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Yao N, Ma C, Dou R, Shen C, Yuan Y, Li W, Qu J. Exploring the link between vitamin D deficiency and obstructive sleep apnea: A comprehensive review. J Sleep Res 2024:e14166. [PMID: 38414320 DOI: 10.1111/jsr.14166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2023] [Revised: 01/20/2024] [Accepted: 01/23/2024] [Indexed: 02/29/2024]
Abstract
Despite the high prevalence and significant health burden of obstructive sleep apnea (OSA), its underlying pathophysiology remains incompletely understood. This comprehensive review explores the emerging connection between vitamin D deficiency and OSA, discusses potential mechanisms underlying this association, and explores the therapeutic implications of these findings. Recent research has consistently highlighted the high incidence of vitamin D deficiency among patients with OSA, which often occurs independently of geographical location. This suggests that factors beyond lack of sunlight exposure may be involved. This review also discusses how reduced vitamin D may be associated with more severe manifestations of OSA. In addition, it explores the potentiality of using vitamin D supplements as a therapeutic strategy for OSA, noting that some studies have found improvements in sleep quality and a reduction in OSA severity. Potential mechanisms are proposed, including the role of vitamin D deficiency in promoting inflammation, oxidative stress, hypoxia, impairing immune function, muscle function, and gene polymorphism of vitamin D receptors, all of which could contribute to the pathogenesis of obstructive sleep apnea. The paper underscores the need for future research to validate these observations, to determine optimal vitamin D supplementation dosage and duration, to explore potential side effects and risks, and to investigate potential interactions with other treatments.
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Affiliation(s)
- Nan Yao
- Department of General Surgery, Aerospace Center Hospital, Beijing, China
| | - Chenyuan Ma
- Department of Emergency, Gansu Provincial People's Hospital, Gansu, China
| | - Ruixue Dou
- Department of Ultrasound, Aerospace Center Hospital, Beijing, China
| | - Chao Shen
- Department of Gastrointestinal, Peking University International Hospital, Beijing, China
| | - Ye Yuan
- Department of Neurosurgery, People's Hospital of Chiping District, Liaocheng, China
| | - Wei Li
- Department of Gastrointestinal, Peking University International Hospital, Beijing, China
| | - Jun Qu
- Department of General Surgery, Aerospace Center Hospital, Beijing, China
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Paramonova N, Trapina I, Gradauskiene (Sitkauskiene) B, Plavina S, Tamasauskiene L, Bastyte D, Rumba-Rozenfelde I, Tapina S, Stakaitiene I, Ugenskiene R, Shih-Hsin Wu L, Wang JY, Hsieh MH, Chen PC, Sjakste N. Genetic Diversity in Bronchial Asthma Susceptibility: Exploring the Role of Vitamin D Receptor Gene Polymorphisms in Varied Geographic Contexts. Int J Mol Sci 2024; 25:1943. [PMID: 38339221 PMCID: PMC10856277 DOI: 10.3390/ijms25031943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Revised: 01/18/2024] [Accepted: 01/28/2024] [Indexed: 02/12/2024] Open
Abstract
Bronchial asthma (BA) exhibits varying prevalence across global populations, prompting a comprehensive investigation into genetic and environmental determinants. Vitamin D is a potent immunomodulator capable of suppressing inflammatory signals in several cell types involved in the asthmatic response; it exerts effects on the immune system by binding to the nuclear vitamin D receptor (VDR). VDR gene genetic variations are affecting serum vitamin D levels with a possible role in the BA risk. The current study aimed to examine the complex interaction of various factors (genetic background, serum vitamin D levels, and geographic location) to identify differences in the influence of these factors on the susceptibility to asthma between populations at different latitudes. Focusing on Eastern European cohorts from Latvia and Lithuania and comparing them with published data on East Asian populations, we explore the impact of VDR gene polymorphisms on BA susceptibility. Genotyping four key VDR SNPs and assessing their association with 25-hydroxyvitamin D levels, our study unveils significant associations of the studied loci with the risk of asthma-both risk-reducing and increasing effects, differently distributed between Baltic and East Asian populations. The functional effects of in silico VDR gene genetic variations are also identified and discussed.
