The effect of pharmacological correction with vitamin D on the cytokine response in children with atopic bronchial asthma

Aim. To study the state of the cytokine response in children with atopic bronchial asthma during pharmacological correction with vitamin D. Methods. 63 children aged 3-17 years with atopic bronchial asthma of varying severity were examined. As a control group, 10 practically healthy children of the same age who had no history of allergic manifestations and no hereditary complications, were examined. The patients were divided into two groups matched by age: group 1 included 33 patients with mild (n=20) and moderate (n=13) bronchial asthma who received only basic anti-inflammatory therapy according to the severity of asthma; group 2 included 30 children with mild (n=18) and moderate (n=12) bronchial asthma who received basic anti-inflammatory therapy with vitamin D containing Tridrop [3 drops (1500 IU) per day for 1 month]. Patients were assessed for interleukin-2, -13 and -17 in the blood serum using a solid-phase enzyme-linked immunosorbent assay before and after treatment. Results. The results obtained made it possible to clarify the changes in the cytokine spectrum in patients with atopic bronchial asthma in the course of the disease and the effect of pharmacological correction with vitamin D on it. The mean level of interleukin-2 in group 1 remained practically unchanged, the value of this cytokine was 2.77±1.51 pg/ml (p >0.05). In group 2, the mean interleukin-2 level increased to 5.07±1.02 pg/ml (p <0.01). The mean level of interleukin-13 in group 1 patients increased but not significantly, but in group 2 a decrease of interleukin-13 to 11.3±3.8 pg/ml (p <0.05) was registered. Interleukin-17 decreased by 2.6 times in group 2 (4.8±1.6 pg/ml, p <0.01). In group 1 there was no significant change in the level of interleukin-17, in all children it remained elevated (p >0.05). Conclusion. Pharmacological correction with vitamin D on the background of basic anti-inflammatory therapy promotes the positive dynamics of the level of cytokines during the treatment of atopic bronchial asthma, which is related to the ability of vitamin D to regulate the function of Th2 and, as a result, to reduce the synthesis of interleukin-13 and -17, which participate in the pathogenesis of allergies and play an important protective role in bronchial asthma.

Download Full-text

CLINICAL EVALUATION OF POTENTIAL ANTI-INFLAMMATORY EFFECT OF VITAMIN D3 ADJUVANT THERAPY FOR CHRONIC ASTHMA IN IRAQI PATIENTS

International Journal of Pharmacy and Pharmaceutical Sciences ◽

10.22159/ijpps.2017v9i1.15487 ◽

2016 ◽

Vol 9 (1) ◽

pp. 139 ◽

Cited By ~ 1

Author(s):

Rasha Saadi Abbas ◽

Manal Khalid Abdulridha ◽

Mostafa Abdalfatah Shafek

Keyword(s):

Vitamin D ◽

Treatment Level ◽

Tnf Α ◽

Anti Inflammatory ◽

Pre Treatment ◽

Group 2 ◽

To Receive ◽

Necrosis Factor ◽

Group 1 ◽

Inflammatory Effect

Objective: This study was designed to evaluate the potential anti-inflammatory effect of vitamin D3 supplementation in Iraqi patients with chronic asthma. Methods: Forty-four candidate patients were diagnosed with asthma during their visit to hospital allocated as 20 patients assigned to receive conventional therapy for asthma and 24 patients assigned to receive conventional therapy for asthma plus 2000 I. U vitamin D3 tablet for three months period. Also, 30 apparently healthy subjects were included in the study as a control group. Pulmonary function test, serum 25-OH vitamin D levels, serum Interlukin-10 (IL-10) levels, serum tumor necrosis factor alpha (TNF-α) levels were measured before and after three months therapy.Results: After three months treatment, there was a highly significant improvement in both measured and percentage of predicted value of pulmonary function test (PFT) compared to the pre-treatment value for both group 1 and group 2 patients (p<0.01). Also, a highly significant increase in total endogenous vitamin D level in group 2 when compared to group 1 patients after three months period (p<0.01). Group 2 patients presented with a significant increase in mean IL-10 after three months of treatment when compared to pre-treatment level (p<0.05). The mean TNF-α level was increased non-significantly in both study groups, but the higher level was found in group 1 patients than in group 2 patients when compared to pre-treatment level (p>0.05).Conclusion: There was a significant increase in the level of anti-inflammatory biomarker interleukin-10 (IL-10), though no clear effect on tumor necrosis factor-α (TNF-α) was noticed after three months treatment with vitamin D3 supplementation.

