這是medscape的CME中的一篇，當然，CME不會讓大家寫。

不過，相關的概念可以學一下

Clinical Context

Vitamin D has significant effects on immune function, and an editorial by Devereux and colleagues, which accompanies the current article, reviews the metabolism of vitamin D. Humans obtain approximately 90% of their vitamin D through sunlight, with the remainder coming from diet. Despite this fact, research has demonstrated that more than half of individuals in places with high exposure to sunshine, such as Hawaii, still have evidence of vitamin D deficiency. Foods with significant levels of naturally occurring vitamin D are limited to oily fish and egg yolk, although dairy products are often fortified with vitamin D.

Observational studies regarding the effects of vitamin D on asthma and allergy have yielded mixed results. The current study examines the effects of vitamin D on disease markers in asthmatic children.

Study Highlights

  • Study participants were Costa Rican children between the ages of 6 and 14 years with asthma. All children completed questionnaires regarding asthma severity, as well as pulmonary function testing, methacholine challenge testing, allergy skin testing, and measurement of total and allergen-specific serum IgE as well as peripheral blood eosinophils.
  • The main outcome of the study was the relationship between these outcomes and serum levels of 25(OH)D. Vitamin D deficiency was defined as levels of 25(OH)D less than 20 ng/mL, and levels between 20 and 30 ng/mL indicated insufficient vitamin D.
  • Researchers adjusted the study results to account for potential confounders, including age, sex, parental educational levels, and body mass index.
  • 616 children provided study data. The mean age was 8.7 years, and 40% of participants were girls. Elevated total IgE levels, increased eosinophil count, and skin test reactivity were common findings among this cohort, and 91% of children had experienced an unscheduled medical visit for asthma in the past year. Despite this, only 39% had received an anti-inflammatory medication in the last year.
  • 3.4% of participants had vitamin D deficiency, and another 24.6% were considered to have an insufficient amount of vitamin D.
  • 25(OH)D levels were inversely related to total IgE and eosinophil levels. For each 10-ng/mL increase in 25(OH)D levels in an average male subject, serum total IgE levels and eosinophil counts fell by 25 IU/mL and 29 cells/m3, respectively.
  • Vitamin D levels also were inversely related to the size of skin test reactivity to dust mites.
  • Higher vitamin D levels predicted less airway hyperresponsiveness on methacholine challenge tests, but there was no independent effect of 25(OH)D levels on the mean forced expiratory volume in 1 second.
  • Finally, vitamin D levels were inversely associated with the risk for hospitalization for asthma in the previous year.
  • In full confirmatory analysis, vitamin D levels were unrelated to the use of anti-inflammatory medications.

    • Clinical Implications

    Approximately 90% of vitamin D in humans is derived from the sun, but many individuals in sunny areas still have vitamin D deficiency. Vitamin D is found in oily fish and egg yolks, and it has been demonstrated to have immunomodulating effects.
    The current study of asthmatic children demonstrates that serum vitamin D levels are inversely related to serum total IgE levels and eosinophilia counts, airway hyperresponsiveness, and hospital admissions for asthma. However, vitamin D levels were unrelated to the mean forced expiratory volume in 1 second.Approximately 90% of vitamin D in humans is derived from the sun, but many individuals in sunny areas still have vitamin D deficiency. Vitamin D is found in oily fish and egg yolks, and it has been demonstrated to have immunomodulating effects.
    The current study of asthmatic children demonstrates that serum vitamin D levels are inversely related to serum total IgE levels and eosinophilia counts, airway hyperresponsiveness, and hospital admissions for asthma. However, vitamin D levels were unrelated to the mean forced expiratory volume in 1 second.Approximately 90% of vitamin D in humans is derived from the sun, but many individuals in sunny areas still have vitamin D deficiency. Vitamin D is found in oily fish and egg yolks, and it has been demonstrated to have immunomodulating effects.
    The current study of asthmatic children demonstrates that serum vitamin D levels are inversely related to serum total IgE levels and eosinophilia counts, airway hyperresponsiveness, and hospital admissions for asthma. However, vitamin D levels were unrelated to the mean forced expiratory volume in 1 second.Approximately 90% of vitamin D in humans is derived from the sun, but many individuals in sunny areas still have vitamin D deficiency. Vitamin D is found in oily fish and egg yolks, and it has been demonstrated to have immunomodulating effects.
    The current study of asthmatic children demonstrates that serum vitamin D levels are inversely related to serum total IgE levels and eosinophilia counts, airway hyperresponsiveness, and hospital admissions for asthma. However, vitamin D levels were unrelated to the mean forced expiratory volume in 1 second.

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