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Affiliation(s)
- Natalia Paramonova
- Laboratory of Genomics and Bioinformatics, Institute of Biology, University of Latvia, LV-1004 Riga, Latvia; (N.P.); (S.P.); (N.S.)
| | - Ilva Trapina
- Laboratory of Genomics and Bioinformatics, Institute of Biology, University of Latvia, LV-1004 Riga, Latvia; (N.P.); (S.P.); (N.S.)
| | | | - Samanta Plavina
- Laboratory of Genomics and Bioinformatics, Institute of Biology, University of Latvia, LV-1004 Riga, Latvia; (N.P.); (S.P.); (N.S.)
| | - Laura Tamasauskiene
- Department of Immunology and Allergology, Lithuanian University of Health Sciences, LT-50161 Kaunas, Lithuania (L.T.); (D.B.)
| | - Daina Bastyte
- Department of Immunology and Allergology, Lithuanian University of Health Sciences, LT-50161 Kaunas, Lithuania (L.T.); (D.B.)
| | | | - Sandra Tapina
- Faculty of Medicine, University of Latvia, LV-1586 Riga, Latvia; (I.R.-R.); (S.T.)
| | - Ieva Stakaitiene
- Department of Genetics and Molecular Medicine, Lithuanian University of Health Sciences, LT-50161 Kaunas, Lithuania; (I.S.); (R.U.)
| | - Rasa Ugenskiene
- Department of Genetics and Molecular Medicine, Lithuanian University of Health Sciences, LT-50161 Kaunas, Lithuania; (I.S.); (R.U.)
| | - Lawrence Shih-Hsin Wu
- Graduate Institute of Biomedical Sciences, China Medical University, Taichung 406040, Taiwan;
- Research Center of Allergy, Immunology, and Microbiome (AIM), China Medical University Hospital, Taichung 404327, Taiwan; (J.-Y.W.); (M.-H.H.); (P.-C.C.)
| | - Jiu-Yao Wang
- Research Center of Allergy, Immunology, and Microbiome (AIM), China Medical University Hospital, Taichung 404327, Taiwan; (J.-Y.W.); (M.-H.H.); (P.-C.C.)
- Department of Allergy and Immunology, China Medical University Children’s Hospital, Taichung 404327, Taiwan
| | - Miao-Hsi Hsieh
- Research Center of Allergy, Immunology, and Microbiome (AIM), China Medical University Hospital, Taichung 404327, Taiwan; (J.-Y.W.); (M.-H.H.); (P.-C.C.)
| | - Pei-Chi Chen
- Research Center of Allergy, Immunology, and Microbiome (AIM), China Medical University Hospital, Taichung 404327, Taiwan; (J.-Y.W.); (M.-H.H.); (P.-C.C.)
| | - Nikolajs Sjakste
- Laboratory of Genomics and Bioinformatics, Institute of Biology, University of Latvia, LV-1004 Riga, Latvia; (N.P.); (S.P.); (N.S.)
