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Vitamin D and Respiratory Diseases

Based on 11th Dr. I. C. Verma Excellence in Research Award for Young Pediatricians Delivered as Oration on 15th Oct. 2023

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Abstract

The significance of Vitamin D has been appreciated beyond bone health and calcium metabolism. The importance of Vitamin D in respiratory health has been recognized due to its immunomodulatory and anti-microbial properties. The hypothesis is that Vitamin D could have a significant role in the pathogenesis of respiratory diseases and may represent a novel preventive and therapeutic strategy. Furthermore, enumerable observational studies established the association of Vitamin D deficiency with respiratory diseases such as asthma, bronchiolitis, pneumonia, tuberculosis, etc. However, experimental studies have not shown the encouraging results. This brief review will summarize and discuss the synthesis and metabolism of Vitamin D, the prevalence of Vitamin D deficiency in children, its role in the pathogenesis of various childhood respiratory diseases, and an overview of the therapeutic trials assessing the role of Vitamin D supplementation in childhood respiratory diseases.

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References

  1. Gallagher JC, Rosen CJ, Vitamin D. 100 years of discoveries, yet controversy continues. Lancet Diabetes Endocrinol. 2023;11:362–74.

    Article  CAS  PubMed  Google Scholar 

  2. Christakos S, Dhawan P, Verstuyf A, Verlinden L, Carmeliet G. Vitamin D: metabolism, molecular mechanism of action, and pleiotropic effects. Physiol Rev. 2016;96:365–408.

    Article  CAS  PubMed  Google Scholar 

  3. Bouillon R, Schuit F, Antonio L, Rastinejad F. Vitamin D binding protein: a historic overview. Front Endocrinol (Lausanne). 2020;10:910.

    Article  PubMed  Google Scholar 

  4. Amrein K, Scherkl M, Hoffmann M, et al. Vitamin D deficiency 2.0: an update on the current status worldwide. Eur J Clin Nutr. 2020;74:1498–513.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  5. Gupta P, Dabas A, Seth A, et al. Indian Academy of pediatrics revised (2021) guidelines on prevention and treatment of vitamin D deficiency and rickets. Indian Pediatr. 2022;59:142–58.

    Article  PubMed  Google Scholar 

  6. Khadilkar A, Kajale N, Oza C, et al. Vitamin D status and determinants in Indian children and adolescents: a multicentre study. Sci Rep. 2022;12:16790.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  7. Sandhu MS, Casale TB. The role of vitamin D in Asthma. Ann Allergy Asthma Immunol. 2010;105:191–9.

    Article  CAS  PubMed  Google Scholar 

  8. Rana G, Abraham RA, Sachdev HS, et al. Prevalence and correlates of vitamin D deficiency among children and adolescents from a nationally representative survey in India. Indian Pediatr. 2023;60:202–6.

    Article  PubMed  Google Scholar 

  9. Wang YH, Wills-Karp M. The potential role of interleukin-17 in severe Asthma. Curr Allergy Asthma Rep. 2011;11:388–94.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  10. Rode AKO, Kongsbak M, Hansen MM, et al. Vitamin D counteracts Mycobacterium tuberculosis-induced cathelicidin downregulation in dendritic cells and allows Th1 differentiation and IFNγ secretion. Front Immunol. 2017;8:656.

    Article  PubMed  PubMed Central  Google Scholar 

  11. Jat KR, Khairwa A. Vitamin D and Asthma in children: a systematic review and meta-analysis of observational studies. Lung India. 2017;34:355–63.

    Article  PubMed  PubMed Central  Google Scholar 

  12. Liu J, Dong Y, Yin J, et al. Meta-analysis of vitamin D and lung function in patients with Asthma. Respir Res. 2019;20:161.

    Article  PubMed  PubMed Central  Google Scholar 

  13. Fares MM, Alkhaled LH, Mroueh SM, Akl EA. Vitamin D supplementation in children with Asthma: a systematic review and meta-analysis. BMC Res Notes. 2015;8:23.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Riverin BD, Maguire JL, Li P. Vitamin D supplementation for childhood Asthma: a systematic review and meta-analysis. PLoS ONE. 2015;10:e0136841.

    Article  PubMed  PubMed Central  Google Scholar 

  15. Jolliffe DA, Greenberg L, Hooper RL, et al. Vitamin D supplementation to prevent asthma exacerbations: a systematic review and meta-analysis of individual participant data [published correction appears in Lancet Respir Med. 2018;6:e27]. Lancet Respir Med. 2017;5:881–90.

  16. Forno E, Bacharier LB, Phipatanakul W, et al. Effect of vitamin D3 supplementation on severe Asthma exacerbations in children with Asthma and low vitamin D levels: the VDKA randomized clinical trial. JAMA. 2020;324:752–60.

    Article  CAS  PubMed  Google Scholar 

  17. Jat KR, Goel N, Gupta N, et al. Efficacy of vitamin D supplementation in asthmatic children with vitamin D deficiency: a randomized controlled trial (ESDAC trial). Pediatr Allergy Immunol. 2021;32:479–88.

    Article  CAS  PubMed  Google Scholar 

  18. Thakur C, Kumar J, Kumar P, et al. Vitamin-D supplementation as an adjunct to standard treatment of Asthma in children: a randomized controlled trial (ViDASTA Trial). Pediatr Pulmonol. 2021;56:1427–33.