Download Full-text

Estimating Pulmonary Function, Interleukin-6 (IL-6), And Superoxide Dismutase-3 (EC-SOD3) Levels in Patients with Chronic Bronchial Asthma on Curcumin Adjuvant Therapy

INDONESIAN JOURNAL OF PHARMACY ◽

10.22146/ijp.1136 ◽

2021 ◽

Author(s):

Sura abbas Khdair ◽

Manal khalid Abdulridha

Keyword(s):

Pulmonary Function ◽

Bronchial Asthma ◽

Interleukin 6 ◽

Study Groups ◽

Super Oxide Dismutase ◽

Function Test ◽

The Mean ◽

Group 2 ◽

To Receive ◽

Group 1

This study was designed to evaluate the effectiveness of curcumin supplement as antioxidant and anti-inflammatory in patients with chronic bronchial asthma. Forty patients diagnosed with chronic bronchial asthma were enrolled in this study and allocated into group (1) patients assigned to receive conventional therapy of asthma, and group (2) patient assigned to receive conventional therapy of asthma combined with 750 mg curcumin supplement twice daily for two months. Pulmonary function test, asthma control test, serum interleukin-6 and serum extracellular super oxide dismutase 3 were measured before and after two months in both study groups. After two months, the mean values of pulmonary function test (spirometry) and asthma control score showed significant increase compared to pre-treatment values in group 2 patients (P<0.01). Moreover, there was marked decrease in the level of interleukin-6 in group 2 patients after two months (p< 0.05) compared to the increased in group 1 patients. The mean level of super oxide dismutase 3 didn’t show any increase in both study groups after treatment. Curcumin supplement produced improvement in pulmonary function of patients with chronic bronchial asthma along with the reduction in inflammatory status. No change in endogenous oxidative status after curcumin supplementation.

Download Full-text

Use of magnetoinfrared laser therapy in severe pediatric bronchial asthma

Perm Medical Journal ◽

10.17816/pmj36318-27 ◽

2019 ◽

Vol 36 (3) ◽

pp. 18-27

Author(s):

Ya. Yu. Illek ◽

I. Yu. Mischenko ◽

L. L. Ryseva ◽

M. L. Vyaznikova ◽

E. Yu. Tarasova ◽

...

Keyword(s):

Laser Therapy ◽

Bronchial Asthma ◽

High Efficiency ◽

Side Reactions ◽

Severity Of Disease ◽

Atopic Bronchial Asthma ◽

Asthma Patients ◽

Clinical Indices ◽

Group 2 ◽

Group 1

Aim. To determine the influence of magnetoinfrared laser therapy on the clinicolaboratory indices in children with severe course of bronchial asthma. Material and methods. There were observed 82 children aged 5–14 years, who suffered from severe course of atopic bronchial asthma.Bronchial asthma patients of group 1 (41 patients) received a complex standard therapy, bronchial asthma patients of group 2 – a complex treatment, combined with magnetoinfrared laser therapy courses. Results. Patients with bronchial asthma, attributed to group 2, compared with those of group1 demonstrated a faster positive dynamics of clinical indices, improvement of respiratory function and normalization of most immunologic reactivity parameters, diminished severity of disease course and prolonged clinical remission. Conclusions. High efficiency of magnetoinfrared laser therapy, safety and availability, absence of complications and side reactions permit to recommend its wide use in complex of medical measures for children with severe course of atopic bronchial asthma.

Download Full-text

The Role of Interferences in the Increasing Incidence of Vitamin D Deficiency

Endocrine Metabolic & Immune Disorders - Drug Targets ◽

10.2174/1871530320666200604160208 ◽

2020 ◽

Vol 20 (8) ◽

pp. 1303-1308

Author(s):

Ataman Gonel ◽

Idris Kirhan ◽

Ismail Koyuncu ◽

Nihayet Bayraktar ◽

Mujgan Ercan Karadag ◽

...

