Vitamin D as an adjunctive therapy in asthma. Part 1: A review of potential mechanisms.
Vitamin D deficiency (VDD) is highly prevalent worldwide. The classical role for vitamin D is to regulate calcium absorption form the gastrointestinal tract and influence bone health. Recently vitamin D receptors and vitamin D metabolic enzymes have been discovered in numerous sites systemically supporting diverse extra-skeletal roles of vitamin D, for example in asthmatic disease. Further, VDD and asthma share several common risk factors including high latitude, winter season, industrialization, poor diet, obesity, and dark skin pigmentation. Vitamin D has been demonstrated to possess potent immunomodulatory effects, including effects on T cells and B cells as well as increasing production of antimicrobial peptides (e.g. cathelicidin). This immunomodulation may lead to asthma specific clinical benefits in terms of decreased bacterial/viral infections, altered airway smooth muscle-remodeling and -function as well as modulation of response to standard anti-asthma therapy (e.g. glucocorticoids and immunotherapy). Thus, vitamin D and its deficiency have a number of biological effects that are potentially important in altering the course of disease pathogenesis and severity in asthma. The purpose of this first of a two-part review is to review potential mechanisms whereby altering vitamin D status may influence asthmatic disease.
Respiratory and Sleep Diagnostics Department, Connolly Hospital, Blanchardstown, Dublin 15, Ireland; School of Medicine and Medical Sciences, University College Dublin, Belfield, Dublin 4, Ireland. Electronic address: conorkerley@gmail.com.
Conor P
CP
Kerley
Department of Paediatric Respiratory Medicine, The National Children's Hospital Dublin 24, Ireland. Electronic address: basil.elnazir@amnch.ie.
Basil
B
Elnazir
Respiratory and Sleep Diagnostics Department, Connolly Hospital, Blanchardstown, Dublin 15, Ireland. Electronic address: doctorfaul@gmail.com.
John
J
Faul
Respiratory and Sleep Diagnostics Department, Connolly Hospital, Blanchardstown, Dublin 15, Ireland. Electronic address: liamcormican@rcsi.ie.
Liam
L
Cormican
D056151:Airway Remodeling / Q000187:drug effects; D000818:Animals; D018927:Anti-Asthmatic Agents / Q000008:administration & dosage* / Q000494:pharmacology; D001249:Asthma / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology; D006801:Humans; D009130:Muscle, Smooth / Q000187:drug effects / Q000378:metabolism; D018167:Receptors, Calcitriol / Q000378:metabolism; D012307:Risk Factors; D014807:Vitamin D / Q000008:administration & dosage* / Q000378:metabolism / Q000494:pharmacology; D014808:Vitamin D Deficiency / Q000453:epidemiology; D014815:Vitamins / Q000008:administration & dosage / Q000378:metabolism / Q000494:pharmacology
D018927:Anti-Asthmatic Agents; D018167:Receptors, Calcitriol; D014815:Vitamins; D014807:Vitamin D
Airway inflammation; Airway smooth muscle; Asthma; Respiratory infection; Vitamin D; Wheeze