Is There a Relation between Vitamin D and Interleukin-17 in Vitiligo? A Cross-Sectional Study

Aly, Dalia Gamal; Mohammed, Faisal; Sayed, Khadiga S; Gawdat, Heba I.; Mashaly, Heba M.; Hay, Rania Abdel; Elias, Tahany; Agaiby, Mervat Harvi

doi:10.1159/000479925

Cited by 18 publications

(32 citation statements)

References 19 publications

(20 reference statements)

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“…Of initially identified 165 citations, 11 studies including 626 vitiligo patients and 475 controls were finally selected . The study selection process using PRISMA flow chart is shown in Figure , and the characteristics of the included studies are shown in Table .…”

Section: Resultsmentioning

confidence: 99%

Interleukin‐17 level in patients with vitiligo: A systematic review and meta‐analysis

Acharya

Mathur

2020

Aust J Dermatology

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Background/Objectives: The role of the pro-inflammatory cytokine, interleukin (IL)-17 is being continuously explored in various autoimmune disorders. Studies have assessed the levels of IL-17 in vitiligo patients. This study aims to evaluate the IL-17 levels in vitiligo patients in comparison with the healthy controls by performing a meta-analysis.Methods: A systematic review of the existing literature was performed in PubMed, Scopus and Cochrane databases by two authors independently. The data required to calculate the pooled effect size in the form of standardised mean difference (SMD) with the corresponding 95% confidence interval (CI) were extracted from the eligible studies. Separate analyses for active and stable vitiligo were also performed.Results: A total of 11 case-control studies with 626 vitiligo patients and 475 healthy controls were included. Random-effects meta-analysis found significantly higher serum IL-17 levels in vitiligo patients compared with the healthy controls (SMD = 1.67, 95% CI 1.11 to 2.22, P < 0.001). The IL-17 levels were higher in both active (SMD = 1.31, 95% CI 0.76 to 1.86) and stable (SMD = 1.47, 95% CI 0.59 to 2.35) vitiligo patients compared with the healthy controls. The skin IL-17 levels were also significantly higher in vitiligo patients (SMD = 1.28, 95% CI 0.82 to 1.74). Heterogeneity in the baseline characteristics of the included studies was the major limitation of this study.Conclusions: These results suggest that vitiligo patients have significantly elevated IL-17 levels. Further examination of this association could have implications for the treatment of vitiligo.

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Section: Resultsmentioning

confidence: 99%

Interleukin‐17 level in patients with vitiligo: A systematic review and meta‐analysis

Acharya

Mathur

2020

Aust J Dermatology

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“…A link between IL‐17 levels and the extent of body surface involvement has been reported. Variable results were published regarding their association with disease activity (Abdallah et al, ; Aly et al, ; Basak, Adiloglu, Ceyhan, Tas, & Akkaya, ; Bhardwaj, Rani, Srivastava, Kumar, & Parsad, ; Elela, Hegazy, Fawzy, Rashed, & Rasheed, ).…”

Section: Characteristics and Clinical Evolution Of The Patients In Thmentioning

confidence: 99%

IL‐17A is not a treatment target in progressive vitiligo

Speeckaert

Mylle

Geel

2019

Pigment Cell Melanoma Res

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Multiple reports confirm elevated circulating IL‐17 levels and increased numbers of Th17 lymphocytes in patients with non‐segmental vitiligo. Additionally, melanocyte damaging characteristics have been ascribed to IL‐17. A single‐arm pilot study using secukinumab in active non‐segmental vitiligo was conducted. The large majority of patients developed additional skin depigmentations limiting further enrollment. Overall, laboratory analysis revealed no change in secreted chemokines or Th subsets. Th17 lymphocytes correlated with Th2, Th9, and Th22 cells while an inverse link with Th1 cells and serum sCD25 levels was observed. In contrast, Th17.1 cells correlated positively with Th1 lymphocytes. Confirmatory results were found in an independent group of patients with vitiligo showing a significant increase in Th17.1 and Th1 lymphocytes in progressive vitiligo patients compared to healthy controls, which was not found for Th17 cells. These results do not support a direct pathogenic role of IL‐17 or Th17 cells in vitiligo. Nonetheless, a delicate Th17/Th17.1/Th1 balance seems evident which changes markedly according to disease activity. This may offer new treatment options by interfering with cytokines that drive differentiation of Th17 cells toward Th1.

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“…The available studies in the literature are inconsistent on Vit-D levels and Hypovitaminosis D is still controversial in vitiligo. 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 In this updated systematic review and meta-analysis on vitiligo and Vit-D levels (ViViD Study), the serum Vit-D levels and their association with variables like age, disease duration, affected Body Surface Area (BSA), and Vitiligo Activity and Severity Index (VASI) were studied in vitiligo patients as compared to controls. A subgroup meta-analysis was conducted to study Vit-D levels in relation to gender, skin type, Vitiligo type, disease activity, vitiligo history, autoimmune comorbidities, and indoor-outdoor job status of vitiligo patients.…”

Section: Introductionmentioning

confidence: 99%

Decreased circulatory levels of Vitamin D in Vitiligo: a meta-analysis

Varikasuvu

Aloori²,

Varshney

et al. 2021

Anais Brasileiros de Dermatologia

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Background The serum Vitamin D status in patients with vitiligo is ambiguous when compared to controls. A systematic review and updated meta-analysis were conducted to evaluate the association between Vitamin D and vitiligo. Methods Relevant studies were identified by searching PubMed and other databases. The random effects model was used to obtain standardized mean differences and pooled correlation coefficients. Meta-regression and sub-group analyses were conducted to explore heterogeneity. The presence of publication bias and the study robustness were tested using funnel plot and sensitivity analyses, respectively. Results This meta-analysis finally included 31 studies. Compared with controls, vitiligo patients showed significantly decreased serum Vitamin D levels (standardized mean difference = −1.03; p < 0.0001). The sub-group analysis showed that vitiligo patients with indoor/urban work had a significantly lower Vitamin D level when compared to their outdoor/rural counterparts (standardized mean differences = −0.45; p = 0.03). The sensitivity analysis indicated that no single study had a significant influence on the overall outcome, suggesting the robustness of this meta-analysis. Study limitations Varied sample sizes and heterogeneous study populations from different countries are the limitations of this study. However, the between-study heterogeneity has been addressed by the random-effects model with meta-regression and sensitivity analyses. Conclusions This meta-analysis showed significantly decreased Vitamin D level in vitiligo, and its association with indoor/outdoor type of work of vitiligo patients. This study highlights the need to assess Vitamin D status for improving its level in vitiligo.

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Is There a Relation between Vitamin D and Interleukin-17 in Vitiligo? A Cross-Sectional Study

Cited by 18 publications

References 19 publications

Interleukin‐17 level in patients with vitiligo: A systematic review and meta‐analysis

Interleukin‐17 level in patients with vitiligo: A systematic review and meta‐analysis

IL‐17A is not a treatment target in progressive vitiligo

Decreased circulatory levels of Vitamin D in Vitiligo: a meta-analysis

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