Vitamin D and Responses to Inhaled Fluticasone in Severe Chronic Obstructive Pulmonary Disease

Overview

Journal Int J Chron Obstruct Pulmon Dis

Publisher Dove Medical Press

Specialty Pulmonary Medicine

Date 2011 Feb 12

PMID 21311691

Citations 4

Authors

Ken M Kunisaki

Thomas S Rector

Affiliations

Soon will be listed here.

Abstract

Background: Patients with chronic obstructive pulmonary disease (COPD) demonstrate variable responses to inhaled corticosteroids (ICS). The factors contributing to this variability are not well understood. Data from patients with asthma have suggested that low 25-hydroxyvitamin D [25(OH)D] levels contribute to a lack of ICS response in asthma. The objective of this study was to determine whether serum levels of 25(OH)D were related to ICS responses in patients with COPD.

Methods: A total of 60 exsmokers with severe COPD (mean forced expiratory volume in one second [FEV(1)] 1.07 L, 36% of predicted) spent 4 weeks free of any ICS, followed by 4 weeks of ICS use (fluticasone propionate 500 μg twice daily). Spirometry was performed prior to and after 4 weeks of ICS use. Blood 25(OH)D levels were measured prior to ICS use and examined for relationships to changes in FEV(1) following the 4 weeks of ICS use.

Results: The mean 25(OH)D level was 23.3 ± 9.3 ng/mL. There was a high prevalence of vitamin D insufficiency (35%) and deficiency (40%). There was no relationship between baseline 25(OH)D and changes in FEV(1) following 4 weeks of ICS.

Conclusion: Baseline 25(OH)D does not contribute to the variation in short-term FEV(1) responses to ICS in patients with severe COPD.

Citing Articles

A Literature Review of the Potential Impact of Medication on Vitamin D Status.

Wakeman M Risk Manag Healthc Policy. 2021; 14:3357-3381.

PMID: 34421316 PMC: 8373308. DOI: 10.2147/RMHP.S316897.

Effects of Vitamin D Intake on FEV1 and COPD Exacerbation: A Randomized Clinical Trial Study.

Zendedel A, Gholami M, Anbari K, Ghanadi K, Bachari E, Azargon A Glob J Health Sci. 2015; 7(4):243-8.

PMID: 25946929 PMC: 4802087. DOI: 10.5539/gjhs.v7n4p243.

Vitamin D levels and risk of acute exacerbations of chronic obstructive pulmonary disease: a prospective cohort study.

Kunisaki K, Niewoehner D, Connett J Am J Respir Crit Care Med. 2011; 185(3):286-90.

PMID: 22077070 PMC: 3297108. DOI: 10.1164/rccm.201109-1644OC.

Vitamin d and susceptibility of chronic lung diseases: role of epigenetics.

Sundar I, Rahman I Front Pharmacol. 2011; 2:50.

PMID: 21941510 PMC: 3171063. DOI: 10.3389/fphar.2011.00050.

References

Brehm J, Celedon J, Soto-Quiros M, Avila L, Hunninghake G, Forno E . Serum vitamin D levels and markers of severity of childhood asthma in Costa Rica. Am J Respir Crit Care Med. 2009; 179(9):765-71. PMC: 2675563. DOI: 10.1164/rccm.200808-1361OC. View

Kunisaki K, Rice K, Janoff E, Rector T, Niewoehner D . Exhaled nitric oxide, systemic inflammation, and the spirometric response to inhaled fluticasone propionate in severe chronic obstructive pulmonary disease: a prospective study. Ther Adv Respir Dis. 2009; 2(2):55-64. DOI: 10.1177/1753465808088902. View

Szafranski W, Cukier A, Ramirez A, Menga G, Sansores R, Nahabedian S . Efficacy and safety of budesonide/formoterol in the management of chronic obstructive pulmonary disease. Eur Respir J. 2003; 21(1):74-81. DOI: 10.1183/09031936.03.00031402. View

Riancho J, Gonzalez Macias J, Del Arco C, Amado J, Freijanes J, Anton M . Vertebral compression fractures and mineral metabolism in chronic obstructive lung disease. Thorax. 1987; 42(12):962-6. PMC: 461059. DOI: 10.1136/thx.42.12.962. View

