| Autor: |
E.R., Sutherland, E., Goleva, L.P., et al., Jackson |
| Předmět: |
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| Zdroj: |
Journal of Asthma; May2010, Vol. 47 Issue 4, p489-489, 1p |
| Abstrakt: |
Journal. American Review of Respiratory Critical Care Med 2010 Jan14 epub ahead of print. Rationale. Individuals with asthma have a differential response to inhaled corticosteroids. Vitamin D is postulated to effect the response to gluocorticoids in asthma. The authors’ objective was to determine the effects of vitamin D on the asthma phenotype and response to oral corticosteroids. Methods. Non smoking adults with asthma were enrolled to assess the association between serum 25(OH)(vitamin D) concentrations and pulmonary function, airway hyper responsiveness (AHR) and glucocorticoid response as determined by dexamethasone induced expression of MAP kinase phosphatase-1 (MKP-1) by peripheral blood mononuclear cells. Results. 54 adult asthmatics (FEVI OF 83% ± 16%predicted, serum vitamin D level of 28 ± 10 ng/ml) were enrolled. Elevated vitamin D levels were related to increased pulmonary function, with a 21 ± 9ml increase in FEVI for each ng/ml increase in vitamin D (p = 0.03,r = 0.8). Enrollees with vitamin D insufficiency (<30ng/ml) demonstrated elevated AHR with a PC20 FEVI of 1.03 ± 0.2mg/ml compared with 1.92 ± 0.2 in subjects with vitamin D ≥30ng/ml (p = 0.01). Those participants not on inhaled corticosteroid therapy had a dexamethasone induced MAP kinase phosphatase 1 expression that was enhanced with higher vitamin D levels with a 0.05 ± 0.02 fold enhancement (p = 0.02,r = 0.5) in MKP-1 expression documented with each ng/ml enhancement in vitamin D. There was an inverse correlation between BMI and vitamin D with a decrease of 0.58 ± ng/ml in serum vitamin D for each unit increment in BMI (P = 0.002, R = O.4). This inverse correlation continued to be significant only in asthmatics that were not currently on inhaled corticosteroids (p = 0.009, r = 0.6). These findings were noted in the absence of a significant enhancement of IL-10 expression or mitogenic cell proliferation. Author's conclusions. Decreased vitamin D levels in asthma are related to impairment in pulmonary function, enhancement of airway hyper responsiveness and decline in glucocorticoid response unrelated to IL10. These findings suggest that supplementation with vitamin D in individuals with asthma may ameliorate multiple characteristics of asthma severity and therapeutic responsiveness. Reviewer's conclusions. Further large prospective randomized studies are needed to confirm the findings of the authors that vitamin D levels in asthma are related to pulmonary function parameters and glucocorticoid responsiveness and therefore supplementation with vitamin D may be therapeutic in asthma. [ABSTRACT FROM AUTHOR] |
| Databáze: |
Complementary Index |
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