Pfeffer, PE; Mann, EH; Hornsby, E; Chambers, ES; Chen, Y-H; Rice, L; Hawrylowicz, CM; (2014) Vitamin D Influences Asthmatic Pathology through Its Action on Diverse Immunological Pathways. Annals of the American Thoracic Society , 11 (S5) S314-S321. 10.1513/AnnalsATS.201405-204AW.

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Abstract

The prevalence of vitamin D insufficiency and deficiency has increased markedly in recent decades to current epidemic levels (Hyppönen E, et al. Am J Clin Nutr 2007;85:860–868). In parallel, there has been an increase in the incidence of a range of immune-mediated conditions ranging from cancer to autoimmune and respiratory diseases, including chronic obstructive pulmonary disease and asthma (Holick MF. N Engl J Med 2007;357:266–281; Finklea et al. Adv Nutr 2011;2:244–253). There is also an association with increased respiratory infections, which are the most common cause of asthma exacerbations (Finklea et al. Adv Nutr 2011;2:244–253). Together, this has resulted in considerable interest in the therapeutic potential of vitamin D to prevent and improve treatment of asthma and other respiratory diseases. To this end, data from clinical trials involving supplementation with active vitamin D, or more commonly a precursor, are starting to emerge. This review considers mechanisms by which vitamin D may act on the immune system to dampen inappropriate inflammatory responses in the airway while also promoting tolerance and antimicrobial defense mechanisms that collectively maintain respiratory health.

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