Bose S, Diette GB, Woo H, Koehler K, Romero K, Rule AM, Detrick B, Brigham E, McCormack MC, Hansel NN (2019) J Allergy Clin Immunol Pract. 2019 Feb. pii: S2213-2198(19)30160-6. doi: 10.1016/j.jaip.2019.01.051. [Epub ahead of print]
Indoor fine particulate air pollution (PM2.5) is linked to asthma morbidity; however, whether vitamin D status influences individual susceptibility to airborne exposures is unclear.
We aimed to determine if vitamin D modifies effects of indoor PM2.5 upon asthma symptoms in urban children.
120 children aged 5-12 years with physician-diagnosed asthma were evaluated at baseline and every 3 months for 9 months. Indoor PM2.5, serum 25-hydroxy vitamin D (25-OH D) levels and asthma symptoms were simultaneously assessed at each time point. Adjusting for confounders, generalized estimating equations assessed 3-way interaction effects of 25-OH D, obesity and PM upon asthmasymptoms.
Children were of mean (SD) age 9.7 (2.2) years, 36% were obese, and 95% self-reported black race. Mean (SD) PM2.5 indoorexposure was 38.2 (42.9) μg/m3 and 25-OH D was 19.1 (7.5) ng/ml.
Three-way interaction models demonstrated significantly greater PM2.5-associated effects on daytime asthma symptoms only among obese children with low 25-OH D levels (ORPM2.5=1.26,p =0.049 at vitaminD=15.5 ng/ml), increasingly stronger PM effects at levels2.5, higher 25-OH D was associated with decreased symptom odds (e.g., ORVitamin D = 0.87; p=0.049 at PM2.5 = 52.5 μg/m3, increasingly protective effects >52.5 μg/m3) among obese children.
Among obese urban children with asthma, low individual 25-OH vitamin D enhanced adverse respiratory effects associated with indoor PM2.5. In high PM2.5 environments, 25-OH D was protective against asthma symptoms. Optimizing vitamin D status in children may help reduce asthma morbidity driven by indoor air pollution.