Efficacy of vitamin D supplementation on COPD and asthma control: A systematic review and meta-analysis

Abstract

BackgroundThe role of vitamin D (VD) in the management of chronic obstructive pulmonary disease (COPD) and asthma remains largely undetermined. In the present meta-analysis, we aimed to comprehensively investigate the efficacy of VD in the treatment of COPD and asthma according to the latest update. MethodsThe PubMed, Embase, and Cochrane Library databases were searched from their inception to June 2, 2022. Randomized controlled trials (RCTs) comparing the efficacy of VD with placebo against COPD or asthma were included.Results A total of 11 RCTs consisting of 1183 COPD patients and 19 RCTs consisting of 2025 asthmatic patients were finally included. As for pulmonary function, FEV1/FVC was not changed significantly, while FEV1% was improved in the VD group. In the asthma subgroup, FEV1% was not changed significantly, while FEV1/FVC was improved in the VD group. For the questionnaire and rating scale, the mMRC (modified Medical Research Council) dyspnoea scale score for COPD and ACT (Asthma Control Test) score for asthma were not significantly changed, while the SGRQ (St. George's Respiratory Questionnaire) score for COPD was improved in the VD group. For inflammation indicators, IL-6 and IL-10 were statistically equivalent between the VD and placebo groups, while IgE, IL-5, and IL-10 (baseline VD deficiency subgroup) were improved in the VD group. The exacerbation, length of hospital stays, and mortality were statistically equivalent between the two groups.Conclusions VD supplementation improved the indicators of asthma and COPD, especially in pulmonary function, SGRQ scores, IL-5, and IgE.Registration The protocol could be found at PROSPERO with the registration number of CRD42020218058. Chronic obstructive pulmonary disease (COPD) has the highest mortality rate among chronic respiratory diseases [1]. COPD patients often show incomplete reversibility of airflow obstruction caused by emphysema and chronic bronchitis. It can eventually develop into severe diseases, such as pulmonary heart disease and respiratory failure. Currently, there is no good way to prevent development of the disease. Similarly, asthma is another common chronic inflammatory disease that can start at a young age. Like COPD, asthma can also develop into chronic airway limitation because of uncontrolled inflammation [2]. Because inflammation is crucial in pathogenesis of asthma, inflammation control is primary goal of asthma control [3]. Drug therapy includes bronchodilators, glucocorticoids and some-PAPERS

The effects of vitamin D supplementation on inflammatory biomarkers in patients with asthma: a systematic review and meta-analysis of randomized controlled trials

“…This finding contrasts with a prior systematic review of 4 RCTs by Wang et al. ( 18 ), which reported no significant effect on IL-10 levels at the endpoint ( 18 ). When comparing included studies, the Wang et al.…”

“…Notably, their review accessed unpublished data, allowing them to also aggregate results on sputum eosinophils at the endpoint ( 30 , 34 , 38 ), where no significant impact was observed for children and adults with asthma ( 5 ). Another meta-analysis on blood eosinophils from three RCTs involving children and adults ( 18 ) incorporated the same studies as ours ( 29 , 31 , 35 ) and similarly concluded that vitamin D supplementation had no statistically significant effect. As for FeNO, our findings, based on 3 RCTs ( 29 , 31 , 34 ), are in line with two previous meta-analyses ( 19 , 20 ) that considered only two RCTs from our selection and also examined biomarker values at the endpoint.…”

“…Particular emphasis has been given to biomarkers commonly measured in clinical practice, such as serum IgE, serum and sputum eosinophils, and fractional exhaled nitric oxide (FeNO) which are indicators of type 2 inflammation ( 15 , 16 ), as well as anti-inflammatory biomarkers like IL-10 ( 17 ). Five systematic reviews and meta-analyses evaluated the impact of vitamin D supplementation in asthma on those inflammatory biomarkers ( 5 , 18 – 21 ). These reviews often included studies with ex vivo experimental designs, pre-post studies without an independent control group, and excluded trials with short follow-up durations (less than 12 weeks).…”

The Power of Vitamin D: Is the Future in Precision Nutrition through Personalized Supplementation Plans?

“…The beneficial impacts of vitamin D supplementation on COPD were confirmed by several other studies [ 30 , 31 ]; however, additional research is needed to better elucidate the effects of vitamin D in COPD patients and to define the supplement dosage that could lead to best results without the risk of potential toxic effects [ 32 ].…”

Association of vitamin D with all-cause and cardiovascular disease mortality in COPD population: A cohort study from NHANES 2007-2018

“…Additionally, studies have revealed the unique effects of 25-hydroxyvitamin D on various cellular processes, such as cell proliferation, differentiation, wound healing, repair, and involvement in the host immune and in ammatory regulatory systems (7).The de ciency of 25-hydroxyvitamin D has been con rmed to be associated with the progression of multiple COPD pathogenesis processes, including in ammation regulation, excessive oxidative stress, increased protease expression, impaired host defense, and pulmonary airway remodeling(8). Evidence from clinical trials and meta-analyses indicates that 25-hydroxyvitamin D supplementation plays a role in reducing COPD exacerbations and improving disease prognosis (9)(10)(11)(12).…”