Can vitamin D3 supplementation reduce the time to severe asthma exacerbations in children with asthma?

Idan Bokobza; Nour El Hadi; Andrew Bush; Heidi Makrinioti

doi:10.1183/20734735.0071-2021

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Figure 1
Actions of vitamin D on B-cells, T-cells and activated mast cells in the context of an allergen/virus-induced exacerbation of asthma. Th: T-helper cell; Treg: regulatory T-cell; Ig: immunoglobulin.

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Table 1

Randomised controlled trials of vitamin D₃ supplementation in preschool and school-age children with asthma

Study	Study type	Study population	Age, years	Baseline 25(OH)D, nmol·L⁻¹	Oral dose of vitamin D₃ (intervention arm)	Outcome
*Urashima et al. [17]*	Randomised controlled trial	School-age children with asthma	9.5 (2.1; 6.0–15.0)	Not determined	1200 IU·day⁻¹	Significant preventive effect against influenza A LRTIs
*Majak et al. [18]*	Randomised controlled trial with a cohort design	School-age children with asthma	10.9 (3.3; 6.0–17.0)	88.9 (38.2; 31.5–184.7)	500 IU·day⁻¹	Reduced the number of asthma exacerbations triggered by acute respiratory tract infection during 6 months of follow-up
*Tachimoto et al. [19]*	Randomised controlled trial with a cohort design	School-age children with asthma	9.9 (2.3; 6.0–15.0)	74.9 (24.6; 20.0–187.2)	800 IU·day⁻¹	Improved ACT at 6 months of follow-up
*Jensen et al. [20]*	Randomised controlled trial with a cohort design	Preschool children with recurrent wheeze	2.9 (1.1; 1.6–5.5)	64.2 (14.0; 42·0–87·0)	100 000 IU bolus plus 400 IU·day⁻¹	No effect on use of oral corticosteroids during 6 months of follow-up
*Kerley et al. [21]*	Randomised controlled trial with a cohort design	School-age children with asthma	8.6 (2.8; 5.0–15.0)	54.4 (17.4; 26.0–92.0)	2000 IU·day⁻¹	No significant difference in asthma control during 4 months of follow-up
*Jat et al. [15]*	Randomised controlled trial with a cohort design	Preschool and school-age children with asthma	8.1 (2.3; 4.0–12.0)	18.6 (4.1; 21.7–32.9)	1000 IU·day⁻¹	No significant difference in asthma control and in the number of asthma exacerbations during 9 months of follow-up

Data are presented as median (minimum; interquartile range), unless stated otherwise. 25(OH)D: 25-hydroxyvitamin D; LRTI: lower respiratory tract infection; ACT: asthma control test.