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Kim J, Shin JY, Choi YH, Joo JH, Kwack MH, Sung YK, Kang NG. Hair Thickness Growth Effect of Adenosine Complex in Male-/Female-Patterned Hair Loss via Inhibition of Androgen Receptor Signaling. Int J Mol Sci 2024; 25:6534. [PMID: 38928239 PMCID: PMC11204140 DOI: 10.3390/ijms25126534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2024] [Revised: 06/11/2024] [Accepted: 06/12/2024] [Indexed: 06/28/2024] Open
Abstract
Aging (senescence) is an unavoidable biological process that results in visible manifestations in all cutaneous tissues, including scalp skin and hair follicles. Previously, we evaluated the molecular function of adenosine in promoting alopecia treatment in vitro. To elucidate the differences in the molecular mechanisms between minoxidil (MNX) and adenosine, gene expression changes in dermal papilla cells were examined. The androgen receptor (AR) pathway was identified as a candidate target of adenosine for hair growth, and the anti-androgenic activity of adenosine was examined in vitro. In addition, ex vivo examination of human hair follicle organ cultures revealed that adenosine potently elongated the anagen stage. According to the severity of alopecia, the ratio of the two peaks (terminal hair area/vellus hair area) decreased continuously. We further investigated the adenosine hair growth promoting effect in vivo to examine the hair thickness growth effects of topical 5% MNX and the adenosine complex (0.75% adenosine, 1% penthenol, and 2% niacinamide; APN) in vivo. After 4 months of administration, both the MNX and APN group showed significant increases in hair density (MNX + 5.01% (p < 0.01), APN + 6.20% (p < 0.001)) and thickness (MNX + 5.14% (p < 0.001), APN + 10.32% (p < 0.001)). The inhibition of AR signaling via adenosine could have contributed to hair thickness growth. We suggest that the anti-androgenic effect of adenosine, along with the evaluation of hair thickness distribution, could help us to understand hair physiology and to investigate new approaches for drug development.
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Affiliation(s)
- Jaeyoon Kim
- LG Household & Health Care (LG H&H) R&D Center, 70, Magokjoongang 10-ro, Gangseo-gu, Seoul 07795, Republic of Korea; (J.K.); (J.y.S.); (Y.-H.C.); (J.H.J.)
| | - Jae young Shin
- LG Household & Health Care (LG H&H) R&D Center, 70, Magokjoongang 10-ro, Gangseo-gu, Seoul 07795, Republic of Korea; (J.K.); (J.y.S.); (Y.-H.C.); (J.H.J.)
| | - Yun-Ho Choi
- LG Household & Health Care (LG H&H) R&D Center, 70, Magokjoongang 10-ro, Gangseo-gu, Seoul 07795, Republic of Korea; (J.K.); (J.y.S.); (Y.-H.C.); (J.H.J.)
| | - Jang Ho Joo
- LG Household & Health Care (LG H&H) R&D Center, 70, Magokjoongang 10-ro, Gangseo-gu, Seoul 07795, Republic of Korea; (J.K.); (J.y.S.); (Y.-H.C.); (J.H.J.)
| | - Mi Hee Kwack
- Department of Immunology, School of Medicine, Kyungpook National University, Daegu 41944, Republic of Korea; (M.H.K.); (Y.K.S.)
| | - Young Kwan Sung
- Department of Immunology, School of Medicine, Kyungpook National University, Daegu 41944, Republic of Korea; (M.H.K.); (Y.K.S.)
| | - Nae Gyu Kang
- LG Household & Health Care (LG H&H) R&D Center, 70, Magokjoongang 10-ro, Gangseo-gu, Seoul 07795, Republic of Korea; (J.K.); (J.y.S.); (Y.-H.C.); (J.H.J.)
