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Zhang P, Xu Q, Zhu R. Vitamin D and allergic diseases. Front Immunol 2024; 15:1420883. [PMID: 39026686 PMCID: PMC11254667 DOI: 10.3389/fimmu.2024.1420883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2024] [Accepted: 06/24/2024] [Indexed: 07/20/2024] Open
Abstract
In recent years, the relationship between vitamin D and allergic diseases has received widespread attention. As a fat-soluble vitamin, vitamin D plays a crucial role in regulating the immune system and may influence the onset and progression of diseases such as atopic dermatitis, allergic rhinitis, and asthma. To understand the underlying mechanisms, we have summarized the current research on the association between vitamin D and allergic diseases. We also discuss the impact of vitamin D on the immune system and its role in the course of allergic diseases, particularly focusing on how vitamin D supplementation affects the treatment outcomes of these conditions. We aim to provide a theoretical basis and practical guidance for optimizing the management and treatment of allergic diseases by modulating vitamin D levels.
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Affiliation(s)
- Panyu Zhang
- Department of Allergy, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Qingxiu Xu
- Department of Allergy, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Rongfei Zhu
- Department of Allergy, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Institute of Allergy and Clinical Immunology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Çiçek F, Köle MT. Evaluation of the Impact of Serum Vitamin D Levels on the Scoring Atopic Dermatitis Index in Pediatric Atopic Dermatitis. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1522. [PMID: 37761483 PMCID: PMC10529228 DOI: 10.3390/children10091522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/13/2023] [Revised: 09/05/2023] [Accepted: 09/06/2023] [Indexed: 09/29/2023]
Abstract
Atopic dermatitis (AD) is a chronic and recurrent inflammatory skin condition characterized by itching, eczematous plaques, and dry skin. Despite ongoing research, its exact cause remains elusive. In this study, we aimed to explore the factors that influence the severity of AD in children and assess the relationship between serum vitamin D levels and the disease's severity. We enrolled 96 AD patients in our investigation, evaluated their clinical condition using the Scoring Atopic Dermatitis (SCORAD) index, and compared them to a group of 90 healthy controls. Our analysis revealed that serum vitamin D levels and eosinophil counts significantly impacted the SCORAD index (p < 0.001). According to standardized regression coefficients, for each incremental unit in serum vitamin D levels, the SCORAD index exhibited a decrease of 0.449 units. Similarly, a one-unit increase in eosinophil count resulted in a 0.009 unit increase in the SCORAD index. It is worth noting that the influence of serum vitamin D levels on disease severity surpasses that of eosinophil counts and atopic conditions. In our patient cohort, we uncovered a negative correlation (r = -0.419, p < 0.001) between serum vitamin D levels and the SCORAD index. Our findings suggest that low serum vitamin D levels may have a more substantial impact on AD severity than atopic conditions and eosinophilia. Furthermore, we observed a negative association between the severity of AD and serum 25(OH)D3 levels.
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Affiliation(s)
- Fatih Çiçek
- Department of Pediatric Allergy and Immunology, Kartal Dr. Lütfi Kırdar City Hospital, University of Health Sciences, Istanbul 34870, Turkey
| | - Mehmet Tolga Köle
- Department of Pediatrics, Kartal Dr. Lütfi Kırdar City Hospital, University of Health Sciences, Istanbul 34870, Turkey;
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Shafi T, Rasool R, Ayub S, Bhat IA, Gull A, Hussain S, Hassan Shah I, Shah ZA. Analysis of intronic SNP (rs4147358) and expression of SMAD3 gene in Atopic Dermatitis: A case-control study. Immunobiology 2023; 228:152390. [PMID: 37100019 DOI: 10.1016/j.imbio.2023.152390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 04/10/2023] [Accepted: 04/18/2023] [Indexed: 04/28/2023]
Abstract
BACKGROUND Atopic Dermatitis (AD) is a multifactorial cutaneous disorder associated with chronic inflammation of the skin. Growing evidence points to TGF-β/SMAD signaling as a key player in mediating inflammation and the subsequent tissue remodeling, often resulting in fibrosis. This study investigates the role of a core transcription factor involved in TGF-β signaling i.e., SMAD3 genetic variants (rs4147358) in AD predisposition and its association with SMAD3 mRNA expression, serum IgE levels, and sensitization to various allergens in AD patients. METHODS A total of 246 subjects including 134 AD cases and 112 matched healthy controls were genotyped for SMAD3 intronic SNP by PCR-RFLP. mRNA expression of SMAD3 was determined by quantitative Real-Time PCR (qRT-PCR), Vitamin-D levels by chemiluminescence, and total serum IgE levels by ELISA. In-vivo allergy testing was performed for the evaluation of allergic reactions to house dust mites (HDM) and food allergens. RESULTS A significantly higher frequency of mutant genotype AA (cases: 19.4% vs controls: 8.9%) (OR = 2.8, CI = 1.2 - 6.7, p = 0.01) was observed in AD cases. The mutant allele 'A' also showed a 1.9-fold higher risk for AD compared to the wild allele 'C' indicating that the carriers of the A allele have a higher risk for AD predisposition (OR-1.9, CI = 1.3-2.8, p < 0.001). In addition, quantitative analysis of SMAD3 mRNA in peripheral blood showed 2.8-fold increased expression in AD cases as compared to healthy controls. Stratification analysis revealed the association of the mutant AA genotype with deficient serum Vitamin D levels (p = 0.02) and SMAD3 mRNA overexpression with HDM sensitization (p = 0.03). Furthermore, no significant association of genotypes with SMAD3 mRNA expression was observed. CONCLUSION Our study indicates that SMAD3 intronic SNP bears a significant risk of AD development. Moreover, overexpression of SMAD3 mRNA and its association with HDM sensitization highlights the possible role of this gene in AD pathogenesis.
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Affiliation(s)
- Tabasum Shafi
- Department of Immunology & Molecular Medicine, SKIMS, Srinagar 190011, India
| | - Roohi Rasool
- Department of Immunology & Molecular Medicine, SKIMS, Srinagar 190011, India.
| | - Sakeena Ayub
- Department of Immunology & Molecular Medicine, SKIMS, Srinagar 190011, India
| | - Imtiyaz A Bhat
- Department of Immunology & Molecular Medicine, SKIMS, Srinagar 190011, India
| | - Ayaz Gull
- Department of Immunology & Molecular Medicine, SKIMS, Srinagar 190011, India
| | - Showkat Hussain
- Department of Immunology & Molecular Medicine, SKIMS, Srinagar 190011, India
| | - Iffat Hassan Shah
- Department of Dermatology, Venereology, and Leprosy, GMC- Srinagar 190010, India
| | - Zafar A Shah
- Department of Immunology & Molecular Medicine, SKIMS, Srinagar 190011, India
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Serum Vitamin D Level and Efficacy of Vitamin D Supplementation in Children with Atopic Dermatitis: A Systematic Review and Meta-analysis. COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE 2022; 2022:9407888. [PMID: 35912161 PMCID: PMC9328962 DOI: 10.1155/2022/9407888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 06/28/2022] [Accepted: 07/04/2022] [Indexed: 11/18/2022]
Abstract
Background The relationship between vitamin D and atopic dermatitis (AD) is controversial. This meta-analysis is aimed at exploring vitamin D level and its deficiency in pediatric AD and at evaluating the efficacy of vitamin D supplementation. Methods PubMed, Medline, Embase, Ovid, Cochrane Library, ISI Web of Science, and ClinicalTrials were searched. Binary variables and continuous variables were measured by odds ratio (OR) and mean difference (MD) with 95% confidence intervals, respectively. The modified Jadad scale, Newcastle-Ottawa Scale (NOS), and Cochrane's bias risk tools were used to evaluate study quality and the risk of bias of eligible studies, respectively. Results A total of 22 literature were included in the analysis. Serum 25 (OH) D level in pediatric AD patients was significantly lower than that of the control group with a combined MD value of -8.18 (95% CI: -13.15, -3.22). Patients with AD were more prone to develop vitamin D deficiency with a combined OR value of 2.17 (95% CI: 1.15, 4.11). According to the score of SCORAD, the level of serum 25 (OH) D level in patients with severe AD was significantly lower than that in patients with mild AD (combined MD = 9.23, 95% CI: 6.92, 11.55). Both self-control studies and randomized controlled trials showed improved SCORAD score and EASI score after vitamin D supplementation. Conclusion This meta-analysis showed lower serum 25 (OH) D level and increased risk of vitamin D deficiency in pediatric AD patients as compared with healthy controls. The serum 25 (OH) D level in severe AD patients was significantly lower than that in the mild AD patients. The SCORAD and EASI score improved after vitamin D supplementation, suggesting its beneficial effect to AD patients. At the same time, more homogeneous studies are needed to reduce confounding factors and further evaluate the impact of vitamin D treatment on the outcome of AD patients.
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Lucas R, Szklenar M, Mihály J, Szegedi A, Töröcsik D, Rühl R. Plasma Levels of Bioactive Vitamin D and A5 Ligands Positively Correlate with Clinical Atopic Dermatitis Markers. Dermatology 2022; 238:1076-1083. [PMID: 35609515 DOI: 10.1159/000524343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 03/27/2022] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Over the past decade, several controversial studies described a relationship between vitamin D and atopic diseases. Low plasma vitamin D levels or even vitamin D deficiency was associated with an increased incidence of atopic disease, postulating that a higher dietary intake of vitamin D may be a beneficial strategy against atopic diseases such as atopic dermatitis (AD). OBJECTIVE Our aim was to determine the relationship between plasma 25-hydroxyvitamin D3 (25(OH)D3) levels, the levels of the ligand of the vitamin D receptor (VDR) heterodimerization partner as well as the retinoid X receptor (RXR) and the active vitamin A5 derivative 9-cis-13,14-dihydroretinoic acid (9CDHRA) and AD severity. METHODS/RESULTS Samples from AD patients (n = 20) and healthy volunteers (n = 20) were assessed. In our study, the frequently measured VDR ligand precursor 25(OH)D3 in addition to the VDR-ligand 1,25-dihydroxyvitamin D3 (1,25(OH)2D3) and 9CDHRA displayed no different levels when compared with the plasma of AD patients and healthy volunteers. When performing further correlation studies focusing on AD patients, plasma 25(OH)D3 levels showed a negative correlation with eosinophils in blood (EOS) and SCORing Atopic Dermatitis (SCORAD) values, while 1,25(OH)2D3 and 9CDHRA levels correlated positively with plasma IgE, EOS, and SCORAD values. CONCLUSION In consequence, the metabolic activation of vitamin D from 25(OH)D3 towards 1,25(OH)2D3 as well as the co-liganding of the RXR by 9CDHRA may be an important signalling mechanism, an important marker for AD development and severity as well as the basis for novel nutritional and pharmaceutical AD treatment options.
