Vitamin D3 in children with allergic asthma in clinical practice

Abstract

Asthma is a chronic inflammatory disorder; type 2 inflammation is the most common asthma endotype in childhood. T regulatory cells are functionally and allergen‐specifically defective in allergic patients. Vitamin D3 exerts many functions on immune system, mainly concerning T regulatory function. Asthma control is the goal of the asthma treatment. We aimed to stratified a group of 76 consecutive children (50 males, 26 females, mean age 10.4 + 2.2 years) with allergic asthma and visited for the first time at a third‐level paediatric clinic during a 3‐month period, considering the Vitamin D3 serum levels. The three Vitamin D3 classes were not able to discriminate significant difference for all the parameters considered. In conclusion, Vitamin D3 serum assessment seems to be scarcely useful to pheno/endotyping allergic asthmatic children in clinical practice.

Suboptimal Serum 25-Hydroxy-Vitamin D Is Associated with a History of Recent Disease Exacerbation in Pediatric Patients with Bronchial Asthma or Asthma-Suggestive Recurrent Wheezing

“…In our report, more than half of the patients had a suboptimal serum vitamin D 3 level, with the observed prevalence of vitamin D deficiency/insufficiency being 58.8%, a finding similar to that outlined in other prevalence studies [ 18 , 21 ]. In regard to the geographical area, a previous large ( n = 6631) cross-sectional study that evaluated the vitamin D serum level in a Romanian population of all ages (0–85 years) from all regions of the country [ 22 ] concluded that the pediatric cohort in the first decade of age presented normal vitamin D levels, with the highest mean value of serum 25-OH-VitD 3 occurring in children under three years of age.…”

“…Vitamin D reportedly reduces eosinophilic airway inflammation in murine lung tissue [ 40 ] and sputum from asthma patients [ 41 ]. Even though the literature reports a positive correlation between sputum and serum eosinophilia [ 42 ], several articles mention that vitamin D supplements and serum 25-OH-VitD status do not seem to significantly influence serum eosinophils [ 18 , 43 ], similar to the finding reported in the current study. Our results can be explained by the fact that the link between the eosinophil count and serum 25-OH-VitD was only evaluated once, at the moment that the patient was included in the study, therefore offering only a snapshot of the inflammation, whereas monitoring the dynamics of the serum levels of both might yield a more accurate reflection of the evolution of inflammation during oral vitamin D 3 therapy [ 29 ].…”

“…Prior work has explored the serum level of 25-OH-VitD [ 14 ] as a marker for vitamin D 3 adequacy and reported decreased concentrations in pediatric asthmatics, both pre- and school-aged children. Moreover, associations between the deficiency state and various asthma characteristics have been noted [ 18 , 19 , 20 , 21 ]. The present study looked into vitamin D 3 status in pediatric asthmatic and asthma-suggestive recurrent wheezing patients from the region of Cluj County in Transylvania, Romania, and analyzed whether a suboptimal serum vitamin D 3 level was related to several factors associated with unsatisfactory control of the disease.…”

Is there a rationale for supplementing with vitamin D patients under treatment with allergen immunotherapy?

“…Same considerations were made by other authors showing that the VD status in human allergic patients has a nonlinear relationship with immune parameters relevant for allergic disease (e. g. serum IgE levels) [ 36 ]. Similarly, VD serum assessment seemed to be scarcely useful to pheno/endotyping allergic asthmatic children in clinical practice as the VD classes (normal, insufficient or deficient) were not able to discriminate clinical, functional and laboratory parameters in allergic asthma [ 37 ]. Some authors also did not show association between maternal levels of VD and atopic disease outcomes (eczema, food allergy, asthma, allergic rhinitis) at 2 and 5 years in a disease-specific cohort in childhood with prospectively collected, validated atopic outcomes [ 38 ].…”

Vitamin D and asthma in children: insights from total and free 25-hydroxyvitamin D and vitamin D binding protein measurements

“…In addition to its traditional functions, vitamin D modulates different processes; evidence shows that it has an important role in various allergic diseases (11) . Hypovitaminosis D has been associated with an increased risk of asthma development, asthma exacerbations, airway hyperresponsiveness, reduced lung function, and decreased responsiveness to glucocorticoids in both children and adults with asthma (8,(12)(13)(14)(15) . Low levels of 25(OH) vitamin D have also been found in children with COVID-19 (16) .…”