https://doi.org/10.4081/monaldi.2022.2230
Association of vitamin D levels and asthma exacerbations in children and adolescents: Experience from a tertiary care center
Submitted: February 10, 2022
Accepted: May 11, 2022
Published: May 24, 2022
Accepted: May 11, 2022
Abstract Views: 1433
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All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Authors
The role of vitamin D as an immunosuppressant and anti-inflammatory has been studied previously for different pathologies in different populations globally. Relationships between serum vitamin D levels and its effect on asthma exacerbations in the adolescent asthma population are not well studied in this region. Therefore, this study was conducted to determine the vitamin D status in pediatric and adolescent asthma patients, and its association with asthma exacerbations. A retrospective study was conducted at The Aga Khan University Hospital from 2016 to 2020. Children and adolescents who were diagnosed and admitted with acute asthma exacerbations and who had at least one measurement of 25 hydroxy-vitamin D (25 OHD) were included in the study. Serum vitamin D levels were documented for enrolled patients and their past 2-year data was analyzed for asthma exacerbations, mean length of stay per admission, and admission plus length of stay at High Dependency Unit. 114 patients were included in the study. 41 patients (35.96%) were found to be vitamin D deficient, 38 patients (33.3%) were vitamin D insufficient, and 35 patients (30.7%) were labeled as vitamin D sufficient. The average number of exacerbations per year was significantly high in vitamin D deficient group (2.82±1.11) in comparison with insufficient (2.05±0.92) and sufficient groups (1.37±0.59) (p<0.001). Vitamin D deficiency is related to an increased number of annual asthma exacerbations, length of stay per admission, and admission into High Dependency Unit (HDU).
Dharmage SC, Perret JL, Custovic A. Epidemiology of asthma in children and adults. Front Pediatr 2019;7:246.
DOI: https://doi.org/10.3389/fped.2019.00246
Kim Y-R, Seo SC, Yoo Y, Choung JT. Are children with asthma in South Korea also associated with vitamin D deficiency? Environ Health Toxicol.2017;32:e2017005.
DOI: https://doi.org/10.5620/eht.e2017005
Esfandiar N, Alaei F, Fallah S, et al. Vitamin D deficiency and its impact on asthma severity in asthmatic children. Ital J Pediatr 2016;42:108.
DOI: https://doi.org/10.1186/s13052-016-0300-5
Hatami G, Ghasemi K, Motamed N, et al. Relationship between vitamin D and childhood asthma: A case-control study. Iran J Pediatr 2014;24:710–4.
Al-Zayadneh E, Alnawaiseh NA, Ajarmeh S, et al. Vitamin D deficiency in children with bronchial asthma in southern Jordan: a cross-sectional study. J Int Med Res 2020;48:300060520974242.
DOI: https://doi.org/10.21203/rs.3.rs-34670/v1
Lange NE, Litonjua A, Hawrylowicz CM, Weiss S. Vitamin D, the immune system and asthma. Expert Rev Clin Immunol 2009;5:693–702.
DOI: https://doi.org/10.1586/eci.09.53
Adam-Bonci T-I, Cherecheș-Panța P, Bonci E-A, et al. Suboptimal serum 25-hydroxy-vitamin D is associated with a history of recent disease exacerbation in pediatric patients with bronchial asthma or asthma-suggestive recurrent wheezing. Int J Environ Res Public Health 2020;17:6545.
DOI: https://doi.org/10.3390/ijerph17186545
Litonjua AA. Vitamin D and childhood asthma: causation and contribution to disease activity. Curr Opin Allergy Clin Immunol 2019;19:126–31.
DOI: https://doi.org/10.1097/ACI.0000000000000509
Brehm JM, Schuemann B, Fuhlbrigge AL, et al. Serum vitamin D levels and severe asthma exacerbations in the childhood asthma management program study. J Allergy Clin Immunol 2010;126:52-8.e5.
DOI: https://doi.org/10.1016/j.jaci.2010.03.043
Brehm JM, Acosta-Pérez E, Klei L, et al. Vitamin D insufficiency and severe asthma exacerbations in Puerto Rican children. Am J Respir Crit Care Med 2012;186:140–6.
DOI: https://doi.org/10.1164/rccm.201203-0431OC
Havan M, Razi CH, Bulus AD, et al. Effects of 25 hydroxy vitamin D levels on the severity and asthma control in school age asthma patients. Arch Argent Pediatr 2017;115:336–42.
