Serum25（OH） D₃and Asthma In Adult

Bronchial asthma, which is characterized by cough, gasping and short of breath, isone of the most common chronic respiratory diseases that influence on life qualities of thepatients. Investigating the mechanism of asthma is always the focus of preclinical andclinical medicine as the incidence of asthma soars year by year. Many inflammatoryells,constructive cells and their components contribute to the chronic inflammatory disease.In recent years, many researches showed that the skewing of the Th1to Th2has arelationship with asthma.Vitamin D is well established to have a role in the calciummetabolism and bone formation, and recently be found to involve in immune regulation byinhibiting the proliferation and differentiation of Th2cell and enhancing the expression ofcytokines like IL-10, which restrain the release of Th2cytokin profile induced byallergens. Some reseaches indicated that the children with asthma had lower25（OH）D₃levels than normal ones and that the deficiency or shortage of25（OH）D₃was associatedwith children asthma and increased airway responsiveness in children under3years old.But few is known regarding the relationship between adults asthma and25（OH）D₃. In thisreserch, we investigated the association of serum25（OH）D₃concentrations with lungfunction and the treatment response in adult chronic persistent asthmatics. This reserch consisted of two parts.Part One: Serum25（OH）D₃Concentrations and Lung Function Test in Adultpatients with asthmaObjective：To determine the serum levels of25-hydroxyvitamin D₃（25（OH）D₃） inadult asthma patients and its relationship to lung function. Methods：A total of162adultswith asthma were enrolled, serum25（OH）D₃was determined by theelectrochemoluminescence method. Lung function was measured with the GermanyJAEGER lung function instrument，which include forced vital capacity （FVC）, forcedexpiratory volume in1second （FEV1）, FEV1%predicted value and FEV1/FVC ratio.Bronchial provocation test or bronchial relaxation test were performed based on the valueof FEV1. The relationship between serum concentrations of25（OH）D₃and PD20FEV1formethacholine（PD20MCH-FEV1）,increase in FEV1, increase in FEV1ratio were allanalyzed. Results：The Serum25（OH）D₃in asthmatic adult was lower compared to thereference value in health adults. In patients receiving bronchial provocation test, positivecorrelation was found between PD20FEV1（MCH） and serum25（OH）D₃（r=0.73,P<0.001）. In patients had bronchial relaxation test, serum25（OH）D₃concentrations werepositively correlated with both increase in FEV1and in FEV1%pred.（r=0.53and0.59,respectively, P<0.01）.Conclusions: In adult asthma, serum level of25（OH）D₃is lowerthan the reference values in health adults, and negatively correlated with airwayhyperresponsiveness （AHR）, and positively with the improvement of airway obstruction inpatients receiving short-acting β2receptor agonist.Part Two: Serum25（OH）D₃Concentrations and Asthma control.Objective: To explore the relationship of serum25（OH）D₃concentrations with theresponse to ICS combined with LABA in adult patients with moderate persistent asthma.Methods:95patients with moderate persistent asthma were tested for serum25（OH）D₃concentrations and treated with standard salmeterolticasone（50ug/250ug）inhalation（1inhalation, twice a day for3months）. Lung function index included FEV1,FEV1%pred.,FEF25%-75%,as well as asthma control test scores before and after the treatment wereall evaluated. Results: A total of40patients were followed to the end of the study. Serum 25（OH）D₃concentrations were positively related to the increase of FEV1%pred（.r=0.445,P=0.004）, FEF25%-75%（r=0.557, P<0.001）and ACT （r=0.477, P=0.002） after3-monthtreatment. Conclusion: Serum25（OH）D₃is positively related to the degree of theimprovement of lung function and ACT scores after treatment by ICS combined withLABA in paersistent asthmatic adult.