Associations between vitamin D status and biomarkers linked with inflammation in patients with asthma: a systematic review and meta-analysis of interventional and observational studies.

IF 5.8 2区 医学 Q1 Medicine
Asmae El Abd, Harika Dasari, Philippe Dodin, Helen Trottier, Francine M Ducharme
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引用次数: 0

Abstract

Background: Numerous studies indicate an association between vitamin D status and inflammatory biomarkers in patients with asthma, but findings are inconsistent. This review aims to summarize the relationship between serum vitamin D status, assessed by 25-hydroxyvitamin D (25(OH)D) level, and inflammatory biomarkers in children and adults with asthma.

Methods: A literature search of interventional and observational studies on 25(OH)D up to November 2022 was conducted across six electronic databases. Outcomes of interest included a range of inflammatory biomarkers classified in four categories: T helper 2 (Th2) pro-inflammatory, non-Th2 pro-inflammatory, anti-inflammatory, and non-specific biomarkers. Study characteristics were extracted and risk of bias was evaluated using the American Academy of Nutrition and Dietetics tool. Meta-analysis was conducted on studies with a low risk of bias, while narrative reporting was used to present the direction of associations (positive, no association, or negative) for each biomarker, overall and within the low-risk studies.

Results: We included 71 studies (3 interventional, 68 observational) involving asthma patients. These studies investigated the association between serum 25(OH)D and Th2 pro-inflammatory biomarkers (N = 58), non-Th2 pro-inflammatory biomarkers (N = 18), anti-inflammatory biomarkers (N = 16), and non-specific biomarkers (N = 10). Thirteen (18.3%) studies, 50 (70.4%), and 8 (11.3%) were at high, moderate, and low risk of bias, respectively. In all studies, irrespective of risk of bias, the most frequently reported finding was no significant association, followed by a negative association between 25(OH)D and pro-inflammatory biomarkers and a positive association with anti-inflammatory biomarkers. In low-risk studies, one biomarker could be meta-analysed. The pooled estimate for 25(OH)D and serum IgE showed a negative association (β (95% CI)= - 0.33 (-0.65 to - 0.01); I2 = 88%; N = 4 studies). A negative association between 25(OH)D and blood eosinophils was also observed in the largest of three studies, as well as with cathelicidin (LL-37) in the only study reporting it. For other biomarkers, most low-risk studies revealed no significant association with 25(OH)D.

Conclusion: Serum 25(OH)D is negatively associated with serum IgE and possibly with blood eosinophils and LL-37, supporting an in vivo immunomodulatory effect of 25(OH)D. Future research should employ rigorous methodologies and standardized reporting for meta-analysis aggregation to further elucidate these associations.

哮喘患者维生素 D 状态与炎症相关生物标志物之间的关系:对干预性和观察性研究的系统回顾和荟萃分析。
背景:大量研究表明,哮喘患者的维生素 D 状态与炎症生物标志物之间存在关联,但研究结果并不一致。本综述旨在总结以25-羟基维生素D(25(OH)D)水平评估的儿童和成人哮喘患者血清维生素D状态与炎症生物标志物之间的关系:在六个电子数据库中检索了截至 2022 年 11 月有关 25(OH)D 的干预性和观察性研究文献。感兴趣的结果包括一系列炎症生物标志物,分为四类:T辅助2(Th2)促炎、非Th2促炎、抗炎和非特异性生物标志物。使用美国营养与饮食学会工具提取了研究特征并评估了偏倚风险。对偏倚风险较低的研究进行了荟萃分析,同时使用叙述性报告来说明总体和低风险研究中每种生物标志物的关联方向(正相关、无关联或负相关):我们纳入了 71 项涉及哮喘患者的研究(3 项干预性研究,68 项观察性研究)。这些研究调查了血清 25(OH)D 与 Th2 促炎生物标志物(58 项)、非 Th2 促炎生物标志物(18 项)、抗炎生物标志物(16 项)和非特异性生物标志物(10 项)之间的关系。分别有 13 项(18.3%)、50 项(70.4%)和 8 项(11.3%)研究存在高、中和低偏倚风险。在所有研究中,无论偏倚风险如何,最常报告的发现是无显著关联,其次是 25(OH)D 与促炎症生物标志物呈负相关,与抗炎症生物标志物呈正相关。在低风险研究中,可以对一种生物标志物进行荟萃分析。25(OH)D与血清IgE的汇总估计值呈负相关(β (95% CI)= - 0.33 (-0.65 to - 0.01);I2 = 88%;N = 4项研究)。在三项最大的研究中,也观察到 25(OH)D 与血液中的嗜酸性粒细胞呈负相关;在唯一一项报告中,也观察到 25(OH)D 与 cathelicidin(LL-37)呈负相关。至于其他生物标志物,大多数低风险研究显示与 25(OH)D 没有显著关联:结论:血清 25(OH)D 与血清 IgE 呈负相关,可能还与血液中的嗜酸性粒细胞和 LL-37 呈负相关,这支持了 25(OH)D 的体内免疫调节作用。未来的研究应采用严格的方法和标准化报告进行荟萃分析,以进一步阐明这些关联。
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来源期刊
Respiratory Research
Respiratory Research RESPIRATORY SYSTEM-
CiteScore
9.70
自引率
1.70%
发文量
314
审稿时长
4-8 weeks
期刊介绍: Respiratory Research publishes high-quality clinical and basic research, review and commentary articles on all aspects of respiratory medicine and related diseases. As the leading fully open access journal in the field, Respiratory Research provides an essential resource for pulmonologists, allergists, immunologists and other physicians, researchers, healthcare workers and medical students with worldwide dissemination of articles resulting in high visibility and generating international discussion. Topics of specific interest include asthma, chronic obstructive pulmonary disease, cystic fibrosis, genetics, infectious diseases, interstitial lung diseases, lung development, lung tumors, occupational and environmental factors, pulmonary circulation, pulmonary pharmacology and therapeutics, respiratory immunology, respiratory physiology, and sleep-related respiratory problems.
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