Skip to main content
Top
Published in: European Archives of Oto-Rhino-Laryngology 10/2019

01-10-2019 | Allergic Rhinitis | Rhinology

Therapeutic effect of vitamin D supplementation on allergic rhinitis

Authors: Mehdi Bakhshaee, Mohammadreza Sharifian, Freshteh Esmatinia, Bashir Rasoulian, Masoud Mohebbi

Published in: European Archives of Oto-Rhino-Laryngology | Issue 10/2019

Login to get access

Abstract

Purpose

In this study, we aimed to determine whether short-term (2 months) vitamin D supplementation could improve the allergic symptoms in AR patients.

Methods

A randomized double-blind placebo-controlled clinical trial was performed on allergic rhinitis patients with vitamin D deficiency from Nov. 2017–2018. 80 cases with allergic rhinitis and vitamin D deficiency were divided into two groups and vitamin D plus routine antihistamine medication (cetirizine) was prescribed for the study group, whereas the control group received cetirizine plus placebo. The clinical symptoms questionnaire was completed at baseline and after 4 and 8 weeks of treatment initiation. Vitamin D levels were re-measured at the end of the 8-week treatment course.

Results

In total, 80 patients with allergic rhinitis and vitamin D deficiency were enrolled. Among them, 35 cases and 33 controls visited the clinic after 8 weeks; the mean age in the aforementioned groups was 29.68 years and 29.13 years demonstrating no meaningful difference (P > 0.05). At study initiation, the mean vitamin D level was 14 ng/ml and 14.67 ng/ml in the study and control groups, respectively, indicating no significant difference (P = 0.189). The mean serum vitamin D level at 8 weeks of treatment in the study group (24.08 ng/ml) indicated a statistically meaningful difference with the mean vitamin D level at baseline (P < 0.001). Comparison of the mean scores of symptoms severity showed no significant difference between the two groups at study initiation and 4 weeks later (P = 0.073), whereas a significant difference was obtained between baseline and 8 weeks of treatment initiation (P = 0.007).