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Affiliation(s)
- Renata Lucas
- Department of Dermatology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | | | - Johanna Mihály
- Department of Biochemistry and Molecular Biology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Andrea Szegedi
- Department of Dermatology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Daniel Töröcsik
- Department of Dermatology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Ralph Rühl
- Paprika Bioanalytics BT, Debrecen, Hungary.,Department of Biochemistry and Molecular Biology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
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Effect of Vitamin D Serum Levels and Supplementation on Atopic Dermatitis: A Systematic Review and Meta-analysis. Am J Clin Dermatol 2022; 23:267-275. [PMID: 35246808 DOI: 10.1007/s40257-022-00677-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/16/2022] [Indexed: 11/01/2022]
Abstract
BACKGROUND Previous studies have shown that serum 25-hydroxyvitamin D (25(OH)D) may be associated with atopic dermatitis (AD), and that vitamin D (VD) supplementation may decrease AD severity. OBJECTIVE The aim of this study was to investigate the association between serum 25(OH)D level and AD, and the effect of VD supplementation on AD severity, while providing stratified analyses based on latitude and region. METHODS A systematic review was performed on all published studies in MEDLINE, Embase, and Cochrane Library databases that analyzed effects of serum 25(OH)D and VD supplementation on AD. RESULTS This systematic review and meta-analysis includes 20 studies with 1882 cases of AD. We found significantly lower 25(OH)D levels in AD patients compared with healthy controls (HC) (p < 0.001), significantly lower 25(OH)D levels in severe AD compared with both mild and moderate AD (p < 0.001), and VD supplementation improved AD symptoms (p < 0.001). LIMITATIONS Factors like seasonal and environmental changes, sunlight exposure, and cultural practices may confound the relationship between serum 25(OH)D and AD severity. There are limited randomized controlled trials that assess this association. CONCLUSION Overall, lower serum 25(OH)D is associated with more severe AD, and VD supplementation may help lower AD severity. Further research is needed to confirm the presence and direction of causality of the relationship between VD and AD pathogenesis.
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Naik PP, Farrukh SN. Influence of Ethnicities and Skin Color Variations in Different Populations: A Review. Skin Pharmacol Physiol 2021; 35:65-76. [PMID: 34515229 DOI: 10.1159/000518826] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Accepted: 07/30/2021] [Indexed: 11/19/2022]
Abstract
BACKGROUND In the world scientific tradition, skin color is the primary physical characteristic used to divide humans into groups. Human skin has a wide range of tones and colors, which can be seen in a wide range of demographic populations. Many factors influence the color of people's skin, but the pigment melanin is by far the most important. Melanin is produced by cells called melanocytes in the skin and is the primary determinant of skin color in people with darker skin. Indeed, >150 genes have now been identified as having a direct or indirect effect on skin color. Vitamin D has recently been discovered to regulate cellular proliferation and differentiation in a variety of tissues, including the skin. The mechanisms through which the active vitamin D metabolite 1,25 dihydroxyvitamin D3 (or calcitriol) affects keratinocyte development are numerous and overlap with the mechanisms by which calcium influences keratinocyte differentiation. Ultraviolet (UV) is the most major modifiable risk factor for skin cancer and many other environmental-influenced skin disorders when it is abundant in the environment. Although the UV component of sunlight is known to cause skin damage, few researches have looked at the impact of non-UV solar radiation on skin physiology in terms of inflammation, and there is less information on the role of visible light in pigmentation. SUMMARY The quantity and quality of melanin are regulating by the expression of genes. The enzyme tyrosinase is primarily responsible for the genetic mechanism that controls human skin color. Genetics determines constitutive skin color, which is reinforced by facultative melanogenesis and tanning reactions. High quantities of melanin and melanogenic substances are typically accepted in darker skin to protect against UV radiation-induced molecular damage. Previous research has proposed that skin color variation is caused by a dynamic genetic mechanism, contributing to our understanding of how population demographic history and natural selection shape human genetic and phenotypic diversity. However, the most significant ethnic skin color difference is determined by melanin content. This current review aimed to assess the influence of skin color variations in skin structure and functions as well as difference in dermatological disease patterns. Also, this article reviewed several cases of skin color adaptation in different populations. Key Messages: Skin color impacts the composition and activity. Therefore, the contrast of dermatological ailments between distinct race-related categories is remarkable. Skin color adaptation is a challenging procedure. Refinement of skin color is an age-old craving of humans with ever-evolving drifts.
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Affiliation(s)
- Piyu Parth Naik
- Department of Dermatology, Saudi-German Hospital & Clinic, Dubai, United Arab Emirates
| | - Syed Nadir Farrukh
- Department of Internal Medicine, Adam-Vital Hospital, Dubai, United Arab Emirates
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Holm JG, Hurault G, Agner T, Clausen ML, Kezic S, Tanaka RJ, Thomsen SF. Immunoinflammatory Biomarkers in Serum Are Associated with Disease Severity in Atopic Dermatitis. Dermatology 2021; 237:513-520. [PMID: 33730733 DOI: 10.1159/000514503] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Accepted: 01/16/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND A growing body of evidence links various biomarkers to atopic dermatitis (AD). Still, little is known about the association of specific biomarkers to disease characteristics and severity in AD. OBJECTIVE To explore the relationship between various immunological markers in the serum and disease severity in a hospital cohort of AD patients. METHODS Outpatients with AD referred to the Department of Dermatology, Bispebjerg Hospital, Copenhagen, Denmark, were divided into groups based on disease severity (SCORAD). Serum levels of a preselected panel of immunoinflammatory biomarkers were tested for association with disease characteristics. Two machine learning models were developed to predict SCORAD from the measured biomarkers. RESULTS A total of 160 patients with AD were included; 53 (33.1%) with mild, 73 (45.6%) with moderate, and 34 (21.3%) with severe disease. Mean age was 29.2 years (range 6-70 years) and 84 (52.5%) were females. Numerous biomarkers showed a statistically significant correlation with SCORAD, with the strongest correlations seen for CCL17/thymus and activation-regulated chemokine (chemokine ligand-17/TARC) and CCL27/cutaneous T cell-attracting-chemokine (CTACK; Spearman R of 0.50 and 0.43, respectively, p < 0.001). Extrinsic AD patients were more likely to have higher mean SCORAD (p < 0.001), CCL17 (p < 0.001), CCL26/eotaxin-3 (p < 0.001), and eosinophil count (p < 0.001) than intrinsic AD patients. Predictive models for SCORAD identified CCL17, CCL27, serum total IgE, IL-33, and IL-5 as the most important predictors for SCORAD, but with weaker associations than single cytokines. CONCLUSIONS Specific immunoinflammatory biomarkers in the serum, mainly of the Th2 pathway, are correlated with disease severity in patients with AD. Predictive models identified biomarkers associated with disease severity but this finding warrants further investigation.
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Affiliation(s)
- Jesper Grønlund Holm
- Department of Dermato-Venereology, Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark,
| | - Guillem Hurault
- Department of Bioengineering, Faculty of Engineering, Imperial College, London, United Kingdom
| | - Tove Agner
- Department of Dermato-Venereology, Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Maja Lisa Clausen
- Department of Dermato-Venereology, Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Sanja Kezic
- Coronel Institute, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Reiko J Tanaka
- Department of Bioengineering, Faculty of Engineering, Imperial College, London, United Kingdom
| | - Simon Francis Thomsen
- Department of Dermato-Venereology, Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark.,Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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Ibrahim HM, El-Taieb MA, Hassan MH, Mohamed AAE, Kotop EA, Abd-Ellah OH, Hegazy EM. Relations between vitamin D3, total and specific IgE for house dust mites in atopic dermatitis patients. Sci Rep 2020; 10:21000. [PMID: 33268802 PMCID: PMC7710713 DOI: 10.1038/s41598-020-77968-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Accepted: 10/28/2020] [Indexed: 01/12/2023] Open
Abstract
Atopic dermatitis (AD) is a chronic recurrent inflammatory skin disease. There are a lot of evidences on the importance of vitamin D and house dust mite (HDM) allergens in the etiology and course of AD. The objectives of this study are to evaluate the relation between vitamin D3 level and house dust mites (HDM) Dermatophagoidspecies sensitization in pathogenesis of atopic dermatitis. Cross-sectional design study was conducted on 50 atopic dermatitis patients. Blood analysis were done to determine level of vitamin D3, total IgE by fluorescent immunoassay & specific IgE for HDM (d1, d2) & other inhalant allergens by ELISA test. There was significant high negative correlation with the specific IgE for HDM (r = −0. 62, p < 0.001) and vitamin D3. & there was non-significant minimal negative correlation with the specific IgE and other inhalant allergens (r = − 0.10, p > 0.05). There was a statistically significant relation between level of vitamin D3 and atopic dermatitis severity and sensitization to HDM and other allergens.
