A randomised trial of vitamin D in acute-stage allergic bronchopulmonary aspergillosis complicating asthma.

Abstract

Vitamin D has been demonstrated to have an immunomodulatory role in cystic fibrosis with allergic bronchopulmonary aspergillosis (ABPA). Herein, we evaluate supplemental vitamin D in acute-stage ABPA complicating asthma. Thirty subjects were randomised to receive either prednisolone (n = 15, control) or prednisolone and oral vitamin D (n = 15, intervention arm). Serum vitamin D levels were significantly higher in the intervention versus the control arm, following therapy. The mean decline in total IgE at 2 months (primary outcome) was 10% higher in the intervention arm than the control arm; however, this was not statistically significant (48.6% vs 38.1%, P = 0.27). The percentage decline in total IgE after 4 and 6 months of randomisation was also similar in the two arms. There was no difference in asthma exacerbations (0 vs 2, intervention vs control; P = 0.16). No ABPA exacerbation occurred in either arm. The other outcomes including the Th2 (IL-4, IL-6 and IL-10) and Th17 (IL-17) cytokine levels were similar in the two groups. None of the participants experienced hypervitaminosis D. There was no significant improvement in the clinical or immunological outcomes following vitamin D supplementation. A larger trial is required to ascertain the role of vitamin D in ABPA complicating asthma [Clinicaltrials.gov: NCT03133299].

• Authors: Manjunath Havalappa Dodamani, Valliappan Muthu, Reetu Thakur, Arnab Pal, Inderpaul Singh Sehgal, Sahajal Dhooria, Ashutosh N Aggarwal, Mandeep Garg, Arunaloke Chakrabarti, Ritesh Agarwal
• Journal: Mycoses (Mycoses) Vol. 62 Issue 4 Pg. 320-327 (Apr 2019) ISSN: 1439-0507 [Electronic] Germany
• PMID: 30561849 (Publication Type: Journal Article, Randomized Controlled Trial)
• Copyright: © 2018 Blackwell Verlag GmbH.

Chemical References

• Cytokines
• Immunologic Factors
• Vitamin D
• Immunoglobulin E
• Prednisolone

Topics

• Administration, Oral
• Adolescent
• Adult
• Aged
• Aged, 80 and over
• Aspergillosis, Allergic Bronchopulmonary (complications, drug therapy, pathology)
• Asthma (complications, drug therapy, pathology)
• Child
• Cytokines (blood)
• Female
• Humans
• Immunoglobulin E (blood)
• Immunologic Factors (administration & dosage)
• Male
• Middle Aged
• Prednisolone (administration & dosage)
• Prospective Studies
• Treatment Outcome
• Vitamin D (administration & dosage)
• Young Adult