Relationship between vitamin D and chronic spontaneous urticaria: a systematic review

Abstract

BackgroundVitamin D has been reported to be associated with many allergic diseases. There are a limited number of the studies of vitamin D supplementation in patients with chronic spontaneous urticaria (CSU). This study aims to study the relationship between vitamin D and CSU in terms of serum vitamin D levels, and the outcomes of vitamin D supplementation.MethodsA literature search of electronic databases for all relevant articles published between 1966 and 2018 was performed. The systematic literature review was done following Preferred Reporting Items for Systematic Reviews and Meta-analysis recommendations.ResultsSeventeen eligible studies were included. Fourteen (1321 CSU cases and 6100 controls) were concerned with serum vitamin D levels in CSU patients. Twelve studies showed statistically significant lower serum vitamin D levels in CSU patients than the controls. Vitamin D deficiency was reported more commonly for CSU patients (34.3–89.7%) than controls (0.0–68.9%) in 6 studies. Seven studies concerned with vitamin D supplementation in CSU patients showed disease improvement after high-dosages of vitamin D supplementation.ConclusionCSU patients had significantly lower serum vitamin D levels than the controls in most studies. However, the results did not prove causation, and the mechanisms were not clearly explained. Despite the scarcity of available studies, this systematic review showed that a high dosage of vitamin D supplementation for 4–12 weeks might help to decrease the disease activity in some CSU patients. Well-designed randomized placebo-controlled studies are needed to determine the cut-off levels of vitamin D for supplementation and treatment outcomes.

Advanced Biomarkers: Therapeutic and Diagnostic Targets in Urticaria

“…Vitamin D is an essential molecule to maintain the homeostasis of bones and minerals, and it also has immune regulation functions in the human body. Many studies have shown that vitamin D deficiency is associated with various autoimmune and allergic diseases, such as multiple sclerosis and CU [75,76]. The availability of vitamin D supplements in the treatment of CSU has been confirmed by some small-scale clinical trials [77,78], but the mechanism is still unclear, which may contribute to the pathogenic pathway inhibition of vitamin D-binding protein.…”

Highlights and recent developments in skin allergy and related diseases in EAACI journals (2018)

“…A systematic review assessed the relationship between vitamin D and CSU [36 ]. Fourteen studies (1321 CSU cases and 6100 controls) were considered.…”

The Role of Bradykinin Receptors in the Etiopathogenesis of Chronic Spontaneous Urticaria

“…This, in turn, suggests that higher vitamin D levels are linked with faster disease progression and the occurrence of more severe symptoms, which is contradictory to previous reports. The vitamin D level is dependent on many factors and its correlation with disease severity can also be cohort dependent, as summarized in a review [ 49 ]. Since many CSU patients had significantly lower serum vitamin D levels than the controls in most studies, there were some trials performed to check the efficacy of its implementation.…”