Samih Kokandi

  • Samih KokandiSamih Kokandi is from Saudi Arabia. She completed her PhD in January 2017 and her thesis title is 'Effect of Vitamin D Supplementation on Asthma Severity and Airway Inflammation'.

    Tell us about your research project.

    My PhD is focusing on the role of oral high dose vitamin D supplementation on asthma outcomes, mainly on airway inflammation. I am based in the Functional Food Centre (FFC) at Oxford Brookes University, which is an excellent place for researchers. The laboratories in the FFC include essential tools for research, and many studies are currently ongoing.  

    I am a Saudi Dietician and prior to starting my PhD, I had worked for more than three years as a clinical dietitian in King Abdullah University Hospital (KAUH), one of the largest educational hospitals in Jeddah, Saudi Arabia. I have a Master degree in Human Nutrition and my dream was to do a PhD in my field. The dream started to become a reality when I enrolled as a research student at Brookes. The University and the Department offer us great opportunities to develop our research skills.

    The first nine months of my PhD were spent designing my study protocol and obtaining ethical approval from the University Research and Ethics Committee (UREC) at  both Oxford Brookes University and King Abdulaziz University, which is where the study was partly conducted.

    A number of studies have been conducted to investigate the association between vitamin D levels and allergic disease, such as asthma. However, there are a lack in studies and trials that have investigated the effectiveness of vitamin D supplementation on such diseases. Moreover, there have been a number of shortcomings within the clinical trials conducted to study the effectiveness of vitamin D supplements, such as lack in power of study, inadequate vitamin D supplement or dose and ineffective study time.. 

    Vitamin D deficiency is a serious problem in Saudi Arabia, although it is a sunny country. According to a recent study, vitamin D deficiency and insufficiency were found in 80-90% of the Saudi population. In addition to a very high rate of vitamin D deficiency, asthma is widely spread in Saudi Arabia. For these reasons we decided to undertake our intervention study in Saudi Arabia.

    Vitamin D is an important component for human health. Calcium homeostasis is the classic function of vitamin D. However in my study, we are focusing on the non-classical effects of vitamin D, mainly its immunological effects. The intervention study aimed to investigate the effect of oral high dose vitamin D supplement (200 000 IU) on airway inflammation (primary outcome), lung function and control of the symptoms (secondary outcomes) of asthma participants. Of the sixty-two Saudi adult male and female asthma patients screened, 38 completed the study. Participants were recruited from the allergy and asthma outpatient clinic at KAUH in Jeddah.

    In this study vitamin D level was measured by assessing serum 25(OH)D in nanomoles per litre by radioimmunoassay method (RIA). We used a portable spirometer to assess the lung function, including forced expiratory volume in a second (FEV1) and forced vital capacity (FVC). To assess the airway inflammation level, the Aerocrine NIOX set was used to measure the fractional exhaled nitric oxide (FeNO). A sun exposure questionnaire and short food frequency questionnaire were developed to be matched with the Saudi culture. The Arabic version of the international physical activity questionnaire (IPAQ) was used to investigate the activity level of participants. The asthma control test (ACT) was also used to classify the participants to well-controlled asthma, partially-controlled asthma and poorly-controlled asthma, depending on their symptoms control score. 

    From the first visit, which was the screening visit of the participants, we found that the mean serum vitamin D level was 32 nmol/l. Eighty-six percent of participants were vitamin D deficient or insufficient. Our initial findings also found that 39.5% were well-controlled, 14% were partially-controlled and 46.5% were poorly-controlled asthma patients. Vitamin D deficient patients also had lower FEV1 and higher FENO, which predicts more airway inflammation. 

    After finishing my PhD, I am would like to have an academic job in King Abdulaziz University. My dream would be to stimulate the desire of learning in students instead of just handing out the information. I would also like to continue my research, as well as being a part-time dietitian specialising in allergic disease.