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| Effects of vitamin D supplementation on bronchial asthma of different severity in children |
| WANG Zhihua |
| Department of Pediatrics, the Second Hospital of Chaoyang, Liaoning Province, Chaoyang 122000, China |
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Abstract Objectives To explore the effects of vitamin D supplementation on symptoms of children with bronchial asthma of different severity and relevant mechanisms. Methods Ninety children with bronchial asthma were included from the Second Hospital of Chaoyang from January 2015 to January 2017. Random blocks design was used in this study, the children were assigned to mild (n = 30), moderate and severe attack (n = 60) groups, then they were assigned to the treatment and control subgroups with 45 for each with random number table. The children in the control group were treated with Salbutamol Sulfate Aerosol Inhalation and Fluticasone Propionate Aerosol, and the children received additionally oral vitamin D3 at dose of 800 U daily in the treatment group. All children were treated for 3 months. The childhood asthma control test was used to assess the state of illness of children with bronchial asthma at 3 months after treatment. In addition, serum levels of 25(OH)D3, specific IgE and eosinophil cationic protein were determined before and 3 months after treatment. Results Illness control rate and serum level of 25(OH)D3 in the children with mild attack in the treatment group were significantly higher than those of the control group, the differences were statistically significant (P < 0.05). Conversely, serum levels of specific IgE and eosinophil cationic protein in the children with mild attack in the treatment group were significantly lower than the control group (P < 0.05). Compared with before treatment, serum levels of 25(OH)D3 of children with bronchial asthma in each group was significantly decreased after treatment (P < 0.05) with the exception of mild attack children, but specific IgE and eosinophil cationic protein were significantly increased after treatment (P < 0.05). Conclusion Effects of vitamin D supplementation on symptoms of children with bronchial asthma of different severity are varied, those are more obvious in mild asthmatic attack children, and the underlying mechanisms may involve the increased serum level of 25(OH)D3 and the decreased serum levels of specific IgE and eosinophil cationic protein.
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| [1] Rzehak P，Wijga AH，Keil T，et al. Body mass index trajectory classes and incident asthma in childhood： results from 8 European Birth Cohorts——a Global Allergy and Asthma European Network initiative [J]. J Allergy Clin Immunol，2013，131（6）：1528-1536.
[2] 陶金金，贾春梅.免疫调节剂在哮喘治疗中的作用及研究进展[J].中国小儿急救医学，2015，22（7）：494-497.
[3] 张楠，万斯鳭，张苏婉，等.信号传导子和转录激活子家族与支气管哮喘发病机制的研究进展[J].中国小儿急救医学，2013，20（5）：535-537.
[4] 尹冰如，钱素云.维生素Ｄ免疫调节作用及其与脓毒症的关系[J].中华实用儿科临床杂志，2014，29（14）：1104-1106.
[5] Mann EH，Chambers ES，Pfeffer PE，et al. Immunoregulatory mechanisms of vitamin D relevant to respiratory health and asthma [J]. Ann NY Acad Sci，2014，1317：57-69.
[6] Riverin BD，Maguire JL，Li P. Vitamin D supplemention for childhood asthma：a systematic review and meta analysis [J]. PLoS One，2015，10（8）：e0136841.
[7] Tamagauskiene L，Gasioniene E，Lavinskiene S，et al. Evaluation of vitamin D levels in allergic and non-allergic asthma [J]. Medicina，2015，51（6）：321-327.
[8] Iordanidou M，Paraskakis E，Giasari G，et al. VDR and VDBP polymorphisms are associated with 25（OH）D3 levels in asthmatic children [J]. Eur Respir J，2014，44（Suppl 58）：4211.
[9] Bischoff-Ferrari HA，Dawson-Hughes B，Stöcklin E，et al. Oral supplementation with 25（OH）D3 versus vitamin D３ -effects on 25（OH）D levels，lower extremity function，blood pressure，and markers of innate immunity [J]. J Bone Miner Res，2012，27（1）：160-169.
[10] Riverin BD，Maguire JL，Li P. Vitamin D supplementation for childhood asthma：a systematic review and Meta analysis [J]. PLoS One，2015，10（8）：e0136841.
