World Allergy Organization-McMaster University Guidelines for Allergic Disease Prevention (GLAD-P): Vitamin D

Juan José Yepes-Nuñez; Alessandro Fiocchi; Ruby Pawankar; Carlos A. Cuello-Garcia; Yuan Zhang; Gian Paolo Morgano; Kangmo Ahn; Suleiman Al-Hammadi; Arnav Agarwal; Shreyas Gandhi; Kirsten Beyer; Wesley Burks; Giorgio W. Canonica; Motohiro Ebisawa; Rose Kamenwa; Bee Wah Lee; Haiqi Li; Susan Prescott; John J. Riva; Lanny Rosenwasser; Hugh Sampson; Michael Spigler; Luigi Terracciano; Andrea Vereda; Susan Waserman; Holger J. Schünemann; Jan L. Brozek

doi:10.1186/s40413-016-0108-1

World Allergy Organization-McMaster University Guidelines for Allergic Disease Prevention (GLAD-P): Vitamin D

Juan José Yepes-Nuñez, Alessandro Fiocchi, Ruby Pawankar, Carlos A. Cuello-Garcia, Yuan Zhang, Gian Paolo Morgano, Kangmo Ahn, Suleiman Al-Hammadi, Arnav Agarwal, Shreyas Gandhi, Kirsten Beyer, Wesley Burks, Giorgio W. Canonica, Motohiro Ebisawa, Rose Kamenwa, Bee Wah Lee, Haiqi Li, Susan Prescott, John J. Riva, Lanny RosenwasserHugh Sampson, Michael Spigler, Luigi Terracciano, Andrea Vereda, Susan Waserman, Holger J. Schünemann, Jan L. Brozek

Department of Pediatrics

Research output: Contribution to journal › Article › peer-review

74 Citations (Scopus)

Abstract

Background: The prevalence of allergic diseases is approximately 10 % in infants whose parents and siblings do not have allergic diseases and 20-30 % in those with an allergic first-degree relative. Vitamin D is involved in the regulation of the immune system and it may play a role in the development, severity and course of asthma and other allergic diseases. Objective: The World Allergy Organization (WAO) convened a guideline panel to develop evidence-based recommendations addressing the use of Vitamin D in primary prevention of allergic diseases. Methods: Our WAO guideline panel identified the most relevant clinical questions and performed a systematic review of randomized controlled trials and non-randomized studies (NRS), specifically cohort and case-control studies, of Vitamin D supplementation for the prevention of allergic diseases. We also reviewed the evidence about values and preferences, and resource requirements (up to January 2015, with an update on January 30, 2016). We followed the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach to develop recommendations. Results: Having reviewed the currently available evidence, the WAO guideline panel found no support for the hypothesis that Vitamin D supplementation reduces the risk of developing allergic diseases in children. The WAO guideline panel suggest not using Vitamin D in pregnant women, breastfeeding mothers, or healthy term infants as a means of preventing the development of allergic diseases. This recommendation does not apply to those mothers and infants who have other indications for prophylactic or therapeutic use of Vitamin D. The panel's recommendations are conditional and supported by very low certainty evidence. Conclusions: WAO recommendations about Vitamin D supplementation for the prevention of allergic diseases support parents, clinicians and other health care professionals in their decisions whether or not to use Vitamin D in preventing allergic diseases in healthy, term infants.

Original language	English
Article number	17
Journal	World Allergy Organization Journal
Volume	9
Issue number	1
DOIs	https://doi.org/10.1186/s40413-016-0108-1
Publication status	Published - May 17 2016

Keywords

Allergic Diseases
GRADE
Practice guidelines
Prevention
Vitamin D

ASJC Scopus subject areas

Immunology and Allergy
Immunology
Pulmonary and Respiratory Medicine

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10.1186/s40413-016-0108-1

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Yepes-Nuñez, J. J., Fiocchi, A., Pawankar, R., Cuello-Garcia, C. A., Zhang, Y., Morgano, G. P., Ahn, K., Al-Hammadi, S., Agarwal, A., Gandhi, S., Beyer, K., Burks, W., Canonica, G. W., Ebisawa, M., Kamenwa, R., Lee, B. W., Li, H., Prescott, S., Riva, J. J., ... Brozek, J. L. (2016). World Allergy Organization-McMaster University Guidelines for Allergic Disease Prevention (GLAD-P): Vitamin D. World Allergy Organization Journal, 9(1), Article 17. https://doi.org/10.1186/s40413-016-0108-1

