Reduction of respiratory infections in asthma patients supplemented with vitamin D is related to increased serum IL-10 and IFNγ levels and cathelicidin expression

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BackgroundVitamin D is a molecule that modulates the immune response and shows anti-inflammatory effects that are beneficial for the control of chronic diseases such as asthma. The trial aim was to explore the effect of vitamin D supplementation on the colonization of pathogenic bacteria in the upper respiratory tract of allergic asthmatic patients.MethodsThis study was conducted in 86 patients between 18 and 50 years of age who were randomly divided into two groups. Both groups received the treatment recommended by the Global Initiative for Asthma (GINA). One group also received calcitriol (1,25-(OH)2D3), and the other group received a placebo. At baseline and 6 months, skin prick tests were conducted, pharyngeal bacterial cultures were performed, and cathelicidin LL-37 was measured in sputum. Serum levels of IgE, eosinophils, IL-5, IL-9, IL-10, IL-13, and IFNγ were quantified at the beginning and the end of the study.ResultsSerum levels of IL-10 and IFNγ increased significantly in the group of patients with vitamin D supplementation, while IL-5, IL-9, and IL-13 decreased significantly. At the end of the trial, IgE and eosinophil levels significantly decreased but allergen sensitivity did not show any changes from baseline. Respiratory infections were drastically reduced, and this decrease was related to the number of patients who had high serum levels of IL-10 and IFNγ and expressed LL-37 in their sputum.ConclusionTreatment of asthma patients with vitamin D reduced respiratory infections, and this effect was related to the increase of cathelicidin LL-37.Graphical abstractHighlightsVitamin D supplementation in asthmatic patients causes a decrease in colonization by pathogenic bacteria in airway.Vitamin D supplementation is associated with a increase of seric levels of IL-10 and IFNγ.Decrease of pathogenic bacteria in airway is associated with the expression of cathelicidin LL-37.

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