Abstract
Vitamin D is one of the thoroughly studied risk factors in the pathogenesis of allergic rhinitis (AR). Low serum level of vitamin D is well documented in the urban population of India. The supplementation policy of vitamin D is not uniform among practitioners. The study aims to assess the impact of vitamin D deficiency on AR & long-term quality of life in perennial AR patients with low vitamin D levels after its supplementation in the urban population. The policy for evaluation of serum level of vitamin D & its supplementation in deficit patients in AR is not uniform in our hospital. The data was extracted from the hospital records & the patients came to OPD in the year 2018–2019. Inclusion criteria were the clinical diagnosis (ARIA guideline) of the perennial form of AR where vitamin D assessment was performed before prescribing treatment & the patients received a complete course of vitamin D as per the recommendation followed in our Institute. The patients received oral antihistaminic & topical steroids based nasal spray and were clubbed together as a control group whereas, in the study group, the patients were pooled together who received vitamin D supplementation along with oral antihistaminic & topical steroids based nasal spray. Pre-treatment & post-treatment (at 8 weeks, 6 months, and 12 months) SNOT-22 scores were obtained from the records. The data were analyzed statistically using repeated measures ANOVA test. The study showed a significant decrease in the SNOT-22 score in both Groups in comparison to pre-treatment scores, but post-treatment group comparison was not found statistically significant at each point of comparison. The scores were found on the lower side in the study group at the initial two evaluation points whereas it was higher at the third point of evaluation. This study showed the additional therapeutic effect of vitamin D supplementation as an adjunct in the treatment of perennial AR patients but the effectiveness of the treatment does not last forever so maintenance therapy is required especially in areas following the Indian lifestyle.
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References
Bousquet J, Van Cauwenberge P, Khaltaev N (2001) Allergic rhinitis and its impact on asthma. J Allergy Clin Immunol 108(5 suppl):S147-334
Maurer M, Zuberbier T (2007) Undertreatment of rhinitis symptoms in Europe: findings from a cross-sectional questionnaire survey. Allergy 62:1057–1063
Bousquet J, Neukirch F, Bousquet PJ et al (2006) Severity and impairment of allergic rhinitis in patients consulting in primary care. J Allergy Clin Immunol 117:158–162
Greiner AN, Hellings PW, Rotiroti G, Scadding GK (2011) Allergic rhinitis. Lancet 378(9809):2112–2122
Restimulia L, Pawarti DR, Ekorini HM (2018) The relationship between serum vitamin D levels with allergic rhinitis incidence and total nasal symptom score in allergic rhinitis patients. Open Access Maced J Med Sci 6(8):1405–1409
Kamen D, Tangpricha V (2010) Vitamin D and molecular actions on the immune system: modulation of innate and autoimmunity. J Mol Med 88:441–450
Mora JR, Iwata M, von Andrian UH (2008) Vitamin effects on the immune system: vitamins A and D take centre stage. Nat Rev Immunol 8:685–698
Aparna P, Muthathal S, Nongkynrih B, Gupta SK (2018) Vitamin D deficiency in India. J Family Med Prim Care 7(2):324–330
Randev S, Kumar P, Guglani V (2018) Vitamin D Supplementation in Childhood - A Review of Guidelines [published correction appears in Indian J Pediatr. 2018 Aug;85(8):712]. Indian J Pediatr 85(3):194–201. https://doi.org/10.1007/s12098-017-2476-0.