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Ashok N, Saraswathy R. Association of polymorphisms of vitamin D gene in children with asthma and allergic rhinitis - Hospital based study. Heliyon 2024; 10:e23673. [PMID: 38223709 PMCID: PMC10784161 DOI: 10.1016/j.heliyon.2023.e23673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 11/24/2023] [Accepted: 12/09/2023] [Indexed: 01/16/2024] Open
Abstract
Vitamin D gene polymorphisms are known to be associated with asthma and allergic rhinitis in children. However, the genetic association of the same in South Indian children with above condition is still unknown. The present study was designed with the objective to analyze the association of polymorphisms of vitamin D receptor gene (VDR) (rs797532, rs154410, rs2258470, rs731236) and transport gene of vitamin D (rs7041) in children with asthma and allergic rhinitis in South India. Children (1-18years) presenting with symptoms suggestive of asthma and allergic rhinitis to hospital based outpatient department, in Vellore, South India were recruited as cases and children presenting with minor illness without respiratory complaints were enrolled as controls during January 2018 to September 2021. Polymorphisms were genotyped using tetra-arms PCR. Significant increase in levels of absolute eosinophil counts and serum IgE levels with decrease in vitamin D levels was seen among the cases. Significant association between levels of vitamin D and serum IgE was also observed. Analysis of polymorphisms showed that, in comparison to homozygous major allele the odds of having heterozygous (OR0.55 (0.3, 0.99) and homozygous minor form (OR0.52 (0.28, 0.97) of rs7975232, homozygous minor (OR 0.51 (0.34, 0.76)) and alternate allele (OR 0.7 (0.53, 0.93)) of rs154410 and homozygous minor form (OR 0.57 (0.37, 0.88) of rs731236 was significantly lesser among the cases. Genotypic model of rs154410 (p0.023) and allele form of rs7041 (p 0.041) were significantly associated with vitamin D levels however no association of gene blocks with cases was seen in haplotype analysis. There was an apparent gene pool difference noted in comparative analysis between Indian studies. The study is the first in south India to analyze levels of serum IgE, Vitamin D levels, association of VDR polymorphisms, and rs7041 in children with asthma.
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Affiliation(s)
- Narmada Ashok
- Department of School of Biosciences and Technology, Vellore Institute of Technology, Vellore, India
| | - Radha Saraswathy
- Department of School of Biosciences and Technology, Vellore Institute of Technology, Vellore, India
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Ashok N, Kirubakaran R, Saraswathy R. Association of vitamin D gene polymorphisms in children with asthma - A systematic review. Heliyon 2020; 6:e04795. [PMID: 32939414 PMCID: PMC7479342 DOI: 10.1016/j.heliyon.2020.e04795] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Revised: 06/23/2020] [Accepted: 08/24/2020] [Indexed: 11/30/2022] Open
Abstract
INTRODUCTION The association of Vitamin D and children with asthma is known and there are several individual studies on Vitamin D polymorphisms. However, systematic reviews on all vitamin D associated gene polymorphisms have not been done in children with asthma. OBJECTIVE To investigate the association of Vitamin D associated gene polymorphisms and asthma in children (0-18 years) by systematic review and meta-analytic approach. METHODS Our search included 20 full text articles of which 15 were case control studies and 5 used family based linkage disequilibrium method. Total of 2491cases and 3682 controls were included in case control studies, with mean age of 9.58 years and 10.16 years respectively. Quantitative and qualitative analysis were done. RESULTS Quantitative analysis revealed significant association with protective effect of Apa1 polymorphism in allele (OR 0.81 (0.71,0.91) and homozygous major form (OR 0.83 (0.70,0.98) and Taq 1 minor allele in homozygous form (OR 0.73 (0.58,0.92) in children with asthma. However, the minor allele of Apa1(OR 1.21 (1.07,1.37), Bsm 1 in heterozygous (OR 1.35 (1.07,1.71) and homozygous minor form (OR 1.95 (1.59,2.39), major allele of Fok1(OR1.34 (1.17,1.52) and Taq1 (OR 1.22 (1.08,1.38) were found to be increasing the odds of asthma. Ethnic variations were noted in subgroup analysis. Qualitative analysis of the polymorphisms of the Vitamin D associated metabolic genes also showed significant associations. CONCLUSION Our review shows significant associations with VDR polymorphisms - Apa1, Bsm1, Fok 1, Taq 1, polymorphisms of Vitamin D metabolic genes - CYP27A1, CYP 2R1, CYP 24A1, GC and genes related to Vitamin D response element (VDRE) in children with asthma. Conducting large studies involving various ethnic regions will strengthen our knowledge on the association and aid in targeted interventions for control of asthma in children.
