Resumen
El asma es una enfermedad de etiología desconocida que cursa con inflamación crónica de las vías respiratorias. Las células que median la respuesta inflamatoria generan especies reactivas de oxígeno, que en conjunto con otras especies oxidantes presentes de manera natural en las vías aéreas ocasionan la ruptura del equilibrio redox, generando estrés oxidativo. Se ha propuesto que este puede revertirse mediante la administración de vitaminas antioxidantes como A, C, E y D y de esta forma aliviar, mejorar o proteger a las personas con asma. En esta investigación se revisaron los ensayos observacionales y controlados con placebo relativos al papel de las vitaminas antioxidantes en el curso del asma, publicados entre 1979 y 2016. Los motores de búsqueda fueron Google y Google Scholar; las bases de datos consultadas fueron PubMed y The Cochrane Library. Se encontraron y revisaron 75 artículos relevantes para el tema, de los cuales se concluyó que no está claro si la ingesta de suplementos de estas vitaminas tiene algún efecto clínico benéfico en el control del asma. Son necesarios más ensayos controlados y de mayor duración para elucidar el papel de estos nutrientes en el curso del asma.
Referencias
Global Asthma Network. [Sitio web]. The Global Asthma Report 2014. Nueva Zelanda: Global Asthma Network; 2014. Disponible en: http://www.globalasthmareport.org/resources/Global_Asthma_Report_2014.pdf
Han YY, Blatter J, Brehm JM, Forno E, Litonjua AA, Celedón JC. Diet and asthma: vitamins and methyl donors. Lancet Respir Med. 2013;1(10):813-822. DOI: 10.1016/S2213-2600(13)70126-7
Rebolledo-Cobos RC, Teixeira B, Correa C. Asma, estrés oxidativo y ejercicio físico: revisión de literatura. Fisioterapia. 2014;36(1):40-48. DOI: 10.1016/j.ft.2013.06.002
Barnes PJ. Reactive oxygen species and airway inflammation. Free Radic Biol Med. 1990;9(3):235-243. DOI: 10.1016/0891-5849(90)90034-G
Henricks PA, Nijkamp FP. Reactive oxygen species as mediators in asthma. Pulm Pharmacol Ther. 2001;14(6):409-420. DOI: 10.1006/pupt.2001.0319
Riccioni G, Barbara M, Bucciarelli T, Di-Ilio C, D’Orazio N. Antioxidant vitamin supplementation in asthma. Ann Clin Lab Sci. 2007;37(1):96-101.
Rosanna DP, Salvatore C. Reactive oxygen species, inflammation, and lung diseases. Curr Pharm Des. 2012;18(26):3889-3900. DOI: 10.2174/138161212802083716
Martínez-Cayuela M. Oxygen free radicals and human disease. Biochimie. 1995;77(3):147-161. DOI: 10.1016/0300-9084(96)88119-3
Oberholzer HM, Pretorius E. The role of vitamins and minerals in the alleviation of asthma symptoms. Early Child Dev Care. 2006;180(7):913-920. DOI: 10.1080/03004430802525047
Rahman I, Biswas SK, Kode A. Oxidant and antioxidant balance in the airways and airway diseases. Eur J Pharmacol. 2006;533(1-3):222-239. DOI: 10.1016/j.ejphar.2005.12.087
Birben E, Sahiner, UM, Sackesen C, Erzurum S, Kalayci O. Oxidative stress and antioxidant defense. World Allergy Organ J. 2012;5(1):9-19. DOI: 10.1097/WOX.0b013e3182439613
Moreno-Macías H, Romieu I. Effects of antioxidant supplements and nutrients on patients with asthma and allergies. J Allergy Clin Immunol. 2014;133(5):1237-1244. DOI: 10.1016/j.jaci.2014.03.020
Nadeem A, Chhabra SK, Masood A, Raj HG. Increased oxidative and altered levels of antioxidants in asthma. J Allergy Clin Immunol. 2003;111(1):72-78. DOI: 10.1067/mai.2003.17
Sahiner UM, Birben E, Erzurum S, Sackesen C, Kalayci O. Oxidative stress in asthma. World Allergy Organ J. 2011;4(10):151-158. DOI: 10.1097/WOX.0b013e318232389e
Patel BD, Welch AA, Bingham SA, Luben RN, Day NE, Khaw KT, et al. Dietary antioxidants and asthma in adults. Thorax. 2006;61(5):388-393. DOI: 10.1136/thx.2004.024935
Harik-Khan RI, Muller DC, Wise RA. Serum vitamin levels and the risk of asthma in children. Am J Epidemiol 2004;159(4):351-357.
