• J. Allergy Clin. Immunol. · Mar 2015

    Randomized Controlled Trial

    Vitamin D reduces eosinophilic airway inflammation in nonatopic asthma.

    • Jantina C de Groot, Eric N H van Roon, Huib Storm, Nic J G M Veeger, Aeilko H Zwinderman, Pieter S Hiemstra, Elisabeth H D Bel, and Anneke ten Brinke.
    • Department of Respiratory Medicine, Medical Centre Leeuwarden, Leeuwarden, The Netherlands. Electronic address: christa_de_groot@yahoo.com.
    • J. Allergy Clin. Immunol. 2015 Mar 1;135(3):670-5.e3.

    BackgroundLow 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.ObjectiveWe sought to evaluate the effect of vitamin D supplementation on eosinophilic and neutrophilic airway inflammation in patients with nonatopic asthma.MethodsIn 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.ResultsTreatment 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).ConclusionsVitamin 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.Copyright © 2015 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

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