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Affiliation(s)
- Narmada Ashok
- School of Biosciences & Technology, VIT University, Vellore
- Nalam Medical Centre & Hospital, Vellore
| | | | - Radha Saraswathy
- 120TT Biomedical Genetics Research Lab (BMGRL), Dept of Biomedical Sciences, School of Biosciences & Technology, VIT University 632014, Vellore
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Amo G, Martí M, García-Menaya JM, Cordobés C, Cornejo-García JA, Blanca-López N, Canto G, Doña I, Blanca M, Torres MJ, Agúndez JAG, García-Martín E. Identification of Novel Biomarkers for Drug Hypersensitivity After Sequencing of the Promoter Area in 16 Genes of the Vitamin D Pathway and the High-Affinity IgE Receptor. Front Genet 2019; 10:582. [PMID: 31293618 PMCID: PMC6603231 DOI: 10.3389/fgene.2019.00582] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Accepted: 06/04/2019] [Indexed: 12/16/2022] Open
Abstract
The prevalence of allergic diseases and drug hypersensitivity reactions (DHRs) during recent years is increasing. Both, allergic diseases and DHRs seem to be related to an interplay between environmental factors and genetic susceptibility. In recent years, a large effort in the elucidation of the genetic mechanisms involved in these disorders has been made, mostly based on case-control studies, and typically focusing on isolated SNPs. These studies provide a limited amount of information, which now can be greatly expanded by the complete coverage that Next Generation Sequencing techniques offer. In this study, we analyzed the promoters of sixteen genes related to the Vitamin D pathway and the high-affinity IgE receptor, including FCER1A, MS4A2, FCER1G, VDR, GC, CYP2R1, CYP27A1, CYP27B1, CYP24A1, RXRA, RXRB, RXRG, IL4, IL4R, IL13, and IL13RA1. The study group was composed of patients with allergic rhinitis plus asthma (AR+A), patients with hypersensitivity to beta-lactams (BLs), to NSAIDs including selective hypersensitivity (SH) and cross-reactivity (CR), and healthy controls without antecedents of atopy or adverse drug reactions. We identified 148 gene variations, 43 of which were novel. Multinomial analyses revealed that three SNPs corresponding to the genes FCER1G (rs36233990 and rs2070901), and GC (rs3733359), displayed significant associations and, therefore, were selected for a combined dataset study in a cohort of 2,476 individuals. The strongest association was found with the promoter FCER1G rs36233990 SNP that alters a transcription factor binding site. This SNP was over-represented among AR+A patients and among patients with IgE-mediated diseases, as compared with control individuals or with the rest of patients in this study. Classification models based on the above-mentioned SNPs were able to predict correct clinical group allocations in patients with DHRs, and patients with IgE-mediated DHRs. Our findings reveal gene promoter SNPs that are significant predictors of drug hypersensitivity, thus reinforcing the hypothesis of a genetic predisposition for these diseases.
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Affiliation(s)
- Gemma Amo
- University Institute of Molecular Pathology Biomarkers, UEx, Cáceres, Spain.,ARADyAL Instituto de Salud Carlos III, Cáceres, Spain
| | - Manuel Martí
- University Institute of Molecular Pathology Biomarkers, UEx, Cáceres, Spain.,ARADyAL Instituto de Salud Carlos III, Cáceres, Spain
| | - Jesús M García-Menaya
- Allergy Service, Badajoz University Hospital, Badajoz, Spain.,ARADyAL Instituto de Salud Carlos III, Badajoz, Spain
| | - Concepción Cordobés
- Allergy Service, Mérida Hospital, Badajoz, Spain.,ARADyAL Instituto de Salud Carlos III, Cáceres, Spain
| | - José A Cornejo-García
- Research Laboratory, IBIMA, Regional University Hospital of Málaga, UMA, Málaga, Spain.,ARADyAL Instituto de Salud Carlos III, Cáceres, Spain
| | - Natalia Blanca-López
- Allergy Service, Infanta Leonor University Hospital, Madrid, Spain.,ARADyAL Instituto de Salud Carlos III, Madrid, Spain
| | - Gabriela Canto
- Allergy Service, Infanta Leonor University Hospital, Madrid, Spain.,ARADyAL Instituto de Salud Carlos III, Madrid, Spain
| | - Inmaculada Doña
- Allergy Unit, IBIMA, Regional University Hospital of Málaga, UMA, Málaga, Spain.,ARADyAL Instituto de Salud Carlos III, Málaga, Spain
| | - Miguel Blanca
- Allergy Service, Infanta Leonor University Hospital, Madrid, Spain.,ARADyAL Instituto de Salud Carlos III, Madrid, Spain
| | - María José Torres