Gilliland FD, Berhane KT, Li YF, Gauderman WJ, McConnell R, Peters J. Children’s lung function and antioxidant vitamin, fruit, juice and vegetable intake. Am J Epidemiol. 2003;158(6):576-584. DOI: 10.1093/aje/kwg181
Allen S, Britton JR, Leonardi-Bee JA. Association between antioxidant vitamins and asthma outcome measures: systematic review and meta-analysis. Thorax. 2009;64(7):610-619. DOI: 10.1136/thx.2008.101469
Murr C, Schroecksnadel K, Winkler C, Ledochowski M, Fuchs D. Antioxidants may increase the probability of developing allergic diseases and asthma. Med Hypotheses. 2005;64(5):973-977. DOI: 10.1016/j.mehy.2004.11.011
Kerley CP, Elnazir B, Faul J, Cormican L. Vitamin D as an adjunctive therapy in asthma. Part 1: A review of potential mechanisms. Pulm Pharmacol Ther. 2015:32:60-74. DOI: 10.1016/j.pupt.2015.02.004
Hollick MF. Photosynthesis of vitamin D in the skin: Effect of environmental and life-style variables. Fed Proc. 1987;46(5):1876-1882.
Adams JS, Hewison M. Update in vitamin D. J Clin Endocrinol Metab. 2010;95(2):471-478. DOI: 10.1210/jc.2009-1773
Watkins RR, Lemonovich TL, Salata RA. An update on the association of vitamin D deficiency with common infectious diseases. Can J Physiol Pharmacol. 2015;93(5):363-368. DOI: 10.1139/cjpp-2014-0352
Kerley CP, Elnazir B, Faul J, Cormican L. Vitamin D as an adjunctive therapy in asthma. Part 2: a review of human studies. Pulm Pharmacol Ther. 2015;32:75-92. DOI: 10.1016/j.pupt.2015.02.010
Majak P, Jerzyńska J, Smejda K, Stelmach I, Timler D, Stelmach W. Correlation of vitamin D with Foxp3 induction and steroid-sparing effect of immunotherapy in asthmatic children. Ann Allergy Asthma Immunol. 2012;109(5):329-335. DOI: 10.1016/j.anai.2012.08.002
Tse SM, Kelly HW, Litonjua AA, Van-Natta ML, Weiss ST, Tantisira KG, et al. Corticosteroid use and bone mineral accretion in children with asthma: effect modification by vitamin D. J Allergy Clin Immunol. 2012;130(1):53-60. DOI: 10.1016/j.jaci.2012.04.005
Lewis E, Fernández C, Nella A, Hopp R, Gallagher JC, Casale TB. Relationship of 25-hydroxyvitamin D and asthma control in children. Ann Allergy Asthma Immunol. 2012;108(4):281-282. DOI: 10.1016/j.anai.2012.01.003
Wagner CL, Greer FR, American Academy of Pediatrics Section on Breastfeeding, American Academy of Pediatrics Committee on Nutrition. Prevention of rickets and vitamin D deficiency in infants, children, and adolescents. Pediatrics. 2008;122(5):1142-1152. DOI: 10.1542/peds.2008-1862
Institute of Medicine (US) Committee to Review Dietary Reference Intakes for Vitamin D and Calcium; Ross C, Taylor CL, Yaktine AL, Del Valle HB, editors. Dietary reference intakes for calcium and vitamin D. Washington, DC: The National Academies Press; 2011. p. 345-402.
