asthma.

Evidence suggests that:

• Vitamin D deficiency is associated with increased airway hyper-responsiveness, lower pulmonary functions, worse asthma control, and possibly steroid resistance.

• Lung epithelial cells express high baseline levels of 1alpha-hydroxylase. This allows the conversion of inactive calcidiol [prehormone the body makes from naturally occuring D3] to active calcitriol locally within the lung. Calcitriol has been shown to inhibit the synthesis and release of certain cytokines, such as RANTES, platelet-derived growth factor, and matrix metalloproteinases, from bronchial smooth muscle cells, thereby leading to decreased lung inflammation and smooth muscle cell proliferation.

• Vitamin D also increases synthesis of interleukin 10 [an anti-inflammatory cytokine] by CD4+CD25+Foxp3+ T-regulatory cells and dendritic cells,

• While concurrently inhibiting dendritic cell activation by downregulating expression of costimulatory molecules CD40 and CD80/86.

• Vitamin D is also capable of inducing the expression of several anti-infective molecules, such as cathelicidin.

Thus, vitamin D has a number of biologic effects that are likely important in regulating key mechanisms in asthma.

Conclusions: We hypothesize that vitamin D supplementation may lead to improved asthma control by inhibiting the influx of inflammatory cytokines in the lung and increasing the secretion of interleukin 10 by T-regulatory cells and dendritic cells.

Source: American College of Allergy, Asthma and Immunology news release, Sep 8, 2010 [Email: thomascasale@creighton.edu]





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