ASTHMA — comparing the impact of vitamin D versus UVR on clinical and immune parameters

Morgan, K; Mann, Elizabeth H.; Young, Antony R.; Hawrylowicz, Catherine M.

doi:10.1039/c6pp00407e

Cited by 10 publications

(8 citation statements)

References 116 publications

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“…Vitamin D insufficiency / deficiency are extremely common in the developed world [64] and a healthy diet alone rarely contains adequate vitamin D to achieve sufficient status. Although ultraviolet (UV) light supplementation might be an option [65], population-level oral vitamin D supplementation may be necessary to alleviate the epidemic of vitamin D deficiency and reduce harm from air pollution.…”

Section: Discussionmentioning

confidence: 99%

Effects of vitamin D on inflammatory and oxidative stress responses of human bronchial epithelial cells exposed to particulate matter

Pfeffer

Mann

et al. 2018

Preprint

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41 Background: Particulate matter (PM) pollutant exposure, which induces oxidative stress and 42 inflammation, and vitamin D insufficiency, which compromises immune regulation, are 43 detrimental in asthma. 55 versus asthmatic donor cultures. Vitamin D also differentially affected PM-stimulated GM-56 CSF, with suppression in healthy HBECs and enhancement in asthmatic cultures. Vitamin D 57 increased HBEC expression of the antioxidant pathway gene G6PD, increased the ratio of 58 reduced to oxidised glutathione, and in PM-stimulated cultures decreased the formation of 8-59 isoprostane. Pre-treatment with vitamin D decreased CXCL8 and further decreased IL-6 60 production in PM-stimulated cultures, an effect abrogated by inhibition of G6PD with DHEA, 61 supporting a role for this pathway in the anti-inflammatory actions of vitamin D. 62 Conclusions: In a study using HBECs from 18 donors, vitamin D enhanced HBEC 63 antioxidant responses and modulated the immune response to PM, suggesting that vitamin D 64 may protect the airways from pathological pollution-induced inflammation. prevalence, implying the importance of environmental factors in its aetiology [1]. Vitamin D 68 insufficiency/deficiency and ambient air pollution are two major environmental factors that 69 appear to influence the pathogenesis and stability of asthma [2] [3] [4] [5], as well as other 70 respiratory diseases [6] [7]. However there remains debate resulting from the heterogeneity 71 of findings relating to the effects of these environmental factors on airway pathology [5] [8] [9] 72 [10]. For example, European studies have shown heterogeneity between different cities in 73 the magnitude of the effects of pollution on health outcomes such as hospital admissions for 74 respiratory diseases [9] and asthma incidence [11], despite using standardised analyses. 75 Environment-environment interactions are a major possible explanation for inconsistent 76 results between different patient cohorts but have been little studied, particularly at the 77 mechanistic level. In a recent meta-analysis, latitude of study location influenced 78 associations between air pollutants and severe asthma exacerbations, and latitude is also 79 known to affect sunlight-derived vitamin D production, although this association is 80 complicated by other factors such as hours of daily skin exposure to sunlight [5]. In the 81 urban environment Rosser and colleagues have shown that vitamin D insufficient children, 82 but not those vitamin D sufficient, living close to major roads show an elevated risk of severe 83 asthma exacerbations [12], although the mechanisms by which vitamin D may protect 84 against pollution toxicity remain unclear and the interaction likely complex. 85 86 A growing body of research highlights the importance of epithelial immunology in 87 asthma [13]. Evidence shows that inhaled ambient particulate matter (PM) adversely affects 88 the bronchial epithelium through various mechanisms including the imposition of oxidative 89 stress, which stimulates redox sensi...

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Section: Discussionmentioning

confidence: 99%

Effects of vitamin D on inflammatory and oxidative stress responses of human bronchial epithelial cells exposed to particulate matter

Pfeffer

Mann

et al. 2018

Preprint

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“… 44 In addition, vitamin D deficiency may contribute to asthma severity. 45 An increase in serum vitamin D levels was observed in 73 patients with ankylosing spondylitis who stayed at moderate altitude for 3 weeks during spring. 46 It is possible that increased UVR exposure at moderate altitude may improve serum vitamin D levels in asthmatic patients, but this should be tested in future, well‐controlled, studies.…”

Section: Uv Radiation At Moderate Altitudementioning

confidence: 96%

Alpine altitude climate treatment for severe and uncontrolled asthma: An EAACI position paper

