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A recent study published in the current issue of the American Thoracic Society’s "American Journal of Respiratory and Critical Care Medicine" studied the effect of vitamin D on the pathophysiology of asthma in children with severe, therapy resistant asthma (STRA). They found that low levels of vitamin D in the blood of children suffering from STRA may cause structural changes in the airway muscles resulting in breathlessness.

 

Though treatment with corticosteroids is the standard way of treating asthma, 5 to 10 percent of children suffering from asthma do not respond to low dose corticosteroids. The episodes of asthma in these children are more severe in nature and more frequent too. They require more treatment as compared to other children suffering from asthma. Such children are said to be suffering from STRA.

 

The researchers, led by Dr. Atul Gupta, from Royal Brompton Hospital and the National Heart and Lung Institute (NHLI) at Imperial College and King's College London, examined 86 children for the study. 36 children suffered from STRA, 26 had moderate asthma and 24 non-asthmatic children served as controls. The researchers studied the relationships between vitamin D levels and lung function, the amount of medicines used and episodes of symptom exacerbations. They also examined samples of airway tissue from the patients of STRA and noted the changes in the smooth muscles lining the airways.

 

At the end of the study, the researchers found that children suffering from STRA had lower levels of vitamin D in their blood. They suffered from more severe episodes of asthma and consumed more medicine to control their symptoms. The tissue sample from the airways of such patients showed increased muscle mass. As the increased muscle mass in the airways makes breathing more labored, the researchers suggest that supplementation of vitamin D in patients suffering from STRA may aid in reducing this muscle mass and help in better control of asthma. The exact mechanism by which vitamin D effects the structural changes in the airways is yet to be studied. Once this mechanism becomes clear, it will open new treatment strategies for children with STRA.

 

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