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Chen Y, Dong X, Wang Y, Li Y, Xiong L, Li L. Serum 25 hydroxyvitamin D in non-scarring alopecia: A systematic review and meta-analysis. J Cosmet Dermatol 2024; 23:1131-1140. [PMID: 38010941 DOI: 10.1111/jocd.16093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 09/18/2023] [Accepted: 11/09/2023] [Indexed: 11/29/2023]
Abstract
INTRODUCTION Non-scarring alopecia mainly includes androgenetic alopecia (AGA), female pattern hair loss (FPHL), alopecia areata (AA), telogen effluvium (TE), anagen effluvium (AE) and so on. Many studies had investigated the serum 25-hydroxyvitamin D level and vitamin D deficiency of patients with these diseases, but opinions varied, and no conclusion was reached. METHODS Relevant articles were retrieved through PubMed, Web of Science, EMBASE, Cochrane Library, China National Knowledge Infrastructure (CNKI) and other databases. Serum 25-hydroxyvitamin D [25(OH) D] levels and vitamin D deficiency were used as our primary outcome. The odds ratio (OR) and the standardized mean difference (SMD) with 95% confidence interval were both examined for vitamin D deficiency and levels. RESULTS Our meta-analysis had included a total of 3374 non-scarring alopecia patients and 7296 healthy controls from 23 studies through the inclusion criteria and exclusion criteria. We found non-scarring alopecia had decreased serum 25(OH)D level (WMD -7.29; 95% CI -9.21, -5.38) and increased vitamin D deficiency incidence (OR 3.11 95% CI 2.29, 4.22), compared with healthy controls. This meta-analysis chose to conduct random-effect model and subgroup analysis, because of the high heterogeneity (serum 25(OH)D level: I2 = 95%, vitamin D deficiency: I2 = 0%). CONCLUSION Patients with non-scarring alopecia (including AA, FPHL, AGA and TE) have insufficient serum level of 25(OH)D and increased incidence of vitamin D deficiency. Vitamin D supplementation and monitoring for vitamin D deficiency may be helpful in treating non-scarring alopecia.
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Affiliation(s)
- Yuling Chen
- Department of Dermatology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Xin Dong
- Department of Dermatology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Yixin Wang
- Department of Dermatology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Yu Li
- Department of Dermatology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Lidan Xiong
- Department of Dermatology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
- Center of Cosmetics Evaluation, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Li Li
- Department of Dermatology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
- Center of Cosmetics Evaluation, West China Hospital, Sichuan University, Chengdu, Sichuan, China
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AbdElneam AI, Al-Dhubaibi MS, Bahaj SS, Mohammed GF, Alantry AK, Atef LM. C-reactive protein as a novel biomarker for vitamin D deficiency in alopecia areata. Skin Res Technol 2024; 30:e13657. [PMID: 38528743 DOI: 10.1111/srt.13657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Accepted: 03/01/2024] [Indexed: 03/27/2024]
Abstract
BACKGROUND Alopecia areata (AA) is an autoimmune condition characterized by sudden and unpredictable hair loss, with a lifetime incidence of 2%. AA can be divided into three categories: patchy alopecia, alopecia totalis, and alopecia universalis. It can affect a person's psychological health and overall quality of life. Elevated C-reactive protein (CRP) levels in the liver may indicate an inflammatory response in autoimmune diseases. Vitamin D, essential for immune system control and skin health, may be related to AA. Hair follicles contain vitamin D receptors, which control immunological responses in the skin. However, no study has found a relationship between CRP and vitamin D in AA patients in our region. SUBJECTS AND METHODS An analytical cross-sectional study with a case-control design research investigation of 82 AA patients and 81 healthy controls was carried out. Both groups' medical histories were taken. Biochemical analysis was done for both groups as well as the serum vitamin D levels, and CRP. Genetic analysis for CDX2 rs11568820 variant detected by PCR (T-ARMS-PCR) method and vitamin D receptor (VDR) gene expression measured by real-time PCR analysis for both patients and healthy subjects. RESULTS CRP levels are higher in AA patients, AA patients with G/G genotypes exhibited higher concentrations of CRP when compared to those with A/A and A/G genotypes while patients with A/A genotypes have higher levels of Serum vitamin D as compared to the A/G and G/G genotypes. G allele was more abundant in AA patients. VDR gene expression was lower in AA compared to control and lower in ophiasis compared to localized and multiple patchy AA. An important inverse linear correlation was observed between vitamin D and CRP levels in ophiasis AA. CONCLUSION CRP concentrations were found to be elevated in AA patients. The considerable accuracy of CRP in the diagnosis of AA is substantiated by a statistically significant al. A noteworthy inverse linear association was observed between serum vitamin D and CRP concentrations in ophiasis AA.
