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MOJ Immunology
Vitamin D and Allergy
Submit Manuscript | http://medcraveonline.com
Volume 3 Issue 2 - 2016
Department of Pediatrics, Research and Training Hospital of
Sakarya University, Turkey
*Corresponding author: Öner Özdemir, Division of Allergy
and Immunology, Department of Pediatrics, Research and
Training Hospital of Sakarya University, Faculty of Medicine,
Received:| Published: April 12, 2016
Mini Review
Abstract
After the modern vitamin D hypothesis firstly suggested in 1999 for the allergy
pandemic, numerous conditions have been thought to be associated with
vitamin D deficiency such as allergy, autoimmunity and neoplasm. Consistently,
previous observational studies have linked lower vitamin D status to increased
markers of atopy and allergic diseases e.g. atopic dermatitis, anaphylaxis and
food allergy. Vitamin D is a “hormone” having important immunomodulatory
and immunoregulatory properties. In vitamin D deficient conditions, disrupted
mucosal and skin complex integrity and intercurrent infections may act
synergistically with allergenic exposure to amplify sensitization risk. There has
been emerging data to show that vitamin D can enhance the anti-inflammatory
effects of glucocorticoids and potentially be used as adjuvant therapy in
steroid-resistant severe asthma. And recent in vivo data suggest that vitamin D
supplementation reduce the severity of eczema and allergic rhinitis as well as
urticaria symptoms. However, there is presently inadequate evidence to support
daily vitamin D supplementation in the prevention and/or treatment of allergic
diseases in infants, children and adolescents.
Keywords:
Introduction
1999 for the allergy pandemic, numerous conditions have been
atherosclerosis, autoimmunity and neoplasm [1]. Consistently,
previous observational studies have related lower vitamin D
diseases e.g. increased airway hyperresponsiveness, asthma,
Furthermore, recent research on vitamin D suggests that higher
serum vitamin D levels might improve some disorder outcomes
Vitamin D is a “hormone” having immunomodulatory and
disrupted skin/mucosal complex integrity and coincidental
infections might serve synergistically with allergen exposure
to amplify sensitization risk at critical periods of immune
development before tolerance is developed [6].
Vitamin D Deciency
The serum 25-hydroxyvitamin D concentration is accepted
as the marker of vitamin D status. In the general population, the
Institute of Medicine considers that a vitamin D level >20ng/ml
assume that an optimal vitamin D status is better described by
is more common reported worldwide than considered to be.
older children, female, African and Mexican Americans, drank
Low vitamin D levels have also been demonstrated in various
allergic diseases such as in asthma, eczema, allergic rhinitis, food
allergy, anaphylaxis and urticaria. Whether low vitamin D levels
are primary or secondary to allergic disease is not clear [2-6].
For instance: since more severe asthmatic patients spend less
time outdoors, this situation is an apparent cause of vitamin D
Vitamin D Supplementation
Primary sun wavelengths converting vitamin D are UV-B. When
someone makes vitamin D in the skin it remains 2-3 times longer
in the human body. However, there is no known evidence showing
any difference in disorder outcomes between the effect of oral
supplements and sun exposure. Sun exposure is an ineffective
mechanism of boosting vitamin D of the human body [9]. Food
sources of vitamin D might be required for boosting vitamin
D status in human under some circumstances e.g. cod liver oil
preparations including vitamin A and D [2]. There is emerging
effects of glucocorticoids and potentially be used as adjuvant
therapy in steroid-resistant severe asthma patients. And recent in
vivo data suggest that vitamin D intake can also reduce asthma
exacerbations, severity of atopic dermatitis, allergic rhinitis as
well as chronic urticaria symptoms [10,11].
Vitamin D and Allergy 2/4
Copyright:
©2016 Özdemir
Citation:
2D3 and
affect expression of over 200 genes, up regulations nearly two-
thirds and down regulating one-third of those genes. Therefore,
VDRs found in different alleles having different effects [12,13]. A
mutated VDR in hereditary vitamin D-resistant rickets prevents
VDR ApaI an allele is associated with better childhood asthma
control and improvement in ability for daily activities [15]. Overall,
allergic disease development.
