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. 2009 Nov;5(6):693-702.
doi: 10.1586/eci.09.53.

Vitamin D, the immune system and asthma

Nancy E Lange  1 , Augusto Litonjua, Catherine M Hawrylowicz, Scott Weiss
Affiliations

Vitamin D, the immune system and asthma

Nancy E Lange et al. Expert Rev Clin Immunol. 2009 Nov.

Abstract

The effects of vitamin D on bone metabolism and calcium homeostasis have long been recognized. Emerging evidence has implicated vitamin D as a critical regulator of immunity, playing a role in both the innate and cell-mediated immune systems. Vitamin D deficiency has been found to be associated with several immune-mediated diseases, susceptibility to infection and cancer. Recently, there has been increasing interest in the possible link between vitamin D and asthma. Further elucidation of the role of vitamin D in lung development and immune system function may hold profound implications for the prevention and treatment of asthma.

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Figures

Figure 1
Figure 1. Extraskeletal effects of vitamin D
In humans, vitamin D is obtained through ultraviolet B exposure, diet and supplement intake. It is converted to 25-hydroxyvitamin D3 by the liver. Circulating 25-hydroxyvitamin D3 is converted to the active form, 1,25-dihydroxyvitamin D3, in a variety of sites including the kidney and cells of the immune system. Experimental evidence suggests an effect of 1,25-dihydroxyvitamin D3 on multiple different processes and cell types. In the immune system it leads to a decrease in the Th1 response, thought to be the mechanism involved in the association between low vitamin D levels and a variety of autoimmune diseases. It modulates the Th2 response affecting cytokines such as IL-4, IL-5 and IL-13. This is one possible link between vitamin D and allergy/asthma. It has been shown to upregulate T-regulatory cells, leading to an increase in the synthesis of the anti-inflammatory cytokine IL-10. In macrophages, vitamin D upregulates synthesis of the antimicrobial peptide cathelicidin, which may enhance the ability to fight infections. In airway smooth muscle cells, it has been shown to modulate chemokine release. Vitamin D may play a role in fetal lung development and in the differentiation of type II pneumocytes and surfactant secretion. Vitamin D has also been associated with a lower incidence of and mortality from a variety of cancers.
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Websites

    1. ClinicalTrials.gov. Randomized trial: Maternal Vitamin D Supplementation to Prevent Childhood Asthma (VDAART) http://clinicaltrials.gov/ct2/show/NCT00920621.
    1. ClinicalTrials.gov. Vitamin D for the Treatment of Severe Asthma http://clinicaltrials.gov/ct2/show/NCT00712205.