These results could be of help for individualization of vitamin D supplementation doses in this vulnerable population. .
Background and Objectives: Although vitamin D insufficiency or deficiency is prevalent in children with allergic diseases, recommendations for supplementation dosing regimens are imprecise and variable in the literature, because clinical trials aiming to determine optimal doses were scarce in the past. This study aimed to investigate supplementation of vitamin D3 that may achieve therapeutically effective but not toxic serum levels in a subpopulation of children with allergic diseases and concomitant hypovitaminosis D. Materials and Methods: The retrospective, observational study with a cross-sectional design included 94 children suffering from allergic diseases and having vitamin D deficiency/insufficiency who were prescribed high-dose vitamin D3 supplementation by a pediatrician for at least 6 weeks and not more than 9 weeks. Serum levels of the major metabolite of vitamin D (25-(OH)D) were determined in all children twice: before and two weeks after the end of vitamin D3 supplementation. Results: An increase in serum level of the 25-(OH)D after supplementation was significant. However, if the subjects had higher serum levels of the 25-(OH)D before the supplementation, and if the supplementation lasted 8 instead of 6 weeks, the absolute increase in serum level of the 25-(OH)D was lower. Patients taking corticosteroids as inhalation or intranasally had a more intense effect of vitamin D3 supplementation, i.e., the absolute increase in levels of 25-(OH)D was higher than in patients not using such medication. Conclusions: Vitamin D deficiency and insufficiency in children with allergic diseases can be treated with maximal recommended doses of vitamin D3 for a short period of time, especially if they were prescribed with inhalation or intranasal corticosteroids.
Asthma, obesity, and irrational use of antibiotics early in a life can be considered to be the three epidemics of modern times, which encourage one another and whose base is the loss of bioavailability. Disruption of the intestinal microbiome early in the life is the basis for the development of metabolic diseases, allergic immunological diseases, and high mortality rate due to infection with resistant strains of bacteria. During the irrational use of penicillin and macrolides postnatally, the composition of the intestinal microbiota and its functions change 12-24 months after the antibiotics treatment, the settlement of advantage intestinal flora with probiotic microorganisms is delayed, the maturation of the intestinal mucosa is compromised. Respiratory and systemic inflammation is strongly influenced by the rich adipocyte metabolism so that the treatment of these children is complex, and their asthma often remains only partially controlled. The phenotype "obese asthma" is characterized by a steroid and bronchodilator resistance. Therapeutic solution could be the body weight reducing, vitamin D3 substitution, and antileukotriene application. The prophylactic therapy of this asthma, using macrolides for a long time, should be supported, mandatory, with the substitution of probiotic/synbiotic during, and at least 6-9 months after discontinuation of therapy with macrolide.
Introduction/Objective Recent researches show a link between low vitamin D serum levels and increased prevalence of allergic disease. The objective of this study was to show whether there is any dependence of the allergic status markers: skin prick test (SPT), total immunoglobulin E IgE (tIgE), and allergen-specific IgE (sIgE ≥ 3 class) in serum from the serum 25(OH)D (vitDs) level in children with allergic disease/s. Methods A total of 150 children with allergic disease/s were enrolled into this study. The vitDs, tIgE, SPT, and sIgE ≥ 3 class for aeroallergens and common food allergens were simultaneously assessed. Results We found a negative correlation between vitDs level and age groups and a statistically significant positive correlation between vitDs level and tIgE, sIgE ≥ 3 class for hen's egg yolk and hen's egg white. A statistically significant positive correlation was determined between vitDs level and SPT on Dermatophagoides pteronyssinus, and a negative correlation between tIgE and SPT on Dermatophagoides pteronyssinus, as well as between vitDs level and sIgE ≥ 3 class for Cladosporium and Alternaria molds. We confirmed the dependence of nettle rash and comorbidity asthma from the vitamin D insufficiency and vitamin D deficiency. We did not find any dependence of serum tIgE on vitDs level for the sample. Conclusion In order to get an adequate insight into the allergic status in children, we must take into account the pleotropic effects of vitamin D, according to which we suggest that, in the future, vitDs level should be determined synchronously with known markers of allergic status.
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