Fieten

Drijver-Messelink

Cogo

et al. 2022

Allergy

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Currently available European Alpine Altitude Climate Treatment (AACT) programs combine the physical characteristics of altitude with the avoidance of environmental triggers in the alpine climate and a personalized multidisciplinary pulmonary rehabilitation approach. The reduced barometric pressure, oxygen pressure, and air density, the relatively low temperature and humidity, and the increased UV radiation at moderate altitude induce several physiological and immunological adaptation responses. The environmental characteristics of the alpine climate include reduced aeroallergens such as house dust mites (HDM), pollen, fungi, and less air pollution. These combined factors seem to have immunomodulatory effects controlling pathogenic inflammatory responses and favoring less neuro‐immune stress in patients with different asthma phenotypes. The extensive multidisciplinary treatment program may further contribute to the observed clinical improvement by AACT in asthma control and quality of life, fewer exacerbations and hospitalizations, reduced need for oral corticosteroids (OCS), improved lung function, decreased airway hyperresponsiveness (AHR), improved exercise tolerance, and improved sinonasal outcomes. Based on observational studies and expert opinion, AACT represents a valuable therapy for those patients irrespective of their asthma phenotype, who cannot achieve optimal control of their complex condition despite all the advances in medical science and treatment according to guidelines, and therefore run the risk of falling into a downward spiral of loss of physical and mental health. In the light of the observed rapid decrease in inflammation and immunomodulatory effects, AACT can be considered as a natural treatment that targets biological pathways.

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“…Morgan et al [ 41 ] noted that asthma incidence has increased in parallel with temporal increases in vitamin D deficiency, that epidemiological studies have reported associations between low serum 25(OH)D and increased asthma incidence, and that some evidence exists for a positive correlation between asthma incidence and latitude. Hollams et al [ 42 ] reported that serum 25(OH)D <50 nmol/L in childhood was positively associated with increased risk for asthma or wheeze in a small longitudinal study of 263 children (198 participated up to age five, and 147 up to age 10).…”

Section: Evidence For Health Benefits Of Sun Exposurementioning

confidence: 99%

“…However, this benefit was independent of starting 25(OH)D levels. Mechanistically, vitamin D may not only regulate immune cell activity to reduce infections and sensitization but may also regulate the development of structural cells of the lung [ 41 ]. Some trials have also reported reduced development of wheeze or asthma, but not respiratory tract infections, in offspring of pregnant women supplemented with vitamin D; this effect was independent of starting 25(OH)D levels.…”

Section: Evidence For Health Benefits Of Sun Exposurementioning

confidence: 99%

Insufficient Sun Exposure Has Become a Real Public Health Problem

Alfredsson

Armstrong

Butterfield

et al. 2020

IJERPH

Self Cite

108

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This article aims to alert the medical community and public health authorities to accumulating evidence on health benefits from sun exposure, which suggests that insufficient sun exposure is a significant public health problem. Studies in the past decade indicate that insufficient sun exposure may be responsible for 340,000 deaths in the United States and 480,000 deaths in Europe per year, and an increased incidence of breast cancer, colorectal cancer, hypertension, cardiovascular disease, metabolic syndrome, multiple sclerosis, Alzheimer’s disease, autism, asthma, type 1 diabetes and myopia. Vitamin D has long been considered the principal mediator of beneficial effects of sun exposure. However, oral vitamin D supplementation has not been convincingly shown to prevent the above conditions; thus, serum 25(OH)D as an indicator of vitamin D status may be a proxy for and not a mediator of beneficial effects of sun exposure. New candidate mechanisms include the release of nitric oxide from the skin and direct effects of ultraviolet radiation (UVR) on peripheral blood cells. Collectively, this evidence indicates it would be wise for people living outside the tropics to ensure they expose their skin sufficiently to the sun. To minimize the harms of excessive sun exposure, great care must be taken to avoid sunburn, and sun exposure during high ambient UVR seasons should be obtained incrementally at not more than 5–30 min a day (depending on skin type and UV index), in season-appropriate clothing and with eyes closed or protected by sunglasses that filter UVR.

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ASTHMA — comparing the impact of vitamin D versus UVR on clinical and immune parameters

Cited by 10 publications

References 116 publications

Effects of vitamin D on inflammatory and oxidative stress responses of human bronchial epithelial cells exposed to particulate matter

Effects of vitamin D on inflammatory and oxidative stress responses of human bronchial epithelial cells exposed to particulate matter

Alpine altitude climate treatment for severe and uncontrolled asthma: An EAACI position paper

Insufficient Sun Exposure Has Become a Real Public Health Problem

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