    Article  PubMed  Google Scholar 

  19. Kumar J, Kumar P, Goyal JP, et al. Vitamin D supplementation in childhood Asthma: a systematic review and meta-analysis of randomized controlled trials. ERJ Open Res. 2021;8:00662–2021.

    PubMed  PubMed Central  Google Scholar 

  20. Williamson A, Martineau AR, Sheikh A, Jolliffe D, Griffiths CJ. Vitamin D for the management of Asthma. Cochrane Database Syst Rev. 2023;2:CD011511.

    PubMed  Google Scholar 

  21. Golan-Tripto I, Loewenthal N, Tal A, et al. Vitamin D deficiency in children with acute bronchiolitis: a prospective cross-sectional case- control study. BMC Pediatr. 2021;21:211.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  22. Estalella-Mendoza A, Castellano-Martínez A, Flores-González JC, et al. Vitamin D levels and cardiopulmonary status in infants with acute bronchiolitis. Indian Pediatr. 2022;59:384–7.

    Article  PubMed  Google Scholar 

  23. Alakaş Y, Celiloğlu C, Tolunay O, Matyar S. The relationship between bronchiolitis severity and vitamin D status. J Trop Pediatr. 2021;67:fmab081.

    Article  PubMed  Google Scholar 

  24. Beigelman A, Castro M, Schweiger TL, et al. Vitamin D levels are unrelated to the severity of respiratory syncytial virus bronchiolitis among hospitalized infants. J Pediatr Infect Dis Soc. 2015;4:182–8.

    Article  Google Scholar 

  25. Papadaki M, Marmarinos A, Tsolia M, Gourgiotis D, Soldatou A. Cathelicidin levels in nasal secretions are associated with the severity of acute bronchiolitis. Pediatr Pulmonol. 2021;56:1673–80.

    Article  PubMed  Google Scholar 

  26. Khoshnevisasl P, Sadeghzadeh M, Kamali K, et al. A randomized clinical trial to assess the effect of zinc and vitamin D supplementation in addition to hypertonic saline on treatment of acute bronchiolitis. BMC Infect Dis. 2022;22:538.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  27. Oktaria V, Triasih R, Graham SM, et al. Vitamin D deficiency and severity of Pneumonia in Indonesian children. PLoS ONE. 2021;16:e0254488.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  28. Guo LY, Li W, Cheng XF, et al. Relationship between vitamin D status and viral Pneumonia in children. Pediatr Allerg Immunol Pulmonol. 2017;30:86–91.

    Article  Google Scholar 

  29. Zhou YF, Luo BA, Qin LL. The association between vitamin D deficiency and community-acquired Pneumonia: a meta-analysis of observational studies. Med (Baltim). 2019;98:e17252.

    Article  Google Scholar 

  30. Jat KR. Vitamin D deficiency and Lower Respiratory Tract Infections in children: a systematic review and meta-analysis of observational studies. Trop Doct. 2017;47:77–84.

    Article  PubMed  Google Scholar 

  31. Yakoob MY, Salam RA, Khan FR, Bhutta ZA. Vitamin D supplementation for preventing Infections in children under five years of age. Cochrane Database Syst Rev. 2016;11:CD008824.

    PubMed  Google Scholar 

  32. Das RR, Singh M, Naik SS. Vitamin D as an adjunct to antibiotics for the treatment of acute childhood Pneumonia. Cochrane Database Syst Rev. 2023;1:CD011597.

    PubMed  Google Scholar 

  33. Zeng J, Wu G, Yang W, et al. A serum vitamin D level < 25 nmol/L pose high Tuberculosis risk: a meta-analysis. PLoS ONE. 2015;10:e0126014.

    Article  PubMed  PubMed Central  Google Scholar 

  34. Gou X, Pan L, Tang F, et al. The association between vitamin D status and Tuberculosis in children: a meta-analysis. Medicine. 2018;97:e12179.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  35. Xia J, Shi L, Zhao L, Xu F. Impact of vitamin D supplementation on the outcome of Tuberculosis treatment: a systematic review and meta-analysis of randomized controlled trials. Chin Med J. 2014;127:3127–34.

    PubMed  Google Scholar 

  36. Jolliffe DA, Ganmaa D, Wejse C, et al. Adjunctive vitamin D in Tuberculosis treatment: meta-analysis of individual participant data. Eur Respir J. 2019;53:1802003.

    Article  CAS  PubMed  Google Scholar 

  37. Goyal JP, Singh S, Bishnoi R, et al. Efficacy and safety of vitamin D in Tuberculosis patients: a systematic review and meta-analysis. Expert Rev Anti Infect Ther. 2022;20:1049–59.

    Article  CAS  PubMed  Google Scholar 

  38. Bartley J, Garrett J, Camargo CA Jr, et al. Vitamin D3 supplementation in adults with bronchiectasis: a pilot study. Chron Respir Dis. 2018;15:384–92.

    Article  PubMed  PubMed Central  Google Scholar 

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JPG has written this manuscript as part of Dr. I. C. Verma Excellence in Research Award. He will act as guarantor for this manuscript.

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Correspondence to Jagdish Prasad Goyal.

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Goyal, J.P. Vitamin D and Respiratory Diseases. Indian J Pediatr 91, 67–72 (2024). https://doi.org/10.1007/s12098-023-04904-2

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