Pulmonary Pharmacology & Therapeutics, doi:10.1016/j.pupt.2015.02.004
Conor P. Kerley, BSca, b, , , Basil Elnazir, MDc, , John Faul, MDa, , Liam Cormican, MDa,
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Vitamin D deficiency (VDD) is highly prevlalent worldwide. The classical role for vitamin D is to regulate calcium absorption form the gastrointestinal tract and influence bone health. Recently vitamin D receptors and vitamin D metabolic enzymes have been discovered in numerous sites systemically supporting diverse extra-skeletal roles of vitamin D, for example in asthmatic disease.
Further, VDD and asthma share several common risk factors including
- high latitude,
- winter season,
- poor diet,
- obesity, and
- dark skin pigmentation.
Vitamin D has been demonstrated to possess potent immunomodulatory effects, including effects on T cells and B cells as well as increasing production of antimicrobial peptides (e.g. cathelicidin). This immunomodulation may lead to asthma specific clinical benefits in terms of decreased bacterial/viral infections, altered airway smooth muscle-remodeling and –function as well as modulation of response to standard anti-asthma therapy (e.g. glucocorticoids and immunotherapy).
Thus, vitamin D and its deficiency have a number of biological effects that are potentially important in altering the course of disease pathogenesis and severity in asthma. The purpose of this first of a two-part review is to review potential mechanisms whereby altering vitamin D status may influence asthmatic disease.