The effect of oral steroids with and without vitamin D3 on early efficacy of immunotherapy in asthmatic children
Article first published online: 7 OCT 2009
© 2009 Blackwell Publishing Ltd
Clinical & Experimental Allergy
Volume 39, Issue 12, pages 1830–1841, December 2009
How to Cite
Majak, P., Rychlik, B. and Stelmach, I. (2009), The effect of oral steroids with and without vitamin D3 on early efficacy of immunotherapy in asthmatic children. Clinical & Experimental Allergy, 39: 1830–1841. doi: 10.1111/j.1365-2222.2009.03357.x
- Issue published online: 13 NOV 2009
- Article first published online: 7 OCT 2009
- Submitted 26 March 2009; revised 20 July 2009; accepted 21 July 2009
- vitamin D3
Background The possibility of additional strategies to enhance the effectiveness of specific immunotherapy (SIT) is highly attractive.
Aim The aim of our study was to assess the influence of oral corticosteroids and oral corticosteroids combined with vitamin D3 on the early clinical and immunological effects of SIT.
Methods It was a randomized, double-blind, placebo-controlled trial conducted in 54 asthmatic children allergic to house dust mites. Intervention was based on receiving a single dose of oral steroid, with or without vitamin D3, or placebo only on the day of the build-up phase of SIT.
Results After 12 months of SIT, the median daily inhaled corticosteroid (ICS) dose, which controls the symptoms of asthma, was reduced by 25% in the steroid group. However, a 50% reduction of the median daily ICS dose was observed in the control group. The clinical effects of SIT were not affected in the steroid+D3 group. Concomitantly, we found that intervention with prednisone significantly impaired the induction of T regulatory lymphocytes. Importantly, the clinical and immunological effects of SIT were not affected by intervention with steroids administered with vitamin D3.
Conclusions Our study failed to show a beneficial effect of oral corticosteroids on allergen-specific immunotherapy. We observed that the combined administration of a corticosteroid drug and allergen extract suppressed the early clinical and immunological effects of SIT and that vitamin D3 prevented this ‘adverse’ influence of steroids.