- Allergy Unit, IBIMA, Regional University Hospital of Málaga, UMA, Málaga, Spain.,ARADyAL Instituto de Salud Carlos III, Málaga, Spain
| | - José A G Agúndez
- University Institute of Molecular Pathology Biomarkers, UEx, Cáceres, Spain.,ARADyAL Instituto de Salud Carlos III, Cáceres, Spain
| | - Elena García-Martín
- University Institute of Molecular Pathology Biomarkers, UEx, Cáceres, Spain.,ARADyAL Instituto de Salud Carlos III, Cáceres, Spain
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6
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Eigenmann P. Editorial comments on this issue of the Journal. Pediatr Allergy Immunol 2018. [PMID: 29532579 DOI: 10.1111/pai.12891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Batmaz SB, Arikoglu T, Uyar N, Barlas IÖ, Kuyucu S. The Effect of Vitamin D Pathway Genes on Asthma Susceptibility, Asthma Control and Vitamin D Levels in Turkish Asthmatic Children. INT J HUM GENET 2017. [DOI: 10.1080/09723757.2017.1351128] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Affiliation(s)
- Sehra Birgül Batmaz
- Department of Pediatric Allergy and Immunology, Tokat State Hospital, 60100, Tokat, Turkey
| | - Tugba Arikoglu
- Department of Pediatric Allergy and Immunology, Faculty of Medicine, Mersin University, 33110, Mersin, Turkey
| | - Nisa Uyar
- Department of Medical Biology and Genetics, Faculty of Medicine, Mersin University, 33110, Mersin, Turkey
| | - Ibrahim Ömer Barlas
- Department of Medical Biology and Genetics, Faculty of Medicine, Mersin University, 33110, Mersin, Turkey
| | - Semanur Kuyucu
- Department of Pediatric Allergy and Immunology, Faculty of Medicine, Mersin University, 33110, Mersin, Turkey
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Vitamin D levels and susceptibility to asthma, elevated immunoglobulin E levels, and atopic dermatitis: A Mendelian randomization study. PLoS Med 2017; 14:e1002294. [PMID: 28486474 PMCID: PMC5423551 DOI: 10.1371/journal.pmed.1002294] [Citation(s) in RCA: 64] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2016] [Accepted: 03/27/2017] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Low circulating vitamin D levels have been associated with risk of asthma, atopic dermatitis, and elevated total immunoglobulin E (IgE). These epidemiological associations, if true, would have public health importance, since vitamin D insufficiency is common and correctable. METHODS AND FINDINGS We aimed to test whether genetically lowered vitamin D levels were associated with risk of asthma, atopic dermatitis, or elevated serum IgE levels, using Mendelian randomization (MR) methodology to control bias owing to confounding and reverse causation. The study employed data from the UK Biobank resource and from the SUNLIGHT, GABRIEL and EAGLE eczema consortia. Using four single-nucleotide polymorphisms (SNPs) strongly associated with 25-hydroxyvitamin D (25OHD) levels in 33,996 individuals, we conducted MR studies to estimate the effect of lowered 25OHD on the risk of asthma (n = 146,761), childhood onset asthma (n = 15,008), atopic dermatitis (n = 40,835), and elevated IgE level (n = 12,853) and tested MR assumptions in sensitivity analyses. None of the four 25OHD-lowering alleles were associated with asthma, atopic dermatitis, or elevated IgE levels (p ≥ 0.2). The MR odds ratio per standard deviation decrease in log-transformed 25OHD was 1.03 (95% confidence interval [CI] 0.90-1.19, p = 0.63) for asthma, 0.95 (95% CI 0.69-1.31, p = 0.76) for childhood-onset asthma, and 1.12 (95% CI 0.92-1.37, p = 0.27) for atopic dermatitis, and the effect size on log-transformed IgE levels was -0.40 (95% CI -1.65 to 0.85, p = 0.54). These results persisted in sensitivity analyses assessing population stratification and pleiotropy and vitamin D synthesis and metabolism pathways. The main limitations of this study are that the findings do not exclude an association between the studied outcomes and 1,25-dihydoxyvitamin D, the active form of vitamin D, the study was underpowered to detect effects smaller than an OR of 1.33 for childhood asthma, and the analyses were restricted to white populations of European ancestry. This research has been conducted using the UK Biobank Resource and data from the SUNLIGHT, GABRIEL and EAGLE Eczema consortia. CONCLUSIONS In this study, we found no evidence that genetically determined reduction in 25OHD levels conferred an increased risk of asthma, atopic dermatitis, or elevated total serum IgE, suggesting that efforts to increase vitamin D are unlikely to reduce risks of atopic disease.
