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Vitamin D, respiratory infections, and asthma

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Abstract

Over the past decade, interest has grown in the role of vitamin D in many nonskeletal medical conditions, including respiratory infection. Emerging evidence indicates that vitamin D-mediated innate immunity, particularly through enhanced expression of the human cathelicidin antimicrobial peptide (hCAP-18), is important in host defenses against respiratory tract pathogens. Observational studies suggest that vitamin D deficiency increases risk of respiratory infections. This increased risk may contribute to incident wheezing illness in children and adults and cause asthma exacerbations. Although unproven, the increased risk of specific respiratory infections in susceptible hosts may contribute to some cases of incident asthma. Vitamin D also modulates regulatory T-cell function and interleukin-10 production, which may increase the therapeutic response to glucocorticoids in steroid-resistant asthma. Future laboratory, epidemiologic, and randomized interventional studies are needed to better understand vitamin D’s effects on respiratory infection and asthma.

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References and Recommended Reading

  1. Moorman JE, Rudd RA, Johnson CA, et al.: National surveillance for asthma—United States, 1980–2004. MMWR Surveill Summ 2007, 56:1–54.

    PubMed  Google Scholar 

  2. Ginde AA, Espinola JA, Camargo CA Jr: Improved overall trends but persistent racial disparities in emergency department visits for acute asthma, 1993–2005. J Asthma Clin Immunol 2008, 122:313–318.

    Article  Google Scholar 

  3. Nicholson KG, Kent J, Ireland DC: Respiratory viruses and exacerbations of asthma in adults. BMJ 1993, 307:982–986.

    PubMed  CAS  Google Scholar 

  4. Johnston SL, Pattemore PK, Sanderson G, et al.: Community study of the role of viral infections in exacerbations of asthma in 9–11 year old children. BMJ 1995, 310:1225–1229.

    PubMed  CAS  Google Scholar 

  5. Sutherland ER, Martin RJ: Asthma and atypical bacterial infection. Chest 2007, 132:1962–1966.

    Article  PubMed  CAS  Google Scholar 

  6. Gombart AF, Borregaard N, Koeffler HP: Human cathelicidin antimicrobial peptide (CAMP) is a direct target of the vitamin D receptor and is strongly upregulated in myeloid cells by 1,25-dihydroxyvitamin D-3. FASEB J 2003, 19:1067–1077.

    Article  CAS  Google Scholar 

  7. Liu PT, Stenger S, Li H, et al.: Toll-like receptor triggering of a vitamin D-mediated human antimicrobial response. Science 2006, 311:1770–1773.

    Article  PubMed  CAS  Google Scholar 

  8. Liu PT, Stenger S, Tang DH, Modlin RL: Cutting edge: vitamin D-mediated human antimicrobial activity against Mycobacterium tuberculosis is dependent on the induction of cathelicidin. J Immunol 2007, 179:2060–2063.

    PubMed  CAS  Google Scholar 

  9. Yim S, Dhawan P, Ragunath C, et al.: Induction of cathelicidin in normal and CF bronchial epithelial cells by 1,25-dihydroxyvitamin D(3). J Cyst Fibros 2007, 6:403–410.

    Article  PubMed  CAS  Google Scholar 

  10. Weber G, Heilborn JD, Chamorro Jimenez CI, et al.: Vitamin D induces the antimicrobial protein hCAP18 in human skin. J Invest Dermatol 2005, 124:1080–1082.

    Article  PubMed  CAS  Google Scholar 

  11. Laaksi I, Ruohola JP, Tuohimaa P, et al.: An association of serum vitamin D concentrations < 40 nmol/L with acute respiratory tract infection in young Finnish men. Am J Clin Nutr 2007, 86:714–717.

    PubMed  CAS  Google Scholar 

  12. Wayse V, Yousafzai A, Mogale K, Filteau S: Association of subclinical vitamin D deficiency with severe acute lower respiratory infection in Indian children under 5 y. Eur J Clin Nutr 2004, 58:563–567.

    Article  PubMed  CAS  Google Scholar 

  13. Karatekin G, Kaya A, Salihoglu O, et al.: Association of subclinical vitamin D deficiency in newborns with acute lower respiratory infection and their mothers. Eur J Clin Nutr 2007 Nov 21 (Epub ahead of print).

  14. Camargo CA Jr, Ingham T, Wickens K, et al.: Cord blood 25-hydroxyvitamin D levels and risk of childhood wheeze in New Zealand [abstract]. Am J Respir Crit Care Med 2008, 177(Suppl):A993.

    Google Scholar 

  15. van Elden LJ, Sachs AP, van Loon AM, et al.: Enhanced severity of virus associated lower respiratory tract disease in asthma patients may not be associated with delayed viral clearance and increased viral load in the upper respiratory tract. J Clin Virol 2008, 41:116–121.

