Sypniewska Grazyna, Krintus Magdalena, Fulgheri Gabriele, Siodmiak Joanna, Kuligowska-Prusinska Magdalena, Stepien-Jaszowska Beata, Staszak-Kowalska Radosława, Zawadzka-Krajewska Anna, Kierat Szymon, Bergmann Katarzyna, Demkow Urszula
Allergy Asthma Proc. 2017 May 1;38(3):29-36. doi: 10.2500/aap.2017.38.4026.
Low 25-hydroxyvitamin D (25[OH]D) and asthma development may be related to airway remodeling and eosinophilia. Periostin is proposed as a key molecule that links remodeling and eosinophilic inflammation.
We evaluated the association of 25(OH)D concentration with periostin, peripheral blood eosinophil counts, and immunoglobulin E (IgE) in children with newly diagnosed asthma.
The study included 150 children: 110 with atopic asthma and 40 constituted a reference group. Fasting blood was collected for cell counts and serum for measurements of 25(OH)D, periostin, IgE, and C-reactive protein (CRP) concentrations.
Significantly lower 25(OH)D, elevated IgE concentrations, and eosinophil counts were found in children with asthma compared with the reference group (p = 0.0001). A lower forced expiratory volume in the first second of expiration percentage predicted value was associated with a lower 25(OH)D value in children with asthma. The bronchodilator reversibility was inversely related to serum 25(OH)D concentrations (R = -0.45, p = 0.029). The children with asthma and with a 25(OH)D deficient concentration (≤20 ng/mL) had higher concentrations of periostin (p = 0.035) and CRP (p = 0.01) than those with a sufficient 25(OH)D concentration (≥30 ng/L). Additional analysis revealed statistically significant differences (p = 0.013) when comparing periostin concentrations between subjects with a 25(OH)D deficient concentration (≤20 ng/mL) and subjects who did not have a deficient concentration (>20 ng/mL). In individuals with asthma, a 25(OH)D concentration of <30 ng/mL had no impact on eosinophilia, whereas IgE concentrations were associated with increased eosinophils, and the effect of periostin on eosinophilia was small although significant. Multivariate regression, including 25(OH)D concentration, CRP level, eosinophil counts, and sex, accounted for 7% of periostin variation in subjects with asthma.
In newly diagnosed pediatric asthma, 25(OH)D concentrations revealed a small although significant association with periostin levels but no effect on eosinophilia. A low vitamin D concentration may increase airway remodeling induced by inflammatory mediators, but further clinical studies aimed to explain the causal link between vitamin D insufficiency and asthma are needed.
低水平的25-羟基维生素D（25[OH]D）与哮喘的发生可能与气道重塑和嗜酸性粒细胞增多有关。骨膜蛋白被认为是连接重塑和嗜酸性粒细胞炎症的关键分子。
我们评估了新诊断哮喘儿童中25(OH)D浓度与骨膜蛋白、外周血嗜酸性粒细胞计数及免疫球蛋白E（IgE）之间的关联。
该研究纳入150名儿童：110名患有特应性哮喘，40名作为参照组。采集空腹血进行细胞计数，采集血清测量25(OH)D、骨膜蛋白、IgE及C反应蛋白（CRP）浓度。
与参照组相比，哮喘儿童的25(OH)D水平显著降低，IgE浓度及嗜酸性粒细胞计数升高（p = 0.0001）。哮喘儿童第一秒用力呼气量占预计值百分比降低与25(OH)D值降低相关。支气管扩张剂可逆性与血清25(OH)D浓度呈负相关（R = -0.45，p = 0.029）。25(OH)D浓度不足（≤20 ng/mL）的哮喘儿童的骨膜蛋白（p = 0.035）和CRP（p = 0.01）浓度高于25(OH)D浓度充足（≥30 ng/L）的儿童。进一步分析显示，比较25(OH)D浓度不足（≤20 ng/mL）的受试者与浓度未不足（>20 ng/mL）的受试者的骨膜蛋白浓度时，差异具有统计学意义（p = 0.013）。在哮喘患者中，25(OH)D浓度<30 ng/mL对嗜酸性粒细胞增多无影响，而IgE浓度与嗜酸性粒细胞增多相关，骨膜蛋白对嗜酸性粒细胞增多的影响虽小但显著。多因素回归分析（包括25(OH)D浓度、CRP水平、嗜酸性粒细胞计数及性别）解释了哮喘患者中7%的骨膜蛋白变异。
在新诊断的儿童哮喘中，25(OH)D浓度与骨膜蛋白水平存在虽小但显著的关联，但对嗜酸性粒细胞增多无影响。低维生素D浓度可能会增加炎症介质诱导的气道重塑，但需要进一步的临床研究来解释维生素D不足与哮喘之间的因果关系。
