The Role of Vitamin D in Atopic Dermatitis

Dębińska, Anna; Sikorska-Szaflik, Hanna; Urbanik, Magdalena; Boznański, Andrzej

doi:10.1097/der.0000000000000128

Cited by 17 publications

(15 citation statements)

References 71 publications

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“…Brehm et al reported that lower vitamin D levels are associated with increased allergy markers, such as total IgE, in children with asthma. In studies on AD patients, Wang et al and Cheon et al found an inverse correlation between vitamin D and total IgE, similar to our findings [9, 10, 12, 19, 20]. …”

Section: Discussionsupporting

confidence: 92%

“…Some studies have suggested that a high intake of vitamin D or an elevated serum vitamin D level in infancy or during gestation can be associated with the development of eczema and asthma later in childhood. Thus, some studies have shown that vitamin D is a protective factor for allergic disease, while others have shown that it is a risk factor for AD [1, 12–14]. …”

Section: Discussionmentioning

confidence: 99%

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The relationship between severity of disease and vitamin D levels in children with atopic dermatitis

Su¹,

Bahalı²,

Demir³

et al. 2017

pdia

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IntroductionAtopic dermatitis (AD) is a chronic relapsing inflammatory skin disorder. Vitamin D is a liposoluble vitamin synthesized mainly in the skin. Vitamin D has several effects on the skin.AimTo assess the serum level of vitamin D in children with AD and determine its relation to AD severity.Material and methodsSixty patients with AD were enrolled in the study. We evaluated disease severity using the SCORing Atopic Dermatitis (SCORAD) index. The control group consisted of 37 healthy subjects.ResultsThe mean serum concentration of 25(OH)D3 in patients with AD was not statistically different from control subjects (p = 0.065). The vitamin D level was significantly lower in moderate and severe AD compared with mild AD, and this difference was statistically significant (p = 0.001 and p = 0.004). Vitamin D showed a negative correlation with serum total IgE levels (p = 0.007). There was no significant correlation between total IgE levels and SCORAD scores (p = 0.089).ConclusionsThis study suggests that a low serum vitamin D level is inversely associated with severity of AD in children. Vitamin D has not been included in the routine treatment of AD because of the conflicting results of various studies. Thus, there is a need for more detailed and prospective studies.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

The relationship between severity of disease and vitamin D levels in children with atopic dermatitis

Su¹,

Bahalı²,

Demir³

et al. 2017

pdia

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“…Our findings for atopic dermatitis and IgE agree with recent observational studies and RCTs [3,4,9]. In contrast, we have used the same methods to provide evidence supporting a causal role for 25OHD in risk of multiple sclerosis [41].…”

Section: Discussionsupporting

confidence: 88%

“…Although two randomized controlled trials (RCTs) [12,13] and a recent Cochrane meta-analysis of RCTs for asthma [14] showed a role for vitamin D supplementation in the reduction of atopic exacerbations, other recent data do not support the benefits of vitamin D supplementation for asthma [12,13,15,16], atopic dermatitis, or IgE levels [17–19]. Given this lingering controversy, clinical practice guidelines do not support vitamin D supplementation to prevent atopic disease [1,4]. However, RCT evidence is typically of low quality in vitamin D trials because of their small sample size and limited duration; since vitamin D therapy cannot be patented, large-scale trials would rely upon the limited means of the public purse.…”

Section: Introductionmentioning

confidence: 99%

Vitamin D levels and susceptibility to asthma, elevated immunoglobulin E levels, and atopic dermatitis: A Mendelian randomization study