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Affiliation(s)
- Ahmed Ibrahim AbdElneam
- Department of Clinical Biochemistry, Department of Basic Medical Sciences, College of Medicine, Shaqra University, Dawadmi, Saudi Arabia
- Molecular Genetics and Enzymology Department, Human Genetics and Genome Research Institute, National Research Center, Dokki, Cairo, Egypt
| | | | - Saleh Salem Bahaj
- Department of Microbiology and Immunology, Faculty of Medicine and Health Sciences, Sana'a University, Sanaa, Yemen
| | - Ghada Farouk Mohammed
- Department of Dermatology, Venereology, and Sexology, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
| | - Ahmed Kaid Alantry
- Basic Medical Sciences Department, Physiology unit, Uniazah College of Medicine and Medical Sciences, Qassim University, Unaizah, Saudi Arabia
| | - Lina Mohamed Atef
- Department of Dermatology, Venereology, and Sexology, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
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Ly S, Manjaly P, Kamal K, Shields A, Wafae B, Afzal N, Drake L, Sanchez K, Gregoire S, Zhou G, Mita C, Mostaghimi A. Comorbid Conditions Associated with Alopecia Areata: A Systematic Review and Meta-analysis. Am J Clin Dermatol 2023; 24:875-893. [PMID: 37464249 DOI: 10.1007/s40257-023-00805-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/18/2023] [Indexed: 07/20/2023]
Abstract
BACKGROUND Alopecia areata (AA) is a complex autoimmune condition resulting in nonscarring hair loss. In recent years, many studies have provided new evidence on comorbid diseases present in patients with AA. However, some studies have conflicting results, and analyses conducting a comprehensive approach are lacking. OBJECTIVE The aim of our study was to provide an updated systematic review and meta-analysis of medical comorbidities associated with AA. METHODS We searched PubMed, Embase, and Web of Science for case-control, cross-sectional, and cohort studies investigating medical comorbidities in AA published from inception through 1 February 2023. RESULTS We screened 3428 abstracts and titles and reviewed 345 full text articles for eligibility. Ultimately, 102 studies were analyzed, comprising 680,823 patients with AA and 72,011,041 healthy controls. Almost all included studies (100 of 102 studies) were of satisfactory to high quality (Newcastle-Ottawa scale score ≥ 4). Among patients with AA, comorbidities with the highest odds ratios (OR) compared with healthy controls and data available from more than one study included vitamin D deficiency (OR 10.13, 95% CI 4.24-24.20), systemic lupus erythematous (OR 5.53, 95% CI 3.31-9.23), vitiligo (OR 5.30, 95% CI 1.86-15.10), metabolic syndrome (OR 5.03, 95% CI 4.18-6.06), and Hashimoto's thyroiditis (OR 4.31, 95% CI 2.51-7.40). AA may be a protective factor for certain disorders, for which the AA group had lower odds compared with healthy controls, such as irritable bowel syndrome (OR 0.38, 95% CI 0.14-0.99) and colorectal cancer (OR 0.61, 95% CI 0.42-0.89). CONCLUSION These findings corroborate and contextualize the risks across comorbidities for patients with AA. Further work should be done to identify the underlying pathophysiology and understand appropriate screening criteria.
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Affiliation(s)
- Sophia Ly
- College of Medicine, University of Arkansas for Medical Sciences, Little Rock, AR, USA
- Department of Dermatology, Brigham and Women's Hospital, 221 Longwood Avenue, Boston, MA, 02115, USA
| | - Priya Manjaly
- Department of Dermatology, Brigham and Women's Hospital, 221 Longwood Avenue, Boston, MA, 02115, USA
- Boston University School of Medicine, Boston, MA, USA
| | - Kanika Kamal
- Department of Dermatology, Brigham and Women's Hospital, 221 Longwood Avenue, Boston, MA, 02115, USA
- Harvard Medical School, Boston, MA, USA
| | - Ali Shields
- Department of Dermatology, Brigham and Women's Hospital, 221 Longwood Avenue, Boston, MA, 02115, USA
- Drexel University College of Medicine, Philadelphia, PA, USA
| | - Bruna Wafae
- Department of Dermatology, Brigham and Women's Hospital, 221 Longwood Avenue, Boston, MA, 02115, USA
- Harvard Medical School, Boston, MA, USA
| | - Najiba Afzal
- Department of Dermatology, Brigham and Women's Hospital, 221 Longwood Avenue, Boston, MA, 02115, USA
- University of California, Davis School of Medicine, Sacramento, CA, USA
| | - Lara Drake
- Department of Dermatology, Brigham and Women's Hospital, 221 Longwood Avenue, Boston, MA, 02115, USA
- Tufts University School of Medicine, Boston, MA, USA
| | - Katherine Sanchez
- Department of Dermatology, Brigham and Women's Hospital, 221 Longwood Avenue, Boston, MA, 02115, USA
- Lake Erie College of Osteopathic Medicine, Erie, PA, USA
| | - Samantha Gregoire
- Department of Dermatology, Brigham and Women's Hospital, 221 Longwood Avenue, Boston, MA, 02115, USA
- University at Buffalo Jacobs School of Medicine, Buffalo, NY, USA
| | - Guohai Zhou
- Department of Dermatology, Brigham and Women's Hospital, 221 Longwood Avenue, Boston, MA, 02115, USA
| | - Carol Mita
- Countway Library of Medicine, Harvard University, Boston, MA, USA
| | - Arash Mostaghimi
- Department of Dermatology, Brigham and Women's Hospital, 221 Longwood Avenue, Boston, MA, 02115, USA.
