Asthma research and practice最新文献

{"title":"Vitamin D supplementation decreases <i>Aspergillus fumigatus</i> specific Th2 responses in CF patients with aspergillus sensitization: a phase one open-label study.","authors":"Nikki Lynn Hue Nguyen, Joseph M Pilewski, Juan C Celedón, Sivanarayana Mandalapu, Megan L Blanchard, Adrienne DeRicco, Elizabeth Hartigan, John F Alcorn, Jay K Kolls","doi":"10.1186/s40733-015-0003-5","DOIUrl":"10.1186/s40733-015-0003-5","url":null,"abstract":"<p><strong>Background: </strong>Patients with cystic fibrosis (CF) complicated by allergic bronchopulmonary aspergillosis (ABPA) are vitamin D deficient and <i>in vitro</i> treatment with 1,25 (OH)₂ vitamin D₃ of CD4+ cells from CF patients with ABPA decreases <i>Aspergillus fumigatus</i>(Af)-induced Th2 responses. This Phase I clinical trial investigated the safety and effectiveness of daily vitamin D₃ supplementation in CF patients with ABPA to reduce allergic responses and ABPA symptoms, and increase serum vitamin D levels.</p><p><strong>Methods: </strong>Seven patients ages 12 years and older with a clinical diagnosis of CF and ABPA with current evidence of Af sensitization received 4000 IU vitamin D₃ (cholecalciferol) daily for 24 weeks. The primary outcome of the study was safety followed by the <i>Aspergillus</i> induced IL-13 response in CD4+ T cells to test the hypothesis that vitamin D supplementation is safe and reduces <i>Aspergillus</i> induced IL-13 responses in CD4+ T cells. Secondary outcomes included total IgE, <i>Aspergillus</i>-specific IgE, vitamin D levels, FEV₁, urinary calcium/creatinine ratio, and cytokine production by <i>Aspergillus</i>-stimulated peripheral blood T cells.</p><p><strong>Results: </strong>Six months of vitamin D₃ supplementation resulted in significant increases in serum 25-(OH) vitamin D level, and the treatment was well tolerated without evidence of vitamin D toxicity or hypercalcemia. There were no serious adverse events. Daily vitamin D supplementation led to significantly decreased <i>Aspergillus</i> induced IL-13 responses between the baseline visit and that at 24 weeks (p = 0.04). <i>Aspergillus</i>-specific IgE level was also significantly decreased after 8 (p = 0.035) and 24 weeks of daily vitamin D supplementation (p = 0.04).</p><p><strong>Conclusions: </strong>4000 IU vitamin D₃ daily over a 24-week period is well tolerated in CF patients with a history ABPA and current evidence of Th2 immunity to Af. . Daily vitamin D supplementation was associated with reduced <i>Aspergillus</i> induced IL-13 responses from peripheral. . CD4+ T cells and <i>Aspergillus</i>-specific IgE levels, as well as increased serum vitamin D levels. This treatment was well tolerated and the study supports further investigation of the use of vitamin D supplementation in Th2 mediated diseases.</p><p><strong>Trial registration: </strong>This trial was registered at www.clinicaltrials.gov as NCT01222273.</p>","PeriodicalId":8572,"journal":{"name":"Asthma research and practice","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2015-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4801182/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"65749022","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}