Gimeno J. Recomendaciones sobre cómo administrar la vitamina D. Guías internacionales y nacionales. Rev Osteoporos Metab Miner. 2014;6 Suppl 1:19-22. DOI: 10.4321/S1889-836X2014000500004
Määtä AM, Kotaniemi-Syrjänen A, Malmström K, Malmberg LP, Sundvall J, Pelkonen AS, et al. Vitamin D, high-sensitivity C-reactive protein, and airway hyperresponsiveness in infants with recurrent respiratory symptoms. Ann Allergy Asthma Immunol. 2017;119(3):227-231. DOI: 10.1016/j.anai.2017.06.014
Van-Oeffelen AA, Bekkers MBM, Smit HA, Kerkhof M, Koppelman GH, Haveman-Nies A, et al. Serum micronutrient concentrations and childhood asthma: the PIAMA birth cohort study. Pediatr Allergy Immunol. 2011;22(8):784-793. DOI: 10.1111/j.1399-3038.2011.01190.x
Litonjua AA, Carey VJ, Laranjo N, Harshfield BJ, McElrath TF, O’Connor GT, et al. Effect of prenatal supplementation with vitamin D on asthma or recurrent wheezing in offspring by age 3 years: the VDAART randomized clinical trial. JAMA. 2016;315(4):362-370. DOI: 10.1001/jama.2015.18589
Chawes BL, Bønnelykke K, Stokholm J, Vissing NH, Bjarnadóttir E, Schoos AMM, et al. Effect of vitamin D3 supplementation during pregnancy on risk of persistent wheeze in the offspring. A randomized clinical trial. JAMA. 2016;315(4):353-361. DOI: 10.1001/jama.2015.18318
Von-Mutius E, Martínez FD. Inconclusive results of randomized trials of prenatal vitamin D for asthma prevention in offspring: curbing the enthusiasm. JAMA. 2016;315(4):347-348. DOI: 10.1001/jama.2015.18963
Hahn DL. Glucocorticosteroids are potential confounders in studies of vitamin D and asthma. Am J Respir Crit Care Med. 2012;185(11):1245-1246. DOI: 10.1164/ajrccm.185.11.1245a
Skversky AL, Kumar J, Abramowitz MK, Kaskel FJ, Melamed ML. Association of glucocorticoid use and low 25-hydroxyvitamin D levels: results from the National Health and Nutrition Examination Survey (NHANES): 2001-2006. J Clin Endocrinol Metab. 2011;96(12):3838-3845. DOI: 10.1210/jc.2011-1600
Schauber J, Dorschner RA, Coda AB, Büchau AS, Liu PT, Kiken D, et al. Injury enhances TLR2 function and antimicrobial peptide expression through a vitamin D-dependent mechanism. J Clin Invest. 2007;117(3):803-811. DOI: 10.1172/JCI30142
Schauber J, Gallo RL. Vitamin D and asthma: not a strong link-yet. J Allergy Clin Immunol. 2008;121(3):782-784. DOI: 10.1016/j.jaci.2007.12.1170
Martineau AR, Cates CJ, Urashima M, Jensen M, Griffiths AP, Nurmatov U, et al. Vitamin D for the management of asthma. Cochrane Database Syst Rev. 2016;9:CD011511. DOI: 10.1002/14651858.CD011511.pub2
Fogarty A, Lewis SA, Scrivener SL, Antoniak M, Pacey S, Pringle M, et al. Corticosteroid sparing effects of vitamin C and magnesium in asthma: a randomised trial. Respir Med. 2006;100(1):174-179. DOI: 10.1016/j.rmed.2005.03.038
Biltagi MA, Baset AA, Bassiouny M, Kasrawi M, Attia M. Omega-3 fatty acids, vitamin C and Zn supplementation in asthmatic children: a randomized self-controlled study. Acta Paediatr. 2009;98(4):737-742. DOI: 10.1111/j.1651-2227.2008.01213.x
Tecklenburg SL, Mickleborough TD, Fly AD, Bai Y, Stager JM. Ascorbic acid supplementation attenuates exercise-induced bronchoconstriction in patients with asthma. Respir Med. 2007;101(8):1770-1778. DOI: 10.1016/j.rmed.2007.02.014
