Journal of Postgraduate Medicine, Education and Research

Register      Login

VOLUME 50 , ISSUE 2 ( April-June, 2016 ) > List of Articles

REVIEW ARTICLE

Vitamin D reduces Exacerbation in Children with Asthma: A Systematic Review and Meta-analysis

Anil Chauhan, Nishant Jaiswal, Manvi Singh, Kiran Kumar Thumburu, Shailender Singh Chauhan, Sunil Dhatwalia, Mananda S Bhende, Meenu Singh

Citation Information : Chauhan A, Jaiswal N, Singh M, Thumburu KK, Chauhan SS, Dhatwalia S, Bhende MS, Singh M. Vitamin D reduces Exacerbation in Children with Asthma: A Systematic Review and Meta-analysis. J Postgrad Med Edu Res 2016; 50 (2):86-92.

DOI: 10.5005/jp-journals-10028-1198

Published Online: 01-06-2014

Copyright Statement:  Copyright © 2016; The Author(s).


Abstract

Aim

The question whether treatment with vitamin D improves asthma exacerbations in children and adults still needs to be addressed.

Background

Recent studies in children and adults found a higher prevalence of hypovitaminosis D associated with a higher severity of asthma and impaired pulmonary function. In asthmatic children, patients with vitamin D deficiency demonstrated increased airway hyperresponsiveness and corticosteroid requirements.

Results

Of 469 records/studies identified through database searching, 5 studies were included in this systematic review. The overall pooled effect showed a significant reduction in acute asthma exacerbation in the vitamin D group (odds ratio 0.45, 95% confidence interval 0.22—0.93). There were no studies that focus on the quality of life.

Conclusion

This systematic review supports the role of vitamin D in reducing the number of asthma exacerbations in children but not in adults.

Clinical significance

The present systematic review demonstrates reduction in asthma exacerbations in children. Most of the asthma children are on inhaled corticosteroid, which poses a threat for its side effects. However, vitamin D having multiple functions in body could be used as an alternative therapy in asthmatic children. In adults, more trials are needed wherein the deficient individuals are supplemented with vitamin D and further assessed for asthma exacerbations. There is no harm in supplementation of vitamin D to deficient and insufficient asthmatic individuals.

How to cite this article

Chauhan A, Singh M, Jaiswal N, Thumburu KK, Agarwal A, Chauhan SS, Dhatwalia S, Bhende MS, Singh M. Vitamin D reduces Exacerbation in Children with Asthma: A Systematic Review and Meta-analysis. J Postgrad Med Edu Res 2016;50(2):86-92.


PDF Share
  1. Global asthma prevalence in adults: findings from the cross-sectional world health survey. BMC Public Health 2012 Mar19;12:204.
  2. Vitamin D deficiency. N Engl J Med 2007;357:266-281.
  3. Chromosome 12q harbors multiple genetic loci related to asthma and asthma-related phenotypes. Hum Mol Genet 2003 Aug 15;12(16):1973-1979.
  4. High prevalence of vitamin D deficiency among inner-city African American youth with asthma in Washington, DC. J Pediatr 2010 Jun;156(6):948-952.
  5. Serum vitamin D levels and markers of severity of childhood asthma in Costa Rica. Am J Respir Crit Care Med 2009 May 1;179(9):765-771.
  6. Vitamin D levels, lung function, and steroid response in adult asthma. Am J Respir Crit Care Med 2010 Apr 1;181(7):699-704.
  7. Decreased serum vitamin D levels in children with asthma are associated with increased corticosteroid use. J Allergy Clin Immunol 2010 May;125(5):995-1000.
  8. Effect of vitamin D and inhaled corticosteroid treatment on lung function in children. Am J Respir Crit Care Med 2012 Sep 15;186(6):508-513.
  9. Serum vitamin D levels and severe asthma exacerbations in the Childhood Asthma Management Program study. J Allergy Clin Immunol 2010 Jul;126(1):52-58.e5.
  10. Reversing the defective induction of IL-10-secreting regulatory T cells in glucocorticoid-resistant asthma patients. J Clin Invest 2006 Jan;116(1):146-155.
  11. Enhanced production of IL-17A in patients with severe asthma is inhibited by 1alpha, 25-dihydroxyvitamin D3 in a glucocorticoid-independent fashion. J Allergy Clin Immunol 2013 Aug;132(2):297-304.e3.
  12. Introducing GRADE: a systematic approach to rating evidence in systematic reviews and to guideline development. (2013). KT Update (1)5. Austin, TX: SEDL, Center on Knowledge Translation for Disability and Rehabilitation Research; 2013.
  13. Cochrane Handbook for Systematic Reviews of Interventions Version 5.1 [updated March 2011]. Available from: http://www.cochrane-handbook.org . The Cochrane Collaboration; 2011.
  14. G. A. On behalf of the CSMG. Analyzing data and undertaking meta-analysis. In: Higgins JPT, Green S, editors. Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 [updated March 2011]. The Cochrane Collaboration 2011.
  15. Serum 25-dihydroxyvitamin D levels correlate with CD4(+)Foxp3(+) T-cell numbers in moderate/ severe asthma. J Allergy Clin Immunol 2012 Aug;130(2):542-544.
  16. Asthma in the elderly: a study of the role of vitamin D. Allergy Asthma Clin Immunol 2014 Sep 5;10(1):48
  17. Vitamin D supplementation reduces airway hyperresponsiveness and allergic airway inflammation in a murine model. Clin Exp Allergy 2013 Jun;43(6):672-683.
  18. Inhaled corticosteroids may have a beneficial effect on bone metabolism in newly diagnosed asthmatic children. Pulm Pharmacol Ther 2011 Aug;24(4):414-420.
  19. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med 2009;6:e1000097
  20. Effect of vitamin D3 on asthma treatment failures in adults with symptomatic asthma and lower vitamin D levels: the VIDA randomized clinical trial. JAMA 2014 May;311(20):2083-2091.
  21. Vitamin D supplementation in children may prevent asthma exacerbation triggered by acute respiratory infection. J Allergy Clin Immunol 2011 May;127(5):1294-1296.
  22. Randomized trial of vitamin D supplementation to prevent seasonal influenza A in schoolchildren. Am J Clin Nutr 2010 May;91(5):1255-1260.
  23. Effect of vitamin D supplementation on moderate to severe bronchial asthma. Indian J Pediatr 2014 Jul;81(7):650-654.
  24. Double-blind randomised placebo-controlled trial of bolus-dose vitamin D3 supplementation in adults with asthma (ViDiAs). Thorax 2015 May;70(5):451-457.
  25. Efficacy of high-dose vitamin D in pediatric asthma: a systematic review and meta-analysis. J Asthma 2015 May;52(4):382-390.
  26. Vitamin D with asthma and COPD: not a false hope? A systematic review and meta-analysis. Genet Mol Res 2014 Feb 13;13(3):7607-7616.
  27. Vitamin D supplementation for childhood asthma: a systematic review and meta-analysis. PLoS One 2015 Aug31;10(8):e0136841.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.