Vitamin D supplementation during pregnancy positively affects wheezing in children (2023)

August 21, 2023

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(Video) The Best and Worst Times to Take Your Vitamin D! Dr. Mandell

Kim et al.JAllergiesClinImmunol. 2023; doi:10.1016/j.jaci.2023.06.030.

disclosures:Kim makes no financial disclosures. See the study for the relevant financial disclosures of all other authors.

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Key Learning Points:

  • Higher vitamin D levels 1 week postpartum were associated with an enriched sphingomyelin pathway.
  • This profile was associated with a reduced risk of recurrent wheezing and wheezing exacerbations.

The benefits of vitamin D exposure during pregnancy for children's respiratory health are driven by specific changes in maternal metabolism, according to a study published inThe diary of allergiesInClinical Immunology.

These protective effects were associated with a metabolism enriched in sphingomyelins,Min Kim, MSc, PhD,postdoctoral researcher, Copenhagen Prospective Studies on Asthma in Childhood (COPSAC), Herlev and Gentofte Hospital, University of Copenhagen, and colleagues wrote.

Vitamin D supplementation during pregnancy positively affects wheezing in children (1)

As part of the 2010 COPSAC cohort, 315 women received 2,800 IUsupplement with vitamin D3and 308 received 400 IU every day from week 24 of their pregnancy to 1 week postpartum.

The Vitamin D Reduction in Antenatal Asthma Trial (VDAART) included 876 women at high risk of having children with asthma who received 4,400 IU or 400 IU of vitamin D each day from weeks 10 to 18 of their pregnancy.

The COPSAC cohort also included 672 plasma metabolic profiles available 1 week after birth, including 276 from the low-dose vitamin D group, 286 from the high-dose vitamin D group, and 110 who did not receive vitamin D.

These datasets yielded 753 annotated metabolites from nine hypermetabolic pathways. Also, 565 children presented metabolic profiles at 6 months of age. VDAART included 779 women whose plasma metabolic profiles were measured between 32 and 38 weeks of pregnancy.

There were no significant differences between the metabolic profiles of women on standard and high doses of vitamin D3in the 2010 COPSAC cohort 1 week postpartum, the researchers said.

Similarly, the researchers said there were no significant differences in calibrated 25-hydroxyvitamin D (25(OH)D) levels 1 week after birth in an orthogonal partial least squares-Y (OPLS-Y) model.

But in a univariate approach with linear regression, 153 metabolites were nominally significant (Pi< .05) with 42 metabolites with a false discovery rate of 5% (FDR 5%), indicating that associations with 25(OH)D may be restricted to specific pathways, the researchers said.

Using 46 metabolites with a variable influence projection (VIP) score of less than 2, the researchers created a principal component analysis (PCA) model that showed that sphingomyelins were the metabolites that contributed the most to principal components 1 and 2.

Maternal standardized 25(OH)D had positive correlations with principal component 1 (B = 0.02;Pi= 1,93 × 108) and principal component 2 (B = 0.01;Pi= 7,86 × 107). Significant separation after cross-validation (Pi= 0.01) in a new OPLS-Y model also showed that exposure to 25(OH)D affects the metabolic profile of the 46 selected metabolites.

Sphingomyelins and phosphatidylcholine were both nominally significantly enriched in the 24 submetabolic pathways that also include the 46 selected metabolites, but only the sphingomyelin subpathway with 12 of these metabolites showed significant enrichment at an FDR of 5%.

In addition, principal component 2 was significantassociated with repetitive wheezing(HR = 0.92; 95% CI, 0.84-0.97) and wheezing exacerbations (HR = 0.92; 95% CI, 0.84-0.97), the researchers said.

But when the researchers stratified these results by the child's 17q21 rs12936231 genotype, the associations between primary component 2 and recurrent wheezing (HR = 0.87; 95% CI, 0.76-0.99) and worsening of wheezing (HR = 0.79; 90.6% 0.95) were significant only in children with low-risk GG genotype.

The 12 sphingomyelins belonging to the pathway showed significant enrichment, the researchers said, but none of them had an individual association with recurrent wheezing, persistent wheezing or asthma, worsening wheezing or the number of bothersome lung symptoms in children aged 0 to 3 years.

The researchers had measurements for 45 of the 46 selected metabolites in COPSAC 2010 available on VDAART from weeks 32 to 38 of pregnancy. Asthma and wheezing were associated with principal components 1 (OR = 0.92; 95% CI, 0.85-0.99) and 2 (OR = 0.88; 95% CI, 0.78-0.99 ;Pi= .03) at ages 0 to 3 years.

Primary component 2 was associated with asthma status at age 3 years (OR = 0.88, 95% CI, 0.77–0.99). Primary component 1 was associated with total number of infections (odds ratio = 0.97, 95% CI 0.94–0.99) from age 3 months to age 3 years.

Consistent with the 2010 COPSAC results, the researchers said sphingomyelin was the most significantly enriched metabolic pathway in a pathway enrichment analysis of the 38 metabolites with a VIP score greater than 2.

(Video) Vitamin D supplementation during pregnancy and the prevention of childhood asthma

The researchers further found that 25(OH)D levels had little effect on associations between maternal metabolic profiles 1 week postpartum and COPSAC 2010 clinical endpoints in a model adjusted for the effect of 25(OH)D levels on children. at 6 months of age and other confounding variables.

In addition, principal components 1 and 2 of a PCA based on the 38 metabolites available in the children's metabolism showed no effect on repeated wheezing or wheezing, the researchers said.

There were significant increases in sphingosine-1-phosphate levels when human bronchial epithelial cells were treated with high doses of 25(OH)D3, including 0nM vs. 1nM (Pi< .05) en 0nM vs. 10nM (Pi< .001) as well, the researchers said.