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Affiliation(s)
- Hassan M Ibrahim
- Dermatology, Andrology and Venereology, Qena Faculty of Medicine, South Valley University, Qena, 83523, Egypt.
| | - Moustafa A El-Taieb
- Department of Dermatology, Andrology and Venereology, Aswan Faculty of Medicine, Aswan University, Tingar, Egypt
| | - Mohammed H Hassan
- Department of Medical Biochemistry, Qena Faculty of Medicine, South Valley University, Qena, Egypt
| | - Abd Allah E Mohamed
- Clinical Pathology, Qena Faculty of Medicine, South Valley University, Qena, Egypt
| | - Ebtihal A Kotop
- Dermatology, Venereology and Andrology, Qena University Hospital, South Valley University, Qena, Egypt
| | - Osama H Abd-Ellah
- Parasitology Department, Qena Faculty of Medicine, South Valley University, Qena, Egypt
| | - Eisa M Hegazy
- Department of Dermatology, Andrology and Venereology, Qena Faculty of Medicine, South Valley University, Qena, Egypt
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Sanmartin R, Pardos C, Doste D, Aguilera J, Alijarde R, Jesús Agón-Banzo P, García-Malinis AJ, Puzo J, Hernández-Martín Á, Gilaberte Y. The association between atopic dermatitis and serum 25-hydroxyvitamin D in children: Influence of sun exposure, diet, and atopy features-A cross-sectional study. Pediatr Dermatol 2020; 37:294-300. [PMID: 31997408 DOI: 10.1111/pde.14049] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND Previous studies have linked low serum vitamin D (VD) or 25-hydroxyvitamin D (25(OH)D) levels with increased severity of atopic dermatitis (AD) in children. OBJECTIVE To investigate the association between serum VD (25(OH)D) levels and AD and AD severity, considering the influence of diet and sun exposure. METHODS We performed a prospective cross-sectional study of healthy controls and children diagnosed with AD. Participants were recruited between January 2011 and December 2012, and the following parameters were assessed: age, sex, body mass index (BMI), AD severity, Fitzpatrick skin type, asthma and rhinitis history, dietary VD intake, daily potential sun-induced VD production, sunscreen use, 25(OH)D and IgE serum levels, and results of the ImmunoCAP Phadiatop Infant test. RESULTS The study population consisted of 105 healthy controls and 134 AD patients. Serum 25(OH)D levels were significantly lower in moderate and severe AD than in mild AD, although this association was only significant for patients with light Fitzpatrick skin type (mean(SD) 36.7 (11.9) ng/mL; moderate 28.8 [11.5] ng/mL; and severe 27.6 [12.1] ng/mL, P = .045). Logistic regression analysis revealed a positive association between severe AD and both positive ImmunoCAP Phadiatop test and BMI. CONCLUSION Our data support an association between VD deficiency and AD severity only in patients with light complexion.
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Affiliation(s)
| | - Carlos Pardos
- Perpetuo Socorro, Primary Care Center, Huesca, Spain
| | | | - Jose Aguilera
- Photobiological Dermatology Laboratory, Department of Dermatology and Medicine, Medical Research Center, Faculty of Medicine, University of Málaga, Málaga, Spain
| | | | | | | | - José Puzo
- Department of Biochemistry, San Jorge Hospital, Huesca, Spain
| | | | - Yolanda Gilaberte
- Department of Dermatology, University Hospital Miguel Servet, IIS Aragón, Zaragoza, Spain
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Hattangdi-Haridas SR, Lanham-New SA, Wong WHS, Ho MHK, Darling AL. Vitamin D Deficiency and Effects of Vitamin D Supplementation on Disease Severity in Patients with Atopic Dermatitis: A Systematic Review and Meta-Analysis in Adults and Children. Nutrients 2019; 11:nu11081854. [PMID: 31405041 PMCID: PMC6722944 DOI: 10.3390/nu11081854] [Citation(s) in RCA: 47] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Revised: 08/05/2019] [Accepted: 08/06/2019] [Indexed: 12/16/2022] Open
Abstract
Research has investigated 25-hydroxyvitamin D (25(OH)D) levels in the Atopic Dermatitis (AD) population, as well as changes in AD severity after vitamin D (VitD) supplementation. We performed an up-to-date systematic review and meta-analysis of these findings. Electronic searches of MEDLINE, EMBASE and COCHRANE up to February 2018 were performed. Observational studies comparing 25(OH)D between AD patients and controls, as well as trials documenting baseline serum 25(OH)D levels and clinical severity by either SCORAD/EASI scores, were included. Of the 1085 articles retrieved, sixteen were included. A meta-analysis of eleven studies of AD patients vs. healthy controls (HC) found a mean difference of −14 nmol/L (95% CI −25 to −2) for all studies and −16 nmol/L (95% CI −31 to −1) for the paediatric studies alone. A meta-analysis of three VitD supplementation trials found lower SCORAD by −11 points (95% CI −13 to −9, p < 0.00001). This surpasses the Minimal Clinical Important Difference for AD of 9.0 points (by 22%). There were greater improvements in trials lasting three months and the mean weighted dose of all trials was 1500–1600 IU/daily. Overall, the AD population, especially the paediatric subset, may be at high-risk for lower serum 25(OH)D. Supplementation with around 1600 IU/daily results in a clinically meaningful AD severity reduction.
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Affiliation(s)
- Sonal R Hattangdi-Haridas
- Department of Nutritional Sciences, School of Biosciences and Medicine, Faculty of Health and Medical Sciences, University of Surrey, Guildford, Surrey, GU2 7XH, UK
| | - Susan A Lanham-New
- Department of Nutritional Sciences, School of Biosciences and Medicine, Faculty of Health and Medical Sciences, University of Surrey, Guildford, Surrey, GU2 7XH, UK
| | - Wilfred Hing Sang Wong
- Department of Paediatrics and Adolescent Medicine, Queen Mary Hospital, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Marco Hok Kung Ho
- Department of Paediatrics and Adolescent Medicine, Queen Mary Hospital, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Andrea L Darling
- Department of Nutritional Sciences, School of Biosciences and Medicine, Faculty of Health and Medical Sciences, University of Surrey, Guildford, Surrey, GU2 7XH, UK.
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Ahmed Mohamed A, Salah Ahmed EM, Farag YMK, Bedair NI, Nassar NA, Ghanem AIM. Dose-response association between vitamin D deficiency and atopic dermatitis in children, and effect modification by gender: a case-control study. J DERMATOL TREAT 2019; 32:174-179. [PMID: 31296076 DOI: 10.1080/09546634.2019.1643447] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
BACKGROUND Vitamin D is a regulatory factor for immunity and skin barrier functions. It is hypothesized to be linked to atopic dermatitis (AD) which is characterized by interaction between epidermal barrier dysfunction and dysregulation of skin immune functions. METHODS One hundred AD patients and one hundred and one normal controls were collected from outpatient clinic based on their clinical condition, both had measurement of 25-hydroxyvitamin D [25(OH)D]. We assessed the relationship between 25(OH)D deficiency and AD prevalence using adjusted Poisson regression model. RESULTS Serum 25(OH)D levels were significantly lower in cases than controls (mean 35.1 versus 22.6 ng/mL, p < .001). The unadjusted prevalence ratios (PRs) (95% CI) for AD for comparing participants with intermediate and deficient vitamin D levels to those with optimal levels were 3.11 (1.91, 5.06) and 4.77 (2.99, 7.60), respectively. The association did not materially change after adjusting for potential confounders. In the fully adjusted analysis stratified by gender, PRs for AD for comparing male participants with intermediate and deficient vitamin D levels to those with optimal levels were 3.38 (1.21, 9.40) and 5.20 (1.91, 14.13), respectively, whereas in the female participants were 1.32 (0.96, 1.83) and 1.49 (1.04, 2.14), respectively (p-interaction <.001). CONCLUSION In this case-control study in children, we found a statistically significant dose-response association between vitamin D deficiency and AD. We also observed a statistically significant effect modification of this association by gender. Further research is recommended to study this association longitudinally, and to examine whether treating vitamin D deficiency may potentially improve AD. Key points Question: Can atopic dermatitis be associated with vitamin D deficiency? Finding: Serum 25(OH)D levels were significantly lower in cases with AD than in controls. Prevalence ratios for comparing male participants with intermediate and deficient vitamin D levels to those with optimal levels were 3.38 (1.21, 9.40) and 5.20 (1.91, 14.13), respectively, whereas in the female participants were 1.32 (0.96, 1.83) and 1.49 (1.04, 2.14), respectively (p-interaction <.001). Meaning: vitamin D deficiency is associated with AD in children, effect modification of this association by gender was also observed.
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Affiliation(s)
- Amal Ahmed Mohamed
- Biochemistry Department, National Hepatology and Tropical Medicine Research Institute, Cairo, Egypt
| | - Eman Mohamed Salah Ahmed
- Department of Dermatology, Andrology, Sexual Medicine and STDs, Faculty of Medicine, Helwan University, Cairo, Egypt
| | - Youssef M K Farag
- Welch Center for Prevention, Epidemiology, and Clinical Research and Clinical Research and Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Nermeen Ibrahim Bedair
- Department of Dermatology, Andrology, Sexual Medicine and STDs, Faculty of Medicine, Helwan University, Cairo, Egypt
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Topical calcipotriol vs narrowband ultraviolet B in treatment of alopecia areata: a randomized-controlled trial. Arch Dermatol Res 2019; 311:629-636. [DOI: 10.1007/s00403-019-01943-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Revised: 06/14/2019] [Accepted: 06/18/2019] [Indexed: 02/03/2023]
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Vaughn AR, Foolad N, Maarouf M, Tran KA, Shi VY. Micronutrients in Atopic Dermatitis: A Systematic Review. J Altern Complement Med 2019; 25:567-577. [PMID: 30912673 DOI: 10.1089/acm.2018.0363] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Objective: The pathophysiology of atopic dermatitis (AD) involves a complex interplay between immune system dysfunction, genetics, and environmental factors. It is well known that nutritional status is essential to a proper functioning immune system, leading to a highly debated question regarding the role of dietary factors in the pathogenesis of AD. Food allergies and elimination diets have been broadly studied in atopy; however, less consideration has been given to how vitamins, minerals, and other micronutrients influence the risk for AD and severity of symptoms. This systematic review discusses evidence on how various micronutrients, including vitamins (C, E, and D) and trace minerals (zinc, selenium, iron, copper, magnesium, and strontium) are associated with AD, and how supplementation influence disease severity. Design: A systematic search was conducted to identify the role that oral micronutrients have on AD. The authors reviewed 49 studies herein. Results: While there are weak associations between vitamins C or E and AD, there is sufficient evidence to suggest that vitamin D supplementation provides benefit in AD patients. Deficiency of selenium and zinc may exacerbate AD. Current reports are not sufficient to confidently discern the role of other vitamins and trace minerals on AD. Conclusions: Though oral micronutrients may play a role in AD, the current literature is limited, and there is a need for more comprehensive randomized controlled trials (RCTs) to truly decipher the role between oral micronutrients and AD.