DOI: https://doi.org/10.5546/aap.2017.eng.336
Brehm JM, Celedón JC, Soto-Quiros ME, et al. Serum vitamin D levels and markers of severity of childhood asthma in Costa Rica. Am J Respir Crit Care Med 2009;179:765-71.
DOI: https://doi.org/10.1164/rccm.200808-1361OC
Jolliffe DA, Greenberg L, Hooper RL, et al. Vitamin D supplementation to prevent asthma exacerbations: a systematic review and meta-analysis of individual participant data. Lancet Respir Med 2017;5:881–90.
DOI: https://doi.org/10.1016/S2213-2600(17)30306-5
Martineau AR, Cates CJ, Urashima M, et al. Vitamin D for the management of asthma. Cochrane database Syst Rev 2016;9:CD011511.
DOI: https://doi.org/10.1002/14651858.CD011511.pub2
Forno E, Celedón JC. Predicting asthma exacerbations in children. Curr Opin Pulm Med 2012;18:63–9.
DOI: https://doi.org/10.1097/MCP.0b013e32834db288
Global Initiative for Asthma (GINA). Global Strategy for Asthma Management and Prevention 2021. Accessed: 20 Jan 2022. Available from: www.ginasthma.org
Rothe T, Spagnolo P, Bridevaux P-O, et al. Diagnosis and management of asthma – The Swiss Guidelines. Respiration 2018;95:364–80.
DOI: https://doi.org/10.1159/000486797
Global Initiative for Asthma (GINA). Global Strategy for Asthma Management and Prevention 2020. Available from: https://ginasthma.org/wp-content/uploads/2020/06/GINA-2020-report_20_06_04-1-wms.pdf
Gupta A, Sjoukes A, Richards D, et al. Relationship between serum vitamin D, disease severity, and airway remodeling in children with asthma. Am J Respir Crit Care Med 2011;184:1342–9.
DOI: https://doi.org/10.1164/rccm.201107-1239OC
Searing DA, Zhang Y, Murphy JR, et al. Decreased serum vitamin D levels in children with asthma are associated with increased corticosteroid use. J Allergy Clin Immunol 2010;125:995-1000.
DOI: https://doi.org/10.1016/j.jaci.2010.03.008
Kurahashi I, Matsunuma A, Kawane T, et al. Dexamethasone enhances vitamin D-24-hydroxylase expression in osteoblastic (UMR-106) and renal (LLC-PK1) cells treated with 1α,25-dihydroxyvitamin D3. Endocrine 2002;17:109–18.
DOI: https://doi.org/10.1385/ENDO:17:2:109
Dhawan P, Christakos S. Novel regulation of 25-hydroxyvitamin D3 24-hydroxylase (24(OH)ase) transcription by glucocorticoids: Cooperative effects of the glucocorticoid receptor, C/EBPβ, and the Vitamin D receptor in 24(OH)ase transcription. J Cell Biochem 2010;110:1314–23.
DOI: https://doi.org/10.1002/jcb.22645
Xystrakis E. Reversing the defective induction of IL-10-secreting regulatory T cells in glucocorticoid-resistant asthma patients. J Clin Invest 2005;116:146–55.
DOI: https://doi.org/10.1172/JCI21759
Jackson DJ, Johnston SL. The role of viruses in acute exacerbations of asthma. J Allergy Clin Immunol 2010;125:1178–87; quiz 1188–9.
DOI: https://doi.org/10.1016/j.jaci.2010.04.021
Reid D, Toole BJ, Knox S, et al. The relation between acute changes in the systemic inflammatory response and plasma 25-hydroxyvitamin D concentrations after elective knee arthroplasty. Am J Clin Nutr 2011;93:1006–11.
DOI: https://doi.org/10.3945/ajcn.110.008490
Litonjua AA. Childhood asthma may be a consequence of vitamin D deficiency. Curr Opin Allergy Clin Immunol 2009;9:202–7.
DOI: https://doi.org/10.1097/ACI.0b013e32832b36cd
How to Cite
Aziz, Danish Abdul, Aiza Abbas, Werdah Viquar, and Ali Munawar Hussain. 2022. “Association of Vitamin D Levels and Asthma Exacerbations in Children and Adolescents: Experience from a Tertiary Care Center”. Monaldi Archives for Chest Disease 93 (1). https://doi.org/10.4081/monaldi.2022.2230.
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