Measurement of level of vitamin D and Antioxidants in Discoid Lupus Erythematosus patients

Abstract

D ISCOID Lupus Erythematosus (DLE) is a chronic dermatological disease that can lead to scarring, hair loss, and hyperpigmentation changes in skin if it is not treated early and promptly. Diagnosis of discoid lupus is generally made based on clinical features. Sometimes, tests are required, including blood and urine samples. Similar to other many autoimmune conditions, DLE is generally a lifelong condition. However, there are treatments available that are usually effective and can help keep symptoms under control. IL-17 isoforms (IL-17A and IL-17F) are implicated in DLE. Active Vitamin D3 (1, 25(OH) 2D3) is a fat-soluble vitamin that its principle action is to increase the absorption of calcium and phosphate ions from the intestine and directly affect the calcification process. Beside its crucial role in calcium metabolism and bone remodeling, active vitamin D3 is considered an immunomodulator. Increased reactive oxygen species (ROS), lipid peroxides, and low antioxidant status occur in autoimmune disorder. This study aims to assess the level of vitamin D3 [25(OH) D3] in Discoid Lupus Erythematosus (DLE) patients compared to normal controls, its correlation with disease activity parameters, laboratory parameters and antioxidants levels. Twenty patients with (DLE) and 20 healthy controls matched for age and gender were included into this prospective study. Serum vitamin D3 [25(OH) D3] is measured as it is the precursor of active vitaminD3 [1, 25(OH) 2D3 ] which has a very short half-life. Oxidative stress was assessed by measuring serum malondialdehyde (MDA) and enzymatic antioxidant status by estimating superoxide dismutase (SOD) and glutathione peroxidase (GPX). The results of the present work are highly suggestive of the importance of vitamin D3 supplementation in (DLE) and the importance of topical antioxidants to control flare in DLE patients. The serum levels of vitamin D3, SOD, and GPX were significantly lower in DLE patients when compared to their levels in the control group (p< 0.000) .On the other hand, MDA was significantly higher in the DLE patients than that in the healthy control subjects (p<0.001). A highly statistical negative correlation between vitamin D3 with MDA level (P <0.004and r =-0.615) was observed. On the other hand, SOD and GPX positively correlated with vitamin D3 level (P < 0.001 and P<0.000 respectively and r = 0.680 and 0.734 respectively). It could be suggested that low vitamin D3 and disturbed antioxidant levels are prevalent in the Egyptian DLE patients. There is a clear association between vitamin D3 and antioxidants with different signs of disease activity. A routine vitamin D3 and antioxidant supplementations are recommended to DLE patients for better prognosis.