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Affiliation(s)
- Alexandra R Vaughn
- 1 Department of Dermatology, University of California-Davis, Sacramento, CA
| | - Negar Foolad
- 2 School of Medicine, University of California-Davis, Sacramento, CA
| | - Melody Maarouf
- 3 College of Medicine, University of Arizona-Tucson, Tucson, AZ
| | - Khiem A Tran
- 3 College of Medicine, University of Arizona-Tucson, Tucson, AZ
| | - Vivian Y Shi
- 4 Division of Dermatology, Department of Medicine, University of Arizona-Tucson, Tucson, AZ
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Holm JG, Agner T, Clausen ML, Thomsen SF. Determinants of disease severity among patients with atopic dermatitis: association with components of the atopic march. Arch Dermatol Res 2019; 311:173-182. [PMID: 30770978 DOI: 10.1007/s00403-019-01895-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Revised: 02/08/2019] [Accepted: 02/12/2019] [Indexed: 12/13/2022]
Abstract
We aimed to explore the association of key clinical characteristics with disease severity in atopic dermatitis (AD) and its relation to components of the atopic march in a large hospital cohort. Outpatients with AD referred to the Department of Dermatology, Bispebjerg Hospital, Copenhagen, Denmark, between January 2012 and December 2017, were compared based on disease severity (SCORAD); mild (< 25), moderate (25-50) and severe (> 50). A total of 470 AD patients were included: 122 small children (< 4 years of age), 103 children/adolescents (age 4-15 years) and 245 adults (> 15 years of age). A significant difference between severity groups in small children was observed for FLG mutation carrier status (16.7 vs. 30.2 vs. 60.0% mutation carriers among patients with mild, moderate and severe AD, respectively, p = 0.012) and self-rated health (3.2 vs. 2.7 vs. 2.8 with 4 being excellent health, p = 0.022). A significant difference between severity groups in adults was observed for male sex (24.4 vs. 39.8 vs. 52.9%, p = 0.003), serum total IgE (577 vs. 1269 vs. 2379 × 103 IU/L, p < 0.001), blood eosinophil count (0.28 vs. 0.39 vs. 0.61 × 109/L, p < 0.001) and asthma (42.9 vs. 38.8 vs. 72.0%, p < 0.001). Early onset of AD (< 1 year of age) and FLG mutation was associated with more severe disease and high serum total IgE levels. In conclusion, the distribution of key clinical characteristics varies significantly according to the severity of AD measured by SCORAD. Sub-typing of AD patients related to determinants of disease severity may be helpful in establishing prognosis and targeted treatment of AD.
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Affiliation(s)
- Jesper Grønlund Holm
- Department of Dermato-venereology, Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark.
| | - Tove Agner
- Department of Dermato-venereology, Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Maja-Lisa Clausen
- Department of Dermato-venereology, Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Simon Francis Thomsen
- Department of Dermato-venereology, Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark
- Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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Xiang J, Wang H, Li T. Comorbidity of Vitamin A and Vitamin D Deficiency Exacerbates the Severity of Atopic Dermatitis in Children. Dermatology 2019; 235:196-204. [DOI: 10.1159/000496603] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/29/2023] Open
Abstract
<b><i>Background:</i></b> Several studies have suggested that vitamin D (VD) deficiency (VDD) is associated with atopic dermatitis (AD). However, little is known about the relationship between AD and vitamin A (VA). The interaction between VA and VD on AD requires further study. <b><i>Objective:</i></b> We detected serum levels of VA and VD in children with AD to explore how VA deficiency (VAD) and VDD affect AD severity. <b><i>Methods:</i></b> We assessed the SCORing Atopic Dermatitis (SCORAD) index, total immunoglobin E levels and peripheral blood eosinophil counts. VA and VD levels were determined with high-performance liquid chromatography. Correlations among variables were investigated with Pearson’s correlation analysis. <b><i>Results:</i></b> The VD and VA levels were significantly lower in children with AD than in normal children (p < 0.001, p = 0.0423). Both VD and VA levels were negatively correlated with SCORAD scores. The SCORAD scores were significantly higher in AD patients with both VDD and VAD (co-deficiency) than in other AD patients. Significant inverse correlations were observed between peripheral blood eosinophil counts and serum VA and VD levels. <b><i>Conclusions:</i></b> VA and VD co-deficiency may exacerbate AD symptoms in children, but the specific mechanism underlying this relationship requires further study. These findings may indicate the need for studies evaluating the use of VD and VA as potential treatments for AD patients.
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Dogru M. Is vitamin D level associated with the natural course of atopic dermatitis? Allergol Immunopathol (Madr) 2018; 46:546-551. [PMID: 29559281 DOI: 10.1016/j.aller.2017.12.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2017] [Revised: 11/24/2017] [Accepted: 12/02/2017] [Indexed: 11/16/2022]
Abstract
INTRODUCTION AND OBJECTIVES Atopic dermatitis (AD) is a chronic inflammatory disease of the skin. Apart from its well-known role on calcium metabolism, vitamin D is reported to affect skin functions. The study aims were to: compare the vitamin D levels of children with AD and healthy children; investigate the relationship between the severity of AD and vitamin D levels; and investigate the effect of vitamin D on the natural course of AD. PATIENTS OR MATERIALS AND METHODS Sixty-nine patients with AD were enrolled. Seventy healthy children were assigned as control group. Clinical and demographic features of groups were recorded. The skin prick test, eosinophil counts, immunoglobulin (Ig) E levels and serum 25 OH cholecalciferol (25OHD3) levels were measured. After at least 4 years of follow-up, patients were re-evaluated for natural course of AD. RESULTS Mean 25OHD3 level was lower in patient group vs. control group; 19.86±6.7ng/mL (min-max: 6.8-40) vs. 24.07±9.08ng/mL, respectively, (p=0.002). Mean 25OHD3 levels, and vitamin D status were significantly different between AD severity groups. (p<0.05). In terms of vitamin D status in the pairwise comparison, vitamin D deficiency was greater in children with severe and moderate AD groups (respectively, p=0.005, p=0.018). In Tukey's post hoc analysis for 25OHD3 level, the 25OHD3 levels of severe AD are significantly lower than mild or moderate AD (respectively, p=0.001, p=0.026). There was a negative correlation between 25OHD3 levels and severity of AD (r=-0.480; p=0.001). In patients reassessed after 4 years: age, the age of AD onset, vitamin D deficiency, SCORAD level and severe AD were higher in the persistent group vs. remission group, 25OHD3 levels were higher in the remission group vs. persistent group (p<0.05). CONCLUSIONS Mean vitamin D levels were lower in patients with AD. A negative correlation between vitamin D levels and disease severity was documented. Vitamin D may affect the natural course of atopic dermatitis. There is a need for more comprehensive studies in this regard.
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Affiliation(s)
- M Dogru
- Health Sciences University, Zeynep Kamil Woman and Children Health Practice and Research Center, Department of Pediatrics, Istanbul, Turkey.
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Huang CM, Lara-Corrales I, Pope E. Effects of Vitamin D levels and supplementation on atopic dermatitis: A systematic review. Pediatr Dermatol 2018; 35:754-760. [PMID: 30284328 DOI: 10.1111/pde.13639] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
BACKGROUND Atopic dermatitis (AD) is a chronic inflammatory skin condition affecting 5%-20% of children worldwide. Studies suggested both a correlation between serum vitamin D (VD) levels and AD severity and a therapeutic potential role for VD supplementation. OBJECTIVES To determine whether serum VD levels correlate with AD severity and the effects of supplementation for disease improvement in children. DATA SOURCES Ovid MEDLINE, EMBASE, and Cochrane Library databases were searched. STUDY SELECTION Publications with children 0-18 years old with AD and data evaluating effects of VD levels or supplementation on AD severity were included. DATA EXTRACTION Author, year, inclusion criteria, study design, location, age, VD levels, VD supplementation regimens, and baseline and final disease severities were extracted. RESULTS Of the 21 included publications, 15, 5, and 1 evaluated VD level, VD supplementation, and both factors with disease severity, respectively. There were 4 randomized control trials (RCTs), 5 cohort, 6 case-control, and 6 cross-sectional studies. A significant inverse correlation between VD level and severity was described in 62.5% (10/16) of studies. There were 67% (4/6) that reported a significant improvement in AD severity with supplementation. LIMITATIONS Studies meeting inclusion criteria were limited. Furthermore, papers were heterogeneous in terms of location, season, and VD supplementation regimen. Language and publication bias was another potential limitation. CONCLUSION In children, the majority of existing literature confirmed a link between serum VD levels and AD severity. Weak evidence was found supporting improvement of AD with VD supplementation. Future large-scale studies are needed to support our findings.
