Relationship between vitamin D status and the inflammatory state in patients with chronic spontaneous urticaria

Grzanka, Alicja; Machura, Edyta; Mazur, Bogdan; Misiołek, Maciej; Jochem, Jerzy; Kasperski, Jacek; Kasperska−Zając, Alicja

doi:10.1186/1476-9255-11-2

Cited by 52 publications

(64 citation statements)

References 25 publications

(36 reference statements)

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“…Furthermore, whereas Thorp et al [57] and Grzanka et al [59] found that ASST was not correlated with serum 25[OH]D levels, Chandrashekar et al [58] and Woo et al [53] found that in ASST-positive patients, serum 25[OH]D levels were significantly lower than the ASST-negative group. Although more research is needed in this area, these findings suggest that vitamin D deficiency may be a supplementary marker for autoimmune urticaria [53].…”

Section: Chronic Urticariamentioning

confidence: 99%

Vitamin D in atopic dermatitis, chronic urticaria and allergic contact dermatitis

Quirk

Rainwater

Shure

et al. 2016

Expert Review of Clinical Immunology

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Summary Vitamin D influences allergen-induced pathways in the innate and adaptive immune system, and its potential immunomodulatory role in allergic skin disorders has been explored. This comprehensive review article provides an overview of the role of vitamin D in three common dermatologic conditions: atopic dermatitis (AD), chronic urticaria, and allergic contact dermatitis (ACD). Whereas the literature regarding vitamin D and AD has resulted in mixed findings, several studies have described an inverse relationship between vitamin D levels and AD severity, and improvement in AD with vitamin D supplementation. Similarly, several studies report an inverse relationship between vitamin D levels and severity of chronic urticaria. Although current research in humans remains limited, an increased likelihood of ACD has been demonstrated in vitamin D-deficient mice. Additional well-designed clinical trials will be necessary to determine whether vitamin D supplementation should be recommended for prevention or adjuvant treatment of these common dermatologic conditions.

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Section: Chronic Urticariamentioning

confidence: 99%

Vitamin D in atopic dermatitis, chronic urticaria and allergic contact dermatitis

Quirk

Rainwater

Shure

et al. 2016

Expert Review of Clinical Immunology

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“…Our group originally reported in 2007 that serum vitamin D (25(OH)D) levels were significantly reduced in subjects with chronic urticaria as compared to subjects with allergic rhinitis (p = 0.016) [8]. More recently, Grzanka et al in Poland investigated vitamin D levels in healthy adults (n = 33) and chronic urticaria subjects (n = 35) and reported similar findings that patients with chronic urticaria had increased prevalence rates of vitamin D deficiency, defined as 25(OH)D less than 20 ng/ml [9]. In this study, chronic urticaria was further defined as mild and moderate to severe; however, there was no difference between those groups and vitamin D level.…”

