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Thursday, 17 April 2014

Asthma in Folate points of view

The widespread of incidence of asthma over large 20 years in South East Asian population, specially in children and aging group has caused some concerns to the government and scientific community. It may be due to over intake in artificial ingredients, polluted environment as well as intake foods  triggering the inflammatory allergens.

Folate, also known as folic acid, vitamin B9, is a water soluble vitamin, found abundantly in leafy vegetables, citrus fruits, beans, whole grain, etc. The vitamin plays an important role in synthesize DNA, repair DNA, and methylate DNA as well as to act as a cofactor in certain biological reactions, production of red blood cells for anemia prevention.

1. Serum levels of folate
 Scientific studies, serum levels of folate may associate to risk of asthma. The study by Ain Shams University showed that serum folate levels are significantly lower among atopics, and correlate inversely with the degree of atopy  among asthmatics(1). Other researchers suggested that low serum folate and impaired folate metabolism may be a potential risk factors for development of asthma and atopic disease. According to The Capital Region of Denmark, in a random sample of 6784 persons from a general population aged 30-60 years participated in a health examination in 1999-2001, low levels of serum of folate were associated with self-reported doctor-diagnosed asthma and attacks of shortness of breath, but not with lung function or atopy(2). The Johns Hopkins School of Medicine study also indicated that the effects of serum levels of folate were associated inversely associated with high total IgE levels, atopy, and wheeze(3).

2. The effects of folate in maternal intake
Folic acid supplementation has an established role in early pregnancy for preventing neural tube defects, but its causes of childhood asthma and asthmatic symptoms in epidemiological studies have been inconclusive. According to the University of Western Australia, maternal folic acid exposure may be associated to childhood asthma and wheeze(4). Other in the study of pre-natal FACSs exposure population showed a small increased risk of early wheeze, but no adverse association of respiratory or allergic outcomes(5). In the study using the data from an Australian prospective birth cohort study (n = 557) from 1998 to 2005. At 3.5 years and 5.5 years, 490 and 423 mothers and children participation, researchers at the The University of Adelaide, indicated the correlation of the supplementation with folate in pregnancy and incidence of childhood allergic asthma through epigenetic mechanisms and also associated with poorer respiratory outcomes in young children(6).

Since the search of the effect of folate intake in reduced risk and treatment of asthma have produced limitation of result, we concluded that folate deficiency or low levels of folate may be associated to increased risk of early onset of the disease, but multi centers and large sample size studies are necessary to improve its validation. Overdoses of folate may cause stomach problems, sleep problems, skin reactions, seizures, etc., please make sure you follow the guideline of the Institute of Medicine of the National Academies.


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References
(1) Study of folate status among Egyptian asthmatics by Farres MN1, Shahin RY, Melek NA, El-Kabarity RH, Arafa NA.(PubMed)
(2) Atopy, asthma, and lung function in relation to folate and vitamin B(12) in adults by Thuesen BH1, Husemoen LL, Ovesen L, Jørgensen T, Fenger M, Gilderson G, Linneberg A.(PubMed)
(3) Higher serum folate levels are associated with a lower risk of atopy and wheeze by Matsui EC1, Matsui W.(PubMed)
(4) Folic acid in pregnancy - is there a link with childhood asthma or wheeze? by Sharland E1, Montgomery B, Granell R.(PubMed)
(5) Maternal use of folic acid supplements during pregnancy, and childhood respiratory health and atopy by Bekkers MB1, Elstgeest LE, Scholtens S, Haveman-Nies A, de Jongste JC, Kerkhof M, Koppelman GH, Gehring U, Smit HA, Wijga AH.(PubMed)
(6) Effect of supplemental folic acid in pregnancy on childhood asthma: a prospective birth cohort study by Whitrow MJ1, Moore VM, Rumbold AR, Davies MJ.(PubMed)