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Affiliation(s)
| | - Irene Lara-Corrales
- Section of Dermatology, Division of Pediatric Medicine, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
| | - Elena Pope
- Section of Dermatology, Division of Pediatric Medicine, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
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Lara-Corrales I, Huang CM, Parkin PC, Rubio-Gomez GA, Posso-De Los Rios CJ, Maguire J, Pope E. Vitamin D Level and Supplementation in Pediatric Atopic Dermatitis: A Randomized Controlled Trial. J Cutan Med Surg 2018; 23:44-49. [PMID: 30336685 DOI: 10.1177/1203475418805744] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
BACKGROUND: Atopic dermatitis (AD) is a chronic inflammatory skin condition characterized by a pruritic eczematous rash. Evidence surrounding the role of serum vitamin D (VD) in modifying disease severity is inconsistent. OBJECTIVES: To determine whether VD levels are correlated with AD severity and the effects of VD supplementation on disease modification. METHODS: This was a 2-phase study, using a cross-sectional design to evaluate the relationship between VD level and severity, as well as a double-blinded, randomized control trial to elucidate the effects of VD supplementation. Patients aged 0 to 18 years with AD were included in phase 1, and disease severity and serum VD levels were determined. Those with renal, liver, or other dermatologic conditions were excluded. Patients with abnormal (<72.7 nmol/L) VD levels were eligible for phase 2 and to be randomized to either VD supplementation of 2000 IU/d or placebo. VD level and severity were assessed at baseline and 3 months. RESULTS: The 77 patients included in phase 1 had a mean (SD) age of 7.4 (4.5) years, and 45.5% (33/77) were female. Increased severity was significantly correlated with lower VD levels ( P = .015). Of the 45 patients included in phase 2, 21 and 24 were assigned to the supplementation and placebo arm, respectively. The mean (SD) change in severity did not differ significantly between the supplementation (15.35 [9.71]) and placebo (15.13 [8.97]) groups after 3 months of intervention ( P = .7). CONCLUSION: Although VD levels correlated with AD severity, VD supplementation did not significantly improve disease severity.
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Affiliation(s)
- Irene Lara-Corrales
- 1 Section of Dermatology, Division of Pediatric Medicine, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
| | | | - Patricia C Parkin
- 3 Division of Pediatric Medicine, Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
| | | | | | - Jonathon Maguire
- 3 Division of Pediatric Medicine, Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
| | - Elena Pope
- 1 Section of Dermatology, Division of Pediatric Medicine, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
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Interleukin 1-β, interleukin-1 receptor antagonist and vitamin D levels in children with atopic dermatitis. Cent Eur J Immunol 2018; 43:180-185. [PMID: 30135631 PMCID: PMC6102616 DOI: 10.5114/ceji.2018.77388] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2016] [Accepted: 01/16/2017] [Indexed: 11/28/2022] Open
Abstract
Introduction Among the broad spectrum of cytokines, interleukin 1-β (IL-1β) has been implicated in induction and subsequent aggravation of skin lesions in atopic dermatitis (AD). A considerable body of evidence suggests that vitamin D status also influences the risk and/or severity of AD. Material and methods Fifty-seven children suffering from mild to severe AD were enrolled in the study. The control group consisted of 33 matched healthy children. In all the children serum concentrations of IL-1β/IL-1F2 and the interleukin-1 receptor antagonist IL-Ra/1F3 were measured. Serum 25(OH)D concentration was obtained for 49 patients with AD and all healthy children. Results In children with AD 59.2% of children had insufficiency, 24.5% had deficiency and 16.3% had a sufficient serum 25(OH)D level. In the control group 26.5%, 52.9% and 20% of participants had insufficiency/deficiency/sufficiency of 25(OH)D, respectively. The severity of AD was positively correlated with total IgE level, percentage and absolute count of eosinophils and IL-1Ra. IL-1β correlated with IL-1Ra. Conclusions In children with AD the serum vitamin D level was lower than in healthy children. The correlation between severity of AD and IL-1Ra may prove that inflammasome-dependent IL-1β is involved in immunopathogenesis of the disease. Further studies are needed on a larger population of children to confirm the role of this cytokine in development of AD.
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Role of Vitamin D Beyond the Skeletal Function: A Review of the Molecular and Clinical Studies. Int J Mol Sci 2018; 19:ijms19061618. [PMID: 29849001 PMCID: PMC6032242 DOI: 10.3390/ijms19061618] [Citation(s) in RCA: 122] [Impact Index Per Article: 20.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2018] [Revised: 05/07/2018] [Accepted: 05/08/2018] [Indexed: 12/11/2022] Open
Abstract
The classical function of Vitamin D, which involves mineral balance and skeletal maintenance, has been known for many years. With the discovery of vitamin D receptors in various tissues, several other biological functions of vitamin D are increasingly recognized and its role in many human diseases like cancer, diabetes, hypertension, cardiovascular, and autoimmune and dermatological diseases is being extensively explored. The non-classical function of vitamin D involves regulation of cellular proliferation, differentiation, apoptosis, and innate and adaptive immunity. In this review, we discuss and summarize the latest findings on the non-classical functions of vitamin D at the cellular/molecular level and its role in complex human diseases.
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Asthma and Allergy "Epidemic" and the Role of Vitamin D Deficiency. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2018; 996:169-183. [PMID: 29124699 DOI: 10.1007/978-3-319-56017-5_14] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
The increase in asthma and allergies prevalence that has been recorded in many countries during the last decades, and the reemergence of vitamin D (VD) deficiency in many populations worldwide, renders fairly plausible the assumption of an underlying association between these two conditions and justifies the research effort invented in this issue. Indeed, there is growing body of evidence from epidemiological, laboratory, and clinical studies, suggesting that such an association does exist. The hypothesis of low levels of VD leading to compromised fetal programming and impairment of various immune functions involved in asthma and allergic disorders, stands as the most credible explanation of this presumed association. However, the evidence is not yet definite and there are some conflicting results among studies. As a consequence, no safe conclusions can be drawn yet, and more research is required in order to fully clarify the involvement of VD deficiency in the pathogenesis of asthma and allergies, and decide if VD has a role to play in the prevention and therapy of these disorders.
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Umar M, Sastry KS, Al Ali F, Al-Khulaifi M, Wang E, Chouchane AI. Vitamin D and the Pathophysiology of Inflammatory Skin Diseases. Skin Pharmacol Physiol 2018; 31:74-86. [DOI: 10.1159/000485132] [Citation(s) in RCA: 77] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2017] [Accepted: 11/07/2017] [Indexed: 12/13/2022]
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Byun EJ, Heo J, Cho SH, Lee JD, Kim HS. Suboptimal vitamin D status in Korean adolescents: a nationwide study on its prevalence, risk factors including cotinine-verified smoking status and association with atopic dermatitis and asthma. BMJ Open 2017; 7:e016409. [PMID: 28698345 PMCID: PMC5541452 DOI: 10.1136/bmjopen-2017-016409] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE To determine the prevalence and risk factors for suboptimal vitamin D status in Korean adolescents and to assess its relationship with atopic dermatitis (AD) and asthma at a national level. DESIGN This is a cross-sectional study with data from the Korean National Health and Nutrition Examination Survey. Information regarding socioeconomic characteristics, clinical data and environmental factors was collected. Blood and urine samples were taken for vitamin D and cotinine, respectively. Descriptive and multivariable logistic regression was performed on the data. SETTING South Korea (nationwide). PARTICIPANTS 2515 individuals aged 10-18 years who participated in the Korean National Health and Nutrition Examination Survey from 2008 to 2011. MAIN OUTCOME MEASURES Vitamin D status was determined through measurement of serum 25-hydroxyvitamin D (25OHD). Smoking status was classified based on the urine cotinine level. Physician diagnosed with AD and asthma were assessed using a questionnaire. RESULTS Overall, 73.3% of the subjects were vitamin D deficient (25OHD <20 ng/mL) and 24.4% of the subjects were vitamin D insufficient (25OHD, 20-29.9 ng/mL). Older age (p<0.001), female gender (p<0.001), urban residence (p=0.019), higher body mass index (p=0.003) and sampling in winter months (November-March) (p<0.001) were independently associated with low serum 25OHD levels. With cotinine verification, 18.2% of the participants were classified as active smokers, and 43.4% were classified as passive smokers. After adjusting for potential confounders, serum 25OHD status showed no association with AD or asthma. CONCLUSION Vitamin D deficiency is highly prevalent in Korean adolescents. Cotinine-verified prevalence of smoking was also high, but its relationship with vitamin D deficiency was not confirmed in our study. Above all, our results provide epidemiological evidence against the association of vitamin D status with AD and asthma at the national level among Korean adolescents.
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Affiliation(s)
- Eun Jung Byun
- Department of Dermatology, Incheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Incheon, Republic of Korea
| | - Jinyoung Heo
- Department of Preventive Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Sang Hyun Cho
- Department of Dermatology, Incheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Incheon, Republic of Korea
| | - Jeong Deuk Lee
- Department of Dermatology, Incheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Incheon, Republic of Korea
| | - Hei Sung Kim
- Department of Dermatology, Incheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Incheon, Republic of Korea
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Jang YH, Sim HB, Moon SY, Lee WJ, Lee SJ, Jin M, Kim SH, Kim DW. House Dust Mite Sensitization Is Inversely Associated with Plasma 25-Hydroxyvitamin D3 Levels in Patients with Severe Atopic Dermatitis. Ann Dermatol 2017; 29:400-406. [PMID: 28761286 PMCID: PMC5500703 DOI: 10.5021/ad.2017.29.4.400] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2016] [Accepted: 08/31/2016] [Indexed: 12/23/2022] Open
Abstract
Background The relationship between atopic dermatitis (AD) and low vitamin D levels has been studied. Emerging evidence has implicated vitamin D as a critical regulator of immunity, playing a role in both the innate and cell-mediated immune systems. However, the effect of vitamin D on house dust mite (HDM) sensitization in patients with AD has not been established. Objective We investigated the association between vitamin D levels and HDM sensitization according to AD severity. Methods In total, 80 patients (43 men and 37 women) with AD were included. We classified AD severity using Rajka and Langeland scores. Laboratory tests included serum 25-hydroxyvitamin D3, total immunoglobulin E (IgE), and specific IgE antibody titer against Dermatophagoides farinae and D. pteronyssinus. Results There were no differences in vitamin D levels between the mild or moderate AD and severe AD groups. In the severe AD group, high HDM sensitization group had lower serum vitamin D levels compared to low HDM sensitization group with statistical significance. In addition, a significant negative correlation was found between vitamin D levels and HDM sensitization in the severe AD group. Conclusion Our results demonstrate that low vitamin D levels may link to high HDM sensitization in patients with the severe AD. Further elucidation of the role of vitamin D in HDM sensitization may hold profound implications for the prevention and treatment of AD.
