Современное представление о витамине D и генетической регуляции воспаления на примере бронхиальной астмы

Abstract

Bronchial asthma (BA) is a heterogeneous chronic inflammatory disease characterized by a variety of symptoms in the form of wheezing, breathlessness, chest tightness and/or cough, as well as variable exhaled airflow limitation, with both the combination of symptoms and airflow limitation changing with time and intensity. Asthma is associated with both airway hyperresponsiveness to direct or indirect stimuli and chronic airway inflammation. Therapy for BA in accordance with national guidelines and clinical recommendations successfully controls asthma symptoms in most patients. However, there are several problems. Firstly, up to 5% of patients with asthma have a refractory course, respond inadequately to traditional therapeutic approaches and, therefore, are at greater risk of life-threatening asthma exacerbations. Secondly, a significant number of patients, even with mild to moderate asthma, have poor symptom control and may experience severe exacerbations. Low vitamin D levels are associated with decreased lung function, increased asthma exacerbations, and drug use, although it is not clear whether there is a causal relationship between these observations, and whether asthma patients may benefit from vitamin D supplementation. The authors present in this literature review the mechanisms by which vitamin D can reduce the severity of inflammation in BA. The research is focused on studying the mechanisms of chronic respiratory inflammation and their exogenous and genetic regulation involving genetic variants of the VDR gene and vitamin D metabolites. Keywords: children, vitamin D, 25(OH)D deficiency, asthma, inflammation, VDR