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The effect of oral steroids with and without vitamin D 3 on early efficacy of immunotherapy in asthmatic children
Author(s) -
Majak P.,
Rychlik B.,
Stelmach I.
Publication year - 2009
Publication title -
clinical and experimental allergy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.462
H-Index - 154
eISSN - 1365-2222
pISSN - 0954-7894
DOI - 10.1111/j.1365-2222.2009.03357.x
Subject(s) - medicine , placebo , prednisone , asthma , corticosteroid , adverse effect , vitamin d and neurology , clinical trial , vitamin , randomized controlled trial , immunotherapy , allergy , dexamethasone , immunology , alternative medicine , pathology , cancer
Summary Background The possibility of additional strategies to enhance the effectiveness of specific immunotherapy (SIT) is highly attractive. Aim The aim of our study was to assess the influence of oral corticosteroids and oral corticosteroids combined with vitamin D 3 on the early clinical and immunological effects of SIT. Methods It was a randomized, double‐blind, placebo‐controlled trial conducted in 54 asthmatic children allergic to house dust mites. Intervention was based on receiving a single dose of oral steroid, with or without vitamin D 3 , or placebo only on the day of the build‐up phase of SIT. Results After 12 months of SIT, the median daily inhaled corticosteroid (ICS) dose, which controls the symptoms of asthma, was reduced by 25% in the steroid group. However, a 50% reduction of the median daily ICS dose was observed in the control group. The clinical effects of SIT were not affected in the steroid+D 3 group. Concomitantly, we found that intervention with prednisone significantly impaired the induction of T regulatory lymphocytes. Importantly, the clinical and immunological effects of SIT were not affected by intervention with steroids administered with vitamin D 3 . Conclusions Our study failed to show a beneficial effect of oral corticosteroids on allergen‐specific immunotherapy. We observed that the combined administration of a corticosteroid drug and allergen extract suppressed the early clinical and immunological effects of SIT and that vitamin D 3 prevented this ‘adverse’ influence of steroids.