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Affiliation(s)
- Yong Hyun Jang
- Department of Dermatology, Kyungpook National University School of Medicine, Daegu, Korea
| | - Hyun Bo Sim
- Department of Dermatology, Kyungpook National University School of Medicine, Daegu, Korea
| | - Sun Young Moon
- Department of Dermatology, Kyungpook National University School of Medicine, Daegu, Korea
| | - Weon Ju Lee
- Department of Dermatology, Kyungpook National University School of Medicine, Daegu, Korea
| | - Seok-Jong Lee
- Department of Dermatology, Kyungpook National University School of Medicine, Daegu, Korea
| | - Meiling Jin
- Department of Pharmacology, Kyungpook National University School of Medicine, Daegu, Korea
| | - Sang-Hyun Kim
- Department of Pharmacology, Kyungpook National University School of Medicine, Daegu, Korea
| | - Do Won Kim
- Department of Dermatology, Kyungpook National University School of Medicine, Daegu, Korea
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The relationship between severity of disease and vitamin D levels in children with atopic dermatitis. Postepy Dermatol Alergol 2017; 34:224-227. [PMID: 28670250 PMCID: PMC5471369 DOI: 10.5114/pdia.2017.66054] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2015] [Accepted: 04/29/2016] [Indexed: 01/09/2023] Open
Abstract
Introduction Atopic 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. Aim To assess the serum level of vitamin D in children with AD and determine its relation to AD severity. Material and methods Sixty 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. Results The 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). Conclusions This 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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D'Auria E, Barberi S, Cerri A, Boccardi D, Turati F, Sortino S, Banderali G, Ciprandi G. Vitamin D status and body mass index in children with atopic dermatitis: A pilot study in Italian children. Immunol Lett 2017; 181:31-35. [PMID: 27838470 DOI: 10.1016/j.imlet.2016.11.004] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2016] [Revised: 10/27/2016] [Accepted: 11/08/2016] [Indexed: 12/24/2022]
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Kim MJ, Kim SN, Lee YW, Choe YB, Ahn KJ. Vitamin D Status and Efficacy of Vitamin D Supplementation in Atopic Dermatitis: A Systematic Review and Meta-Analysis. Nutrients 2016; 8:nu8120789. [PMID: 27918470 PMCID: PMC5188444 DOI: 10.3390/nu8120789] [Citation(s) in RCA: 72] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2016] [Revised: 11/10/2016] [Accepted: 11/24/2016] [Indexed: 12/23/2022] Open
Abstract
Recent literature has highlighted the possible role of vitamin D in atopic dermatitis (AD), and that vitamin D supplementation might help to treat AD. This study determined the relationship between vitamin D level and AD, and assessed the efficacy of vitamin D supplementation. We searched the MEDLINE, EMBASE, and Cochrane databases up to May 2015. Observational studies and randomized controlled trials were included based on the available data on the serum 25-hydroxyvitamin D (25(OH)D) level and quantified data available for severity assessed using the Scoring Atopic Dermatitis (SCORAD) index or Eczema Area and Severity Index (EASI) score. Compared with healthy controls, the serum 25(OH)D level was lower in the AD patients of all ages (standardized mean difference = −2.03 ng/mL; 95% confidence interval (CI) = −2.52 to −0.78), and predominantly in the pediatric AD patients (standardized mean difference = −3.03 ng/mL; 95% CI = −4.76 to −1.29). In addition, the SCORAD index and EASI score decreased after vitamin D supplementation (standardized mean difference = −5.85; 95% CI = −7.66 to −4.05). This meta-analysis showed that serum vitamin D level was lower in the AD patients and vitamin D supplementation could be a new therapeutic option for AD.
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Affiliation(s)
- Min Jung Kim
- Department of Dermatology, Konkuk University School of Medicine, Seoul 05030, Korea.
| | - Soo-Nyung Kim
- Department of Obstetrics and Gynecology, Konkuk University School of Medicine, Seoul 05030, Korea.
| | - Yang Won Lee
- Department of Dermatology, Konkuk University School of Medicine, Seoul 05030, Korea.
- Research Institute of Medical Science, Konkuk University, Seoul 05030, Korea.
| | - Yong Beom Choe
- Department of Dermatology, Konkuk University School of Medicine, Seoul 05030, Korea.
- Research Institute of Medical Science, Konkuk University, Seoul 05030, Korea.
| | - Kyu Joong Ahn
- Department of Dermatology, Konkuk University School of Medicine, Seoul 05030, Korea.
- Research Institute of Medical Science, Konkuk University, Seoul 05030, Korea.
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Tamagawa-Mineoka R. Biomarkers for Atopic Dermatitis in Children. PEDIATRIC ALLERGY, IMMUNOLOGY, AND PULMONOLOGY 2016; 29:164-169. [PMID: 35923059 DOI: 10.1089/ped.2016.0703] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Numerous studies investigating the correlations between the severity of atopic dermatitis (AD) and various biomarkers have been reported over the past few decades. Recent studies have indicated that certain soluble mediators, including chemokines (such as thymus and activation-regulated chemokine/C-C motif chemokine ligand [CCL]17 and macrophage-derived chemokine/CCL22) and cytokines (such as thymic stromal lymphopoietin), could be good markers of inflammation in AD. This review focuses on circulating biomarkers of AD, including pediatric AD.
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Affiliation(s)
- Risa Tamagawa-Mineoka
- Department of Dermatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
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Schlichte MJ, Vandersall A, Katta R. Diet and eczema: a review of dietary supplements for the treatment of atopic dermatitis. Dermatol Pract Concept 2016. [PMID: 27648380 DOI: 10.5826/dpc.0603a06.] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/26/2022] Open
Abstract
In the context of increasing popularity of "natural" alternatives to conventional medicine, several dietary supplements have gained the attention of researchers and consumers alike in the treatment of atopic dermatitis (AD). Readily available without a prescription and frequently perceived to have fewer side effects than traditional medications, these "natural" remedies may be featured in discussions with patients, and clinicians should therefore be familiar with their efficacy and safety. Based on trials to date, no dietary supplements can be recommended for routine use in the treatment of AD. However, some promising results have been noted from the use of probiotics and prebiotics taken in combination. Given significant differences in study design to date, however, further studies would be needed to clarify dose and strains of probiotics. Studies of vitamin D have been limited and have produced conflicting results, although further trials in selected subsets of patients may be indicated. Very limited data is available on fish oil supplements, while future studies on Chinese herbal medicine would require evaluation of comparable herbs and formulations. Finally, multiple trials of evening primrose oil and borage seed oil have shown improvement similar to placebo, and neither is currently recommended in eczema therapy.
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Affiliation(s)
- Megan J Schlichte
- Department of Medicine, Houston Methodist Hospital, Houston, TX, USA
| | - Abbey Vandersall
- The Ohio State University College of Medicine, Columbus, OH, USA
| | - Rajani Katta
- Division of Dermatology, Houston Methodist Hospital, Houston, TX, USA
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Schlichte MJ, Vandersall A, Katta R. Diet and eczema: a review of dietary supplements for the treatment of atopic dermatitis. Dermatol Pract Concept 2016; 6:23-9. [PMID: 27648380 PMCID: PMC5006549 DOI: 10.5826/dpc.0603a06] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2016] [Accepted: 06/23/2016] [Indexed: 10/31/2022] Open
Abstract
In the context of increasing popularity of "natural" alternatives to conventional medicine, several dietary supplements have gained the attention of researchers and consumers alike in the treatment of atopic dermatitis (AD). Readily available without a prescription and frequently perceived to have fewer side effects than traditional medications, these "natural" remedies may be featured in discussions with patients, and clinicians should therefore be familiar with their efficacy and safety. Based on trials to date, no dietary supplements can be recommended for routine use in the treatment of AD. However, some promising results have been noted from the use of probiotics and prebiotics taken in combination. Given significant differences in study design to date, however, further studies would be needed to clarify dose and strains of probiotics. Studies of vitamin D have been limited and have produced conflicting results, although further trials in selected subsets of patients may be indicated. Very limited data is available on fish oil supplements, while future studies on Chinese herbal medicine would require evaluation of comparable herbs and formulations. Finally, multiple trials of evening primrose oil and borage seed oil have shown improvement similar to placebo, and neither is currently recommended in eczema therapy.
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Affiliation(s)
- Megan J Schlichte
- Department of Medicine, Houston Methodist Hospital, Houston, TX, USA
| | - Abbey Vandersall
- The Ohio State University College of Medicine, Columbus, OH, USA
| | - Rajani Katta
- Division of Dermatology, Houston Methodist Hospital, Houston, TX, USA
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Kim K, Kang J, Won Kim S, Sung M. Relationship Between the Presence of Eczema Herpeticum and the Significance of Clinical and Laboratory Tests in Korean Children With Atopic Dermatitis. IRANIAN JOURNAL OF PEDIATRICS 2016; 26:e4683. [PMID: 27713812 PMCID: PMC5045560 DOI: 10.5812/ijp.4683] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/11/2015] [Revised: 02/17/2016] [Accepted: 03/09/2016] [Indexed: 01/30/2023]
Abstract
BACKGROUND Eczema herpeticum (EH) is a herpes simplex virus (HSV) infection superimposed on atopic dermatitis (AD). OBJECTIVES The aim of this study was to evaluate the relationship between clinical features and laboratory tests, including skin cultures, total IgE, eosinophil count, eosinophil cationic protein, and 25-hydroxyvitamin D3 (25-(OH)D3), in Korean children with AD according to the presence of EH. PATIENTS AND METHODS We enrolled 380 patients aged 6 months to 18 years who were admitted to Busan St. Mary's hospital from January 2012 to December 2014. All 380 subjects were divided into two groups: the control and the AD group. The AD group was further divided into two subgroups: EH+ and EH-. RESULTS The male gender was related to the presence of EH (odds ratio of 2.56; 95% confidence interval, 1.19 - 5.53, P = 0.01), but age and 25-(OH)D3 levels were not. After adjusting for age, gender, and 25-(OH)D3, no significant relationship was found between total IgE, eosinophil cationic protein or eosinophil count levels and the presence of EH. The relationship between positive skin cultures and the presence of EH was significant (P < 0.001) and the presence of methicillin-resistant Staphylococcus aureus (MRSA) was also related to the development of EH (OR, 0.19; 95% CI, 0.04 - 0.92, P = 0.03). CONCLUSIONS We conclude that while male gender, positive skin culture results, and the presence of MRSA are factors influencing EH, serum 25-(OH)D3 levels are not associated with EH in Korean AD children.
