Vitamin D3 for uncontrolled childhood asthma: A pilot study

• Published in: Pediatric allergy and immunology Vol. 27; no. 4; pp. 404 - 412
• Main Authors: Kerley, Conor P., Hutchinson, Katrina, Cormican, Liam, Faul, John, Greally, Peter, Coghlan, David, Elnazir, Basil
• Format: Journal Article
• Language: English
• Published: England Wiley Subscription Services, Inc 01.06.2016
• Subjects: Absenteeism; allergy; Asthma; Asthma - diagnosis; Asthma - drug therapy; Asthma - immunology; Asthma - physiopathology; Biomarkers - blood; bone; Child; Cholecalciferol - adverse effects; Cholecalciferol - therapeutic use; Double-Blind Method; Female; Forced Expiratory Volume; Humans; infection; Ireland; Lung - drug effects; Lung - immunology; Lung - physiopathology; Male; pediatric; Pediatrics; Pilot Projects; pulmonary function; Schools; Time Factors; Treatment Outcome; Vitamin D; Vitamin D - analogs & derivatives; Vitamin D - blood; Vitamin deficiency; infection; vitamin D; pulmonary function; allergy; asthma; bone; pediatric
• ISSN: 0905-6157; 1399-3038
• DOI: 10.1111/pai.12547

Background Observational and mechanistic data suggest a role for vitamin D in childhood asthma. However, subsequent interventional trials have been inconsistent. We aimed to assess the effect of 15 weeks of vitamin D3 supplementation compared with placebo (PL) in Irish children with asthma. Methods We conducted a double‐blind, randomized, PL‐controlled trial of vitamin D supplementation (2000 IU/day) in 44 urban, Caucasian children at high latitude. Assessments were completed at baseline and after 15 weeks of supplementation. Outcome measures were lung function, subjective asthma control and biochemical parameters of total vitamin D, allergy, immunity, airway inflammation, and systemic inflammation. Finally, parents/guardians completed a weekly diary during the trial. Results There was no significant difference in baseline 25(OH)D levels, but there was a significant increase in median 25(OH)D in the vitamin D3 group (57.5–105 nmol/l) compared with the PL group (52.5–57.5 nmol/l) (p < 0.0001). There was no significant difference between groups regarding subjective asthma control. Compared with PL, there was a significant decrease in school days missed due to asthma (1 vs. 5 days, p = 0.04) and alkaline phosphatase (−3.4 vs. +16; p = 0.037) in the vitamin D3 group, but there were no beneficial effects regarding several other secondary end‐points. However, there were non‐significant, advantageous changes in the PL group compared with the vitamin D3 group in subjective asthma control and lung function, particularly percentage of predicted forced expiratory volume in 1 s (+2.5 vs. −4; p = 0.06). Conclusion Vitamin D3 supplementation led to a significant increase in serum 25(OH)D and decreased school days missed (p = 0.04), but no other advantageous changes in asthma parameters compared with PL. The potential adverse effect of vitamin D deficiency on growth and the potential negative effect of high serum 25(OH)D on pulmonary function warrant further investigation.