McKeever Tricia M, Britton John. Diet and asthma. Am J Respir Crit Care Med. 2004;170(7):725-729. DOI: 10.1164/rccm.200405-611PP
Kaur B, Rowe BH, Ram FS. Vitamin C supplementation for asthma. Cochrane Database Syst Rev. 2001;(4):CD000993. DOI: 10.1002/14651858.CD000993
Fogarty A, Lewis SA, Scrivener SL, Antoniak M, Pacey S, Pringle M, et al. Oral magnesium and vitamin C supplements in asthma: a parallel group randomized placebo-controlled trial. Clin Exp Allergy. 2003;33(10):1355-1359. DOI: 10.1046/j.1365-2222.2003.01777.x
Kordansky DW, Rosenthal RR, Norman PS. The effect of vitamin C on antigen-induced bronchospasm. J Allergy Clin Immunol. 1979;63(1):61-64. DOI: 10.1016/0091-6749(79)90163-5
Malo JL, Cartier A, Pineau L, L'Archevêque J, Ghezzo H, Martin RR. Lack of acute effects of ascorbic acid on spirometry and airway responsiveness to histamine in subjects with asthma. J Allergy Clin Immunol. 1986;78(6):1153-1158. DOI: 10.1016/0091-6749(86)90265-4
Wilkinson M, Hart A, Milan SJ, Sugumar K. Vitamins C and E for asthma and exercise-induced bronchoconstriction. Cochrane Database Syst Rev. 2014;(6):CD010749. DOI: 10.1002/14651858.CD010749.pub2
Hernández M, Zhou H, Zhou B, Robinette C, Crissman K, Hatch G, et al. Combination treatment with high-dose vitamin C and alpha-tocopherol does not enhance respiratory-tract lining fluid vitamin C levels in asthmatics. Inhal Toxicol. 2009;21(3):173-181. DOI: 10.1080/08958370802161077
Brigelius-Flohé R, Traber MG. Vitamin E: functions and metabolism. FASEB J. 1999;13(10):1145-1155.
Kollek I, Sinha P, Rüstow B. Vitamin E as an antioxidant of the lung: mechanisms of vitamin E delivery to alveolar type II cells. Am J Respir Crit Care Med. 2002;166(12 Pt 2):S62-S66. DOI: 10.1164/rccm.2206019
Wood LG, Garg ML, Blake RJ, Simpson JL, Gibson PG. Oxidized vitamin E and glutathione as markers of clinical status in asthma. Clin Nutr. 2008;27(4):579-586. DOI: 10.1016/j.clnu.2007.12.002
Mabalirajan U, Aich J, Leishangthem, GD, Sharma SK, Dinda, AK, Ghosh B. Effects of vitamin E on mitochondrial dysfunction and asthma features in an experimental allergic murine model. J Appl Physiol (1985). 2009;107(4):1285-1292. DOI: 10.1152/japplphysiol.00459.2009
Pearson P, Lewis S, Britton J, Fogarty A. Vitamin E supplements in asthma: a parallel group randomized placebo controlled trial. Thorax. 2004;59(8):652-656. DOI: 10.1136/thx.2004.022616
Berdnikovs S, Abdala-Valencia H, McCary C, Somand M, Cole R, García A, et al. Isoforms of vitamin E have opposing immunoregulatory functions during inflammation by regulating leukocyte recruitment. J Immunol. 2009;182(7);4395-4405. DOI: 10.4049/jimmunol.0803659
Cook-Mills JM. Isoforms of vitamin E differentially regulate PKC α and inflammation: A review. J Clin Cell Immunol. 2013;4(137):1000137. DOI: 10.4172/2155-9899.1000137
Feray J, Britton J. Dietary supplements and asthma: Another one bites the dust. Thorax. 2007;62(6):466-468. DOI: 10.1136/thx.2006.073866
Márquez HA, Cardoso WV. Vitamin A-retinoid signaling in pulmonary development and disease. Mol Cell Pediatr. 2016;3(1):28-32. DOI: 10.1186/s40348-016-0054-6
Schuster GU, Kenyon NJ, Stephensen CB. Vitamin A deficiency decreases and high dietary vitamin A increases disease severity in the mouse model of asthma. J Immunol. 2008;180(3):1834-1842. DOI: 10.4049/jimmunol.180.3.1834