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Affiliation(s)
- Kohwoon Kim
- Department of Pediatrics, Busan St. Mary’s Hospital, Busan, Korea
| | - Junseok Kang
- Department of Pediatrics, Busan St. Mary’s Hospital, Busan, Korea
| | - Sung Won Kim
- Department of Pediatrics, Busan St. Mary’s Hospital, Busan, Korea
| | - Myongsoon Sung
- Department of Pediatrics, CHA Gumi Medical Center, CHA University School of Medicine, Gumi, Korea
- Corresponding author: Myongsoon Sung, Department of Pediatrics, CHA Gumi Medical Center, CHA University School of Medicine, Gumi, Korea. Tel: +82-544509700, Fax: +82-544509970, E-mail:
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Berents T, Lødrup Carlsen K, Mowinckel P, Sandvik L, Skjerven H, Rolfsjord L, Kvenshagen B, Hunderi J, Bradley M, Lieden A, Carlsen K, Thorsby P, Gjersvik P. Vitamin D levels and atopic eczema in infancy and early childhood in Norway: a cohort study. Br J Dermatol 2016; 175:95-101. [DOI: 10.1111/bjd.14537] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/02/2016] [Indexed: 12/19/2022]
Affiliation(s)
- T.L. Berents
- Institute of Clinical Medicine University of Oslo Oslo Norway
- Department of Dermatology Oslo University Hospital Oslo Norway
| | - K.C. Lødrup Carlsen
- Institute of Clinical Medicine University of Oslo Oslo Norway
- Department of Pediatrics Oslo University Hospital Oslo Norway
| | - P. Mowinckel
- Department of Pediatrics Oslo University Hospital Oslo Norway
| | - L. Sandvik
- Institute of Clinical Medicine University of Oslo Oslo Norway
- Department of Biostatistics and Epidemiology Oslo University Hospital Oslo Norway
- University of Oslo Oslo Norway
| | - H.O. Skjerven
- Institute of Clinical Medicine University of Oslo Oslo Norway
- Department of Pediatrics Oslo University Hospital Oslo Norway
| | - L.B. Rolfsjord
- Institute of Clinical Medicine University of Oslo Oslo Norway
- Department of Pediatrics Elverum Hospital Elverum Norway
| | - B. Kvenshagen
- Department of Pediatrics Østfold Hospital Fredrikstad Norway
| | - J.O.G. Hunderi
- Institute of Clinical Medicine University of Oslo Oslo Norway
- Department of Pediatrics Oslo University Hospital Oslo Norway
- Department of Pediatrics Østfold Hospital Fredrikstad Norway
| | - M. Bradley
- Department of Molecular Medicine Karolinska Institute at Karolinska Hospital Stockholm Sweden
| | - A. Lieden
- Department of Molecular Medicine Karolinska Institute at Karolinska Hospital Stockholm Sweden
| | - K.‐H. Carlsen
- Institute of Clinical Medicine University of Oslo Oslo Norway
- Department of Pediatrics Oslo University Hospital Oslo Norway
| | - P.M. Thorsby
- Institute of Clinical Medicine University of Oslo Oslo Norway
- Hormone Laboratory Department of Medical Biochemistry Oslo University Hospital Oslo Norway
| | - P. Gjersvik
- Institute of Clinical Medicine University of Oslo Oslo Norway
- Department of Dermatology Oslo University Hospital Oslo Norway
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Fluegge K. Comment on: "Association between Atopic Dermatitis and Autism Spectrum Disorders: A Systematic Review". Am J Clin Dermatol 2016; 17:187-8. [PMID: 26923913 DOI: 10.1007/s40257-016-0180-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Keith Fluegge
- Institute of Health and Environmental Research, P.O. Box 18442, Cleveland, OH, 44118, USA.
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36
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Potential role of reduced environmental UV exposure as a driver of the current epidemic of atopic dermatitis. J Allergy Clin Immunol 2015; 136:1163-9. [DOI: 10.1016/j.jaci.2015.06.042] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2015] [Revised: 06/04/2015] [Accepted: 06/12/2015] [Indexed: 11/23/2022]
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Fornasa G, Tsilingiri K, Caprioli F, Botti F, Mapelli M, Meller S, Kislat A, Homey B, Di Sabatino A, Sonzogni A, Viale G, Diaferia G, Gori A, Longhi R, Penna G, Rescigno M. Dichotomy of short and long thymic stromal lymphopoietin isoforms in inflammatory disorders of the bowel and skin. J Allergy Clin Immunol 2015; 136:413-22. [PMID: 26014813 PMCID: PMC4534776 DOI: 10.1016/j.jaci.2015.04.011] [Citation(s) in RCA: 66] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2014] [Revised: 04/13/2015] [Accepted: 04/17/2015] [Indexed: 01/29/2023]
Abstract
Background Thymic stromal lymphopoietin (TSLP) is a cytokine with pleiotropic functions in the immune system. It has been associated with allergic reactions in the skin and lungs but also homeostatic tolerogenic responses in the thymus and gut. Objective In human subjects TSLP is present in 2 isoforms, short and long. Here we wanted to investigate the differential expression of the TSLP isoforms and discern their biological implications under homeostatic or inflammatory conditions. Methods We evaluated the expression of TSLPs in tissues from healthy subjects, patients with ulcerative colitis, patients with celiac disease, and patients with atopic dermatitis and on epithelial cells and keratinocytes under steady-state conditions or after stimulation. We then tested the immune activity of TSLP isoforms both in vitro and in vivo. Results We showed that TSLP isoforms are responsible for 2 opposite immune functions. The short isoform is expressed under steady-state conditions and exerts anti-inflammatory activities by affecting the capacity of PBMCs and dendritic cells to produce inflammatory cytokines. Moreover, the short isoform TSLP ameliorates experimental colitis in mice and prevents endotoxin shock. The long isoform of TSLP is proinflammatory and is only expressed during inflammation. The isoforms are differentially regulated by pathogenic bacteria, such as Salmonella species and adhesive-invasive Escherichia coli. Conclusions We have solved the dilemma of TSLP being both homeostatic and inflammatory. The TSLP isoform ratio is altered during several inflammatory disorders, with strong implications in disease treatment and prevention. Indeed, targeting of the long isoform of TSLP at the C-terminal portion, which is common to both isoforms, might lead to unwanted side effects caused by neutralization of the homeostatic short isoform.
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Affiliation(s)
- Giulia Fornasa
- Department of Experimental Oncology, European Institute of Oncology, Milan, Italy
| | - Katerina Tsilingiri
- Department of Experimental Oncology, European Institute of Oncology, Milan, Italy
| | - Flavio Caprioli
- Unità Operativa Gastroenterologia ed Endoscopica, Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico di Milano and Dipartimento di Fisiopatologia Medico-Chirurgica e dei Trapianti, Università degli Studi di Milano, Milan, Italy
| | - Fiorenzo Botti
- Unità Operativa Gastroenterologia ed Endoscopica, Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico di Milano and Dipartimento di Fisiopatologia Medico-Chirurgica e dei Trapianti, Università degli Studi di Milano, Milan, Italy
| | - Marina Mapelli
- Department of Experimental Oncology, European Institute of Oncology, Milan, Italy
| | - Stephan Meller
- Department of Dermatology, Medical Faculty, University of Dusseldorf, Düsseldorf, Germany
| | - Andreas Kislat
- Department of Dermatology, Medical Faculty, University of Dusseldorf, Düsseldorf, Germany
| | - Bernhard Homey
- Department of Dermatology, Medical Faculty, University of Dusseldorf, Düsseldorf, Germany
| | - Antonio Di Sabatino
- First Department of Medicine, St Matteo Hospital, University of Pavia, Pavia, Italy
| | - Angelica Sonzogni
- Department of Pathology and Laboratory Medicine, European Institute of Oncology, Milan, Italy
| | - Giuseppe Viale
- Department of Pathology and Laboratory Medicine, European Institute of Oncology, Milan, Italy
| | - Giuseppe Diaferia
- Department of Experimental Oncology, European Institute of Oncology, Milan, Italy
| | - Alessandro Gori
- Istituto di Chimica del Riconoscimento Molecolare, CNR, Milan, Italy
| | - Renato Longhi
- Istituto di Chimica del Riconoscimento Molecolare, CNR, Milan, Italy
| | - Giuseppe Penna
- Department of Experimental Oncology, European Institute of Oncology, Milan, Italy
| | - Maria Rescigno
- Department of Experimental Oncology, European Institute of Oncology, Milan, Italy; Dipartimento di Scienze della Salute, San Paolo, Università degli Studi di Milano, Milan, Italy.
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Vitamin D and atopic dermatitis in childhood. J Immunol Res 2015; 2015:257879. [PMID: 25973433 PMCID: PMC4417995 DOI: 10.1155/2015/257879] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2014] [Accepted: 01/09/2015] [Indexed: 12/26/2022] Open
Abstract
Vitamin D features immunomodulatory effects on both the innate and adaptive immune systems, which may explain the growing evidence connecting vitamin D to allergic diseases. A wealth of studies describing a beneficial effect of vitamin D on atopic dermatitis (AD) prevalence and severity are known. However, observations linking high vitamin D levels to an increased risk of developing AD have also been published, effectively creating a controversy. In this paper, we review the existing literature on the association between AD and vitamin D levels, focusing on childhood. As of today, the role of vitamin D in AD is far from clear; additional studies are particularly needed in order to confirm the promising therapeutic role of vitamin D supplementation in childhood AD.
