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Vitamin D3 and response to glucocorticoids in steroid resistant asthmatics
Clinical Fellow, University College Hospital, London, UK; Samanthakon@aol.com
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Xystrakis E, Kusumakar S, Boswell S, et al. Reversing the defective induction of IL-10 secreting regulatory T cells in glucocorticoid-resistant asthma patients. J Clin Invest 2006;116:146–55[CrossRef][Medline]
This study showed that human IL-10 secreting regulatory T cells (Tregs) inhibit cytokine production from allergen specific Th2 cells in an IL-10 dependent manner. They therefore have the capacity to inhibit the immune response implicated in the pathogenesis of asthma. In steroid resistant asthmatics the failure of T cells to significantly induce IL-10 synthesis in response to dexamethasone was enhanced by the addition of vitamin D3. This restored levels of IL-10 to those seen in steroid sensitive individuals stimulated by dexamethasone alone. Potential mechanisms were explored and it was shown that dexamethasone downregulated glucocorticoid receptor expression, which could be reversed by the addition of vitamin D3. In addition, IL-10 was shown to increase glucocorticoid receptor expression. This suggests
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