The correlation between Cytokines imbalance and Vitamin D level in Patients with early Chronic Obstructive Pulmonary Disease (COPD) and the role of Vitamin D in Pulmonary Disease

Abstract

Background: Vitamin D, recognized for its dual role as an immune regulator and essential nutrient crucial for human well-being, exerts a multifaceted impact on the intricate immune processes found in individuals suffering from Chronic Obstructive Pulmonary Disease (COPD). In addition to its established functions in maintaining phosphate-calcium balance and bone mineralization, it exerts both direct and indirect effects on cellular elements within the COPD environment, thereby influencing the levels of inflammatory factors in the airways. Recent research has unveiled a compelling link between VDD and COPD, demonstrating a positive association between pulmonary function and vitamin D levels in COPD patients. Objective: The study sought to ascertain the role of sunlight and vitamin D in lung disease, as well as the relationship between vitamin D levels and cytokine discord in patients with early-stage chronic obstructive pulmonary disease (COPD). Methodology: A prospective study was conducted at Ponch Medical College, Rawalakot, between January 2020 to December 2020 and comprised 120 patients. COPD pulmonary function (LF) I & COPD LF II patients were divided into two groups (n = 60 each). An immunosorbent assay that uses enzymes was used to measure the blood levels of inflammatory TNF-α, IFN-γ, interleukin 4 (IL-4), and IL-6 in order to identify the Th1/Th2 marker. A proportion of IFN-γ to IL-4 was also a part of the treatment. The quantity of 25 [OH]D, or 25-hydroxyl vitamin D, in the blood was determined by chemiluminescent assay. The correlations between alterations in the aforementioned variables and the LF or vitamin D level were assessed after statistical processing. Results: Between the LF I alongside LF II groups, there was a significant difference (p < 0.04) in FEV1pred%, FEV1 or IFN-γ, IL-4, F, IFN-γ/IL-4, and IL-6. In patients with early-stage COPD, cytokines (Th1/Th2) were significantly correlated with forced volume percent (FEV1pred%) (r < 0.485, p < 0.002) and compelled exhalation volume/forced lifespan (FEV1/FVC) (r = 0.254, p = 0.015).  Additionally, a significant correlation was observed between Th1/Th2 inflammatory mediators and the presence of 25 (level and FEV1pred% (r = 0.571, p < 0.001), whereas vitamin D level was associated with (r = 0.21, p < 0.002). Conclusion: Most cases with early-stage COPD had a vitamin D deficiency. Together with the FEV1/FVC LF parameters, it showed a positive correlation. This research offers experimental evidence in favour of vitamin D's role in COPD prevention and treatment, as well as possible anti-inflammatory action mechanisms.