    Article  PubMed  Google Scholar 

  16. Holick MF: Vitamin D deficiency. N Engl J Med 2007, 357:266–281.

    Article  PubMed  CAS  Google Scholar 

  17. Tavera-Mendoza LE, White JH: Cell defenses and the sunshine vitamin. Sci Am 2007, 297:62–65, 68–70, 72.

    Article  PubMed  CAS  Google Scholar 

  18. Autier P, Gandini S: Vitamin D supplementation and total mortality: a meta-analysis of randomized controlled trials. Arch Intern Med 2007, 167:1730–1737.

    Article  PubMed  CAS  Google Scholar 

  19. Dobnig H, Pilz S, Scharnagl H, et al.: Independent association of low serum 25-hydroxyvitamin D and 1,25-dihydroxyvitamin D levels with all-cause and cardiovascular mortality. Arch Intern Med 2008, 168:1340–1349.

    Article  PubMed  CAS  Google Scholar 

  20. Bischoff-Ferrari HA, Giovannucci E, Willett WC, et al.: Estimation of optimal serum concentrations of 25-hydroxyvitamin D for multiple health outcomes. Am J Clin Nutr 2006, 84:18–28.

    PubMed  CAS  Google Scholar 

  21. Scragg R, Camargo CA Jr: Frequency of leisure-time physical activity and serum 25-hydroxyvitamin D levels in the US population: results from the Third National Health and Nutrition Examination Survey. Am J Epidemiol 2008, 168:577–586.

    Article  PubMed  Google Scholar 

  22. Adams JS, Hewison M: Unexpected actions of vitamin D: new perspectives on the regulation of innate and adaptive immunity. Nat Clin Pract Endocrinol Metab 2008, 4:80–90.

    Article  PubMed  CAS  Google Scholar 

  23. Martineau AR, Honecker FU, Wilkinson RJ, Griffiths CJ: Vitamin D in the treatment of pulmonary tuberculosis. J Steroid Biochem Mol Biol 2007, 103:793–798.

    Article  PubMed  CAS  Google Scholar 

  24. Wilkinson RJ, Llewelyn M, Toossi Z, et al.: Influence of vitamin D deficiency and vitamin D receptor polymorphisms on tuberculosis among Gujarati Asians in west London: a case-control study. Lancet 2000, 355:618–621.

    Article  PubMed  CAS  Google Scholar 

  25. Wilbur AK, Kubatko LS, Hurtado AM, et al.: Vitamin D receptor gene polymorphisms and susceptibility M. tuberculosis in native Paraguayans. Tuberculosis (Edinb) 2007, 87:329–337.

    Article  CAS  Google Scholar 

  26. Martineau AR, Wilkinson RJ, Wilkinson KA, et al.: A single dose of vitamin D enhances immunity to mycobacteria. Am J Respir Crit Care Med 2007, 176:208–213.

    Article  PubMed  CAS  Google Scholar 

  27. Hiemstra PS: The role of epithelial beta-defensins and cathelicidins in host defense of the lung. Exp Lung Res 2007, 33:537–542.

    Article  PubMed  CAS  Google Scholar 

  28. Roth DE, Jones AB, Prosser C, et al.: Vitamin D status is not associated with the risk of hospitalization for acute bronchiolitis in early childhood. Eur J Clin Nutr 2007 Oct 31 (Epub ahead of print).

  29. Ginde AA, Mansbach JM, Camargo CA Jr: Association between serum 25-hydroxyvitamin D level and upper respiratory tract infections in the Third National Health and Nutrition Examination Survey. Arch Intern Med 2008 (in press).

  30. Camargo CA Jr, Rifas-Shiman SL, Litonjua AA, et al.: Maternal intake of vitamin D during pregnancy and risk of recurrent wheeze in children at 3 y of age. Am J Clin Nutr 2007, 85:788–795.

    PubMed  CAS  Google Scholar 

  31. Devereux G, Litonjua AA, Turner SW, et al.: Maternal vitamin D intake during pregnancy and early childhood wheezing. Am J Clin Nutr 2007, 85:853–859.

    PubMed  CAS  Google Scholar 

  32. Linday LA, Shindledecker RD, Tapia-Mendoza J, Dolitsky JN: Effect of daily cod liver oil and a multivitamin-mineral supplement with selenium on upper respiratory tract pediatric visits by young, inner-city, Latino children: randomized pediatric sites. Ann Otol Rhinol Laryngol 2004, 113:891–901.

    PubMed  Google Scholar 

  33. Rehman PK: Sub-clinical rickets and recurrent infection [research letter]. J Trop Pediatr 1994, 40:58.

    PubMed  CAS  Google Scholar 

  34. Aloia JF, Li-Ng M: Re: epidemic influenza and vitamin D. Epidemiol Infect 2007, 135:1095–1096; author reply 1097–1098.

