title: Vitamin D reduces eosinophilic airway inflammation in nonatopic asthma.
abstract: BACKGROUND
  Low levels of vitamin D are associated with asthma severity, airway remodeling, and exacerbation rate increase, especially in nonatopic asthma. Reduced steroid responsiveness or impaired antimicrobial defense might be underlying mechanisms.
  
  
  OBJECTIVE
  We sought to evaluate the effect of vitamin D supplementation on eosinophilic and neutrophilic airway inflammation in patients with nonatopic asthma.
  
  
  METHODS
  In a double-blind, randomized, placebo-controlled trial, we investigated the effect of long-acting vitamin D3 (400,000 IU) on sputum neutrophils and eosinophils in 44 patients with nonatopic asthma with neutrophilic (≥53%) and/or eosinophilic (≥3%) airway inflammation. Sputum induction was performed at baseline and after 9 weeks. Other measurements included questionnaires, blood samples, and pulmonary function.
  
  
  RESULTS
  Treatment with vitamin D did not significantly affect sputum neutrophils or eosinophils compared with treatment with placebo in the total group. Regarding sputum eosinophils, the effect of vitamin D appeared to be dependent on baseline sputum eosinophil levels (interaction P = .015). In patients with eosinophil levels of 26.2% or more (median in patients with sputum eosinophilia, >3%), eosinophils decreased from a median of 41.0% to 11.8% after vitamin D treatment as compared with an increase from 51.8% to 63.3% in patients receiving placebo (P = .034). Vitamin D treatment also resulted in slightly better Asthma Control Questionnaire scores (P = .08).
  
  
  CONCLUSIONS
  Vitamin D supplementation reduced eosinophilic airway inflammation in patients with nonatopic asthma with severe eosinophilic airway inflammation, but did not affect sputum neutrophils. Also, a small effect on asthma control was observed. These findings suggest that vitamin D might have potential as an add-on treatment option in eosinophilic asthma.
authors.affiliation: Department of Respiratory Medicine, Medical Centre Leeuwarden, Leeuwarden, The Netherlands. Electronic address: christa_de_groot@yahoo.com.
authors.forename: Jantina C
authors.initials: JC
authors.lastname: de Groot
authors.affiliation: Department of Pharmacotherapy and Pharmaceutical Care, University of Groningen, Groningen, The Netherlands; Department of Hospital Pharmacy, Medical Centre Leeuwarden, Leeuwarden, The Netherlands.
authors.forename: Eric N H
authors.initials: EN
authors.lastname: van Roon
authors.affiliation: Department of Clinical Chemistry, Medical Centre Leeuwarden, Leeuwarden, The Netherlands.
authors.forename: Huib
authors.initials: H
authors.lastname: Storm
authors.affiliation: Department of Clinical Epidemiology, Medical Centre Leeuwarden, Leeuwarden, The Netherlands.
authors.forename: Nic J G M
authors.initials: NJ
authors.lastname: Veeger
authors.affiliation: Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Amsterdam Medical Centre, Amsterdam, The Netherlands.
authors.forename: Aeilko H
authors.initials: AH
authors.lastname: Zwinderman
authors.affiliation: Department of Pulmonology, Leiden University Medical Centre, Leiden, The Netherlands.
authors.forename: Pieter S
authors.initials: PS
authors.lastname: Hiemstra
authors.affiliation: Department of Respiratory Medicine, Amsterdam Medical Centre, Amsterdam, The Netherlands.
authors.forename: Elisabeth H D
authors.initials: EH
authors.lastname: Bel
authors.affiliation: Department of Respiratory Medicine, Medical Centre Leeuwarden, Leeuwarden, The Netherlands.
authors.forename: Anneke
authors.initials: A
authors.lastname: ten Brinke
mesh_terms: D000328:Adult; D000368:Aged; D001249:Asthma / Q000188:drug therapy* / Q000276:immunology / Q000473:pathology; D002762:Cholecalciferol / Q000008:administration & dosage*; D004311:Double-Blind Method; D004804:Eosinophils / Q000187:drug effects* / Q000276:immunology / Q000473:pathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009504:Neutrophils / Q000276:immunology / Q000473:pathology; D011657:Pulmonary Eosinophilia / Q000188:drug therapy* / Q000276:immunology / Q000473:pathology; D012129:Respiratory Function Tests; D012137:Respiratory System / Q000187:drug effects* / Q000276:immunology / Q000473:pathology; D013183:Sputum / Q000166:cytology; D011795:Surveys and Questionnaires
chemical_list: D002762:Cholecalciferol
keywords: Asthma; airway inflammation; eosinophils; neutrophils; nonatopic; vitamin D