The effect of vitamin D on airway inflammation in non-atopic asthma

J.C. De Groot, E. Van Roon, H. Storm, N. Veeger, E. Bel, A. Ten Brinke

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Rationale: Low levels of vitamin D are associated with asthma severity, airway remodeling and exacerbation rate, in particular in nonatopic asthma (Brehm JACI 2010). Reduced steroid responsiveness or impaired antimicrobial defense might be underlying mechanisms. We hypothesized that vitamin D treatment reduces eosinophilic and neutrophilic airway inflammation in asthma. Methods: In a randomized, double-blind, placebo-controlled trial we investigated the effect of a single dose of long-acting oral vitamin D3 (400.000IU) on sputum eosinophils and neutrophils in 44 non-atopic asthma patients with eosinophilic (≥3%) and/or neutrophilic (≥53%) airway inflammation. Next to the study medication, patients received standard asthma treatment with inhaled corticosteroids and/or beta-2-agonists. Most patients had mild asthma. Sputum was induced at baseline and after 9 weeks. Other measurements included questionnaires, blood samples and pulmonary function tests. Results: Multivariable analysis revealed heterogeneity of vitamin D efficacy depending on baseline level of eosinophils (interaction p=0.01). Patients in the highest baseline eosinophil quartile (>26.7%), showed a decrease in eosinophils from median 41.0% to 11.8% in the vitamin D group as compared to an increase from 60.8% to 70.5% in the placebo group, p=0.03. No effect on sputum neutrophils was observed. Vitamin D3 caused a small but significant improvement in FEV1/VC (p=0.01) and a trend for improvement in ACQ (p=0.08). (Table 1) Conclusion: Vitamin D3 reduces eosinophilic airway inflammation in non-atopic asthma patients with high sputum eosinophil counts, but has no effect on sputum neutrophils. In addition, a beneficial effect on airway obstruction and asthma control was observed. (Table Presented).
Original languageEnglish
Article numberA1390
JournalAmerican Journal of Respiratory and Critical Care Medicine
Volume189
Publication statusPublished - 1-Jan-2014
Externally publishedYes

Keywords

  • vitamin D
  • vitamin
  • placebo
  • antiinfective agent
  • beta 2 adrenergic receptor stimulating agent
  • corticosteroid
  • steroid
  • respiratory tract inflammation
  • allergic asthma
  • American
  • society
  • asthma
  • human
  • patient
  • sputum
  • eosinophil
  • neutrophil
  • drug therapy
  • airway obstruction
  • eosinophil count
  • single drug dose
  • blood sampling
  • questionnaire
  • lung function test
  • controlled study
  • airway remodeling

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