- Harvard Medical School, Boston, MA, USA.
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Lim SH, Kang H, Heo YW, Lee WS, Lee S. Prevalence and incidence of comorbid diseases and mortality risk associated with lichen planopilaris: a Korean nationwide population-based study. Clin Exp Dermatol 2023; 48:1230-1237. [PMID: 37433080 DOI: 10.1093/ced/llad235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 07/01/2023] [Accepted: 07/03/2023] [Indexed: 07/13/2023]
Abstract
BACKGROUND Various comorbid diseases have been reported in patients with lichen planopilaris (LPP); however, data regarding the risks of incident diseases and mortality are lacking. OBJECTIVES To investigate the risks of incident diseases and mortality associated with LPP. METHODS This was a retrospective nationwide population-based study, using data from the National Health Insurance Service Database of Korea from 2002 to 2019. Patients aged ≥ 18 years with three or more documented medical visits for LPP were included. The adjusted hazard ratios (aHRs) for incident disease outcomes and mortality were compared with 1 : 20 age-, sex-, insurance type- and income-level-matched controls. RESULTS In total, 2026 patients with LPP and 40 520 controls were analysed. The risks of incident systemic lupus erythematosus [aHR 1.91, 95% confidence interval (CI) 1.21-3.03], psoriasis (aHR 3.42, 95% CI 2.83-4.14), rheumatoid arthritis (aHR 1.39, 95% CI 1.19-1.63), lichen planus (aHR, 10.07, 95% CI 7.17-14.15), atopic dermatitis (aHR 2.15, 95% CI 1.90-2.44), allergic rhinitis (aHR 1.29, 95% CI 1.13-1.49), thyroid diseases (hyperthyroidism: aHR 1.42, 95% CI 1.14-1.77, hypothyroidism aHR 1.19 95% CI 1.01-1.41, and thyroiditis: aHR, 1.35, 95% CI 1.08-1.69), nonmelanoma skin cancer (aHR 2.33, 95% CI 1.00-5.44) and vitamin D deficiency (aHR 1.23, 95% CI 1.03-1.47) were higher in patients with LPP. Patients with LPP had a higher mortality rate than controls (aHR 1.30, 95% CI 1.04-1.61), although the risk was not significant after adjusting for comorbidities (aHR 1.08, 95% CI 0.87-1.34). CONCLUSIONS Patients with LPP had a higher risk of various diseases following LPP diagnosis. Close follow-up is needed to optimize comprehensive patient care.
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Affiliation(s)
- Sung Ha Lim
- Department of Dermatology, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea
| | - Hyun Kang
- Department of Dermatology, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea
| | - Yeon-Woo Heo
- Department of Dermatology, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea
| | - Won-Soo Lee
- Department of Dermatology, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea
| | - Solam Lee
- Department of Dermatology, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea
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Tu W, Cao YW, Sun M, Liu Q, Zhao HG. mTOR signaling in hair follicle and hair diseases: recent progress. Front Med (Lausanne) 2023; 10:1209439. [PMID: 37727765 PMCID: PMC10506410 DOI: 10.3389/fmed.2023.1209439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Accepted: 08/23/2023] [Indexed: 09/21/2023] Open
Abstract
Mammalian target of rapamycin (mTOR) signaling pathway is a major regulator of cell proliferation and metabolism, playing significant roles in proliferation, apoptosis, inflammation, and illness. More and more evidences showed that the mTOR signaling pathway affects hair follicle circulation and maintains the stability of hair follicle stem cells. mTOR signaling may be a critical cog in Vitamin D receptor (VDR) deficiency-mediated hair follicle damage and degeneration and related alopecia disorders. This review examines the function of mTOR signaling in hair follicles and hair diseases, and talks about the underlying molecular mechanisms that mTOR signaling regulates.