[11] 中华医学会儿科学分会呼吸学组.《中华儿科杂志》编辑委员会.儿童支气管哮喘诊断与防治指南[J].中华儿科杂志，2008，46（10）：745-753.
[12] Liu AH，Zeiger R，Sorkness C，et al. Development and cross-sectional validation of the Childhood Asthma Control Test [J]. J Allergy Clin Immunol，2007，119（4）：817-825.
[13] 于永锋，李堂.维生素D、维生素D结合蛋白及维生素D受体和儿童哮喘的关系[J].国际儿科学杂志，2015， 42（4）：439-442.
[14] Freishtat RI，Iqbal SF，Pillai DK，et al. High prevalence of vitamin D deficiency among inner-city Aflicall American youth with asthma in Washington，DC [J]. J Pediatr，2010，156（6）：948-952.
[15] Brehm JM，Schuemann B，Fuhlbfigge AL，et al. Serum vitamin D levels and asthma exacerbations in the Childhood Asthma Management Program study [J]. J Allergy Clin lmmtmol，2010，126（1）：52-58.
[16] Cantorna MT，Snyder L，Lin YD，et al. Vitamin D and 1，25（OH）2 D regulation of T cells [J]. Nutrients，2015， 7（4）：3011-3021.
[17] Cantorna MT，Zhao J，Yang L. Vitamin D，invariant natural killer T-cells and experimental autoimmune disease [J]. Proc Nutr Soc，2012，71（1）：62-66.
[18] Gupta A，Bush A，Hawrylowicz C，et al. Vitamin D and asthma in children [J]. Paediatr Respir Rev，2012，13（4）：236-243.
[19] Jiao J，Castro M. Vitamin D and asthma： current perspectives [J]. Curr Opin Allergy Clin Immunol，2015，15（4）：375-382.
[20] Kolokotroni O，Middleton N，Kouta C，et al. Association of Serum Vitamin D with Asthma and Atopy in Childhood： Review of Epidemiological Observational Studies [J]. Mini Rev Med Chem，2015，15（11）：881-899.
[21] Goleva E，Searing DA，Jackson LP，et al. Steroid requirements and immune associations with vitamin D are stronger in children than adults with asthma [J]. J Allergy Clin Immunol，2012，129（5）：1243-1251.
[22] Lambrecht BN，Hammad H. The airway epithelium in asthma [J]. Nat Med，2012，18（5）：684-692.
[23] Paul G，Brehm JM，Alcorn JF，et al. Vitamin D and asthma [J]. Am J Respir Crit Care Med，2012，182（2）：124-132.
[24] Brehm JM，Celedn JC，Soto-Quims ME，et al. Serum vitamin D levels and markers of severity of childhood asthma in costs rica [J]. Am J Respir Crit Care Med，2009， 179（9）：765-771.
[25] 李明，李林旭，王朔，等.噻托溴铵与异丙托溴铵治疗哮喘-慢阻肺重叠综合征效果及对血清TNF-α、IL-6影响的比较[J].疑难病杂志，2017，16（7）：673-677.
[26] 曲书强，仰曙芬，孙岚玲，等.支气管哮喘免疫学发病机理研究[J].国外医学免疫分册，1997，20（2）：102-104.
[27] 白雪，秦光梅，胡红，等.呼出气一氧化氮、外周血嗜酸性粒细胞及血清总IgE在Eos型哮喘诊断中的意义[J].疑难病杂志，2017，16（9）：889-894.
[28] Holgate ST，Roche WR，Church MR. The role of the eosi?鄄nophil in asthma [J]. Am Rev Respir Dis，1991，143（1）：66-75.
[29] 吕燕青，詹平，谷红梅，等.泛福舒胶囊辅治儿童支气管哮喘疗效及其对细胞免疫和炎性因子的影响[J].疑难病杂志，2016，15（11）：1170-1173.
[30] 黄海鹭，任攸兰，吴振英，等.广东地区健康人群和哮喘患者外周血嗜酸细胞阳离子蛋白水平的研究[J].中国实用内科杂志，1997，17（4）：223-224. |
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