Yepes-Nuñez, JJ, Fiocchi, A, Pawankar, R, Cuello-Garcia, CA, Zhang, Y, Morgano, GP, Ahn, K, Al-Hammadi, S, Agarwal, A, Gandhi, S, Beyer, K, Burks, W, Canonica, GW, Ebisawa, M, Kamenwa, R, Lee, BW, Li, H, Prescott, S, Riva, JJ, Rosenwasser, L, Sampson, H, Spigler, M, Terracciano, L, Vereda, A, Waserman, S, Schünemann, HJ & Brozek, JL 2016, 'World Allergy Organization-McMaster University Guidelines for Allergic Disease Prevention (GLAD-P): Vitamin D', World Allergy Organization Journal, vol. 9, no. 1, 17. https://doi.org/10.1186/s40413-016-0108-1

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title = "World Allergy Organization-McMaster University Guidelines for Allergic Disease Prevention (GLAD-P): Vitamin D",

abstract = "Background: The prevalence of allergic diseases is approximately 10 % in infants whose parents and siblings do not have allergic diseases and 20-30 % in those with an allergic first-degree relative. Vitamin D is involved in the regulation of the immune system and it may play a role in the development, severity and course of asthma and other allergic diseases. Objective: The World Allergy Organization (WAO) convened a guideline panel to develop evidence-based recommendations addressing the use of Vitamin D in primary prevention of allergic diseases. Methods: Our WAO guideline panel identified the most relevant clinical questions and performed a systematic review of randomized controlled trials and non-randomized studies (NRS), specifically cohort and case-control studies, of Vitamin D supplementation for the prevention of allergic diseases. We also reviewed the evidence about values and preferences, and resource requirements (up to January 2015, with an update on January 30, 2016). We followed the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach to develop recommendations. Results: Having reviewed the currently available evidence, the WAO guideline panel found no support for the hypothesis that Vitamin D supplementation reduces the risk of developing allergic diseases in children. The WAO guideline panel suggest not using Vitamin D in pregnant women, breastfeeding mothers, or healthy term infants as a means of preventing the development of allergic diseases. This recommendation does not apply to those mothers and infants who have other indications for prophylactic or therapeutic use of Vitamin D. The panel's recommendations are conditional and supported by very low certainty evidence. Conclusions: WAO recommendations about Vitamin D supplementation for the prevention of allergic diseases support parents, clinicians and other health care professionals in their decisions whether or not to use Vitamin D in preventing allergic diseases in healthy, term infants.",

keywords = "Allergic Diseases, GRADE, Practice guidelines, Prevention, Vitamin D",

author = "Yepes-Nu{\~n}ez, {Juan Jos{\'e}} and Alessandro Fiocchi and Ruby Pawankar and Cuello-Garcia, {Carlos A.} and Yuan Zhang and Morgano, {Gian Paolo} and Kangmo Ahn and Suleiman Al-Hammadi and Arnav Agarwal and Shreyas Gandhi and Kirsten Beyer and Wesley Burks and Canonica, {Giorgio W.} and Motohiro Ebisawa and Rose Kamenwa and Lee, {Bee Wah} and Haiqi Li and Susan Prescott and Riva, {John J.} and Lanny Rosenwasser and Hugh Sampson and Michael Spigler and Luigi Terracciano and Andrea Vereda and Susan Waserman and Sch{\"u}nemann, {Holger J.} and Brozek, {Jan L.}",

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T1 - World Allergy Organization-McMaster University Guidelines for Allergic Disease Prevention (GLAD-P)

T2 - Vitamin D

AU - Yepes-Nuñez, Juan José

AU - Fiocchi, Alessandro

AU - Pawankar, Ruby

AU - Cuello-Garcia, Carlos A.