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James J, Weaver V, Cantorna MT. Control of Circulating IgE by the Vitamin D Receptor In Vivo Involves B Cell Intrinsic and Extrinsic Mechanisms. THE JOURNAL OF IMMUNOLOGY 2016; 198:1164-1171. [PMID: 28003380 DOI: 10.4049/jimmunol.1601213] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Received: 07/12/2016] [Accepted: 11/20/2016] [Indexed: 11/19/2022]
Abstract
Vitamin D deficiency is associated with the development of asthma and allergy. The active form of vitamin D [1,25(OH)2D] regulates B cells in vitro and mice without the vitamin D receptor (VDR knockout [KO]) have high serum IgE. Whole-body VDR KO, T cell-specific VDR (T-VDR) KO, B cell-specific VDR (B-VDR) KO, and vitamin D deficient mice were used to determine the targets of vitamin D in the regulation of IgE in vivo. Vitamin D deficient, VDR KO, and B-VDR KO mice developed hyper-IgE, whereas T-VDR KO mice did not. The data show that IL-10 secretion by B cells and CD1d expression on IL-10 secreting B cells was lower in VDR KO mice. Mesenteric lymph node cultures from VDR KO and B-VDR KO mice secreted higher IgE ex vivo than wild-type (WT) cultures, and the addition of IL-10 eliminated the difference in IgE production between VDR KO and WT cultures. The increase in IgE in VDR KO mice was 2-fold greater than in the B-VDR KO mice, suggesting that VDR deficiency in non-B cells contributes to hyper-IgE in vivo. Antibiotic depletion of the microbiota raised serum IgE 4-fold in both WT and VDR KO mice. The VDR directly and indirectly regulates IgE production in B cells. Through the VDR, vitamin D is an environmental factor that helps to maintain low serum IgE responses.
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Affiliation(s)
- Jamaal James
- Department of Veterinary and Biomedical Science, Pennsylvania State University, University Park, PA 16802.,Molecular Medicine Graduate Program, Pennsylvania State University, University Park, PA 16802; and
| | - Veronika Weaver
- Department of Veterinary and Biomedical Science, Pennsylvania State University, University Park, PA 16802
| | - Margherita T Cantorna
- Department of Veterinary and Biomedical Science, Pennsylvania State University, University Park, PA 16802; .,Center for Molecular Immunology and Infectious Disease, Pennsylvania State University, University Park, PA 16802
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Mastrorilli C, Posa D, Cipriani F, Caffarelli C. Asthma and allergic rhinitis in childhood: what's new. Pediatr Allergy Immunol 2016; 27:795-803. [PMID: 27862336 DOI: 10.1111/pai.12681] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/07/2016] [Indexed: 12/23/2022]
Abstract
Novel approaches are currently offered for the diagnostic workup and therapeutic management of allergic rhinitis and asthma. New predictive biomarkers of allergy and asthma are available. Primary and secondary prevention, earlier intervention, and modification of the natural history of allergic rhinitis and asthma are being intensively investigated. This review highlights advances in the understanding of the etiology, diagnosis, and management of atopic airway diseases in childhood, as well as prenatal and early-life risk factors and strategies for prevention.
