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J Allergy Clin Immunol. 2015 Mar;135(3):670-5.e3. doi: 10.1016/j.jaci.2014.11.033. Epub 2015 Jan 21.

Vitamin D reduces eosinophilic airway inflammation in nonatopic asthma.

Author information

1
Department of Respiratory Medicine, Medical Centre Leeuwarden, Leeuwarden, The Netherlands. Electronic address: christa_de_groot@yahoo.com.
2
Department of Pharmacotherapy and Pharmaceutical Care, University of Groningen, Groningen, The Netherlands; Department of Hospital Pharmacy, Medical Centre Leeuwarden, Leeuwarden, The Netherlands.
3
Department of Clinical Chemistry, Medical Centre Leeuwarden, Leeuwarden, The Netherlands.
4
Department of Clinical Epidemiology, Medical Centre Leeuwarden, Leeuwarden, The Netherlands.
5
Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Amsterdam Medical Centre, Amsterdam, The Netherlands.
6
Department of Pulmonology, Leiden University Medical Centre, Leiden, The Netherlands.
7
Department of Respiratory Medicine, Amsterdam Medical Centre, Amsterdam, The Netherlands.
8
Department of Respiratory Medicine, Medical Centre Leeuwarden, Leeuwarden, The Netherlands.

Abstract

BACKGROUND:

Low levels of vitamin D are associated with asthma severity, airway remodeling, and exacerbation rate increase, especially in nonatopic asthma. Reduced steroid responsiveness or impaired antimicrobial defense might be underlying mechanisms.

OBJECTIVE:

We sought to evaluate the effect of vitamin D supplementation on eosinophilic and neutrophilic airway inflammation in patients with nonatopic asthma.

METHODS:

In a double-blind, randomized, placebo-controlled trial, we investigated the effect of long-acting vitamin D3 (400,000 IU) on sputum neutrophils and eosinophils in 44 patients with nonatopic asthma with neutrophilic (≥53%) and/or eosinophilic (≥3%) airway inflammation. Sputum induction was performed at baseline and after 9 weeks. Other measurements included questionnaires, blood samples, and pulmonary function.

RESULTS:

Treatment with vitamin D did not significantly affect sputum neutrophils or eosinophils compared with treatment with placebo in the total group. Regarding sputum eosinophils, the effect of vitamin D appeared to be dependent on baseline sputum eosinophil levels (interaction P = .015). In patients with eosinophil levels of 26.2% or more (median in patients with sputum eosinophilia, >3%), eosinophils decreased from a median of 41.0% to 11.8% after vitamin D treatment as compared with an increase from 51.8% to 63.3% in patients receiving placebo (P = .034). Vitamin D treatment also resulted in slightly better Asthma Control Questionnaire scores (P = .08).

CONCLUSIONS:

Vitamin D supplementation reduced eosinophilic airway inflammation in patients with nonatopic asthma with severe eosinophilic airway inflammation, but did not affect sputum neutrophils. Also, a small effect on asthma control was observed. These findings suggest that vitamin D might have potential as an add-on treatment option in eosinophilic asthma.

KEYWORDS:

Asthma; airway inflammation; eosinophils; neutrophils; nonatopic; vitamin D

Comment in

PMID:
25617224
DOI:
10.1016/j.jaci.2014.11.033
[Indexed for MEDLINE]

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