Keyword(s):

Vitamin D ◽

Total Cholesterol ◽

Vitamin D Deficiency ◽

Matrix Effect ◽

Blood Lipid ◽

Lipid Profiles ◽

The Matrix ◽

The Mean ◽

Group 2 ◽

Group 1

Objective: Lipemia is one of the causes of interference in immunoassay and LC-MS/MS methods. Increased prevalence of vitamin D deficiency in the US, where obesity is gradually increasing, raises the suspicion that high levels of fat diet and blood lipid levels interfere with vitamin D measurement results. The focus of this study was to investigate the effect of blood lipid profiles on vitamin D results and prevent the matrix effect. Material and Methods: In this study, 25OH vitamin D3 (25OHD3) levels of 100 samples consecutively accepted to biochemistry laboratory regardless of age and sex were measured by the LC-MS/MS method, and each sample was restudied after 1/10 dilution. After dilution restudy, two groups were obtained-group 1 (results deviating below 20%) and group 2 (results deviating above 20%)—and the difference between the groups was investigated. There were 79 patients in group 1 and 21 patients in group 2. In our study, lipid profiles (triglyceride, total cholesterol, HDL, LDL) from the same samples of consecutive vitamin D patients were studied. Results: It was observed that the triglyceride, total cholesterol HDL, LDL, and 25OHD3 measurements of group 1 and group 2 were similar (p > 0.05). While the mean vitamin D value in the second group was 9.94 ± 7.85, the mean vitamin D value after dilution was measured as 39.23 ± 18.13 and was statistically significant. 25OHD3 concentrations of 21 patients out of 100 were found to be falsely low. Measurements were repeated to confirm the results. Conclusion: The matrix effect caused by exogenous and endogenous interferences in the blood could be a hidden factor increasing the prevalence of vitamin D deficiency by causing falsely low 25OHD3 values. Suspicious results should be remeasured by a dilution study.

Download Full-text

The Impact of COVID-19 Pandemic during 2020–2021 on the Vitamin D Serum Levels in the Paediatric Population in Warsaw, Poland

Nutrients ◽

10.3390/nu13061990 ◽

2021 ◽

Vol 13 (6) ◽

pp. 1990

Author(s):

Agnieszka Rustecka ◽

Justyna Maret ◽

Ada Drab ◽

Michalina Leszczyńska ◽

Agata Tomaszewska ◽

...

Keyword(s):

Vitamin D ◽

Seasonal Variability ◽

Serum Levels ◽

Paediatric Population ◽

Sunlight Exposure ◽

Vitamin D Levels ◽

The Mean ◽

Group 2 ◽

The Impact ◽

Group 1

Background: The main source of vitamin D is skin synthesis, which depends on sunlight exposure. During the pandemic, COVID-19 children were obliged to home confinement, which potentially limiting sunlight exposure. The aim of this study was to evaluate whether home confinement led to decreased vitamin D serum levels in children in Warsaw, Poland. Methods: The study included 1472 children who were divided into two groups, based on the date of 25(OH)D level blood sampling: before and during the pandemic. Children under 1 year of age (infants) were analysed separately. Results: A statistically significant decrease in the average level of vitamin D was observed between groups of children over 1 year of age (35 ng/mL ± 18 vs. 31 ng/mL ± 14). In infants from both groups, the mean vitamin D levels were within the normal range (Group 1 inf 54 ng/mL ± 21 vs. Group 2 inf 47 ng/mL ± 15). The characteristic seasonal variability was observed before the pandemic, with maximal vitamin D levels in summer (40 ng/mL ± 17) and minimal levels in winter (30 ng/mL ± 14). During the pandemic, no seasonal variability was observed (summer 30 ng/mL ± 11 vs. winter 30 ng/mL ± 19). Conclusions: The COVID-19 pandemic restrictions led to a significant decrease in vitamin D serum levels in children.