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Affiliation(s)
| | | | | | | | - Heng-Guang Zhao
- Department of Dermatology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
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El-Tatawy RA, Gheida S, Soliman GAM, Ismail M. Oral Vitamin D Treatment in Patients with Telogen Effluvium: Clinical and Dermoscopic Evaluation. Int J Trichology 2023; 15:183-190. [PMID: 39170090 PMCID: PMC11335050 DOI: 10.4103/ijt.ijt_92_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2022] [Accepted: 09/19/2022] [Indexed: 08/23/2024] Open
Abstract
Background Telogen effluvium (TE) is the most common hair loss. Vitamin D is related to hair and skin diseases due to its immunomodulatory and anti-inflammatory effects. Objective To investigate Vitamin D serum level role in TE pathogenesis. Patients and Methods Forty females with TE were collected and twenty age- and sex-matched healthy individuals as controls. Serum 25(OH) Vitamin D level was estimated prior and 3 months after oral Vitamin D. Results The mean serum 25(OH) Vitamin D levels were significantly lower in TE patients than controls (13.31 ± 5.8 ng/ml vs. 33.61 ± 8.16 ng/ml) respectively, P < 0.001. The mean serum 25(OH) Vitamin D levels before treatment in acute TE was 12.31 ± 6.88 ng/ml, compared to 10.6 ± 3.9 ng/ml in chronic TE without a significant difference, (P = 0.544). The mean serum 25(OH) Vitamin D levels in TE group after 3 months oral Vitamin D therapy were 38.4 ± 15.22 ng/ml with significant increase compared to pretreatment level, (P < 0.001). However, without a significant difference between acute TE (45.4 ± 9.22 ng/ml) and chronic TE (42.1 ± 10.6 ng/ml), (P = 0.711). Conclusion Oral Vitamin D has a promising effect in TE treatment, but the results need to be verified on a larger scale with evidence-based recommendation regarding the exact dose and treatment duration.
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Affiliation(s)
- Rania Ahmed El-Tatawy
- Department of Dermatology and Venereology, Faculty of Medicine, Tanta University, Tanta, Egypt
| | - Shereen Gheida
- Department of Dermatology and Venereology, Faculty of Medicine, Tanta University, Tanta, Egypt
| | | | - Mayada Ismail
- Department of Dermatology and Venereology, Faculty of Medicine, Tanta University, Tanta, Egypt
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Touil H, Mounts K, De Jager PL. Differential impact of environmental factors on systemic and localized autoimmunity. Front Immunol 2023; 14:1147447. [PMID: 37283765 PMCID: PMC10239830 DOI: 10.3389/fimmu.2023.1147447] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Accepted: 05/08/2023] [Indexed: 06/08/2023] Open
Abstract
The influence of environmental factors on the development of autoimmune disease is being broadly investigated to better understand the multifactorial nature of autoimmune pathogenesis and to identify potential areas of intervention. Areas of particular interest include the influence of lifestyle, nutrition, and vitamin deficiencies on autoimmunity and chronic inflammation. In this review, we discuss how particular lifestyles and dietary patterns may contribute to or modulate autoimmunity. We explored this concept through a spectrum of several autoimmune diseases including Multiple Sclerosis (MS), Systemic Lupus Erythematosus (SLE) and Alopecia Areata (AA) affecting the central nervous system, whole body, and the hair follicles, respectively. A clear commonality between the autoimmune conditions of interest here is low Vitamin D, a well-researched hormone in the context of autoimmunity with pleiotropic immunomodulatory and anti-inflammatory effects. While low levels are often correlated with disease activity and progression in MS and AA, the relationship is less clear in SLE. Despite strong associations with autoimmunity, we lack conclusive evidence which elucidates its role in contributing to pathogenesis or simply as a result of chronic inflammation. In a similar vein, other vitamins impacting the development and course of these diseases are explored in this review, and overall diet and lifestyle. Recent work exploring the effects of dietary interventions on MS showed that a balanced diet was linked to improvement in clinical parameters, comorbid conditions, and overall quality of life for patients. In patients with MS, SLE and AA, certain diets and supplements are linked to lower incidence and improved symptoms. Conversely, obesity during adolescence was linked with higher incidence of MS while in SLE it was associated with organ damage. Autoimmunity is thought to emerge from the complex interplay between environmental factors and genetic background. Although the scope of this review focuses on environmental factors, it is imperative to elaborate the interaction between genetic susceptibility and environment due to the multifactorial origin of these disease. Here, we offer a comprehensive review about the influence of recent environmental and lifestyle factors on these autoimmune diseases and potential translation into therapeutic interventions.