    Article  PubMed  Google Scholar 

  35. Avenell A, Cook JA, Maclennan GS, Macpherson GC: Vitamin D supplementation to prevent infections: a sub-study of a randomised placebo-controlled trial in older people. Age Ageing 2007, 36:574–577.

    Article  PubMed  Google Scholar 

  36. Black PN, Scragg R: Relationship between serum 25-hydroxyvitamin D and pulmonary function in the Third National Health and Nutrition Examination Survey. Chest 2005, 128:3792–3798.

    Article  PubMed  CAS  Google Scholar 

  37. Burns J, Dockery D, Speizer FE, et al.: Low levels of dietary vitamin D intake and respiratory health in adolescents. Chest 2007, 132:238–245.

    Article  PubMed  CAS  Google Scholar 

  38. Wjst M: The vitamin D slant on allergy. Pediatr Allergy Immunol 2006, 17:477–483.

    Article  PubMed  Google Scholar 

  39. Hypponen E, Sovio U, Wjst M, et al.: Infant vitamin D supplementation and allergic conditions in adulthood: northern Finland birth cohort 1966. Ann N Y Acad Sci 2004, 1037:84–95.

    Article  PubMed  CAS  Google Scholar 

  40. Gale CR, Robinson SM, Harvey NC, et al.: Maternal vitamin D status during pregnancy and child outcomes. Eur J Clin Nutr 2008, 62:68–77.

    Article  PubMed  CAS  Google Scholar 

  41. Poon AH, Laprise C, Lemire M, et al.: Association of vitamin D receptor genetic variants with susceptibility to asthma and atopy. Am J Respir Crit Care Med 2004, 170:967–973.

    Article  PubMed  Google Scholar 

  42. Raby BA, Lazarus R, Silverman EK, et al.: Association of vitamin D receptor gene polymorphisms with childhood and adult asthma. Am J Respir Crit Care Med 2004, 170:1057–1065.

    Article  PubMed  Google Scholar 

  43. Vollmert C, Illig T, Altmuller J, et al.: Single nucleotide polymorphism screening and association analysis: exclusion of integrin beta 7 and vitamin D receptor (chromosome 12q) as candidate genes for asthma. Clin Exp Allergy 2004, 34:1841–1850.

    Article  PubMed  CAS  Google Scholar 

  44. Wjst M: Variants in the vitamin D receptor gene and asthma. BMC Genet 2005, 6:2.

    Article  PubMed  CAS  Google Scholar 

  45. Hijazi N, Abalkhail B, Seaton A: Diet and childhood asthma in a society in transition: a study in urban and rural Saudi Arabia. Thorax 2000, 55:775–779.

    Article  PubMed  CAS  Google Scholar 

  46. Wijga AH, Smit HA, Kerkhof M, et al.: Association of consumption of products containing milk fat with reduced asthma risk in pre-school children: the PIAMA birth cohort study. Thorax 2003, 58:567–572.

    Article  PubMed  CAS  Google Scholar 

  47. Jackson DJ, Gangnon RE, Evans MD, et al.: Wheezing rhinovirus illnesses in early life predict asthma development in high risk children. Am J Respir Crit Care Med 2008, 178:667–672.

    Article  PubMed  Google Scholar 

  48. Mansbach JM, Camargo CA Jr: Bronchiolitis: lingering questions about its definition and the potential role of vitamin D. Pediatrics 2008, 122:177–179.

    Article  PubMed  Google Scholar 

  49. 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, 116:146–155.

    Article  PubMed  CAS  Google Scholar 

  50. Xystrakis E, Urry Z, Hawrylowicz CM: Regulatory T cell therapy as individualized medicine for asthma and allergy. Curr Opin Allergy Clin Immunol 2007, 7:535–541.

    Article  PubMed  Google Scholar 

  51. Pichler J, Gerstmayr M, Szepfalusi Z, et al.: 1 alpha,25(OH)2D3 inhibits not only Th1 but also Th2 differentiation in human cord blood T cells. Pediatr Res 2002, 52:12–28.

    PubMed  CAS  Google Scholar 

  52. Heikkinen T, Jarvinen A: The common cold. Lancet 2003, 361:51–59.

    Article  PubMed  Google Scholar 

  53. Barger-Lux MJ, Heaney RP, Dowell S, et al.: Vitamin D and its major metabolites: serum levels after graded oral dosing in healthy men. Osteoporos Int 1998, 8:222–230.

    Article  PubMed  CAS  Google Scholar 

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Correspondence to Carlos A. Camargo.

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Ginde, A.A., Mansbach, J.M. & Camargo, C.A. Vitamin D, respiratory infections, and asthma. Curr Allergy Asthma Rep 9, 81–87 (2009). https://doi.org/10.1007/s11882-009-0012-7

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