Abstract
Background: Asthma is a heterogeneous disease, usually characterized by chronic airway inflammation. The detrimental effects of vitamin D deficiency in pediatrics have become increasingly apparent and extend beyond skeletal health.
Aims & Objectives: This study was carried out to evaluate the level of vitamin D and immunoglobulin E (IgE) in asthmatic patients of paediatric ages during exacerbation and after remission.
Patients and Methods: This study was carried out on 56 bronchial asthma children of 4 to 14 years of age group attending the ‘Pediatric outpatient department’ of ICARE Institute of Medical Sciences, Haldia, with bronchial asthma diagnosed and classified according to Global Initiative for Asthma 2016 and 48 healthy age and sex matched individuals. Serum vitamin D and IgE were measured using enzyme-linked immunosorbent assay for all participants.
Results: Serum IgE level was found significantly higher among bronchial asthma subjects with respect to controls (443.2 ± 237.3 versus 139.8 ± 82.06 IU/ml; P < 0.001). Moreover, serum 25 OH vitamin D levels were lower in bronchial asthma cases as compared to controls and were statistically significant (15.83 ± 7.44 versus 23.14 ± 8.29 ng/ml; P < 0.001). Serum vitamin D level showed an inverse correlation with IgE (r = -0.77; P < 0.0001) level among bronchial asthma subjects, but no significant correlation was observed in controls (r = 0.077; P = 0.689).
Conclusion: Despite these limitations it has been observed that serum vitamin D levels were lower and IgE levels were higher in patients suffering from bronchial asthma. A clear strong inverse correlation between vitamin D and Ig E also indicates a strong relationship in the pathogenesis of the disease.
Keywords: Bronchial asthma, Immunoglobulin E, Vitamin D, Children.
References
1. Masoli M, Fabian D, Holt S, Beasley R. Global Initiative for Asthma (GINA) Program. The global burden of asthma: executive summary of the GINA Dissemination Committee report. Allergy 2004; 59: 469–478.
2. Robertson CF, Roberts MF, Kappers JH. Asthma prevalence in Melbourne school children have we reached the peak? Med J Aust 2004; 180: 273–276.
3. Moorman JE, Gwynn C, Redd SC. Surveillance for asthma – United States, 1980–1999. MMWR SurveillSumm 2002; 51: 1–3.
4. Davila I, Valero A, Entrenas LM, Valveny N, Herráez L, SIGE Study Group. Relationship between serum total IgE and disease severity in patients with allergic asthma in Spain. J Investig Allergol ClinImmunol, 2015; 25(2): 120–7
5. Sharma SK, Banga A. Prevalence and risk factors for wheezing in children from rural areas of North India. Allergy Asthma Proc 2007; 28:647-53.
6. Awasthi S, Kalra E, Roy S, Awasthi S. Prevalence and risk factors of asthma and wheeze in school-going children in Lucknow, North India. Indian Pediatr 2004; 41: 1205-1210.
7. Litonjua AA, Weiss ST: Is vitamin D deficiency to blame for the asthma epidemic? J Allergy ClinImmunol 2007; 120:1031–1035.
8. Weiss ST, Litonjua AA: Maternal diet versus lack of exposure to sunlight as the cause of the epidemic of asthma, allergies and other autoimmune diseases. Thorax 2007; 62:746–748.
9. Brehm JM, Celedón JC, Soto-Quiros ME, Avila L, Hunninghake GM, Forno E, Laskey D, Sylvia JS, Hollis BW, Weiss ST, Litonjua AA: Serum vitamin D levels and markers of severity of childhood asthma in Costa Rica. Am J RespirCrit Care Med 2009; 179:765–771.
10. Al-Riyami BM, Al-Rawas OA, Al-Riyami AA, Jasim LG, Mohammed AJ. A relatively high prevalence and severity of asthma, allergic rhinitis and atopic eczema in school children in the Sultanate of Oman. Respirology 2003; 8: 69–76.
11. Bajpai A, Bardia A, Mantan M, Hari P, Bagga A. Non-azotemic refractory rickets in Indian children. Indian Pediatr 2005; 42: 23–30.
12. Bener A, Kamal A. Growth patterns of Qatar school children and adolescents aged 6–18 years. J Health Pop Nutr 2005; 23: 250–258.
13. Bener A, Al-Ali M, Hoffmann GF. High prevalence of vitamin D deficiency in young children in a highly sunny humid country: a global health problem. Minerva Pediatr 2009; 61: 15–22.
14. Barday L. Vitamin D insufficiency linked to asthma severity. Am J RespirCrit Care Med 2009; 179: 739–742.
15. Bener A, Ehlayel MS, Tulic MK, Hamid Q. Vitamin D deficiency as a strong predictor of asthma in children. Int Arch Allergy Immunol. 2012; 157:168–175.
16. Freishtat RJ, Iqbal SF, Pillai DK, Klein CJ, Ryan LM, Benton AS et al. High prevalence of vitamin D deficiency among inner city African American youth with asthma in Washington , DC. J Pediatr. 2010; 156: 948-52.
17. Chinellato I, Piazza M, Sandri M, Peroni D, Piacentini G, Boner al. Vitamin D serum levels and markers of asthma control in Italian children. J Pediatr. 2011; 158: 437-41.
18. Brehm JM, Schuemann B, Fuhlbrigge AL, Hollis BW, Strunk RC, Zeiger RS et al. Serum vitamin D levels and severe asthma exacerbations in the Childhood Asthma Management Program study. J Allergy ClinImmunol 2010; 126: 52–58.
19. Poon AH, Laprise C, Lemire M, Montpetit A, Sinnett D, Schurr E, Hudson TJ. Association of vitamin D receptor genetic variants with susceptibility to asthma and atopy. Am J RespirCrit Care Med 2004; 170:967–973.
20. Devereux G, Litonjua AA, Turner SW, Craig LC, McNeill G, Martindale S, et al. Maternal vitamin D intake during pregnancy and early childhood wheezing. Am J ClinNutr 2007; 85:853–859.
21. Searing DA, Zhang Y, Murphy JR, Hauk PJ, Goleva E, Leung DY. Decreased serum vitamin D levels in children with asthma are associated with increased corticosteroid use. J Allergy ClinImmunol 2010; 125:995–1000.
DOI: https://dx.doi.org/10.18535/jmscr/v5i5.120