et al. 2017

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BackgroundLow circulating vitamin D levels have been associated with risk of asthma, atopic dermatitis, and elevated total immunoglobulin E (IgE). These epidemiological associations, if true, would have public health importance, since vitamin D insufficiency is common and correctable.Methods and findingsWe aimed to test whether genetically lowered vitamin D levels were associated with risk of asthma, atopic dermatitis, or elevated serum IgE levels, using Mendelian randomization (MR) methodology to control bias owing to confounding and reverse causation. The study employed data from the UK Biobank resource and from the SUNLIGHT, GABRIEL and EAGLE eczema consortia. Using four single-nucleotide polymorphisms (SNPs) strongly associated with 25-hydroxyvitamin D (25OHD) levels in 33,996 individuals, we conducted MR studies to estimate the effect of lowered 25OHD on the risk of asthma (n = 146,761), childhood onset asthma (n = 15,008), atopic dermatitis (n = 40,835), and elevated IgE level (n = 12,853) and tested MR assumptions in sensitivity analyses. None of the four 25OHD-lowering alleles were associated with asthma, atopic dermatitis, or elevated IgE levels (p ≥ 0.2). The MR odds ratio per standard deviation decrease in log-transformed 25OHD was 1.03 (95% confidence interval [CI] 0.90–1.19, p = 0.63) for asthma, 0.95 (95% CI 0.69–1.31, p = 0.76) for childhood-onset asthma, and 1.12 (95% CI 0.92–1.37, p = 0.27) for atopic dermatitis, and the effect size on log-transformed IgE levels was −0.40 (95% CI −1.65 to 0.85, p = 0.54). These results persisted in sensitivity analyses assessing population stratification and pleiotropy and vitamin D synthesis and metabolism pathways. The main limitations of this study are that the findings do not exclude an association between the studied outcomes and 1,25-dihydoxyvitamin D, the active form of vitamin D, the study was underpowered to detect effects smaller than an OR of 1.33 for childhood asthma, and the analyses were restricted to white populations of European ancestry. This research has been conducted using the UK Biobank Resource and data from the SUNLIGHT, GABRIEL and EAGLE Eczema consortia.ConclusionsIn this study, we found no evidence that genetically determined reduction in 25OHD levels conferred an increased risk of asthma, atopic dermatitis, or elevated total serum IgE, suggesting that efforts to increase vitamin D are unlikely to reduce risks of atopic disease.

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“…However, the literature on vitamin D and AD have resulted in controversial findings; the role of vitamin D in AD is far from clear [61][62][63][64].…”

Section: Re-direct the Imbalanced Immune Polarizationmentioning

confidence: 99%

Potential Treatments for Atopic Dermatitis

Kao¹,

Shieh²,

Lee³

et al. 2016

J immuno Biol

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Atopic Dermatitis (AD) is the most common pruritic inflammatory skin disease which causes economic and social burden. AD is not curable and therapeutic options are limited. Currently, the therapeutic approaches to AD include topical treatment, phototherapy, and systemic treatment. Although traditional therapeutic strategies are efficacious in ameliorating the symptoms of AD in most patients, sometimes it is a tough challenge for physicians as AD is catastrophic and difficult to treat. Several potential treatments for AD are being studied owing to a clearer understanding of its pathogenesis. Additionally, animal models of AD allow comprehensive and thorough investigation of pathogenesis and provide more options of therapeutic interventions. The purpose of non-classical treatment strategies for AD is to decrease skin inflammation, re-direct the imbalanced immune polarization, and induce immune tolerance to allergens. Generally, the intervention for mouse model of AD can be classified into 1) monoclonal antibodies, 2) anti-oxidants, 3) allergen-specific immunotherapy, 4) herbal medicine, 5) treatment with materials extracted from food or micronutrients, 6) microbiota/probiotics, 7) bio-composites films, and 8) others. Since half of the patients with AD lack specific immunoglobulin E against allergens, the pathogenesis of different phenotypes still needs to be clarified. Through novel therapies such as cytokine-targeting therapy, miRNA or suppression of thymic stromal lymphopoietin, patients with AD could have better quality of life with less morbidity.

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The Role of Vitamin D in Atopic Dermatitis

Cited by 17 publications

References 71 publications

The relationship between severity of disease and vitamin D levels in children with atopic dermatitis

The relationship between severity of disease and vitamin D levels in children with atopic dermatitis

Vitamin D levels and susceptibility to asthma, elevated immunoglobulin E levels, and atopic dermatitis: A Mendelian randomization study

Potential Treatments for Atopic Dermatitis

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