Pre-, Peri-, and Post-natal Vitamin D Status and Risk for
Allergy
In various studies, low maternal and cord vitamin D levels
were previously reported to be associated with increased risk
of atopic dermatitis in infancy and wheeze and/or asthma at 3,
begin in early childhood and are among the most common chronic
childhood disorder. The incidence has increased during the last
half of 20th century in developed and underdeveloped societies.
in these societies, possibly caused by a more sedentary indoor
lifestyle and decreased intake of vitamin D containing foods.
Vitamin D possesses a range of immunomodulatory properties,
during pregnancy may affect fetal immune system programming
and contribute to the development of asthma and allergic diseases
Supposed Immunologic Mechanisms of Vitamin D
Affecting Development of Allergy
and receptor agonists have immunomodulatory and
immunoregulatory activities [16]. The immunologic effects of
VDR agonists are shown in vitro studies and they are able to
function thru VDRs, which are widespread in the human body:
I. Innate immunity
b. Up-regulate antimicrobial proteins, maintains
epithelial and mucosal barrier integrity
c. Reduce dendritic cell maturation and migration
II. Th1- / Th2- cell functions
Vitamin D is well-known to inhibit Th1 cytokine release.
vivo environments
B. Stimulate Th2 cytokine secretion by peripheral blood
mononuclear cells [20].
C. Suppress Th2 responses by human cord blood
mononuclear cells [21].
having enhanced Treg phenotype [21].
polarization [22].
and IL-10 cytokines [23].
III. Lymphocytes
b. Decrease T -cell proliferation
c. Increase IL-2 production, steroid responsiveness and
IV. Mast cells: Inhibit maturation and promote apoptosis [25].
VI. Airway epithelium and smooth muscle
Allergy Development The results of investigations about maternal
vitamin D level effect during pregnancy on allergy development
D supplementation, rate of wheezing development was found to
difference for allergy development at 3 years of age [30]. Another
study performed in UK study demonstrated that high maternal
associated higher risk of eczema in children at 9 months of age
10-years of age. But there was a positive association with the
prevalence of eczema [33]. A recent meta-analysis supposes these
above mentioned results as inconclusive of randomized trials of
prenatal vitamin D for asthma prevention in offspring, curbing the
enthusiasm [5].
Development Low cord blood 25-OH-D3 was found as a risk
and multi-trigger wheezing, wheezing and risk of troublesome
lung symptoms development have been reported to be reversely
correlated in three different studies [35,36]. However, recent two
different birth cohort studies showed that cord blood vitamin D
Postnatal Serum Low Vitamin D Status in Allergy/ Allergic
Disease Development Recent studies have linked vitamin D
Vitamin D and Allergy 3/4
Copyright:
©2016 Özdemir
Citation:
normal / high Vitamin D status
On the contrary, some evidence suggests that vitamin D use /
supplementation itself might increase the risk of allergic disease
[2]. As mentioned above, high prenatal vitamin D status has
been mostly linked to decreased risk of atopic diseases in early
childhood, but whether such relations persist until adulthood
has not been explored yet. In a prospective birth cohort with 965
30. This cohort study did not provide support for a protective
effect of a high maternal vitamin D concentration on outcomes
of allergic airway disease and lung function at 20 to 25 years of
age. In contrast, a high maternal vitamin D concentration might be
associated with an increased risk of allergic diseases in offspring
cod liver oil was shown to be able to increase risk of asthma,
showed that children who received vitamin D supplements during
infancy had a higher risk of developing asthma, atopy and allergic
higher intake of vitamin D in 1st year of life was associated an
allergy and allergic disease
controlled trials of allergy-related research reported nowadays.
Most studies performed in this area are retrospective and
supplementation. Many studies did not differ between vitamin
patients demonstrate relations/associations but not causality
between vitamin D levels and allergy-related outcomes are shown
to vary by race and other genetic as well as environmental factors
Conclusion
There is presently inadequate evidence to support daily vitamin
D supplementation in the prevention and/or treatment of allergic
are still unanswered questions such as what dose of supplemental
vitamin D is optimal for prevention or control of allergy? How
status have any effect on the intestinal microbiota modifying the
immune system?
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©2016 Özdemir
Citation:
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