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Hope for resistant asthma therapy
Source : BBC News
A vitamin supplement may help treat asthma patients who do not respond to standard drugs, research suggests.
People who fail to respond to steroid therapy suffer repeated attacks and are at a greater risk of dying.
A team at King's College London found the vitamin D3 could improve these patients' responsiveness to steroids.
The researchers say their work, published in the Journal of Clinical Investigation, could potentially save patients' lives and NHS resources.
This has major implications for how to treat patients with severe asthma and could also substantially reduce the use of NHS resources
Research Professor Tak Lee said "Asthma is usually treated very effectively with inhaled steroids, but for some patients taking steroid tablets is the only option, even though they can cause serious side effects. Some people, however, fail to respond even to high doses of oral steroids." and continued "This research is really exciting and points the direction towards potential new strategies for reversing steroid resistance. This has major implications for how to treat patients with severe asthma and could also substantially reduce the use of NHS resources."
The team's results imply that steroid treatment works, at least in part, by inducing the T-cells of the immune system to synthesise a secreted signalling molecule, called IL-10.
This molecule can inhibit the immune responses that cause the symptoms of allergic and asthmatic disease.
Unlike T-cells from healthy individuals, or patients that respond to steroids, T-cells taken from patients who are steroid resistant do not produce IL-10 when cultured in vitro with the steroid, dexamethasone.
However, the researchers found that when vitamin D3 was added to the culture medium along with dexamethasone, this defect was reversed.
The researchers gave daily vitamin D3 supplements to people with asthma who were unresponsive to steroids for seven days.
Blood tests showed the patients' T-cells were more responsive to dexamethasone after they had taken the supplement.
Further work needed
Lead researcher Dr Catherine Hawrylowicz said: "At the moment we only have a preliminary experimental observation. "We now need to test the benefits of this treatment in the clinic, and we are currently putting a proposal together to carry out this work.
"Interestingly, vitamin D3 is at present occasionally administered to patients with severe asthma to help prevent steroid-induced osteoporosis.
"Our studies suggest that there is an additional potential benefit to this treatment."
Dr Lyn Smurthwaite, research development manager at Asthma UK, said: "Two-point-six million people in the UK have severe asthma symptoms, many of whom have restricted treatment options available to them as they do not respond to conventional steroid therapy.
"This research opens up a potentially important new avenue for developing treatments for people with difficult to control asthma."
Dr Catherine Hawrylowicz, Partner 15 in Euro-Thymaide Consortium is in charge of deciphering the human inducible IL-10 secreting regulatory T cells (IL-10-Treg) in allergy and astha in the Euro-Thymaide Integrated Project. This project is co-financed by the European Union.