Conclusion

Based on the findings of the present study, it can be concluded that vitamin D supplementation along with antihistamines can result in relative symptoms improvement in AR patients with vitamin D deficiency.
Literature
1.
go back to reference Chong SN, Chew FT (2018) Epidemiology of allergic rhinitis and associated risk factors in Asia. World Allergy Organ J 11(1):17CrossRef Chong SN, Chew FT (2018) Epidemiology of allergic rhinitis and associated risk factors in Asia. World Allergy Organ J 11(1):17CrossRef
2.
go back to reference Bauchau V, Durham SR (2004) Prevalence and rate of diagnosis of allergic rhinitis in Europe. Eur Respir J 24(5):758–764CrossRef Bauchau V, Durham SR (2004) Prevalence and rate of diagnosis of allergic rhinitis in Europe. Eur Respir J 24(5):758–764CrossRef
3.
go back to reference Zuberbier T, Lötvall J, Simoens S, Subramanian SV, Church MK (2014) Economic burden of inadequate management of allergic diseases in the European Union: a GA2LEN review. Allergy 69(10):1275–1279CrossRef Zuberbier T, Lötvall J, Simoens S, Subramanian SV, Church MK (2014) Economic burden of inadequate management of allergic diseases in the European Union: a GA2LEN review. Allergy 69(10):1275–1279CrossRef
4.
go back to reference Kulthanan K, Chusakul S, Recto MT, Gabriel M, Aw DC, Prepageran N, Wong A, Leong JL, Foong H, Quang VT, Zuberbier T (2018) Economic burden of the inadequate management of allergic rhinitis and urticaria in asian countries based on the GA2LEN model. Allergy Asthma Immunol Res 10(4):370–378CrossRef Kulthanan K, Chusakul S, Recto MT, Gabriel M, Aw DC, Prepageran N, Wong A, Leong JL, Foong H, Quang VT, Zuberbier T (2018) Economic burden of the inadequate management of allergic rhinitis and urticaria in asian countries based on the GA2LEN model. Allergy Asthma Immunol Res 10(4):370–378CrossRef
5.
go back to reference Bunyavanich S, Rifas-Shiman SL, Platts-Mills TA, Workman L, Sordillo JE, Camargo CA Jr, Gillman MW, Gold DR, Litonjua AA (2016) Prenatal, perinatal, and childhood vitamin D exposure and their association with childhood allergic rhinitis and allergic sensitization. J Allergy Clin Immunol 137(4):1063–1070CrossRef Bunyavanich S, Rifas-Shiman SL, Platts-Mills TA, Workman L, Sordillo JE, Camargo CA Jr, Gillman MW, Gold DR, Litonjua AA (2016) Prenatal, perinatal, and childhood vitamin D exposure and their association with childhood allergic rhinitis and allergic sensitization. J Allergy Clin Immunol 137(4):1063–1070CrossRef
6.
go back to reference Dogru M, Suleyman A (2016) Serum 25-hydroxyvitamin D3 levels in children with allergic or nonallergic rhinitis. Int J Pediatr Otorhinolaryngol 1(80):39–42CrossRef Dogru M, Suleyman A (2016) Serum 25-hydroxyvitamin D3 levels in children with allergic or nonallergic rhinitis. Int J Pediatr Otorhinolaryngol 1(80):39–42CrossRef
7.
go back to reference Bener A, Ehlayel MS, Bener HZ, Hamid Q (2014) The impact of vitamin D deficiency on asthma, allergic rhinitis and wheezing in children: an emerging public health problem. J Fam Community Med 21(3):154CrossRef Bener A, Ehlayel MS, Bener HZ, Hamid Q (2014) The impact of vitamin D deficiency on asthma, allergic rhinitis and wheezing in children: an emerging public health problem. J Fam Community Med 21(3):154CrossRef
8.
go back to reference Tian HQ, Cheng L (2017) The role of vitamin D in allergic rhinitis. Asia Pac Allergy 7(2):65–73CrossRef Tian HQ, Cheng L (2017) The role of vitamin D in allergic rhinitis. Asia Pac Allergy 7(2):65–73CrossRef
9.
go back to reference Muehleisen B, Gallo RL (2013) Vitamin D in allergic disease: shedding light on a complex problem. J Allergy Clin Immunol 131(2):324–329CrossRef Muehleisen B, Gallo RL (2013) Vitamin D in allergic disease: shedding light on a complex problem. J Allergy Clin Immunol 131(2):324–329CrossRef
10.
go back to reference Goldring ST, Griffiths CJ, Martineau AR, Robinson S, Yu C, Poulton S, Kirkby JC, Stocks J, Hooper R, Shaheen SO, Warner JO (2013) Prenatal vitamin d supplementation and child respiratory health: a randomised controlled trial. PLoS ONE 8(6):e66627CrossRef Goldring ST, Griffiths CJ, Martineau AR, Robinson S, Yu C, Poulton S, Kirkby JC, Stocks J, Hooper R, Shaheen SO, Warner JO (2013) Prenatal vitamin d supplementation and child respiratory health: a randomised controlled trial. PLoS ONE 8(6):e66627CrossRef
11.
go back to reference Hyppönen EL, Sovio U, Wjst M, Patel S, Pekkanen J, Hartikainen AL, Järvelinb MR (2004) Infant vitamin D supplementation and allergic conditions in adulthood: northern Finland birth cohort 1966. Ann N Y Acad Sci 1037(1):84–95CrossRef Hyppönen EL, Sovio U, Wjst M, Patel S, Pekkanen J, Hartikainen AL, Järvelinb MR (2004) Infant vitamin D supplementation and allergic conditions in adulthood: northern Finland birth cohort 1966. Ann N Y Acad Sci 1037(1):84–95CrossRef
12.
go back to reference Brożek JL, Bousquet J, Agache I, Agarwal A, Bachert C, Bosnic-Anticevich S, Brignardello-Petersen R, Canonica GW, Casale T, Chavannes NH, de Sousa JC (2017) Allergic rhinitis and its impact on asthma (ARIA) guidelines—2016 revision. J Allergy Clin Immunol 140(4):950–958CrossRef Brożek JL, Bousquet J, Agache I, Agarwal A, Bachert C, Bosnic-Anticevich S, Brignardello-Petersen R, Canonica GW, Casale T, Chavannes NH, de Sousa JC (2017) Allergic rhinitis and its impact on asthma (ARIA) guidelines—2016 revision. J Allergy Clin Immunol 140(4):950–958CrossRef
13.