Carraro S, Giordano G, Reniero F, Carpi D, Stocchero M, Sterk PJ, et al. Asthma severity in childhood and metabolomic profiling of breath condensate. Allergy. 2013;68(1):110-117. DOI: 10.1111/all.12063
Neuman I, Nahum H, Ben-Amotz A. Prevention of exercise-induced asthma by a natural isomer mixture of beta-carotene. Ann Allergy Asthma Immunol. 1999;82(6):549-553. DOI: 10.1016/S1081-1206(10)63165-1
Neuman I, Nahum H, Ben-Amotz A. Reduction of exercise-induced asthma oxidative stress by lycopene, a natural antioxidant. Allergy. 2000;55(12):1184-1189. DOI: 10.1034/j.1398-9995.2000.00748.x
Checkley W, West KP, Wise RA, Baldwin MR, Wu L, LeClerq SC, et al. Maternal vitamin A supplementation and lung function in offspring. N Engl J Med 2010; 362:1782-1794. DOI: 10.1056/NEJMoa0907441
Checkley W, West KP, Wise RA et al. Supplementation with vitamin A early in life and subsequent risk of asthma. Eur Respir J 2011;38(6):1310-1319. DOI: 10.1183/09031936.00006911
Patel S, Murray CS, Woodcock A, Simpson A, Custovic A. Dietary antioxidant intake, allergic sensitization and allergic diseases in young children. Allergy. 2009;64(12):1766-1772. DOI: 10.1111/j.1398-9995.2009.02099.x
Arora P, Kumar V, Batra S. Vitamin A status in children with asthma. Pediatr Allergy Immunol. 2002;13(3):223-226. DOI: 10.1034/j.1399-3038.2002.00010.x
Milner JD, Stein DM, McCarter R, Moon RY. Early infant supplementation is associated with increased risk for food allergy and asthma. Pediatrics. 2004;114(1):27-32.
Arshi S, Fallahpour M, Nabavi M, Bemanian MH, Javad-Mousavi SA, Nojomi M, et al. The effects of vitamin D supplementation on airway functions in mild to moderate persistent asthma. Ann Allergy Asthma Immunol. 2014;113(4):404-409. DOI: 10.1016/j.anai.2014.07.005
Majak P, Olszowiec-Chlebna M, OC, Smejda K, Stelmach. Vitamin D supplementation in children may prevent asthma exacerbation triggered by acute respiratory infection. J Allergy Clin Immunol. 2011;127(5):1294-1296. DOI: 10.1016/j.jaci.2010.12.016
Yadav M, Mittal K. Effect of vitamin D supplementation on moderate to severe bronchial asthma. Indian J Pediatr. 2014;81(7):650-654. DOI: 10.1007/s12098-013-1268-4
Castro M, King TS, Kunselman SJ, Cabana MD, Denlinger L, Holguin F, et al. Effect of vitamin D3 on asthma treatment failures in adults with symptomatic asthma and lower vitamin D levels: the VIDA randomized clinical trial. JAMA. 2014;311(20):2083-2091. DOI: 10.1001/jama.2014.5052
Bar-Yoseph R, Livnat G, Schnapp Z, Hakim F, Dabbah H, Goldbart A, et al. The effect of vitamin D on airway reactivity and inflammation in asthmatic children: a double-blind placebo-controlled trial. Pediatr Pulmonol. 2015;50(8):747-753. DOI: 10.1002/ppul.23076
Nanzer AM, Chambers ES, Ryanna K, Freeman AT, Colligan G, Richards DF, et al. The effects of calcitriol treatment in glucocorticoid-resistant asthma. J Allergy Clin Immunol. 2014;133(6):1755-1777. DOI: 10.1016/j.jaci.2014.03.015
Hemilä H, Al-Biltagi M, Baset AA. Vitamin C and asthma in children: modification of the effect by age, exposure to dampness and the severity of asthma. Clin Transl Allergy. 2011;1(1):9. DOI: 10.1186/2045-7022-1-9
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