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Background
Asthma represents one of the most common chronic diseases and is a major public health problem worldwide. In the majority of patients control of asthma as defined by guidelines can be achieved with long-term maintenance medications. However, a substantial proportion of patients do not achieve optimal asthma control despite even high dose treatment. In particular inadequately controlled patients with severe persistent asthma are at high risk of severe exacerbations and asthma-related mortality. These patients represent the greatest unmet medical need among the asthmatic population today.
Vitamin D insufficiency is increasingly recognized in the general population, and has been largely attributed to dietary, lifestyle and behavioral changes. While its musculoskeletal consequences are well established, a new hypothesis links asthma to subnormal vitamin D levels. Vitamin D has several effects on the innate and adaptive immune systems that might be relevant in the primary prevention of asthma, in the protection against or reduction of asthma morbidity, and in the modulation of the severity of asthma exacerbations. Cross-sectional data indicate that low 25(OH)D levels in patients with mild to moderate asthma are correlated with poor asthma control, reduced lung function, reduced glucocorticoid response, more frequent exacerbations, and consequent increased steroid use. However, there is insufficient evidence to support a causal association between vitamin D status and asthma per se. More so, there are very limited data in adult asthma patients addressing the impact of vitamin D status on disease control and severity. Therefore, the aim of this study was to prospectively investigate the prevalence of vitamin D insufficiency and deficiency in adult patients with asthma and its potential relationship with parameters of asthma severity and control, with a particular focus on patients with severe and uncontrolled disease.
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