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Affiliation(s)
- Carla Mastrorilli
- Pediatric Clinic, Department of Clinical and Experimental Medicine, University of Parma, Parma, Italy.,Department of Pediatric Pneumology and Immunology, Charité Universitätsmedizin, Berlin, Germany
| | - Daniela Posa
- Department of Pediatric Pneumology and Immunology, Charité Universitätsmedizin, Berlin, Germany
| | - Francesca Cipriani
- Pediatric Unit, Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Carlo Caffarelli
- Pediatric Clinic, Department of Clinical and Experimental Medicine, University of Parma, Parma, Italy
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11
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Jolliffe DA, Walton RT, Griffiths CJ, Martineau AR. Single nucleotide polymorphisms in the vitamin D pathway associating with circulating concentrations of vitamin D metabolites and non-skeletal health outcomes: Review of genetic association studies. J Steroid Biochem Mol Biol 2016; 164:18-29. [PMID: 26686945 DOI: 10.1016/j.jsbmb.2015.12.007] [Citation(s) in RCA: 72] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2015] [Revised: 11/03/2015] [Accepted: 12/09/2015] [Indexed: 12/19/2022]
Abstract
Polymorphisms in genes encoding proteins involved in vitamin D metabolism and transport are recognised to influence vitamin D status. Syntheses of genetic association studies linking these variants to non-skeletal health outcomes are lacking. We therefore conducted a literature review to identify reports of statistically significant associations between single nucleotide polymorphisms (SNP) in 11 vitamin D pathway genes (DHCR7, CYP2R1, CYP3A4, CYP27A1, DBP, LRP2, CUB, CYP27B1, CYP24A1, VDR and RXRA) and non-bone health outcomes and circulating levels of 25-hydroxyvitamin D (25[OH]D and 1,25-dihydroxyvitamin D (1,25[OH]2D). A total of 120 genetic association studies reported positive associations, of which 44 investigated determinants of circulating 25(OH)D and/or 1,25(OH)2D concentrations, and 76 investigated determinants of non-skeletal health outcomes. Statistically significant associations were reported for a total of 55 SNP in the 11 genes investigated. There was limited overlap between genetic determinants of vitamin D status and those associated with non-skeletal health outcomes: polymorphisms in DBP, CYP2R1 and DHCR7 were the most frequent to be reported to associate with circulating concentrations of 25(OH)D, while polymorphisms in VDR were most commonly reported to associate with non-skeletal health outcomes, among which infectious and autoimmune diseases were the most represented.
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Affiliation(s)
- David A Jolliffe
- Centre for Primary Care and Public Health, Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London E1 2AB, UK.
| | - Robert T Walton
- Centre for Primary Care and Public Health, Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London E1 2AB, UK
| | - Christopher J Griffiths
- Centre for Primary Care and Public Health, Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London E1 2AB, UK
| | - Adrian R Martineau
- Centre for Primary Care and Public Health, Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London E1 2AB, UK.
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12
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Hollams EM, Teo SM, Kusel M, Holt BJ, Holt KE, Inouye M, De Klerk NH, Zhang G, Sly PD, Hart PH, Holt PG. Vitamin D over the first decade and susceptibility to childhood allergy and asthma. J Allergy Clin Immunol 2016; 139:472-481.e9. [PMID: 27726947 DOI: 10.1016/j.jaci.2016.07.032] [Citation(s) in RCA: 65] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2015] [Revised: 06/29/2016] [Accepted: 07/14/2016] [Indexed: 12/21/2022]
Abstract
BACKGROUND Vitamin D (25(OH)D) deficiency has been implicated as a possible risk factor for asthma development, but studies at selected time points measuring 25(OH)D levels during childhood have yielded conflicting findings. Prospective studies tracking 25(OH)D levels during the initiation phase of asthma in early childhood have not been reported. OBJECTIVE We sought to elucidate relationships between 25(OH)D levels from birth to age 10 years and susceptibility to allergic sensitization, respiratory tract infections, and asthma. METHODS Asthma-, allergy-, and respiratory tract infection-associated phenotypes (including pathogen identification) were characterized in a high-risk birth cohort. Plasma 25(OH)D concentrations were quantified at birth and at clinical follow-ups at the ages of 0.5, 1, 2, 3, 4, 5, and 10 years, and relationships with clinical outcomes were examined. RESULTS Cross-sectional analyses demonstrated inverse associations between 25(OH)D concentrations and the risk for concurrent sensitization at age 0.5, 2, and 3 years, and mixed-effects regression demonstrated inverse longitudinal associations of 25(OH)D levels with both sensitization and eczema. Multivariate regression modeling suggested that the number of 25(OH)D-deficient follow-ups was positively associated with risk for asthma/wheeze, eczema, and sensitization at 10 years; adjustment for sensitization (particularly by 2 years) in the asthma/wheeze models reduced 25(OH)D associations with these latter outcomes. 25(OH)D levels were also inversely associated with early nasopharyngeal colonization with Streptococcus species and age of first febrile lower respiratory illness, both of which are known asthma risk factors. CONCLUSION 25(OH)D deficiency in early childhood is associated with increased risk for persistent asthma, potentially through modulating susceptibility to early allergic sensitization, upper respiratory tract colonization with bacterial pathogens, or both. These relationships are only evident if 25(OH)D status is monitored prospectively and longitudinally.