AU - Zhang, Yuan

AU - Morgano, Gian Paolo

AU - Ahn, Kangmo

AU - Al-Hammadi, Suleiman

AU - Agarwal, Arnav

AU - Gandhi, Shreyas

AU - Beyer, Kirsten

AU - Burks, Wesley

AU - Canonica, Giorgio W.

AU - Ebisawa, Motohiro

AU - Kamenwa, Rose

AU - Lee, Bee Wah

AU - Li, Haiqi

AU - Prescott, Susan

AU - Riva, John J.

AU - Rosenwasser, Lanny

AU - Sampson, Hugh

AU - Spigler, Michael

AU - Terracciano, Luigi

AU - Vereda, Andrea

AU - Waserman, Susan

AU - Schünemann, Holger J.

AU - Brozek, Jan L.

PY - 2016/5/17

Y1 - 2016/5/17

N2 - Background: The prevalence of allergic diseases is approximately 10 % in infants whose parents and siblings do not have allergic diseases and 20-30 % in those with an allergic first-degree relative. Vitamin D is involved in the regulation of the immune system and it may play a role in the development, severity and course of asthma and other allergic diseases. Objective: The World Allergy Organization (WAO) convened a guideline panel to develop evidence-based recommendations addressing the use of Vitamin D in primary prevention of allergic diseases. Methods: Our WAO guideline panel identified the most relevant clinical questions and performed a systematic review of randomized controlled trials and non-randomized studies (NRS), specifically cohort and case-control studies, of Vitamin D supplementation for the prevention of allergic diseases. We also reviewed the evidence about values and preferences, and resource requirements (up to January 2015, with an update on January 30, 2016). We followed the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach to develop recommendations. Results: Having reviewed the currently available evidence, the WAO guideline panel found no support for the hypothesis that Vitamin D supplementation reduces the risk of developing allergic diseases in children. The WAO guideline panel suggest not using Vitamin D in pregnant women, breastfeeding mothers, or healthy term infants as a means of preventing the development of allergic diseases. This recommendation does not apply to those mothers and infants who have other indications for prophylactic or therapeutic use of Vitamin D. The panel's recommendations are conditional and supported by very low certainty evidence. Conclusions: WAO recommendations about Vitamin D supplementation for the prevention of allergic diseases support parents, clinicians and other health care professionals in their decisions whether or not to use Vitamin D in preventing allergic diseases in healthy, term infants.

AB - Background: The prevalence of allergic diseases is approximately 10 % in infants whose parents and siblings do not have allergic diseases and 20-30 % in those with an allergic first-degree relative. Vitamin D is involved in the regulation of the immune system and it may play a role in the development, severity and course of asthma and other allergic diseases. Objective: The World Allergy Organization (WAO) convened a guideline panel to develop evidence-based recommendations addressing the use of Vitamin D in primary prevention of allergic diseases. Methods: Our WAO guideline panel identified the most relevant clinical questions and performed a systematic review of randomized controlled trials and non-randomized studies (NRS), specifically cohort and case-control studies, of Vitamin D supplementation for the prevention of allergic diseases. We also reviewed the evidence about values and preferences, and resource requirements (up to January 2015, with an update on January 30, 2016). We followed the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach to develop recommendations. Results: Having reviewed the currently available evidence, the WAO guideline panel found no support for the hypothesis that Vitamin D supplementation reduces the risk of developing allergic diseases in children. The WAO guideline panel suggest not using Vitamin D in pregnant women, breastfeeding mothers, or healthy term infants as a means of preventing the development of allergic diseases. This recommendation does not apply to those mothers and infants who have other indications for prophylactic or therapeutic use of Vitamin D. The panel's recommendations are conditional and supported by very low certainty evidence. Conclusions: WAO recommendations about Vitamin D supplementation for the prevention of allergic diseases support parents, clinicians and other health care professionals in their decisions whether or not to use Vitamin D in preventing allergic diseases in healthy, term infants.

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KW - GRADE

KW - Practice guidelines

KW - Prevention

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World Allergy Organization-McMaster University Guidelines for Allergic Disease Prevention (GLAD-P): Vitamin D

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