Vitamin D as an adjunct to subcutaneous allergen immunotherapy in asthmatic children sensitized to house dust mite. Issue 2 (4th November 2013)

• Record Type: Journal Article
• Authors: Baris, S.; Kiykim, A.; Ozen, A.; Tulunay, A.; Karakoc‐Aydiner, E.; Barlan, I. B.
• Is Part Of: Allergy. Volume 69:Issue 2(2014:Feb.)
• Page Start: 246
• Page End: 253
• Publication Date: 2013-11-04
• Subjects: Allergy -- Periodicals; 616.97
• DOI: 10.1111/all.12278
• Languages: English
• ISSNs: 0105-4538

Abstract

<abstract abstract-type="main" id="all12278-abs-0001"> <title>Abstract</title> <sec id="all12278-sec-0001" sec-type="section"> <title>Background</title> <p>We aimed to investigate the efficacy, safety, and T regulatory cell response of vitamin D as an adjunct to allergen‐specific immunotherapy (IT).</p> </sec> <sec id="all12278-sec-0002" sec-type="section"> <title>Methods</title> <p>Fifty children with asthma and receiving pharmacotherapy were randomized into three groups as: subcutaneous IT (SCIT) along with vitamin D supplementation (650 U/day; <italic>n</italic>: 17), SCIT alone (<italic>n</italic>: 15), and pharmacotherapy alone (<italic>n</italic>: 18). All patients were evaluated at baseline, 6th and 12th months for scorings of symptoms and medication, skin prick testing, total IgE, specific IgE, and Der p 1‐specific IgG4. In addition, <italic>D. pteronyssinus</italic>‐induced CD4<sup>+</sup>CD25<sup>+</sup>FOXP3<sup>+</sup>T regulatory cell percentage, intracellular Foxp3 expression, and peripheral blood mononuclear cell IL‐10 and TGF‐β responses were assessed.</p> </sec> <sec id="all12278-sec-0003" sec-type="section"> <title>Results</title> <p>In the SCIT + vitamin D and SCIT alone groups, total asthma symptom score (TASS), total symptom score (TSS), and total medication scores (TMS) were significantly lower than pharmacotherapy group at the end of 1 year. While the comparison of delta values (Δ 6th and Δ 12th month − baseline) of those scores revealed no significant differences between the two IT groups, TASS at the 6th month was lower in the SCIT + vitamin D group compared with others. There was a significant and positive trend in the levels of Der p 1‐specific IgG4 in both IT groups throughout the study period. Whereas the levels of Der p 1‐induced IL‐10 and TGF‐β were similar between IT groups, the mean fluorescence intensity of Foxp3 was highest in the SCIT + vitamin D group compared with others at the 12th month. The rate of discontinuation of inhaled corticosteroid (ICS) was 6/17 in SCIT + vitamin D, 3/15 in SCIT, and 0/18 in the pharmacotherapy group (<italic>P</italic> = 0.02).</p> </sec> <sec id="all12278-sec-0004" sec-type="section"> <title>Conclusion</title> <p>Both SCIT groups fared better than pharmacotherapy alone at the end of 1 year. Although the clinical and immunologic outcomes were mostly similar between the two IT groups, some favorable outcomes of vitamin D warrant further investigation in more selected populations with varying doses as adjunct to IT.</p> </sec> </abstract>