Vitamin D in Obstructive Lung Diseases

描述(申请人提供)：哮喘和慢性阻塞性肺疾病(COPD)分别是导致儿童和成人发病的主要原因。在发达国家，哮喘是最常见的儿童慢性疾病，造成巨大的医疗费用，而且哮喘的患病率还在继续增加。据估计，多达1600万美国人患有慢性阻塞性肺病，现在它是美国第四大最常见的死亡原因。在前五大死因中，慢性阻塞性肺病是发病率和死亡率持续上升的唯一一种重大疾病。有初步数据表明，维生素D摄入会影响幼儿喘息表型的发展，血清维生素D水平与肺功能有关。维生素D受体存在于免疫细胞中，维生素D在免疫系统细胞的发育和功能中发挥作用，推测维生素D可能通过对免疫系统的这些作用在哮喘和COPD中发挥作用。然而，还没有研究表明哮喘或慢性阻塞性肺病患者的维生素D水平降低。因此，在进行更昂贵和更明确的研究之前，如维生素D补充剂的临床试验，需要更令人信服的证据来证明维生素D和这些肺部疾病之间的联系。该项目建议在三个队列中测量存储的血清样本中的维生素D水平--两个哮喘队列(儿童哮喘管理计划队列和哥斯达黎加哮喘遗传学队列)和一个成人普通人群队列(标准老龄化研究队列)。我们将确定高加索人、非裔美国人和西班牙裔哮喘患者的维生素D水平是否存在差异，以及维生素D是否与哮喘队列中更严重的哮喘有关。我们还将在成人队列中确定维生素D是否与肺功能下降和COPD的发展有关。如果我们能够证明维生素D和这些结果之间的联系，这将为更明确地研究维生素D在阻塞性肺疾病、哮喘和COPD中的作用铺平道路。显示血清维生素D水平与阻塞性肺疾病之间的关系将具有重大的公共卫生意义，并将增加维生素D建议摄入量需要增加的证据。此外，补充维生素D可以在具有成本效益的基于人群的计划中实施，以预防和治疗这些疾病的发展。

DESCRIPTION (provided by applicant): Asthma and chronic obstructive lung disease (COPD) are some of the leading causes of morbidity in children and adults, respectively. Asthma is the most common chronic disease of childhood in the developed world, incurs significant healthcare costs, and the prevalence of asthma has continued to increase. It has been estimated that as many as 16 million Americans have COPD and it is now the fourth most common cause of death in the United States. Among the top 5 causes of death, COPD is the only major disease that is continuing to increase in both prevalence and mortality. There is preliminary data that vitamin D intake can affect the development of wheezing phenotypes in young children and that serum vitamin D levels are associated with lung function. Vitamin D receptors are present in immune cells and vitamin D plays a role in the development and function of the cells of the immune system, and it is postulated that vitamin D may play a role in asthma and COPD via these effects on the immune system. However, there have been no studies that have shown decreased vitamin D levels in subjects with asthma or COPD. Thus, before pursuing more expensive and definitive studies such as clinical trials of vitamin D supplementation, more convincing evidence is needed for the association between vitamin D and these lung diseases. This project proposes to measure vitamin D levels from stored serum samples in three cohorts - two asthma cohorts (the Childhood Asthma Management Program cohort and the Genetics of Asthma in Costa Rica cohort) and an adult general population cohort (the Normative Aging Study cohort). We will determine whether there are any differences in vitamin D levels between Caucasian, African- American, and Hispanic asthmatics, and whether vitamin D is associated with more severe asthma in the asthma cohorts. We will also determine whether vitamin D is associated with lung function decline and development of COPD in the adult cohort. If we are able to demonstrate an association between vitamin D and these outcomes, this will pave the way for more definitive studies of the role of vitamin D in obstructive lung diseases, asthma and COPD. Showing a relationship between vitamin D levels in serum and obstructive lung diseases will have great public health significance and will add to the evidence that recommended vitamin D intakes need to be increased. Additionally, supplementation with vitamin D can be implemented in cost-effective population-based programs to prevent the development of, and treat these disorders.