Vitamin D in Obstructive Lung Diseases

描述（由申请人提供）：哮喘和慢性阻塞性肺疾病（COPD）分别是儿童和成人发病的主要原因。哮喘是发达国家儿童最常见的慢性疾病，引起大量医疗保健费用，并且哮喘的患病率持续增加。据估计，多达1600万美国人患有慢性阻塞性肺病，它现在是美国第四大最常见的死因。在五大死亡原因中，慢性阻塞性肺病是唯一在患病率和死亡率方面都在持续增加的主要疾病。有初步数据表明，维生素D的摄入可以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，据推测，维生素D可能通过对免疫系统的这些影响在哮喘和慢性阻塞性肺病中发挥作用。然而，目前还没有研究表明哮喘或慢性阻塞性肺病患者体内维生素D水平降低。因此，在进行更昂贵和更明确的研究（如维生素D补充的临床试验）之前，需要更多令人信服的证据来证明维生素D与这些肺部疾病之间的联系。该项目建议在三个队列中测量储存的血清样本中的维生素D水平——两个哮喘队列（儿童哮喘管理项目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（规范老龄化研究队列）。我们将确定白种人、非裔美国人和西班牙裔哮喘患者之间维生素D水平是否存在差异，以及哮喘队列中维生素D是否与更严重的哮喘有关。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与这些结果之间的联系，这将为更明确地研究维生素D在阻塞性肺病、哮喘和慢性阻塞性肺病中的作用铺平道路。显示血清中维生素D水平与阻塞性肺病之间的关系将具有重大的公共卫生意义，并将进一步证明需要增加维生素D的推荐摄入量。此外，补充维生素D可以在具有成本效益的以人群为基础的项目中实施，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.