vitamin-d-2 and Asthma

Vitamin D is obtained from cutaneous production when 7-dehydrocholesterol is converted to vitamin D(3) (cholecalciferol) by ultraviolet B radiation or by oral intake of vitamin D. Rickets appeared to have been conquered with vitamin D intake, and many health care professionals thought the major health problems resulting from vitamin D deficiency had been resolved. However, rickets can be considered the tip of the vitamin D deficiency iceberg. In fact, vitamin D deficiency remains common in children and adults. An individual's vitamin D status is best evaluated by measuring the circulating 25-hydroxyvitamin D (25(OH)D3) concentration. There is increasing agreement that the optimal circulating 25(OH)D3 level should be approximately 30 ng/mL or above. Using this definition, it has been estimated that approximately three-quarters of all adults have low levels. In utero and during childhood, vitamin D deficiency can cause growth retardation and skeletal deformities and may increase the risk of hip fracture later in life. Vitamin D deficiency in adults can exacerbate osteopenia and osteoporosis, cause osteomalacia and muscle weakness, and increase the risk of fracture. More recently, associations between low vitamin D status and increased risk for various non-skeletal morbidities have been recognized; whether all of these associations are causally related to low vitamin D status remains to be determined. The discovery that most tissues and cells in the body have vitamin D receptors and that several possess the enzymatic machinery to convert the 25-hydroxyvitamin D3, to the active form, 1,25-dihydroxyvitamin D3, has provided new insights into the function of this vitamin. Of great interest is its role in decreasing the risk of many chronic illnesses, including common cancers, autoimmune diseases, infectious diseases, and cardiovascular disease. In this review I consider the nature of vitamin D deficiency, discuss its role in skeletal and non-skeletal health, and suggest strategies for prevention and treatment.

Topics: Asthma; Biomarkers; Bone Density Conservation Agents; Bone Diseases, Metabolic; Cholecalciferol; Dietary Supplements; Ergocalciferols; Humans; Metabolic Syndrome; Nervous System Diseases; Parathyroid Hormone; Rickets; Risk Factors; Sunlight; Vitamin D; Vitamin D Deficiency

In 12 patients with allergic bronchial asthma and airway obstruction the effect of calcium in combination with vitamin D 2 (calciferol), given orally, was tested in a cross-over double blind study. Within 60 minutes after application, a statistically significant reduction of airway resistance (Rt) and intrathoracic gas volume (IGV), as well as an increase of forced exspiratory one second volume (FEV1) and forced inspiratory one second volume (FIV1) was observed, in comparison with placebo. It is concluded that calcium, given orally in combination with calciferol, causes a decrease of airway obstruction in patients with allergic bronchial asthma.

Topics: Administration, Oral; Adult; Airway Resistance; Asthma; Calcium; Clinical Trials as Topic; Drug Combinations; Drug Evaluation; Ergocalciferols; Female; Humans; Hypersensitivity; Male; Middle Aged; Placebos; Respiration

Serum osteocalcin (OC) levels were measured in 19 asthmatic patients receiving long term glucocorticoid therapy and in age- and sex-matched asthmatic patients not receiving this treatment. In the glucocorticoid-treated patients, the mean OC level was approximately 50% less than that in the control group (P less than 0.001), and there was a direct correlation between serum OC and 1,25-dihydroxyvitamin D [1,25-(OH)2D; r = 0.71; P less than 0.001]. Multiple regression analysis in a total of 39 glucocorticoid-treated patients indicated that OC correlated directly to 1,25-(OH)2D and inversely to glucocorticoid dose. There was no correlation between OC and 1,25-(OH)2D in the control group and no significant difference in mean serum 1,25-(OH)2D between the steroid-treated asthmatic patients and the asthmatic control patients. The effect of a 4-day course of oral 1,25-(OH)2D on serum OC was studied in six patients with glucocorticoid excess and six normal subjects. There was a similar percent increase in OC levels in both groups, though the basal concentrations and absolute increases were substantially less in the steroid-treated group. It is likely that the depression of serum OC in glucocorticoid-treated patients results from the reduction in the rate of bone formation induced by these hormones.

Topics: Administration, Oral; Adolescent; Adult; Aged; Alkaline Phosphatase; Asthma; Calcium-Binding Proteins; Ergocalciferols; Female; Glucocorticoids; Humans; Male; Middle Aged; Osteocalcin; Radioimmunoassay

A phosphate depletion syndrome developed in a steroid-dependent asthmatic patient. Initially, the clinical picture was confused with steroid-associated myopathy rather than the phosphate depletion syndrome which has similar symptoms. The classic biochemical findings led to the correct diagnosis. Cessation of phosphate-binding antacids and phosphorus repletion rapidly corrected the biochemical findings and led to the patient's clinical improvement. Platelet phosphate metabolism was evaluated; it was found to correlate with the phosphorus-depleted state and clinical recovery with phosphate repletion. Attention is drawn to the clinical entity of phosphate depletion which may mimic steroid-induced side effects, both of which may occur in patients receiving steroids and antacids.

Topics: Antacids; Asthma; Calcium Gluconate; Diagnosis, Differential; Ergocalciferols; Humans; Male; Methylprednisolone; Middle Aged; Osteoporosis; Phosphates; Phosphorus Metabolism Disorders; Prednisolone

Topics: Adrenal Cortex Hormones; Asthma; Calcium Metabolism Disorders; Cortisone; Ergocalciferols; Fractures, Spontaneous; Geriatrics; Humans; Osteoporosis; Phosphorus Metabolism Disorders; Spinal Diseases; Toxicology