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Affiliation(s)
- Elysia M Hollams
- Telethon Kids Institute, University of Western Australia, Perth, Australia
| | - Shu Mei Teo
- Centre for Systems Genomics, University of Melbourne, Melbourne, Australia; Department of Biochemistry and Molecular Biology, Bio21 Molecular Science and Biotechnology Institute, University of Melbourne, Melbourne, Australia; School of BioSciences, University of Melbourne, Melbourne, Australia
| | - Merci Kusel
- Telethon Kids Institute, University of Western Australia, Perth, Australia
| | - Barbara J Holt
- Telethon Kids Institute, University of Western Australia, Perth, Australia
| | - Kathryn E Holt
- Centre for Systems Genomics, University of Melbourne, Melbourne, Australia; Department of Biochemistry and Molecular Biology, Bio21 Molecular Science and Biotechnology Institute, University of Melbourne, Melbourne, Australia
| | - Michael Inouye
- Centre for Systems Genomics, University of Melbourne, Melbourne, Australia; School of BioSciences, University of Melbourne, Melbourne, Australia
| | | | - Guicheng Zhang
- School of Public Health, Curtin University, Perth, Australia
| | - Peter D Sly
- University of Queensland, Brisbane, Australia
| | - Prue H Hart
- Telethon Kids Institute, University of Western Australia, Perth, Australia
| | - Patrick G Holt
- Telethon Kids Institute, University of Western Australia, Perth, Australia; University of Queensland, Brisbane, Australia.
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Hejazi ME, Modarresi-Ghazani F, Entezari-Maleki T. A review of Vitamin D effects on common respiratory diseases: Asthma, chronic obstructive pulmonary disease, and tuberculosis. J Res Pharm Pract 2016; 5:7-15. [PMID: 26985430 PMCID: PMC4776550 DOI: 10.4103/2279-042x.176542] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Despite the classic role of Vitamin D in skeletal health, new aspects of Vitamin D have been discovered in tissues and organs other than bones. Epidemiological and observational studies demonstrate a link between Vitamin D deficiency and risk of developing respiratory diseases including asthma, chronic obstructive pulmonary disease (COPD), and tuberculosis (TB). To review the literature, we searched the terms "Vitamin D" (using the set operator) and "asthma," "COPD" and "TB" in electronic databases, including PubMed/MEDLINE, Scopus, and Google Scholar until July 2015. Non-English articles or articles with unavailable full text were excluded. Both in vivo and in vitro studies were included. All the reviewed articles state that Vitamin D deficiency is very common among patients with respiratory diseases. The present data regarding Vitamin D and asthma is still controversial, but data about COPD and TB are more encouraging. The relevant studies have been conducted in different populations therefore it is not particularly possible to compare the data due to genetic variations. In order to point out a role for Vitamin D, large clinical trials with Vitamin D deficient subjects and sufficient Vitamin D supplementation are needed.
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Affiliation(s)
- Mohammad Esmaeil Hejazi
- Tuberculosis and Lung Disease Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
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