Posted on 09/22/2011 12:44:54 PM PDT by decimon
Children with severe therapy-resistant asthma (STRA) may have poorer lung function and worse symptoms compared to children with moderate asthma, due to lower levels of vitamin D in their blood, according to researchers in London. Lower levels of vitamin D may cause structural changes in the airway muscles of children with STRA, making breathing more difficult. The study provides important new evidence for possible treatments for the condition.
The findings were published online ahead of the print edition of the American Thoracic Society's American Journal of Respiratory and Critical Care Medicine.
"This study clearly demonstrates that low levels of vitamin D are associated with poorer lung function, increased use of medication, worse symptoms and an increase in the mass of airway smooth muscle in children with STRA," said Atul Gupta, MRCPCH, M.D., a researcher from Royal Brompton Hospital and the National Heart and Lung Institute (NHLI) at Imperial College and King's College London. "It is therefore plausible that the link between airway smooth muscle mass and lung function in severe asthma may be partly explained by low levels of vitamin D."
While most children with asthma can be successfully treated with low doses of corticosteroids, about 5 to 10 percent of asthmatic children do not respond to standard treatment. These children have severe therapy-resistant asthma, or STRA, experience more asthma episodes and asthma-related illnesses, and require more healthcare services, than their treatment-receptive peers.
Although previous studies of children with asthma have linked increases in airway smooth muscle mass with poorer lung function and in vitro studies have established a connection between levels of vitamin D and the proliferation of airway smooth muscle, this is the first study to evaluate the relationship between vitamin D and the pathophysiology of children with STRA.
"Little is known about vitamin D status and its effect on asthma pathophysiology in these patients," Dr. Gupta noted. "For our study, we hypothesized that children with STRA would have lower levels of vitamin D than moderate asthmatics, and that lower levels of vitamin D would be associated with worse lung function and changes in the airway muscle tissue."
The researchers enrolled 86 children in the study, including 36 children with STRA, 26 with moderate asthma and 24 non-asthmatic controls, and measured the relationships between vitamin D levels and lung function, medication usage and symptom exacerbations.The researchers also examined tissue samples from the airways of the STRA group to evaluate structural changes in the airway's smooth muscle.
At the conclusion of the study the researchers found children with STRA had significantly lower levels of vitamin D, as well as greater numbers of exacerbations, increased use of asthma medications and poorer lung function compared to children with moderate asthma and non-asthmatic children. Airway muscle tissue mass was also increased in the STRA group.
"The results of this study suggest that lower levels of vitamin D in children with STRA contribute to an increase in airway smooth muscle mass, which could make breathing more difficult and cause a worsening of asthma symptoms," Dr. Gupta said.
The findings suggest new treatment strategies for children suffering from difficult-to-treat asthma, he added.
"Our results suggest that detecting vitamin D deficiency in children with STRA, and then treating that deficiency, may help prevent or reduce the structural changes that occur in the airway smooth muscle, which in turn may help reduce asthma-related symptoms and improve overall lung function," Dr. Gupta said.
Before any widespread treatment recommendations can be made, however, larger studies will need to be conducted to confirm the results, he added.
"The determination of the exact mechanism between low vitamin D and airway changes that occur in STRA will require intervention studies," Dr. Gupta said. "Hopefully, the results of this and future studies will help determine a new course of therapy that will be effective in treating these children."
Ping
Vitamin D is the new Vitamin D.
If you don’t take it, take it. Too many reasons to list.
Just wondering, in all his brilliant “preventive medicine” scams, has Barack Obama done a damn thing to promote Vitamin D?
Obama loves D
More and more is coming out that children need fresh air and sunshine.
We all do - and without sunscreen.
If I have it right then vitamin D acts as a regulator of many chemical processes. If that's so then it makes sense that it would be involved in keeping us healthy in many ways. Just how would be hard to pinpoint in our complex chemical factory bodies.
I wonder how big a grant these fools are looking for.
I wish (oh, how I wish!) our children could play outside without fear. My greatest shame about American society is that we’ve retreated from the perverts and predators instead of driving them back into the dark corners and ratholes where they belong.
I grew up dirt-poor but safe. For a boy to be locked indoors out of fear - that is poverty indeed!
I can vouch personally for Vit D, and urge everyone to have their D level checked. I was absolutely exhausted in February of this year. My feet hurt so badly I could hardly walk my blood pressure was higher than it had ever been and I had headaches. I have a thyroid issue and assumed that it was acting up. My endroconologist ordered some routine thyroid blood work and also level of Vit D. My thyroid was adequate but the d level was 8. Normals start at 30. The doctor said I was seriously deficient and put me on mass doses of Vit D (niacin). I sincerely have not felt this good in years. My recent blood work showed me now at 28.
It’s good to see that your doctor did the tests and that you are better.
Niacin is a B vitamin.
For one thing, they’re British, so they’re not going to get funded by your taxpayer dollars, don’t worry.
For another, they aren’t fools. They’re doing some important research. Asthma kills a lot of kids (and adults), and the number is growing. It’s a particular problem among black children, and research has been trying to figure out why asthma is turning into a costly epidemic among kids in general and black kids in particular, regardless of socioeconomic class. It appears that they don’t get enough Vitamin D because their darker skin blocks sun absorption, and also because kids in the inner city don’t play outside as much as kids in the country.
Kids with asthma don’t get enough fresh air and sunshine anyway because they often don’t feel well enough to go out and play, and/or they’re reactive to the air pollution, tree/grass/flower pollen, molds, and other allergens or irritants outside. So just sending them out to play solves nothing. They will need big Vitamin D supplements, not just time outside. Demonstrating a link between Vitamin D levels and pediatric asthma is a valuable contribution to medicine.
When I see these studies, I always picture the poor inside because they are sick, of course they have a lower vitamin D level.
I would like to see a double blind study where the sick group getting vitamin D get better.
When I see these studies, I always picture the poor person stuck inside because they are sick, of course they have a lower vitamin D level.
I would like to see a double blind study where the sick group getting vitamin D get better.
(Sorry, working, I swear I typed all the words the first time)
This is pure speculation but...
I suspect that vitamin D is most valuable as a preventive agent. That is, to keep the body running properly so to not develop debilitating conditions. OTOH, maybe some conditions can be reversed with vitamin D supplements.
Or a nice double blind multidecade prospective study.
It would be easy to set up a study in Saudi Arabia linking low vitamin D levels to breast growth. As soon as their breasts grow, their vitamin D levels drop. Ignoring the fact that after menarche, Saudi women are cloistered would add as much bias as ignoring that sick people tend not to go outside as much.
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