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Silverberg JI. Association between childhood atopic dermatitis, malnutrition, and low bone mineral density: a US population-based study. Pediatr Allergy Immunol 2015; 26:54-61. [PMID: 25443466 DOI: 10.1111/pai.12315] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/29/2014] [Indexed: 11/30/2022]
Abstract
BACKGROUND Children with atopic dermatitis (AD) have multiple risk factors for low bone mineral density (BMD). METHODS We analyzed data from 3049 children and adolescents aged 8-19 yrs from the 2005-2006 National Health and Nutrition Examination Survey, including a cross-sectional questionnaire, dual energy X-ray absorptiometry, and blood samples. RESULTS In multivariate models that controlled for age, sex, race/ethnicity, level of education and household income, body mass index (BMI), and smoking in the household, AD was associated with lower BMD z-score for the total femur (survey linear regression; adjusted β [95% CI]: -0.42 [0.68, -0.16]), including trochanter (-0.29 [-0.54, -0.05]) and femoral neck (-0.29 [-0.53, -0.05]) and total lumbar spine (-0.31 [-0.52, -0.11]). Children with AD had higher median levels of serum IgE (110.0 vs. 53.0 kU/l), peripheral lymphocyte (2.9 vs. 2.5 × 10(3) cells/μl), and eosinophil counts (0.3 vs. 0.2 × 10(3) cells/μl) (Mann-Whitney U-test, p ≤ 0.003 for all), but not CRP levels (0.03 vs. 0.04 mg/dl) and higher odds of 25-OH vitamin D deficiency (survey logistic regression; odds ratio [OR] [95% CI]: 4.81 [1.21, 20.81]), low calcium (2.56 [1.24, 5.28]), low alkaline phosphatase (2.56 [1.20, 5.44]), and higher tertiles of LDH (tertile 2: 6.36 [1.75, 23.18]; tertile-3: 4.57 [1.32, 15.85]), but not parathyroid hormone (PTH) or albumin. Finally, children with AD had higher rates of low BMD, that is, BMD z-score <-2, of the femur (23.4% vs. 18.4%) and spine (35.3% vs. 24.5%). In multivariate logistic regression models of low BMD of femur and/or spine using stepwise selection of the 30 sociodemographic and clinical factors, laboratory values, and medications used, AD remained a significant covariate (1.33 [1.32-1.34]). The covariates with the largest effects on low BMD were low PTH and albumin, higher basophil count, Hispanic ethnicity, and BMI <5th percentile. Among children with AD, 56.2% of those with Hispanic origin, 52.8% with BMI <5th percentile, 75.0% with low albumin, and 54.0% with low PTH had low BMD. CONCLUSIONS Children with AD have lower BMD, particularly those with malnutrition and Hispanic ethnicity.
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Affiliation(s)
- Jonathan I Silverberg
- Departments of Dermatology, Preventive Medicine and Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
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Hwang YJ, Choi JW, Kim SW, Choi KH, Sung MS. Correlation between serum 25-hydroxyvitamin D 3and the severity of atopic dermatitis in children with allergic or nonallergenic sensitization. ALLERGY ASTHMA & RESPIRATORY DISEASE 2015. [DOI: 10.4168/aard.2015.3.3.213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- Yong Jin Hwang
- Department of Pediatrics, Busan St. Mary's Hospital, Busan, Korea
| | - Jin Wook Choi
- Department of Pediatrics, Busan St. Mary's Hospital, Busan, Korea
| | - Sung Woon Kim
- Department of Pediatrics, Busan St. Mary's Hospital, Busan, Korea
| | - Kwang Hae Choi
- Department of Pediatrics, Yeungnam University Medical Center, Daegu, Korea
| | - Myong Soon Sung
- Department of Pediatrics, CHA Gumi Medical Center, CHA University, Gumi, Korea
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Abstract
The science of food allergy has been rapidly evolving before our eyes in the past half century. Like other allergic disorders, the prevalence of food allergies has dramatically increased, and coupled with the increased public awareness of anaphylaxis due to food allergy, this has driven an explosion in basic and clinical research in this extremely broad subject. Treatment of food allergies has evolved and practices such as food challenges have become an integral part of an allergy practice. The impact of the increase of food allergy has driven package labeling laws, legislation on emergency treatment availability in schools and other public places, and school policy. But to this day, our knowledge of the pathogenesis of food allergy is still incomplete. There are the most obvious IgE-mediated immediate hypersensitivity reactions, but then multiple previously unidentified conditions such as eosinophilic esophagitis, food protein-induced enterocolitis syndrome, milk protein allergy, food-induced atopic dermatitis, oral allergy syndrome, and others have complicated the diagnosis and management of many of our patients who are unable to tolerate certain foods. Many of these conditions are not IgE-mediated, but may be T cell-driven diseases. The role of T regulatory cells and immune tolerance and the newly discovered immunological role of vitamin D have shed light on the variable clinical presentation of food allergy and the development of new methods of immunotherapy in an example of bench-to-bedside research. Component-resolved diagnostic techniques have already begun to allow us to more precisely define the epitopes that are targeted in food allergic patients. The development of biological modulators, research on genomics and proteomics, and epigenetic techniques all offer promising avenues for new modes of therapy of food allergy in the twenty-first century.
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Affiliation(s)
- Patrick S C Leung
- Division of Rheumatology, Allergy and Clinical Immunology, University of California, 451 Health Sciences Drive, Suite 6510, Davis, CA, 95616, USA,
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Yao TC, Tu YL, Chang SW, Tsai HJ, Gu PW, Ning HC, Hua MC, Liao SL, Tsai MH, Chiu CY, Lai SH, Yeh KW, Huang JL. Suboptimal vitamin D status in a population-based study of Asian children: prevalence and relation to allergic diseases and atopy. PLoS One 2014; 9:e99105. [PMID: 24892430 PMCID: PMC4043968 DOI: 10.1371/journal.pone.0099105] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2014] [Accepted: 05/10/2014] [Indexed: 11/26/2022] Open
Abstract
Background New evidence shows high prevalence of vitamin D deficiency in many countries and some studies suggest a possible link between vitamin D status and allergic diseases. The objectives of this study were to determine the prevalence of suboptimal vitamin D status in a population sample of Asian children and to investigate the relationship of vitamin D status with allergic diseases and atopy. Methods Children aged 5–18 years (N = 1315) in the Prediction of Allergies in Taiwanese CHildren (PATCH) study were evaluated using questionnaires, anthropometric measurements, and serum levels of 25-hydroxyvitamin D [25(OH)D] and total and specific immunoglobulin E (IgE). Results The mean concentration of serum 25(OH)D was 20.4 ng/mL (SD: 7.1 ng/mL). Vitamin D deficiency (defined as serum 25(OH)D<20 ng/mL) was present in 670 subjects (51.0%), while vitamin D insufficiency (defined as serum 25(OH)D<30 ng/mL) was observed in 1187 subjects (90.3%). Older age (P<0.001), female gender (P<0.001), higher body mass index (P = 0.001), winter and spring seasons (compared to summer; P both<0.001), and passive smoking (P = 0.011) were independently associated with low serum 25(OH)D levels. After adjusting for potential confounders, serum 25(OH)D status had no association with asthma, rhinitis, eczema, atopy, or total serum IgE (all P>0.05). Conclusions Low serum 25(OH)D levels are remarkably common in this population sample of Asian children, suggesting that millions of children living in Taiwan may have suboptimal levels of vitamin D, which should be a matter of public health concern. Our results provides epidemiological evidence against the association of vitamin D status with various allergic diseases and atopy in Asian children.
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Affiliation(s)
- Tsung-Chieh Yao
- Division of Allergy, Asthma, and Rheumatology, Department of Pediatrics, Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Taoyuan, Taiwan
- Community Medicine Research Center, Chang Gung Memorial Hospital at Keelung, Keelung, Taiwan
- * E-mail: (TCY); (JLH)
| | - Yu-Ling Tu
- Division of Allergy, Asthma, and Rheumatology, Department of Pediatrics, Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Taoyuan, Taiwan
- Community Medicine Research Center, Chang Gung Memorial Hospital at Keelung, Keelung, Taiwan
- Graduate Institute of Clinical Medical Sciences, Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Su-Wei Chang
- Clinical Informatics and Medical Statistics Research Center, Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Hui-Ju Tsai
- Division of Biostatistics and Bioinformatics, Institutes of Population Health Sciences, National Health Research Institutes, Miaoli, Taiwan
- Department of Pediatrics, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, United States of America
- Department of Genome Medicine, Kaohsiung University, Kaohsiung, Taiwan
| | - Po-Wen Gu
- Department of Laboratory Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Hsian-Chen Ning
- Department of Laboratory Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Man-Chin Hua
- Community Medicine Research Center, Chang Gung Memorial Hospital at Keelung, Keelung, Taiwan
- Department of Pediatrics, Chang Gung Memorial Hospital at Keelung, Keelung, Taiwan
| | - Sui-Ling Liao
- Community Medicine Research Center, Chang Gung Memorial Hospital at Keelung, Keelung, Taiwan
- Department of Pediatrics, Chang Gung Memorial Hospital at Keelung, Keelung, Taiwan
| | - Ming-Han Tsai
- Community Medicine Research Center, Chang Gung Memorial Hospital at Keelung, Keelung, Taiwan
- Department of Pediatrics, Chang Gung Memorial Hospital at Keelung, Keelung, Taiwan
| | - Chih-Yung Chiu
- Community Medicine Research Center, Chang Gung Memorial Hospital at Keelung, Keelung, Taiwan
- Department of Pediatrics, Chang Gung Memorial Hospital at Keelung, Keelung, Taiwan
| | - Shen-Hao Lai
- Community Medicine Research Center, Chang Gung Memorial Hospital at Keelung, Keelung, Taiwan
- Division of Pediatric Pulmonology, Department of Pediatrics, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Kuo-Wei Yeh
- Division of Allergy, Asthma, and Rheumatology, Department of Pediatrics, Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Taoyuan, Taiwan
- Community Medicine Research Center, Chang Gung Memorial Hospital at Keelung, Keelung, Taiwan
| | - Jing-Long Huang
- Division of Allergy, Asthma, and Rheumatology, Department of Pediatrics, Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Taoyuan, Taiwan
- Community Medicine Research Center, Chang Gung Memorial Hospital at Keelung, Keelung, Taiwan
- * E-mail: (TCY); (JLH)
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