title: Vitamin D and asthma-life after VIDA?
abstract: The vitamin D hypothesis postulates that lower vitamin D levels are causally associated with increased asthma risk and asthma severity. Multiple epidemiological studies have shown an inverse relationship between circulating vitamin D levels (in the form of 25-hydroxy vitamin D) and asthma severity and control and lung function. However, in the recently published vitamin D and asthma (VIDA) study, vitamin D supplementation failed to show an improvement in asthma control in adults. This article reviews the current epidemiological and trial evidence for vitamin D and asthma and explores some of the possible alternative explanations for previous findings (including "reverse causation" and the importance of studying children and adults). We also address some of the unique challenges of conducting vitamin D trials and potential ways to address them. Finally, I will argue for further clinical trials of vitamin D in asthma, especially in children, using knowledge gained from the VIDA trial.
authors.affiliation: Children's Hospital of Pittsburgh of UPMC, University of Pittsburgh, 4401 Penn Avenue, Pittsburgh, PA, 15224, USA, john.brehm@chp.edu.
authors.forename: John M
authors.initials: JM
authors.lastname: Brehm
mesh_terms: D000328:Adult; D001249:Asthma / Q000188:drug therapy / Q000209:etiology*; D002648:Child; D019587:Dietary Supplements; D006801:Humans; D014807:Vitamin D / Q000031:analogs & derivatives* / Q000097:blood / Q000378:metabolism / Q000627:therapeutic use*; D014808:Vitamin D Deficiency / Q000150:complications*; D014815:Vitamins / Q000378:metabolism / Q000627:therapeutic use*
chemical_list: D014815:Vitamins; D014807:Vitamin D; C104450:25-hydroxyvitamin D
references.citation: Am J Clin Nutr. 2011 Aug;94(2):619-20; author reply 620
references.pmid: 21775574
references.citation: Pediatrics. 2011 Jan;127(1):e180-7
references.pmid: 21187313
references.citation: Epidemiology. 2013 Mar;24(2):310-9
references.pmid: 23377091
references.citation: Am J Respir Crit Care Med. 2011 Dec 15;184(12):1342-9
references.pmid: 21908411
references.citation: Am J Clin Nutr. 2007 Mar;85(3):853-9
references.pmid: 17344509
references.citation: N Engl J Med. 2013 Nov 21;369(21):2047-8
references.pmid: 24256384
references.citation: Allergy. 2010 May;65(5):666-7
references.pmid: 19845573
references.citation: Am J Respir Crit Care Med. 2009 May 1;179(9):765-71
references.pmid: 19179486
references.citation: JAMA Intern Med. 2013 Apr 8;173(7):585-6
references.pmid: 23400578
references.citation: Allergy. 2004 May;59(5):469-78
references.pmid: 15080825
references.citation: JAMA. 2014 May;311(20):2083-91
references.pmid: 24838406
references.citation: J Allergy Clin Immunol. 2010 Jul;126(1):52-8.e5
references.pmid: 20538327
references.citation: Am J Respir Crit Care Med. 2010 Apr 1;181(7):699-704
references.pmid: 20075384
references.citation: Vital Health Stat 3. 2012 Nov;(35):1-58
references.pmid: 24252609
references.citation: J Clin Endocrinol Metab. 2011 Jan;96(1):53-8
references.pmid: 21118827
references.citation: Am J Respir Crit Care Med. 2014 Jun 1;189(11):1351-8
references.pmid: 24796409
references.citation: J Pediatr. 2010 Jun;156(6):948-952
references.pmid: 20236657
references.citation: J Asthma Allergy. 2012;5:11-9
references.pmid: 22690128
references.citation: N Engl J Med. 2006 Nov 23;355(21):2226-35
references.pmid: 17124020
references.citation: Indian J Pediatr. 2013 Nov;80(11):907-10
references.pmid: 23539249