Selvarajan S, Gunaseelan V, Anandabaskar N et al (2017) Systematic review on vitamin D level in apparently healthy indian population and analysis of its associated factors. Indian J Endocrinol Metab 21(5):765–775. https://doi.org/10.4103/ijem.IJEM_168_17
Kamboj P, Dwivedi S, Toteja GS (2018) Prevalence of hypovitaminosis D in India & way forward. Indian J Med Res 148(5):548–556. https://doi.org/10.4103/ijmr.IJMR_1807_18
Jung JW, Kim JY, Cho SH et al (2013) Allergic rhinitis and serum 25-hydroxyvitamin D level in Korean adults. Ann Allergy Asthma Immunol 111(5):352–357
Arshi S, Ghalehbaghi B, Kamrava S-K et al (2012) Vitamin D serum levels in allergic rhinitis: any difference from normal population? Asia Pac Allergy 2(1):45–48
Tian HQ, Cheng L (2017) The role of vitamin D in allergic rhinitis. Asia Pac Allergy 7(2):65–73
Cheng HM, Kim S, Park GH, Chang SE, Bang S, Won CH et al (2014) Low vitamin D levels are associated with atopic dermatitis, but not allergic rhinitis, asthma, or IgE sensitization, in the adult Korean population. J Allergy Clin Immunol 133(4):1048–1055
Wjst M, Hypponen E (2007) Vitamin D serum levels and allergic rhinitis. Allergy 62:1085–1086
Yepes-Nuñez JJ, Brożek JL, Fiocchi A et al (2018) Vitamin D supplementation in primary allergy prevention: systematic review of randomized and non-randomized studies. Allergy 73(1):37–49. https://doi.org/10.1111/all.13241
Jerzyńska J, Stelmach W, Rychlik B et al (2018) Clinical and immunological effects of vitamin D supplementation during the pollen season in children with allergic rhinitis. Arch Med Sci 14(1):122–131. https://doi.org/10.5114/aoms.2016.61978
Bakhshaee M, Sharifian M, Esmatinia F, Rasoulian B, Mohebbi M (2019) Therapeutic effect of vitamin D supplementation on allergic rhinitis. Eur Arch Otorhinolaryngol 276(10):2797–2801. https://doi.org/10.1007/s00405-019-05546-x
Modh D, Katarkar A, Jain A et al (2014) Role of vitamin D supplementation in Allergic rhinitis. Indian J Allergy Asthma Immunol 28:35–39
Bhardwaj B, Singh J (2021) Efficacy of vitamin D supplementation in allergic rhinitis. Indian J Otolaryngol Head Neck Surg 73(2):152–159
Bridgeman MB (2017) Overcoming barriers to intranasal corticosteroid use in patients with uncontrolled allergic rhinitis. Integr Pharm Res Pract 6:109–119. Published 2017 May 4. doi:https://doi.org/10.2147/IPRP.S129544
Lipworth B, Newton J, Ram B, Small I, Schwarze J (2017) An algorithm recommendation for the pharmacological management of allergic rhinitis in the UK: a consensus statement from an expert panel. NPJ Prim Care Respir Med. 27(1):3. Published 2017 Jan 23. doi:https://doi.org/10.1038/s41533-016-0001-y.
Holick MF, Binkley NC, Bischoff-Ferrari HA, Gordon CM, Hanley DA, Heaney RP, Murad MH, Weaver CM (2011) Endocrine Society. Evaluation, treatment, and prevention of vitamin D deficiency: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 96(7):1911–30. doi: https://doi.org/10.1210/jc.2011-0385. Epub 2011 Jun 6. Erratum in: J Clin Endocrinol Metab. 2011 Dec;96(12):3908. PMID: 21646368
Brożek JL, Bousquet J, Agache I et al (2017) Allergic rhinitis and its impact on asthma (ARIA) guidelines-2016 revision. J Allergy Clin Immunol 140(4):950–958. https://doi.org/10.1016/j.jaci.2017.03.050
Bener A, Ehlayel MS, Bener HZ, Hamid Q (2014) The impact of Vitamin D deficiency on asthma, allergic rhinitis and wheezing in children: an emerging public health problem. J Fam Community Med 21:154–161
Scadding GK, Kariyawasam HH, Scadding G, et al (2017) BSACI guideline for the diagnosis and management of allergic and non-allergic rhinitis (Revised Edition 2017; First edition 2007). Clin Exp Allergy. 47(7):856–889. https://doi.org/10.1111/cea.12953.
Majak P, Olszowiec-Chlebna M, Smejda K, Stelmach I (2011) Vitamin D supplementation in children may prevent asthma exacerbation triggered by acute respiratory infection. J Allergy Clin Immunol 127:1294–1296
Li-Ng M, Aloia JF, Pollack S et al (2009) A randomized controlled trial of vitamin D3 supplementation for the prevention of symptomatic upper respiratory tract infections. Epidemiol Infect 137:1396–1404
Chen B, Qu S, Li M, Ye L, Zhang S, Qin T, Fan H (2017) Effects of 1,25-dihydroxyvitamin D3 in an ovalbumin-induced allergic rhinitis model. Int Immunopharmacol 47:182–189
Xystrakis E, Kusumakar S, Boswell S, Peek E, Urry Z, Richards DF et al (2006) Reversing the defective induction of IL-10-secreting regulatory T cells in glucocorticoidresistant asthma patients. J Clin Invest 116:146–155
Yawn J, Lawrence LA, Carroll WW, Mulligan JK (2015) Vitamin D for the treatment of respiratory diseases: Is it the end or just the beginning? J Steroid Biochem Mol Biol 148:326–337
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Shrestha, P., Kaur, J., Gupta, Y. et al. The Long-Term Effect of Vitamin D Supplementation on Quality of Life in Persistent (Perennial) Allergic Rhinitis Patients. Indian J Otolaryngol Head Neck Surg 74, 212–216 (2022). https://doi.org/10.1007/s12070-021-02938-6
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DOI: https://doi.org/10.1007/s12070-021-02938-6