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Affiliation(s)
- Hanane Touil
- Center for Translational and Computational Neuroimmunology, Department of Neurology, Columbia University Irving Medical Center, New York, NY, United States
| | - Kristin Mounts
- Center for Translational and Computational Neuroimmunology, Department of Neurology, Columbia University Irving Medical Center, New York, NY, United States
| | - Philip Lawrence De Jager
- Center for Translational and Computational Neuroimmunology, Department of Neurology, Columbia University Irving Medical Center, New York, NY, United States
- Columbia Multiple Sclerosis Center, Department of Neurology, Columbia University Irving Medical Center, New York, NY, United States
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Zaaroura H, Gilding AJ, Sibbald C. Biomarkers in alopecia Areata: A systematic review and meta-analysis. Autoimmun Rev 2023; 22:103339. [PMID: 37087083 DOI: 10.1016/j.autrev.2023.103339] [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: 03/22/2023] [Accepted: 04/13/2023] [Indexed: 04/24/2023]
Abstract
BACKGROUND Alopecia areata (AA) is an autoimmune non-scarring alopecia that affects the scalp or any hair-bearing areas in the body. The pathophysiology of AA is complex, but Th1, Th2, and Th17 cytokines dysregulation, as well as chemokines, immunoglobulins and other biomarkers have been shown to play a role in the pathogenesis of the disease. OBJECTIVE To conduct a systematic review and Meta-analysis to identify biomarkers that reflect AA activity and severity that could be used to better assess disease activity and response in both trials and clinical practice. METHODS A literature search was conducted using the PUBMED, EMBASE and the Cumulative Index to Nursing and Allied Health Literature (CINAHL) from inception to December 2021. Articles reporting on associations between AA and serum clinical biomarkers (cytokines, chemokines, antibodies, immunoglobulins, and others) were included. Serum biomarkers were identified in patients with AA and were correlated with disease severity and patient characteristics (ex. age, sex, comorbidities). The quality of the studies was assessed using the National Heart, Lung, and Blood Institute's Quality Assessment Tool for Case-Control Studies. Meta-analysis pooling of the standardized mean differences (SMD) by the method of Cohen using the common-effect inverse-variance model was performed. For the Meta-analysis, data was pulled for all the markers with a minimum of 4 studies with means and standard deviations. Analysis of data reported as Median with range or inter-quartile range (IQR) revealed that the data was too skewed to recommend calculation and use of mean with standard deviation (SD). If the data were not skewed, mean and SD were calculated. RESULTS One thousand seven hundred fourteen studies were screened, with 91 included, reporting on a total of 52 biomarkers. Meta-analyses revealed pooled SMD that were significant for interleukin 6 (IL6), C-reactive protein (CRP) and vitamin D. CONCLUSIONS Serum IL6 and CRP levels are significantly increased in patients with AA compared to healthy age and sex matched controls. Conversely, serum vitamn D levels are significantly decreased in patients with AA compared to healthy age and sex matched controls. This data has the potenail to influence the clinical guidelines for the diagnostic workup of AA to include testing the serum levels of CRP and vitamin D.
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Affiliation(s)
- Hiba Zaaroura
- Division of Dermatology, Department of Paediatric Medicine, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
| | - Anthony J Gilding
- Canadian Alopecia Areata Foundation, Toronto, ON, Canada.; Department of Chemistry & Biology, Faculty of Science, Toronto Metropolitan University, Toronto, ON, Canada
| | - Cathryn Sibbald
- Division of Dermatology, Department of Paediatric Medicine, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada.
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Singdia H, Bhargava P, Nijhawan S, Mathur DK. A Study of Correlation of Alopecia Areata and Metabolic Syndrome in Northwest Indian Population: A Case-Control Study. Int J Trichology 2023; 15:63-69. [PMID: 37701557 PMCID: PMC10495065 DOI: 10.4103/ijt.ijt_89_21] [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: 09/02/2021] [Revised: 03/09/2022] [Accepted: 03/11/2022] [Indexed: 09/14/2023] Open
Abstract
Context Alopecia areata (AA) is the most common cause of inflammatory, nonscarring hair loss, involving hair-bearing areas of the body. The etiology of AA still remains uncertain; however, genetic, environmental, and autoimmunity play a role. Newer theories such as oxidative theory, HPA axis activation, and finally, the role of increased inflammatory cytokines such as interleukin 1 (IL1), tumor necrosis factor-alpha, interferon-gamma, IL-2 IL-4, and MIF are suggested to contribute to both AA and metabolic syndrome (MS). Aims Assessment of the degree of association of MS (NCEP ATP III criteria) in clinically diagnosed cases of AA and compare to that of controls. Materials and Methods Similar age/sex-matched AA patients and controls (106 in each group) were taken. Anthropometric measurements, blood-sugar estimation, lipid-profile estimation in venous blood sample, and blood-pressure measurement were done. Results Prevalence of MS was almost similar among cases of AA 9/106 (8.47%) as well as healthy controls 8/106 (7.54%), and the difference was not statistically significant (P = 1). Among all components of MS, waist circumference (WC) (central obesity) was the most common parameter (100% cases). In controls, high systolic blood pressure (SBP) was the most common parameter (77.78% controls). AA is associated with a higher level of SBP, diastolic blood pressure (DBP), WC although nonsignificant, and low level of high-density lipoprotein cholesterol which was the only significant association. Conclusion Insignificant correlation between occurrence of MS and evidence of insulin resistance (IR) in AA was observed in this study population. However, some of the observations in the present study may raise awareness in susceptible individuals that lifestyle changes and regular screening in AA can reduce the risk of cardiovascular diseases and other co-existing autoimmune inflammatory condition-IR, dyslipidemia, and hypertension.