go back to reference Holick MF, Binkley NC, Bischoff-Ferrari HA, Gordon CM, Hanley DA, Heaney RP, Murad MH, Weaver CM (2011) Evaluation, treatment, and prevention of vitamin D deficiency: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab 96(7):1911–1930CrossRef Holick MF, Binkley NC, Bischoff-Ferrari HA, Gordon CM, Hanley DA, Heaney RP, Murad MH, Weaver CM (2011) Evaluation, treatment, and prevention of vitamin D deficiency: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab 96(7):1911–1930CrossRef
14.
go back to reference Weiler JM, Meltzer EO, Benson PM, Weiler K, Widlitz MD, Freitag J (1994) A dose-ranging study of the efficacy and safety of azelastine nasal spray in the treatment of seasonal allergic rhinitis with an acute model. J Allergy Clin Immunol 94(6):972–980CrossRef Weiler JM, Meltzer EO, Benson PM, Weiler K, Widlitz MD, Freitag J (1994) A dose-ranging study of the efficacy and safety of azelastine nasal spray in the treatment of seasonal allergic rhinitis with an acute model. J Allergy Clin Immunol 94(6):972–980CrossRef
15.
go back to reference Norman AW (2008) From vitamin D to hormone D: fundamentals of the vitamin D endocrine system essential for good health. Am J Clin Nutr 88(2):491S–499SCrossRef Norman AW (2008) From vitamin D to hormone D: fundamentals of the vitamin D endocrine system essential for good health. Am J Clin Nutr 88(2):491S–499SCrossRef
16.
go back to reference Litonjua AA, Carey VJ, Laranjo N, Harshfield BJ, McElrath TF, O’connor GT, Sandel M, Iverson RE, Lee-Paritz A, Strunk RC, Bacharier LB (2016) Effect of prenatal supplementation with vitamin D on asthma or recurrent wheezing in offspring by age 3 years: the VDAART randomized clinical trial. JAMA 315(4):362–370CrossRef Litonjua AA, Carey VJ, Laranjo N, Harshfield BJ, McElrath TF, O’connor GT, Sandel M, Iverson RE, Lee-Paritz A, Strunk RC, Bacharier LB (2016) Effect of prenatal supplementation with vitamin D on asthma or recurrent wheezing in offspring by age 3 years: the VDAART randomized clinical trial. JAMA 315(4):362–370CrossRef
17.
go back to reference Tachimoto H, Mezawa H, Segawa T, Akiyama N, Ida H, Urashima M (2016) Improved control of childhood asthma with low-dose, short-term vitamin D supplementation: a randomized, double-blind, placebo-controlled trial. Allergy 71(7):1001–1009CrossRef Tachimoto H, Mezawa H, Segawa T, Akiyama N, Ida H, Urashima M (2016) Improved control of childhood asthma with low-dose, short-term vitamin D supplementation: a randomized, double-blind, placebo-controlled trial. Allergy 71(7):1001–1009CrossRef
18.
go back to reference Wjst M, Hyppönen E (2007) Vitamin D serum levels and allergic rhinitis. Allergy 62(9):1085–1086CrossRef Wjst M, Hyppönen E (2007) Vitamin D serum levels and allergic rhinitis. Allergy 62(9):1085–1086CrossRef
19.
go back to reference Modh D, Katarkar A, Thakkar B, Jain A, Shah P, Joshi K (2014) Role of vitamin D supplementation in allergic rhinitis. Indian J Allergy Asthma Immunol 28(1):35CrossRef Modh D, Katarkar A, Thakkar B, Jain A, Shah P, Joshi K (2014) Role of vitamin D supplementation in allergic rhinitis. Indian J Allergy Asthma Immunol 28(1):35CrossRef
20.
go back to reference Maslova E, Hansen S, Jensen CB, Thorne-Lyman AL, Strøm M, Olsen SF (2013) Vitamin D intake in mid-pregnancy and child allergic disease—a prospective study in 44,825 Danish mother-child pairs. BMC Pregnancy Childbirth 13(1):199CrossRef Maslova E, Hansen S, Jensen CB, Thorne-Lyman AL, Strøm M, Olsen SF (2013) Vitamin D intake in mid-pregnancy and child allergic disease—a prospective study in 44,825 Danish mother-child pairs. BMC Pregnancy Childbirth 13(1):199CrossRef
21.
go back to reference Jerzyńska J, Stelmach W, Rychlik B, Majak P, Podlecka D, Woicka-Kolejwa K, Stelmach I (2018) Clinical and immunological effects of vitamin D supplementation during the pollen season in children with allergic rhinitis. Arch Med Sci AMS 14(1):122CrossRef Jerzyńska J, Stelmach W, Rychlik B, Majak P, Podlecka D, Woicka-Kolejwa K, Stelmach I (2018) Clinical and immunological effects of vitamin D supplementation during the pollen season in children with allergic rhinitis. Arch Med Sci AMS 14(1):122CrossRef
22.
go back to reference Majak P, Jerzyńska J, Smejda K, Stelmach I, Timler D, Stelmach W (2012) Correlation of vitamin D with Foxp3 induction and steroid-sparing effect of immunotherapy in asthmatic children. Ann Allergy Asthma Immunol 109(5):329–335CrossRef Majak P, Jerzyńska J, Smejda K, Stelmach I, Timler D, Stelmach W (2012) Correlation of vitamin D with Foxp3 induction and steroid-sparing effect of immunotherapy in asthmatic children. Ann Allergy Asthma Immunol 109(5):329–335CrossRef
23.
go back to reference Boonstra A, Barrat FJ, Crain C, Heath VL, Savelkoul HF, O’Garra A (2001) 1α, 25-Dihydroxyvitamin D3 has a direct effect on naive CD4+ T cells to enhance the development of Th2 cells. J Immunol 167(9):4974–4980CrossRef Boonstra A, Barrat FJ, Crain C, Heath VL, Savelkoul HF, O’Garra A (2001) 1α, 25-Dihydroxyvitamin D3 has a direct effect on naive CD4+ T cells to enhance the development of Th2 cells. J Immunol 167(9):4974–4980CrossRef
Metadata
Title
Therapeutic effect of vitamin D supplementation on allergic rhinitis
Authors
Mehdi Bakhshaee
Mohammadreza Sharifian
Freshteh Esmatinia
Bashir Rasoulian
Masoud Mohebbi
Publication date
01-10-2019
Publisher
Springer Berlin Heidelberg
Published in
European Archives of Oto-Rhino-Laryngology / Issue 10/2019
Print ISSN: 0937-4477
Electronic ISSN: 1434-4726
DOI
https://doi.org/10.1007/s00405-019-05546-x

Other articles of this Issue 10/2019

European Archives of Oto-Rhino-Laryngology 10/2019 Go to the issue