Steroid requirements and immune associations with vitamin D are stronger in children than adults with asthma.
Goleva. Elena E; Searing. Daniel A DA; Jackson. Leisa P LP; Richers. Brittany N BN; Leung. Donald Y M DY
Key Findings
- Nearly half of both asthmatic patients and healthy controls had vitamin D deficiency (<20 ng/mL).
- In children with asthma, higher vitamin D was associated with lower daily inhaled corticosteroid doses and better lab‑measured steroid response.
- Vitamin D correlated inversely with IgE (allergy marker) in pediatric asthma but not in adults.
- Serum LL‑37 levels rose with vitamin D in both children and adults.
Practical Outcomes
- For biohackers focusing on asthma management in kids, maintaining adequate vitamin D might reduce the need for inhaled steroids and improve steroid effectiveness. However, the findings don’t apply to healthy adults or general longevity protocols, so routine vitamin D supplementation solely for LL‑37 boosting isn’t strongly supported by this study.
Summary
The study found that low vitamin D levels are linked to higher inhaled steroid use and weaker response to steroids in kids with asthma, but these links weren’t seen in adults. Vitamin D also seemed to lower allergy‑related IgE in children. LL‑37 levels in the blood rose with higher vitamin D in both age groups.
Abstract
The effects of serum vitamin D status on atopy, steroid requirement, and functional responsiveness to corticosteroids in children versus adults with asthma have not been studied systematically. We sought to explore the age-specific effects of vitamin D in asthmatic patients. Serum vitamin D levels were examined in a prospective study of adults and children (102 healthy control subjects and 103 asthmatic patients). PBMCs were cultured for 3 hours with or without 100 nmol/L dexamethasone, and the expression of corticosteroid-regulated genes was detected by using real-time PCR. Serum IgE levels were measured, and information about asthmatic patients' steroid requirements was collected. Deficient serum vitamin D levels (<20 ng/mL) were found in 47.6% of asthmatic patients and 56.8% of healthy control subjects, with means ± SDs of 20.7 ± 9.8 and 19.2 ± 7.7 ng/mL, respectively. In multivariate regression models a significant positive correlation between serum vitamin D levels and the expression of vitamin D-regulated targets, cytochrome P450, family 24, subfamily a (cyp24a) expression by PBMCs (P = .0084, pediatric asthma group only) and serum LL-37 levels (P = .0006 in the pediatric group but P = .0067 in the adult asthma group), was found. An inverse association between vitamin D and serum IgE levels was observed in the pediatric (P = .006) asthma group. Serum vitamin D level (P = .05), as well as PBMC cyp24a expression (P = .0312), demonstrated a significant inverse relationship with daily inhaled corticosteroid dose in the pediatric asthma group only. Cyp24a expression in PBMCs correlated positively with in vitro suppression of TNF-α by dexamethasone (P = .05) and IL-13 (P = .0094) in PBMCs in the pediatric asthma group only. This study demonstrated significant associations between serum vitamin D status and steroid requirement and in vitro responsiveness to corticosteroids in the pediatric but not the adult asthma group. Vitamin D was also related to IgE levels in children but not in adults.
Study Information
pubmed
2012
2012-02-11T00:00:00.000Z
10.1016/j.jaci.2012.01.044
103
24