references.citation: J Am Acad Dermatol. 2010 Jun;62(6):929.e1-9
references.pmid: 20363523
references.citation: Respir Res. 2013 Feb 22;14:25
references.pmid: 23432854
references.citation: Allergy Asthma Immunol Res. 2011 Oct;3(4):251-5
references.pmid: 21966605
references.citation: N Engl J Med. 2013 Nov 21;369(21):1991-2000
references.pmid: 24256378
references.citation: Am J Clin Nutr. 2011 May;93(5):1006-11
references.pmid: 21411617
references.citation: NCHS Data Brief. 2012 May;(94):1-8
references.pmid: 22617340
references.citation: Expert Rev Clin Immunol. 2009 Nov;5(6):693-702
references.pmid: 20161622
references.citation: N Engl J Med. 2007 Jul 19;357(3):266-81
references.pmid: 17634462
references.citation: J Allergy Clin Immunol. 2011 May;127(5):1294-6
references.pmid: 21315433
references.citation: J Allergy Clin Immunol. 2010 May;125(5):995-1000
references.pmid: 20381849
references.citation: Thorax. 2012 Nov;67(11):950-6
references.pmid: 22707522
references.citation: Am J Respir Crit Care Med. 2012 Sep 15;186(6):508-13
references.pmid: 22798322
references.citation: Chest. 2004 Jan;125(1):85-92
references.pmid: 14718425
references.citation: Am J Epidemiol. 2012 Dec 15;176(12):1169-76
references.pmid: 23204497
references.citation: Pediatr Allergy Immunol. 2011 May;22(3):327-33
references.pmid: 20880353
references.citation: Eur J Clin Nutr. 2008 Jan;62(1):68-77
references.pmid: 17311057
references.citation: J Asthma. 2014 Oct;51(8):832-8
references.pmid: 24779968
references.citation: J Clin Pathol. 2013 Jul;66(7):620-2
references.pmid: 23454726
references.citation: Proc Am Thorac Soc. 2010 Sep;7(5):325-35
references.pmid: 20844291
references.citation: Clin Exp Allergy. 2015 Jan;45(1):273-82
references.pmid: 24666565
references.citation: J Pediatr. 2011 Mar;158(3):437-41
references.pmid: 20870246
references.citation: Epidemiology. 2012 Jan;23(1):64-71
references.pmid: 22082994
references.citation: J Clin Invest. 2006 Jan;116(1):146-55
references.pmid: 16341266
references.citation: Contemp Clin Trials. 2014 May;38(1):37-50
references.pmid: 24614387
references.citation: J Allergy Clin Immunol. 2012 May;129(5):1243-51
references.pmid: 22330698
references.citation: Int Arch Allergy Immunol. 2012;157(2):168-75
references.pmid: 21986034
references.citation: Pediatrics. 2012 Sep;130(3):e561-7
references.pmid: 22908115
references.citation: Am J Respir Crit Care Med. 2012 Jul 15;186(2):140-6
references.pmid: 22652028
references.citation: J Pediatr Endocrinol Metab. 2012;25(7-8):673-9
references.pmid: 23155692
references.citation: Am J Clin Nutr. 2007 Mar;85(3):788-95
references.pmid: 17344501
references.citation: Eur Respir J. 2003 May;21(5):834-41
references.pmid: 12765430
references.citation: Ann N Y Acad Sci. 2010 Nov;1212 Suppl 1:E1-14
references.pmid: 21105878
references.citation: Br J Sports Med. 2005 Dec;39(12):892-7; discussion 897
references.pmid: 16306494
references.citation: Am J Clin Nutr. 2011 Aug;94(2):578-84
references.pmid: 21697075
references.citation: Ann N Y Acad Sci. 2014 May;1317:57-69
references.pmid: 24738964
references.citation: Am J Clin Nutr. 2013 Jun;97(6):1228-34
references.pmid: 23595876
references.citation: Ann Am Thorac Soc. 2014 May;11(4):571-7
references.pmid: 24601713
references.citation: Eur Respir J. 2011 Dec;38(6):1320-7
references.pmid: 21565922
references.citation: Curr Opin Allergy Clin Immunol. 2012 Jun;12(3):257-62
references.pmid: 22517291
references.citation: Am J Clin Nutr. 2010 May;91(5):1255-60
references.pmid: 20219962