Hankinson J, Odencrantz J, Fedan K . Spirometric reference values from a sample of the general U.S. population. Am J Respir Crit Care Med. 1999; 159(1):179-87. DOI: 10.1164/ajrccm.159.1.9712108. View

. Standardization of Spirometry, 1994 Update. American Thoracic Society. Am J Respir Crit Care Med. 1995; 152(3):1107-36. DOI: 10.1164/ajrccm.152.3.7663792. View

Kunisaki K, Niewoehner D, Singh R, Connett J . Vitamin D status and longitudinal lung function decline in the Lung Health Study. Eur Respir J. 2010; 37(2):238-43. PMC: 3070416. DOI: 10.1183/09031936.00146509. View

Brehm J, Schuemann B, Fuhlbrigge A, Hollis B, Strunk R, Zeiger R . Serum vitamin D levels and severe asthma exacerbations in the Childhood Asthma Management Program study. J Allergy Clin Immunol. 2010; 126(1):52-8.e5. PMC: 2902692. DOI: 10.1016/j.jaci.2010.03.043. View

Sutherland E, Goleva E, Jackson L, Stevens A, Leung D . Vitamin D levels, lung function, and steroid response in adult asthma. Am J Respir Crit Care Med. 2010; 181(7):699-704. PMC: 2868500. DOI: 10.1164/rccm.200911-1710OC. View

10.

Searing D, Zhang Y, Murphy J, Hauk P, Goleva E, Leung D . Decreased serum vitamin D levels in children with asthma are associated with increased corticosteroid use. J Allergy Clin Immunol. 2010; 125(5):995-1000. PMC: 2866800. DOI: 10.1016/j.jaci.2010.03.008. View

11.

Holick M . Vitamin D deficiency. N Engl J Med. 2007; 357(3):266-81. DOI: 10.1056/NEJMra070553. View

12.

Ginde A, Liu M, Camargo Jr C . Demographic differences and trends of vitamin D insufficiency in the US population, 1988-2004. Arch Intern Med. 2009; 169(6):626-32. PMC: 3447083. DOI: 10.1001/archinternmed.2008.604. View

13.

Forli L, Halse J, Haug E, Bjortuft O, Vatn M, Kofstad J . Vitamin D deficiency, bone mineral density and weight in patients with advanced pulmonary disease. J Intern Med. 2004; 256(1):56-62. DOI: 10.1111/j.1365-2796.2004.01337.x. View

14.

Calverley P, Pauwels R, Vestbo J, Jones P, Pride N, Gulsvik A . Combined salmeterol and fluticasone in the treatment of chronic obstructive pulmonary disease: a randomised controlled trial. Lancet. 2003; 361(9356):449-56. DOI: 10.1016/S0140-6736(03)12459-2. View

15.

Xystrakis E, Kusumakar S, Boswell S, Peek E, Urry Z, Richards D . Reversing the defective induction of IL-10-secreting regulatory T cells in glucocorticoid-resistant asthma patients. J Clin Invest. 2005; 116(1):146-55. PMC: 1307558. DOI: 10.1172/JCI21759. View

16.

Chinellato I, Piazza M, Sandri M, Peroni D, Piacentini G, Boner A . Vitamin D serum levels and markers of asthma control in Italian children. J Pediatr. 2010; 158(3):437-41. DOI: 10.1016/j.jpeds.2010.08.043. View

17.

Shane E, Silverberg S, Donovan D, Papadopoulos A, Staron R, Addesso V . Osteoporosis in lung transplantation candidates with end-stage pulmonary disease. Am J Med. 1996; 101(3):262-9. DOI: 10.1016/S0002-9343(96)00155-6. View

18.

Janssens W, Bouillon R, Claes B, Carremans C, Lehouck A, Buysschaert I . Vitamin D deficiency is highly prevalent in COPD and correlates with variants in the vitamin D-binding gene. Thorax. 2009; 65(3):215-20. DOI: 10.1136/thx.2009.120659. View

19.

Aaron S, Vandemheen K, Fergusson D, Maltais F, Bourbeau J, Goldstein R . Tiotropium in combination with placebo, salmeterol, or fluticasone-salmeterol for treatment of chronic obstructive pulmonary disease: a randomized trial. Ann Intern Med. 2007; 146(8):545-55. DOI: 10.7326/0003-4819-146-8-200704170-00152. View