Download Full-text

Relationship between the Severity of Inflammatory Changes in Chronic Sinusitis and the Level of Vitamin D before and after the FESS Procedure

Journal of Clinical Medicine ◽

10.3390/jcm10132836 ◽

2021 ◽

Vol 10 (13) ◽

pp. 2836

Author(s):

Paulina Kalińczak-Górna ◽

Kamil Radajewski ◽

Paweł Burduk

Keyword(s):

Vitamin D ◽

Chronic Sinusitis ◽

Study Groups ◽

New Information ◽

Vitamin D Levels ◽

Before And After ◽

The Mean ◽

Group 2 ◽

Severity Of The Disease ◽

Group 1

There have been a few reports confirming that vitamin D (VD3) deficiency increases inflammation in the paranasal sinuses. The work brings new information that, despite the presence of inflammation before surgery, patients with higher vitamin D levels had less inflammation, and this has been proven on three levels. We show that vitamin D levels clearly correlate with the severity of the disease in chronic sinusitis. These results have been confirmed in imaging studies (Lund MacKay scale), endoscopy (Lund-Kennedy scale) and in the SNOT 20 questionnaire. 40 patients suffering from chronic sinusitis were divided into two equal groups: group 1: with less severe radiological changes (10 or less points on the Lund-Mackay scale), group 2: with a more advanced form (>10 points). The relationship between VD3 and the severity of the disease (clinical and nasal endoscopy) was assessed. The mean VD3 level in patients in group 2 before surgery was lower (23.01 ng/mL) than in group 1 (28.02 ng/mL) (p < 0.05). They presented a higher degree of advanced changes in all the above scales, i.e., before the SNOT 20 procedure, the mean was: group 1: 30.33, group 2: 31.80 (p < NS); Lund-Kennedy: group 1: 3.21, group 2: 6.30 (p < 0.05). After surgery an increase in VD3 levels was observed in both study groups: in group 1 to the value of 37.98 ng/mL (p < 0.002) and in group 2 to 27.67 ng/mL (p < 0.004). Lower VD3 levels were found in patients with a higher stage of the disease. Reduction of inflammation increases the level of VD3 and reduces subjective and objective symptoms of chronic inflammation.

Download Full-text

Creation of physiologic rhythm by closed loop stimulation in heart failure patients with severe chronotropic incompetence: worldwide first results of a pilot study

European Heart Journal ◽

10.1093/ehjci/ehaa946.0803 ◽

2020 ◽

Vol 41 (Supplement_2) ◽

Author(s):

J Proff ◽

B Merkely ◽

R Papp ◽

C Lenz ◽

P.J Nordbeck ◽

...

Keyword(s):

Heart Rate ◽

Closed Loop ◽

Funding Source ◽

Chronotropic Incompetence ◽

First Results ◽

The Mean ◽

Group 2 ◽

Group 1

Abstract Background The prevalence of chronotropic incompetence (CI) in heart failure (HF) population is high and negatively impacts prognosis. In HF patients with an implanted cardiac resynchronisation therapy (CRT) device and severe CI, the effect of rate adaptive pacing on patient outcomes is unclear. Closed loop stimulation (CLS) based on cardiac impedance measurement may be an optimal method of heart rate adaptation according to metabolic need in HF patients with severe CI. Purpose This is the first study evaluating the effect of CLS on the established prognostic parameters assessed by the cardio-pulmonary exercise (CPX) testing and on quality of life (QoL) of the patients. Methods A randomised, controlled, double-blind and crossover pilot study has been performed in CRT patients with severe CI defined as the inability to achieve 70% of the age-predicted maximum heart rate (APMHR). After baseline assessment, patients were randomised to either DDD-CLS pacing (group 1) or DDD pacing at 40 bpm (group 2) for a 1-month period, followed by crossover for another month. At baseline and at 1- and 2-month follow-ups, a CPX was performed and QoL was assessed using the EQ-5D-5L questionnaire. The main endpoints were the effect of CLS on ventilatory efficiency (VE) slope (evaluated by an independent CPX expert), the responder rate defined as an improvement (decrease) of the VE slope by at least 5%, percentage of maximal predicted heart rate reserve (HRR) achieved, and QoL. Results Of the 36 patients enrolled in the study, 20 fulfilled the criterion for severe CI and entered the study follow-up (mean age 68.9±7.4 years, 70% men, LVEF=41.8±9.3%, 40%/60% NYHA class II/III). Full baseline and follow-up datasets were obtained in 17 patients. The mean VE slope and HRR at baseline were 34.4±4.4 and 49.6±23.8%, respectively, in group 1 (n=7) and 34.5±12.2 and 54.2±16.1% in group 2 (n=10). After completing the 2-month CPX, the mean difference between DDD-CLS and DDD-40 modes was −2.4±8.3 (group 1) and −1.2±3.5 (group 2) for VE slope, and 17.1±15.5% (group 1) and 8.7±18.8% (group 2) for HRR. Altogether, VE slope improved by −1.8±2.95 (p=0.31) in DDD-CLS versus DDD-40, and HRR improved by 12.9±8.8% (p=0.01). The VE slope decreased by ≥5% in 47% of patients (“responders to CLS”). The mean difference in the QoL between DDD-CLS and DDD-40 was 0.16±0.25 in group 1 and −0.01±0.05 in group 2, resulting in an overall increase by 0.08±0.08 in the DDD-CLS mode (p=0.13). Conclusion First results of the evaluation of the effectiveness of CLS in CRT patients with severe CI revealed that CLS generated an overall positive effect on well-established surrogate parameters for prognosis. About one half of the patients showed CLS response in terms of improved VE slope. In addition, CLS improved quality of life. Further clinical research is needed to identify predictors that can increase the responder rate and to confirm improvement in clinical outcomes. Funding Acknowledgement Type of funding source: Private company. Main funding source(s): Biotronik SE & Co. KG

