Therapeutic effect of Vitamin D3 in the treatment of allergic rhinitis
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Abstract
Background
Allergic rhinitis is a symptomatic disorder of the nasal passages, induced by hyper-activation of the immune system towards airborne allergens leading to an immunoglobulin E (IgE) mediated response. Domestic allergens, such as mites and insects or external plant-based allergens, including pollen and mold, represent potential triggers for allergic rhinitis. Additional factors, such as latex, tobacco smoke, exhaust fumes, and nitric oxide, can also contribute to its development. Several studies have shown that Vitamin D exerts a preventive role in modulating the immune syste and producing antimicrobial peptides on the respiratory epithelium, limiting the inflammatory response in various autoimmune diseases.
Objective
To evaluate Vitamin D3 supplementation as adjuvant therapy in allergic rhinitis and associated symptoms, such as rhinorrhea, nasal pruritus, sneezing, nasal congestion, nasal obstruction, hyposmia, ocular pruritus and redness, tearing and eyelid edema.
Methodology
A systematic review of the literature was carried out as per the PRISMA statement guidelines, CONSORT guidelines, and STROBE guidelines, resulting in 43 initial results. Following the evaluation of the abstracts, 27 articles were selected for a full-text reading and 6 were deemed eligible for inclusion in our review.
Results
A potentially positive role of Vitamin D3 supplementation as an adjuvant to conventional allergic rhinitis therapy emerged from all of the 6 trials evaluated. These studies showed a reduction in symptoms associated with allergic rhinitis (rhinorrhea, nasal pruritus, sneezing, nasal congestion, nasal obstruction, hyposmia, ocular pruritus and redness, tearing and eyelid edema), an increase in vitamin D blood levels in patients with deficiency, and improved immune system modulation by increasing T cell proliferation, facilitating the induction of FoxP3 + cells and TH 17 lymphocytes, and regulating IL-10 expression.
Conclusions
Available literature data regarding the administration of Vitamin D3 as adjuvant therapy for the treatment of allergic rhinitis and associated symptoms have shown encouraging results, demonstrating that supplementation with this vitamin can play a critical role in the treatment of this pathology. Further studies with larger sample size and shared treatment protocols are needed to confirm the findings reported in our review
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References
[2] Ariano R. (2015) Efficacy of a novel food supplement in the relief of the signs and symptoms of seasonal allergic rhinitis and in the reduction of the consumption of anti-allergic drugs. Acta Biomed; Vol. 86, N. 1: 53-58
[3] Bousquet P, Demoly P, Devillier P, et al (2013) Impact of allergic rhinitis symptoms on quality of life in primary care. Int Arch Allergy Immunol, 160:393-400. 10.1159/000342991
[4] Bukhari A., Felembam M., Halem (2020) 12(8): e9762. DOI 10.7759/cureus.9762
[5] Caprio M, Infante M, Calanchini M (2016) Vitamin D: not just the bone. Evidence for beneficial pleiotropic extraskeletal effects. Eat Weight Disord (2017) 22:27–41. DOI 10.1007/s40519-016-0312-6
[6] Gong W., Feng Y, Yan P. et al (2014). Effect of nasal instillation of vitamin D3 on patient with allergic rhi-nitis symptoms. Jul; 28(14):1031-3. PMID: 25330636
[7] Guillot X., Semeranoa L., Saidenberg-Kermanac’h N. et Al. (2020) Vitamin and infiammation Joint Bone Spine 77 552–557. doi:10.1016/j.jbspin.2010.09.018
[8] Hylander T, Latif L, Petersson-Westin U., et al (2013) Intralymphatic allergen-specific immunotherapy: an effective and safe alternative treatment route for pollen-induced allergic rhinitis. J Allergy Clin Immunol. , 131:412-420. 10.1016/j.jaci.2012.10.056
[9] Jensen SS, Madsen MW, Lukas J., et al. (2001) Inhibitory effects of 1alpha,25-dihydroxyvitamin D(3) on the G(1)-S phase-controlling machinery. Mol Endocrinol 15:1370–1380. doi:10.1210/mend.15.8.0673 Eat Weight Disord (2017) 22:27–41 37 123
[10] Kankova M, Luini W, Pedrazzoni M, et al (1991) Impairment of cytokine production in mice fed a vitamin D3-deficient diet. Immunology 73:466–471
[11] Mehdi B., Mohammadreza S., Freshteh E. et al (2019) Therapeutic effect of vitamin D supplementation on allergic rhinitis. European Archives of Oto-Rhino-Laryngology 276:2797–2801
[12] Modh D, Katarkar A, Thakkar B, et al (2014). Role of vitamin D supplementation in allergic rhinitis. Indian J Allergy Asthma Immunol;28:35-9
[13] Moher D., Liberati A, Tetzlaff J. (2015) Linee guida per il reporting di revisioni sistematiche e meta-analisi: il PRISMA Statemen. Evidence Volume 7 Issue 6 e1000114
[14] Osguthorpe JD. (2013)Pathophysiology of and potential new therapies for allergic rhinitis. Int Forum Aller-gy Rhinol; 3:384-92.
[15] Santoro D, Sebekova K, Teta D., (2015) Extraskeletal Functions of Vitamin D. Biomed Res Int. doi:10.1155/2015/ 294719
[16] Schulz F., Moher D., Altman G. (2010) CONSORT 2010 Statement: updated guidelines for reporting parallel group randomised trials. BMJ 2010; 340 doi: https://doi.org/10.1136/bmj.c332
[17] Seidman M, Gurgel RK, Lin SY, et al. (2015) Clinical practice guideline: allergic rhinitis. Otolaryngol Head Neck Surg., 152:S1-43.
[18] Settipane R, Schwindt C. (2013) Allergic rhinitis. Am J Rhinol Allergy., 27:S52-55. 10.2500/ajra.2013.27.3928
[19] Stokes P. (2016) The Relationship between Serum Vitamin D and Chronic Rhinosinusitis: A Systematic Re-view. American Journal of Rhinology and Allergy 30(1):23-28 DOI: 10.2500/ajra.2016.30.4267
[20] STROBE Statement—checklist of items that should be included in reports of observational studies. (2009) ©ISPM -University of Bern
[21] Tareke A., Hadgu A., Ayana A. (2020). Prenatal vitamin D supplementation and child respiratory health: A systematic review and meta-analysis of randomized controlled trials. World Allergy Organ J Nov 21;13(12):100486
[22] Upadhyay P., Rakhi J. (2017). The Effect of Vitamin D Supplementation on Children with Allergic Rhinitis. Pediatric Oncall Journal. Volume 14, Issue 3 View Pages: 56-59
[23] Webb AR, Pilbeam C, Hanafin N, Holick MF (1990) An evaluation of the relative contributions of exposure to sunlight and of diet to the circulating concentrations of 25-hydroxyvitamin D in an elderly nursing home population in Boston. Am J Clin Nutr 51:1075–1081
[24] Zhi-Jian Y. Lu Z., Xiang-Qian L. (2017). Vitamin D3 inhibits micro RNA 17-92 to promote specific immuno-therapy in allergic rhinitis. Scientific Reports 7: 546