Hall Sannette C, Agrawal Devendra K
Department of Clinical and Translational Science, Creighton University School of Medicine, Omaha, Nebraska.
Department of Clinical and Translational Science, Creighton University School of Medicine, Omaha, Nebraska.
Clin Ther. 2017 May;39(5):917-929. doi: 10.1016/j.clinthera.2017.04.002. Epub 2017 Apr 25.
Vitamin D is a potent immunomodulator capable of dampening inflammatory signals in several cell types involved in the asthmatic response. Its deficiency has been associated with increased inflammation, exacerbations, and overall poor outcomes in patients with asthma. Given the increase in the prevalence of asthma over the past few decades, there has been enormous interest in the use of vitamin D supplementation as a potential therapeutic option. Here, we critically reviewed the most recent findings from in vitro studies, animal models, and clinical trials regarding the role of vitamin D in treating bronchial asthma.
Using the key terms [Vitamin D, asthma, clinical trials, in vivo and in vitro studies], the [PubMed, Google Scholar] databases were searched for [clinical trials, original research articles, meta-analyses, and reviews], English-language articles published from [2012] to the present. Articles that were [Articles that did not meet these criteria were excluded] excluded from the analysis.
Several studies have found that low serum levels of vitamin D (< 20 ng/mL) are associated with increased exacerbations, increased airway inflammation, decreased lung function, and poor prognosis in asthmatic patients. Results from in vitro and in vivo studies in animals and humans have suggested that supplementation with vitamin D may ameliorate several hallmark features of asthma. However, the findings obtained from clinical trials are controversial and do not unequivocally support a beneficial role of vitamin D in asthma. Largely, interventional studies in children, pregnant women, and adults have primarily found little to no effect of vitamin D supplementation on improved asthma symptoms, onset, or progression of the disease. This could be related to the severity of the disease process and other confounding factors.
Despite the conflicting data obtained from clinical trials, vitamin D deficiency may influence the inflammatory response in the airways. Further studies are needed to determine the exact mechanisms by which vitamin D supplementation may induce antiinflammatory effects.
维生素D是一种强大的免疫调节剂，能够抑制参与哮喘反应的多种细胞类型中的炎症信号。其缺乏与哮喘患者炎症增加、病情加重及总体不良预后相关。鉴于过去几十年哮喘患病率上升，人们对使用维生素D补充剂作为一种潜在治疗选择产生了极大兴趣。在此，我们严格审查了关于维生素D在治疗支气管哮喘中作用的体外研究、动物模型和临床试验的最新发现。
使用关键词[维生素D、哮喘、临床试验、体内和体外研究]，在[PubMed、谷歌学术]数据库中搜索[2012年]至今发表的英文[临床试验、原创研究文章、荟萃分析和综述]。不符合这些标准的文章被排除在分析之外。
多项研究发现，哮喘患者血清维生素D水平低（<20 ng/mL）与病情加重增加、气道炎症增加、肺功能下降及预后不良相关。动物和人体的体外及体内研究结果表明，补充维生素D可能改善哮喘的几个标志性特征。然而，临床试验的结果存在争议，并未明确支持维生素D在哮喘中的有益作用。在很大程度上，针对儿童、孕妇和成人的干预性研究主要发现，补充维生素D对改善哮喘症状、疾病发作或进展几乎没有影响。这可能与疾病进程的严重程度和其他混杂因素有关。
尽管临床试验获得的数据相互矛盾，但维生素D缺乏可能会影响气道的炎症反应。需要进一步研究以确定补充维生素D可能诱导抗炎作用的确切机制。
