TITOLO RELAZIONE Vitamina D e aspetti immunologici. DOCENTE Michele Miraglia del Giudice

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1 TITOLO RELAZIONE Vitamina D e aspetti immunologici DOCENTE Michele Miraglia del Giudice

2 ????? bone skin placenta adrenal glands Vitamin D Receptors (VDR) are present in different tissues intestine kidneys parathyroid brain thyroid eye adipose tissue heart pancreatic islets immune cells muscle Baeke, Curr Opin Pharmacol 2010;10:482

3 Vitamin D works on many organs and peripheral tissues

4 Vit.D 3 stimulates innate immune responses by enhancing the chemotactic and phagocytotic responses of macrophages as well as the production of antimicrobial proteins such as cathelicidin antimicrobial peptide.

5 Vitamin D inhibits differentiation of monocytes into immature DC 1,25(OH) 2 D Peelen E. Autoimmunity Reviews 2011

6 Peelen E. Autoimmunity Reviews 2011

7 Muehleisen B et al.j Allergy ClinImmunol 2013;131:324-9

8 Hall SC et al Clin Ther May;39(5):

9 Vitamina D e aspetti immunologici DATI CLINICI

10 In utero exposure to 25-hydroxyvitamin D and risk of childhood asthma, wheeze, and respiratory tract infections: A meta-analysis of birth cohort studies Feng H J Allergy Clin Immunol 2017;139: Associations between 25(OH)D levels in cord blood or maternal venous blood and risk of offspring s asthma, wheeze, and respiratory tract infections. Results: increased in utero exposure to 25(OH)D is inversely associated with the risk of asthma and wheeze during childhood

11 Vitamin D over the first decade and susceptibility to childhood allergy and asthma Hollams EN J Allergy Clin Immunol 2017;139: Asthma, allergy, and respiratory tract infection associated phenotypes were characterized in a high-risk birth cohort 263 ch. Plasma 25(OH)D concentrations were quantified at birth and at the ages of 0.5, 1, 2, 3, 4, 5, and 10 years 25(OH)D deficiency in early childhood is associated with increased risk for persistent asthma, potentially through modulating susceptibility to early allergic sensitization, upper respiratory tract colonization with bacterial pathogens, or both.

12 25-Hydroxyvitamin D concentrations, asthma and eczema in childhood: The generation R study Tromp IM et al Clinical Nutrition 2016 Serum 25(OH) vitamin D concentration was assessed in 3815 children FeNO and Rint were measured Deficient 25(OH) vitamin D concentration were associated with elevated FeNO and determination of airway resistance by Rint and increased risks of eczema.

13 Effects of vitamin D levels on asthma control and severity in preschool children Turkeli A et al Eur Rev Med Pharmacol Sci 2016; 20: Vitamin D levels were measured in 102 preschool ch., aged 1-4 years with asthma and 102 healthy controls in winter. Vitamin D levels Asthma control There was a positive correlation between serum vitamin D levels and asthma control.

14 Vitamin D level and brochial inflammation in asthmatic children M. Miraglia del Giudice et al JBRHA 2015; 2: asthmatic children ( 45 M e 21 F) age range 4-19years The children were allocated into two groups: Group 1 : 46 children with 25(OH)D < 30 ng/ml. Group 2 : 20 children with 25(OH)D > 30 ng/ml. Group 1 (Vit.D<30 ng/ml) Group 2 (Vit.D>30 ng/ml) P* Vit D ( ng/ml ) 21,1 ± 6 32 ± 1 <0,0001 FeNO in ppb 32,3 ± 31,8 10,1 ± 3,6 0,0018 C-ACT 20,3 ± 4,3 20,9 ± 3,6 0,9 We found a significant decrease of FeNO values (p= ) in children with vitamin D levels >30 ng/ml. These findings confirm that vitamin D plays a major role in bronchial inflammation.

15 Improved control of childhood asthma with low-dose, short-term vitamin D supplementation: a randomized, double-blind, placebo-controlled trial. Tachimoto H et al ALLERGY 2016;71(7): We conducted a randomized, double-blind, placebo-controlled trial comparing vitamin D3 supplements (800 IU/day) with placebo for 2 months in schoolchildren with asthma. The primary outcomes were frequency and severity of asthma judging from changes in asthma control levels defined by the Global Initiative for Asthma (GINA) by collaborating doctors at 2 and 6 months.

16 Improved control of childhood asthma with low-dose, short-term vitamin D supplementation: a randomized, double-blind, placebo-controlled trial. Tachimoto H et al ALLERGY 2016;71(7): Daily supplementation with 800 IU of vitamin D for 2 months showed significant improvement in levels of asthma control defined by GINA (P = 0.015), and in those assessed by CACT (P = ). Moreover, the effect continued even 6 months after stopping vitamin D supplementation. The proportion of patients with a peak expiratory flow rate <80% predicted was significantly less in the vitamin D group (15%) than in the placebo group (34%) at 6 months (P = 0.032).

17 VITAMIN D FOR THE MANAGEMENT OF ASTHMA Martineau AL Cochrane Database of Systematic Reviews 2016, Issue 9. Art. No.: CD