Abstract
Oxidative stress plays a significant role in exacerbation of asthma. The role of vitamin D in oxidative stress and asthma exacerbation remains unclear. We aimed to determine the relationship between vitamin D status and oxidative stress in asthma exacerbation. Severe asthma exacerbation patients with 25-hydroxyvitamin D3-deficiency (V-D deficiency) or 25-hydroxyvitamin D-sufficiency (V-D sufficiency) were enrolled. Severe asthma exacerbation with V-D-deficiency showed lower forced expiratory volume in one second (FEV1) compared to that with V-D-sufficiency. V-D-deficiency intensified ROS release and DNA damage and increased TNF-α, OGG1 and NFκB expression and NFκB phosphorylation in severe asthma exacerbation. Supplemental vitamin D3 significantly increased the rates of FEV1 change and decreased ROS and DNA damage in V-D-deficiency. Vitamin D3 inhibited LPS-induced ROS and DNA damage and were associated with a decline in TNF-α and NFκB in epithelial cells. H2O2 reduces nuclear translocation of glucocorticoid receptors in airway epithelial cell lines. V-D pretreatment enhanced the dexamethasone-induced nuclear translocation of glucocorticoid receptors in airway epithelial cell lines and monocytes from 25-hydroxyvitamin D3-deficiency asthma patients. These findings indicate that V-D deficiency aggravates oxidative stress and DNA damage, suggesting a possible mechanism for corticosteroid resistance in severe asthma exacerbation.
Highlights
Severe asthma is unresponsive to treatment, including systemically administered corticosteroids [1]
We studied the effect of the vitamin D status on oxidative stress and DNA damage in patients with severe asthma exacerbation and in LPS-stimulated cells
Severe asthma exacerbation with V-Ddeficiency did not show a difference in the endotoxin level compared to that in severe asthma exacerbation with V-Dsufficiency (Table 1, p = 0.056)
Summary
Severe asthma is unresponsive to treatment, including systemically administered corticosteroids [1]. Severe asthma is defined as asthma that requires treatment with high dose inhaled corticosteroids plus a second controller and/or systemic corticosteroids to prevent it from becoming "uncontrolled" or that remains "uncontrolled" despite this therapy [3]. The multiple risk factors for asthma exacerbation include a complex mix of environmental, immunological and host genetic factors. Epidemiological studies have shown that low serum 25-hydroxyvitamin D3 levels are associated with a higher risk of upper and lower respiratory infections [4]. Vitamin D status has a linear relationship with respiratory infections and lung function [5], and V-D deficiency (a serum 25 (OH) D3 ,30 ng/ml) has been associated with severe asthma exacerbation [6]
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