Abstract
Asthma, a major public health issue, is one of the most common diseases affecting millions of population globally. It is a chronic respiratory disease characterized by increased airway inflammation and hyper-responsiveness. Vitamin D is of particular interest in asthma due to its immunomodulatory effects. Serum 25-hydroxyvitamin D is found to be associated with a wide range of pulmonary diseases, including viral and bacterial respiratory infections, asthma, and cancer. Several researches have reported positive associations between vitamin D and asthma. On the other hand, others have reported contrasting effects of vitamin D on asthma.This review provides an examination of current epidemiologic and experimental evidence of a causal association between vitamin D status and asthma or asthma exacerbations, including its probable protective mechanism. Most of the evidence regarding vitamin D and asthma is reported by observational studies. Therefore, results from the experimental trials of vitamin D supplementation are important as they can provide evidence for future recommendations about the significance of vitamin D for asthma. Moreover, the trials can be effective in assessing the correct dosage and safety of vitamin D supplementation when given in diverse age groups such as children, teenagers, and adults for prevention and treatment of asthma.
Highlights
BackgroundAsthma is one of the most common chronic diseases and its prevalence has increased worldwide in the last few decades affecting approximately 300 million people
This review provides an examination of current epidemiologic and experimental evidence of a causal association between vitamin D status and asthma or asthma exacerbations, including its probable protective mechanism
A study conducted by Gupta, et al was the pioneer research in concluding that serum vitamin D levels were found to be lowest among children with steroid resistant asthma (STRA) [45] with reduced lung function, increased corticosteroid use, and asthma exacerbations
Summary
Asthma is one of the most common chronic diseases and its prevalence has increased worldwide in the last few decades affecting approximately 300 million people. A study conducted by Gupta, et al was the pioneer research in concluding that serum vitamin D levels were found to be lowest among children with steroid resistant asthma (STRA) [45] with reduced lung function, increased corticosteroid use, and asthma exacerbations. A cross-sectional study of 616 asthmatic children in Costa Rica between the ages of 6 and 14 years, reported that vitamin D deficiency/insufficiency was prevalent in 28% of the children and increased levels of vitamin D were related with reduction in asthma exacerbations and reduced visits to emergency department (OR: 0.05; 95% CI: 0.004-0.71) [20]. A 4-year longitudinal study was conducted by Brehm, et al to establish causal relations between serum vitamin D levels and asthma exacerbations in 1024 North American asthmatic children with mild to moderate asthma [25]. A recent study conducted on 70 adult asthmatic patients and 20 healthy controls by Shahin, et al [46], concluded that serum vitamin D level was significantly decreased in asthmatic patients (19.88 ± 9.6 ng/ml) as compared to the control group (33.5 ± 6.1 ng/ml) [46] (Table 1)
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