Download Full-text

New insights into vitamin D regulation: is there a role for alkaline phosphatase?

Journal of Endocrinological Investigation ◽

10.1007/s40618-021-01503-w ◽

2021 ◽

Author(s):

G. Bellastella ◽

L. Scappaticcio ◽

M. Longo ◽

R. Carotenuto ◽

C. Carbone ◽

...

Keyword(s):

Vitamin D ◽

Alkaline Phosphatase ◽

Liver Function ◽

Significant Negative Correlation ◽

Liver Function Tests ◽

Bone Alkaline Phosphatase ◽

Gamma Glutamyl Transpeptidase ◽

Function Tests ◽

Group 2 ◽

Group 1

Abstract Purpose The diagnosis of vitamin D deficiency is based on the determination of total plasma 25-hydroxyvitamin D (25-OHD) concentrations, but the regulation of vitamin D 25-hydroxylation is not a major consideration and very little information is available on this activity. To check what factors could interfere with the activity of vitamin D-25-hydroxylase and thus alter the 25-OHD concentrations, we looked for potential correlations between 25-OHD and results of liver function tests in healthy adults. Methods This single-centre study was retrospective and consisted of evaluating the correlations between 25-OHD and the activities of aspartate aminotransferase (AST), alanine aminotransferase (ALT), gamma-glutamyl transpeptidase (GGT), alkaline phosphatase (ALP), and bone alkaline phosphatase (BALP) in 349 healthy subjects aged from 18 to 65 years. In particular, in Group 1 (n = 119), we looked for correlations between 25OHD and all liver function tests and in Group 2 (n = 230) the correlation between 25OHD and BALP. Results In Group 1, we found no correlation between 25OHD and AST (r = − 0.03; p = 0.8), ALT (r = − 0.02; p = 0.91), GGT (r = − 0.08; p = 0.68), direct bilirubin (r = − 0.02; p = 0.89), indirect bilirubin (r = − 0.24; p = 0.21), and total bilirubin (r = − 0.24; p = 0.21) but one between 25OHD and ALP (r = − 0.2; p = 0.007); in Group 2, we found a significant negative correlation between 25-OHD and BALP (r = − 0.2; p = 0.0008). Conclusions The correlations that we found suggest that ALP and BALP might be involved in the regulation of vitamin D-25-hydroxylase activity, but further studies are mandatory to confirm our assumptions.

Download Full-text

Comparison of the ATRIA, CHA2DS2-VASc, and Modified Scores ATRIA-HSV, CHA2DS2-VASc-HS, for the Prediction of Coronary Artery Disease Severity

Angiology ◽

10.1177/0003319721991410 ◽

2021 ◽

pp. 000331972199141

Author(s):

Arafat Yildirim ◽

Mehmet Kucukosmanoglu ◽

Fethi Yavuz ◽

Nermin Yildiz Koyunsever ◽

Yusuf Cekici ◽

...

