Vitamin D reduces eosinophilic airway inflammation in nonatopic asthma - 05/03/15
, Eric N.H. van Roon, PhD b, c, Huib Storm, PhD d, Nic J.G.M. Veeger, PhD e, Aeilko H. Zwinderman, PhD f, Pieter S. Hiemstra, PhD g, Elisabeth H.D. Bel, MD, PhD h, Anneke ten Brinke, MD, PhD aAbstract |
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.
Le texte complet de cet article est disponible en PDF.Key words : Asthma, vitamin D, airway inflammation, eosinophils, neutrophils, nonatopic
Abbreviations used : Feno, FVC
Plan
| This study was supported by unrestricted grants from GlaxoSmithKline, Medical Centre Leeuwarden research fund, and Frysian Pulmonologists. |
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| Disclosure of potential conflict of interest: J. C. de Groot has received research support from GlaxoSmithKline (GSK), the Medical Centre Leeuwarden research fund, and Frysian Pulmonologists. P. S. Hiemstra has received research support from Boehringer Ingelheim and Galapagos. E. H. D. Bel is a board member for Novartis (2014); has received consultancy fees from GSK (2012), Regeneron (2013), and Cipla (2013); has received research support from GSK and Chiesi; and has received lecture fees from GSK. A. ten Brinke has received research support from GSK; is a board member for Novartis NL (Advisor Research Board); and has received lecture fees from GSK, Boehringer Ingelheim, and Novartis. The rest of the authors declare that they have no relevant conflicts of interest. |
Vol 135 - N° 3
P. 670 - mars 2015 Retour au numéro
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