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Immunoregulatory mechanisms of vitamin D relevant to respiratory health and asthma

Authors

  • Elizabeth H. Mann,

    1. Medical Research Council (MRC) and Asthma U.K. Center for Allergic Mechanisms of Asthma, King's College London, London, United Kingdom
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  • Emma S. Chambers,

    1. Medical Research Council (MRC) and Asthma U.K. Center for Allergic Mechanisms of Asthma, King's College London, London, United Kingdom
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  • Paul E. Pfeffer,

    1. Medical Research Council (MRC) and Asthma U.K. Center for Allergic Mechanisms of Asthma, King's College London, London, United Kingdom
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  • Catherine M. Hawrylowicz

    Corresponding author
    1. Medical Research Council (MRC) and Asthma U.K. Center for Allergic Mechanisms of Asthma, King's College London, London, United Kingdom
    • Address for correspondence: Catherine M. Hawrylowicz, Department of Asthma, Allergy, and Respiratory Science, 5th Floor Tower Wing, Guy's Hospital, King's College London, London SE1 9RT, U.K. catherine.hawrylowicz@kcl.ac.uk

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Abstract

Vitamin D deficiency is prevalent among people with various immune-mediated conditions, including autoimmune diseases and asthma. Serum 25(OH)D levels inversely correlate with asthma severity, glucocorticoid responsiveness/dosage, and markers of pathogenesis, such as airway remodeling, IgE, and eosinophilia. Trials involving supplementation with active vitamin D or a precursor are beginning to emerge with variable results that, in part, reflect differences in study design. This review looks at the mechanisms by which vitamin D may protect against asthma, including increasing glucocorticoid responsiveness, skewing immune cells towards a regulatory phenotype, reducing the incidence of infections, airway remodeling, eosinophilia, and lowering the levels of IgE. Also discussed is the therapeutic potential for vitamin D, which is likely to be applicable to immune-mediated conditions beyond simply asthma.

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