Keyword(s):

Coronary Artery Disease ◽

Coronary Artery ◽

Vascular Disease ◽

Operating Characteristics ◽

Coronary Artery Disease Severity ◽

Group 3 ◽

The Mean ◽

Group 2 ◽

Artery Disease ◽

Group 1

Many parameters included in the Anticoagulation and Risk Factors in Atrial Fibrillation (ATRIA) and CHA2DS2-VASc (congestive heart failure, hypertension, age ≥75 years, diabetes mellitus, stroke, vascular disease, age 65-74 years, sex category) scores also predict coronary artery disease (CAD). We modified the ATRIA score (ATRIA-HSV) by adding hyperlipidemia, smoking, and vascular disease and also male sex instead of female. We evaluated whether the CHA2DS2-VASc, CHA2DS2-VASc-HS, ATRIA, and ATRIA-HSV scores predict severe CAD. Consecutive patients with coronary angiography were prospectively included. A ≥50% stenosis in ≥1epicardial coronary artery (CA) was defined as severe CAD. Patient with normal CA (n = 210) were defined as group 1, with <50% CA stenosis (n = 178) as group 2, and with ≥50% stenosis (n = 297) as group 3. The mean ATRIA, ATRIA-HSV, CHA2DS2-VASc, and CHA2DS2VASc-HS scores increased from group 1 to group 3. A correlation was found between the Synergy between PCI with Taxus and Cardiac Surgery score and ATRIA ( r = 0.570), ATRIA-HSV ( r = 0.614), CHA2DS2-VASc ( r = 0.428), and CHA2DS2-VASc-HS ( r = 0.500) scores ( Ps < .005). Pairwise comparisons of receiver operating characteristics curves showed that ATRIA-HSV (>3 area under curve [AUC]: 0.874) and ATRIA (>3, AUC: 0.854) have a better performance than CHA2DS2-VASc (>1, AUC: 0.746) and CHA2DS2-VASc-HS (>2, AUC: 0.769). In conclusion, the ATRIA and ATRIA-HSV scores are simple and may be useful to predict severe CAD.

Download Full-text

Does Presurgical Nasoalveolar Molding Have a Long-Term Effect on Nasal and Upper Airway Dimensions?

The Cleft Palate-Craniofacial Journal ◽

10.1177/1055665620980234 ◽

2020 ◽

pp. 105566562098023

Author(s):

Ashwina S. Banari ◽

Sanjeev Datana ◽

Shiv Shankar Agarwal ◽

Sujit Kumar Bhandari

Keyword(s):

Upper Airway ◽

P Value ◽

Airway Patency ◽

The Mean ◽

Group 2 ◽

Acoustic Pharyngometry ◽

Nasoalveolar Molding ◽

Area And Volume ◽

Group 1

Objectives: To compare nasal and upper airway dimensions in patients with cleft lip and palate (CLP) who underwent nasoalveolar molding (NAM) with those without NAM during infancy using acoustic pharyngometry and rhinometry. Materials and Methods: Eccovision acoustic pharyngometry and rhinometry (Sleep Group Solutions) was used for assessment of mean area and volume of nasal and upper airway in patients with complete unilateral CLP (age range 16-21 years) treated with NAM (group 1, n = 19) versus without NAM (group 2, n = 22). Results: The mean nasal cross-sectional areas and volume were higher in group 1 compared to group 2 on both cleft ( P value <.001) and noncleft side ( P value >.05). The mean area and volume of upper airway were also significantly higher in group 1 compared to group 2 ( P value <.05). Conclusions: Nasoalveolar molding being one of the first interventions in chronology of treatment of patients with CLP, its long-term outcome on nasal and upper airway patency needs to be ascertained. The results of the present study show that the patients with CLP who have undergone NAM during infancy have better improvement in nasal and upper airway patency compared with those who had not undergone NAM procedure. The basic advantages of being noninvasive, nonionizing and providing dynamic assessment of nasal and upper airway patency make acoustic pharyngometry and rhinometry a diagnostic tool of choice to be used in patients with CLP.

Download Full-text