mentioning

confidence: 52%

Vitamin D supplementation: a potential booster for urticaria therapy

Rorie

Poole

2014

Expert Review of Clinical Immunology

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Chronic urticaria is a common skin condition whereby the etiology remains largely idiopathic and the mainstay therapy is symptomatic control with antihistamines. There have been a limited number of small studies suggesting a potential role for vitamin D in chronic urticaria, and this this editorial review will discuss the current supporting evidence. Associations for decreased serum vitamin 25 hydroxyvitamin D levels in subjects with chronic urticaria have been reported. In addition to observational reports, there has been a randomized, prospective, blinded trial demonstrating symptom improvement when high vitamin D3 supplementation was utilized as an add-on therapy for urticarial management. More research is needed to address mechanisms of action and to investigate vitamin D supplementation in larger and longer duration human trials.Chronic urticaria is a skin condition that is defined as experiencing urticarial wheals daily or nearly daily for a duration of greater than 6 weeks. The lifetime prevalence of this disorder in the general population is 1-3% and may dramatically impair the quality of life [1,2]. The underlying etiology of these skin manifestations is a complex interaction of inflammatory and allergic mediators in the peripheral tissue milieu. There are multiple subtypes of chronic urticaria that include physical, idiopathic, autoimmune, vasculitic and infectious. Autoimmune etiologies account for 30-60% of chronic urticaria with the presence of functional autoantibodies to the high affinity IgE receptor or IgE, and up to 12% are associated with thyroid autoantibodies such as antithyroid peroxidase antibody and antimicrosomal antibody. Approximately 50% of cases of chronic urticaria remain largely idiopathic [1,3].The association between vitamin D and multiple medical conditions has been receiving much attention, which was well summarized by Holick in 2007 [4]. He reviewed the potential associations with vitamin D deficiency in a variety of solid tumors, arthritis, transplant rejection, and autoimmune diseases including Crohn's disease, multiple sclerosis and type 1 diabetes [4]. However, large randomized controlled trials are largely lacking to validate these potential associations. In fact, in early 2014 a systemic review of randomized trials assessing the role of vitamin D supplementation in various medical conditions failed to demonstrate significant benefit for vitamin D, with the exception of reduced all-cause mortality in elderly women [5]. However, there is a growing body of evidence linking vitamin D with allergic diseases. Notably, in 2007, Camargo et al. published a study tracking the regional distribution of 2.5 million epinephrine pens prescribed in a calendar year in the USA [6]. They reported significantly more prescriptions and filled prescriptions in the northern states, with a strong north to south gradient. The authors proposed that sunlight exposure was the important factor because this north-south gradient was demonstrated despite controlling for variables such as population, num...

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“…Even though the role of vitamin D in the etiology and management of CU has been discussed for some time [14,15,16], most participating clinicians were not convinced. Rorie et al [14] reported that vitamin D supplements improved CU outcomes regardless of the level of serum vitamin D. However, the dose of vitamin D given in this study was far more than the usual dose recommended.…”

Section: Discussionmentioning

confidence: 99%

An Observational Study of the Diagnosis and Management of Chronic Urticaria in the UK

Ardern‐Jones

Eren

et al. 2015

Int Arch Allergy Immunol

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Background: Patients with chronic urticaria (CU) in the UK could be referred to health care professionals (HCPs) with diverse specialties using different guidelines. The aims of the present study were to determine which CU guidelines HCPs in the UK use, which tests they use for the diagnosis of CU, and how they manage CU. Methods: In this UK-wide survey, we designed a questionnaire covering the diagnosis and management of CU based on current guidelines. The link to the questionnaire was sent to the British Society for Allergy and Clinical Immunology (BSACI), the British Association of Dermatologists (BAD), the British Society of Immunology (BSI), and the Food Allergy and Intolerance Specialist Group (FAISG) of the British Dietetic Association (BDA), who distributed the link to their members. Results: The questionnaire was completed by 55 allergists/immunologists, 64 dermatologists, and 43 dietitians. More dermatologists used the BAD guidelines in comparison with allergists and immunologists (93.6 vs. 12.5%; p < 0.001). On the other hand, the BSACI guidelines (83.3 vs. 14.9%; p < 0.001) and the European Academy of Allergy and Clinical Immunology (EAACI)/Global Allergy and Asthma European Network (GA²LEN)/European Dermatology Forum (EDF)/World Allergy Organization (WAO) guidelines (2013) (52.1 vs. 10.6%; p < 0.001) were used by more allergists and immunologists compared to dermatologists. Differences were found between allergists/immunologists and dermatologists with regard to guidelines used, investigations performed, preference of first-line antihistamine, and prescription of alternative treatment methods. Conclusion: In conclusion, differences in the diagnosis and management of CU between HCPs of diverse specialties were identified, which reflected differences among the guidelines used.

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Relationship between vitamin D status and the inflammatory state in patients with chronic spontaneous urticaria

Cited by 52 publications

References 25 publications

Vitamin D in atopic dermatitis, chronic urticaria and allergic contact dermatitis

Vitamin D in atopic dermatitis, chronic urticaria and allergic contact dermatitis

Vitamin D supplementation: a potential booster for urticaria therapy

An Observational Study of the Diagnosis and Management of Chronic Urticaria in the UK

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