Overall, elevated maternal 25(OH)D levels 1 week after birth were characterized by sphingomyelins in an enriched sphingolipid pathway, the researchers said, with reduced risk of recurrent wheezing and wheezing exacerbations by age 3 years in the children, even after adjusting the levels. 25(OH)D in 6-month-old children.

There were also no significant associations between the 25(OH)D-related metabolic profile and repeated exacerbations of wheezing and wheezing at 6 months of age, the researchers continued, underscoring the importance of vitamin D exposure during pregnancy for promoting respiratory health. to the children.

The researchers also concluded that their findings showed a correlation between 25(OH)D3 treatment and cytoplasmic production of sphingolipids in bronchial epithelial cells.

Given these beneficial effects of high levels of 25(OH)D in pregnancy on childhood asthma phenotypes, the researchers said strategies to prevent childhood asthma may include treatments targeting maternal sphingomyelin metabolism.

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FAQs

Vitamin D supplementation during pregnancy positively affects wheezing in children? ›

We analyzed if the vitamin D supplementation by pregnant women can prevent the future asthma development in their children (Fig. 2 A, B). Data from clinical trials showed that vitamin D decreased the risk of wheezing incident by 23% (RR = 0.77; 95% CI [0.64; 0.92]; p < 0.0049, I2 = 0%).

Does vitamin D help wheezing? ›

In pediatric and adult populations, several trials have failed to show a significant benefit of vitamin D supplementation on respiratory outcomes, including asthma or upper respiratory infections. In addition, in a study of extremely preterm infants, vitamin D did not affect duration of respiratory support.

Are maternal vitamin D and E intakes during pregnancy associated with asthma in children? ›

Low maternal vitamin D and E intakes during pregnancy are associated with increased risk of children developing asthma in the first 10 years of life.

Can vitamin D deficiency cause wheezing? ›

Several other studies also found that Vitamin D deficiency may lead to an increase in the frequency of asthma and attacks of wheezing and necessitate more medications. [8,9] It is clear that Vitamin D protects children against viral infections and the exacerbation of asthma.

Does vitamin D supplementation affect asthma outcomes? ›

Conclusions: Vitamin D supplementation significantly increased patients' serum vitamin D levels, but it had no benefit for asthma control.

What vitamin deficiency causes wheezing? ›

Some scientists believe that asthma and vitamin deficiencies are linked. It is thought that certain vitamins—most specifically vitamin D, vitamin C, and vitamin E—play a role in not only the development of asthma but also the severity and frequency of asthma attacks.

Does vitamin D help with breathing problems? ›

The study stated that after adjusting for potential confounders, low levels of serum vitamin D were found to be "independently associated" ​with asthma, bronchitis, wheeze and chest tightness. Conversely, higher levels of vitamin D were linked to better lung function.

Is vitamin D deficiency a factor influencing asthma control in children? ›

Children with vitamin D deficiency had significantly less well- controlled asthma as compared to those with insufficient or sufficient levels of 25 (OH) vitamin D (13.3% vs 88.9 % vs 100%). Conclusion: Vitamin D deficiency is associated with suboptimal asthma control.

Does a mother's exposure to pollution during pregnancy affect the child's risk for asthma? ›

Epidemiological studies show that maternal smoking and particulate matter exposure during pregnancy are prominent risk factors for the development of childhood asthma.

What are the effects of vitamin D on maternal fetal outcomes in pregnancy? ›

Several studies have associated low maternal vitamin D status to adverse outcomes in pregnancy, including preeclampsia, gestational diabetes, preterm births, low birth weight, and others.

Which vitamin is good for wheezing? ›

Vitamin A-rich foods: A recent study[3] on the role of Vitamin A supplementation and asthma in children found that Vitamin A aids in asthma control. It was reported that children with asthma typically manifest deficiency of this vitamin, which is also related to various lung disorders.

Can vitamin D cause respiratory problems? ›

Various studies have emphasized the association between low levels or deficiency of vitamin D with increased risk of asthma and other respiratory disease symptoms [7,8,9,10] including lower lung function [11].

How does vitamin D affect the respiratory system? ›

Vitamin D can influence all three innate immune effectors in the lungs and thus may play an important role in how the lung recognizes and responds to pathogens. Activation of the innate immune system drives activation of the long term adaptive immune system (Iwasaki and Medzhitov 2010).

What should I take to stop wheezing? ›

How to stop wheezing
  1. Drinking warm fluids.
  2. Breathing moist air by taking a steamy shower or using a humidifier.
  3. Avoiding smoking or being exposed to smoke.
  4. Avoiding cold, dry air.
  5. Performing deep breathing exercises.
Mar 10, 2022

What is good for wheezing lungs? ›

  • Drink warm liquids. If your wheezing symptoms are caused by mucus in your windpipe, drinking warm liquids might help. ...
  • Inhale moist air. Inhaling moist air or steam works similarly to drinking warm liquids. ...
  • Eat more fruits and vegetables. ...
  • Avoid smoke. ...
  • Try pursed lip breathing. ...
  • Avoid exercising in cold, dry weather.

What does vitamin D do for the respiratory system? ›

Vitamin D can influence all three innate immune effectors in the lungs and thus may play an important role in how the lung recognizes and responds to pathogens. Activation of the innate immune system drives activation of the long term adaptive immune system (Iwasaki and Medzhitov 2010).

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3. Vitamin D in pregnancy, birth and later life - Dr Elina Hypponen
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4. Vitamin D3 Benefits, Uses and Side Effects | Everything You Need To Know!
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5. The MOST Important Video for Pregnant Women
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6. Vitamin D as a Modifier of Genomic Function and Phenotypic expression During Pregnancy
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References

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