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Affiliation(s)
- Heena Singdia
- Department of Skin and V.D., SMS Medical College; Department of Skin and V.D., SMS Medical College and Hospital, Jaipur, Rajasthan, India
- Department of Skin and V.D., SMS Medical College; Department of Skin and V.D., SMS Medical College and Hospital, Jaipur, Rajasthan, India
| | - Puneet Bhargava
- Department of Skin and V.D., SMS Medical College; Department of Skin and V.D., SMS Medical College and Hospital, Jaipur, Rajasthan, India
- Department of Skin and V.D., SMS Medical College; Department of Skin and V.D., SMS Medical College and Hospital, Jaipur, Rajasthan, India
| | - Shivi Nijhawan
- Department of Skin and V.D., SMS Medical College; Department of Skin and V.D., SMS Medical College and Hospital, Jaipur, Rajasthan, India
- Department of Skin and V.D., SMS Medical College; Department of Skin and V.D., SMS Medical College and Hospital, Jaipur, Rajasthan, India
| | - Deepak Kumar Mathur
- Department of Skin and V.D., SMS Medical College; Department of Skin and V.D., SMS Medical College and Hospital, Jaipur, Rajasthan, India
- Department of Skin and V.D., SMS Medical College; Department of Skin and V.D., SMS Medical College and Hospital, Jaipur, Rajasthan, India
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Chirravuri V, Ghonge S, Palal D. Cross-Sectional Study of Serum Vitamin B12 and Vitamin D3 Levels Amongst Corporate Employees. Cureus 2023; 15:e34642. [PMID: 36751576 PMCID: PMC9899440 DOI: 10.7759/cureus.34642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/05/2023] [Indexed: 02/07/2023] Open
Abstract
Background In today's busy world, health is often neglected especially among full-time workers. Consequently, lifestyle disorders such as vitamin deficiencies are increasing, perhaps because of inadequate nutrition and lack of sunlight due to long hours working indoors. These deficiencies can lead to various short-term and long-term complications. Objective To estimate serum levels of vitamin B12 and vitamin D3 among vegetarian employees. Methods and materials A questionnaire about dietary and exercise habits was administered to participants who fulfilled the inclusion criteria and provided informed written consent. Participants also were asked about drug and supplement intake, history of smoking and alcohol, specific symptoms of vitamin B12 and D3 deficiency, and sociodemographic status. Blood samples were collected to estimate serum B12 and D3 levels. Results The results indicated that 14.00% of participants were vitamin B12 deficient and 82.00% were D3 deficient. Differences by gender were not statistically significant; vitamin B12 deficiency was identified in 10.00% of women and 14.44% of men, and vitamin D3 deficiency occurred in 100.00% of the women and 80.00% of men. Among 71 participants aged 35-45 years, 15.49% and 91.55% were deficient in B12 and D3, respectively; among 25 participants aged 46-55, 12.00% and 64.00% were deficient in B12 and D3, respectively; among four participants older than 55, no vitamin B12 deficiency was observed, but 25.00% were deficient in vitamin D3 (p=0.00002). Nearly all (96.15%) participants who reported never exercising were found to be vitamin D3 deficient, compared to 77.02% of those who exercised (OR=0.13, p=0.043). No significant association was found between alcohol consumption and vitamin B12 (p=1) or D3 (p=0.713) deficiency. Conclusions The results revealed a prevalence of both vitamin B12 and D3 deficiencies among corporate employees who identified as vegetarians. Increased awareness, dietary modifications, conscious physical activity, and most importantly, attention to one's health may help improve vitamin sufficiency. Women over age 45 should pay particular attention due to their increased risk of vitamin D3 deficiency. Further research is needed to assess nutrition profiles among other populations to better understand vitamin deficiencies and design adequate preventive measures.
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Affiliation(s)
- Virinchi Chirravuri
- Community Medicine, Dr. D. Y. Patil Medical College, Hospital & Research Centre, Pune, IND
| | - Swati Ghonge
- Community Medicine, Dr. D. Y. Patil Medical College, Hospital & Research Centre, Pune, IND
| | - Deepu Palal
- Community Medicine, Dr. D. Y. Patil Medical College, Hospital & Research Centre, Pune, IND
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12
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Janoušek J, Pilařová V, Macáková K, Nomura A, Veiga-Matos J, Silva DDD, Remião F, Saso L, Malá-Ládová K, Malý J, Nováková L, Mladěnka P. Vitamin D: sources, physiological role, biokinetics, deficiency, therapeutic use, toxicity, and overview of analytical methods for detection of vitamin D and its metabolites. Crit Rev Clin Lab Sci 2022; 59:517-554. [PMID: 35575431 DOI: 10.1080/10408363.2022.2070595] [Citation(s) in RCA: 46] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Vitamin D has a well-known role in the calcium homeostasis associated with the maintenance of healthy bones. It increases the efficiency of the intestinal absorption of dietary calcium, reduces calcium losses in urine, and mobilizes calcium stored in the skeleton. However, vitamin D receptors are present ubiquitously in the human body and indeed, vitamin D has a plethora of non-calcemic functions. In contrast to most vitamins, sufficient vitamin D can be synthesized in human skin. However, its production can be markedly decreased due to factors such as clothing, sunscreens, intentional avoidance of the direct sunlight, or the high latitude of the residence. Indeed, more than one billion people worldwide are vitamin D deficient, and the deficiency is frequently undiagnosed. The chronic deficiency is not only associated with rickets/osteomalacia/osteoporosis but it is also linked to a higher risk of hypertension, type 1 diabetes, multiple sclerosis, or cancer. Supplementation of vitamin D may be hence beneficial, but the intake of vitamin D should be under the supervision of health professionals because overdosing leads to intoxication with severe health consequences. For monitoring vitamin D, several analytical methods are employed, and their advantages and disadvantages are discussed in detail in this review.
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Affiliation(s)
- Jiří Janoušek
- Department of Pharmacognosy, Faculty of Pharmacy, Charles University, Hradec Králové, Czech Republic
| | - Veronika Pilařová
- Department of Analytical Chemistry, Faculty of Pharmacy, Charles University, Hradec Králové, Czech Republic
| | - Kateřina Macáková
- Department of Pharmacognosy, Faculty of Pharmacy, Charles University, Hradec Králové, Czech Republic
| | - Anderson Nomura
- UCIBIO - Applied Molecular Biosciences Unit, REQUIMTE, Laboratory of Toxicology, Department of Biological Sciences, Faculty of Pharmacy, University of Porto, Porto, Portugal.,Associate Laboratory i4HB - Institute for Health and Bioeconomy, Faculty of Pharmacy, University of Porto, Porto, Portugal
| | - Jéssica Veiga-Matos
- UCIBIO - Applied Molecular Biosciences Unit, REQUIMTE, Laboratory of Toxicology, Department of Biological Sciences, Faculty of Pharmacy, University of Porto, Porto, Portugal.,Associate Laboratory i4HB - Institute for Health and Bioeconomy, Faculty of Pharmacy, University of Porto, Porto, Portugal
| | - Diana Dias da Silva
- UCIBIO - Applied Molecular Biosciences Unit, REQUIMTE, Laboratory of Toxicology, Department of Biological Sciences, Faculty of Pharmacy, University of Porto, Porto, Portugal.,Associate Laboratory i4HB - Institute for Health and Bioeconomy, Faculty of Pharmacy, University of Porto, Porto, Portugal.,TOXRUN - Toxicology Research Unit, University Institute of Health Sciences, CESPU CRL, Gandra, Portugal
| | - Fernando Remião
- UCIBIO - Applied Molecular Biosciences Unit, REQUIMTE, Laboratory of Toxicology, Department of Biological Sciences, Faculty of Pharmacy, University of Porto, Porto, Portugal.,Associate Laboratory i4HB - Institute for Health and Bioeconomy, Faculty of Pharmacy, University of Porto, Porto, Portugal
| | - Luciano Saso
- Department of Physiology and Pharmacology "Vittorio Erspamer", Sapienza University of Rome, Rome, Italy
| | - Kateřina Malá-Ládová
- Department of Social and Clinical Pharmacy, Faculty of Pharmacy, Charles University, Hradec Králové, Czech Republic
| | - Josef Malý
- Department of Social and Clinical Pharmacy, Faculty of Pharmacy, Charles University, Hradec Králové, Czech Republic
| | - Lucie Nováková
- Department of Analytical Chemistry, Faculty of Pharmacy, Charles University, Hradec Králové, Czech Republic
| | - Přemysl Mladěnka
- Department of Pharmacology and Toxicology, Faculty of Pharmacy, Charles University, Hradec Králové, Czech Republic
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Diotallevi F, Campanati A, Martina E, Radi G, Paolinelli M, Marani A, Molinelli E, Candelora M, Taus M, Galeazzi T, Nicolai A, Offidani A. The Role of Nutrition in Immune-Mediated, Inflammatory Skin Disease: A Narrative Review. Nutrients 2022; 14:591. [PMID: 35276950 PMCID: PMC8840467 DOI: 10.3390/nu14030591] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 01/23/2022] [Accepted: 01/27/2022] [Indexed: 11/16/2022] Open
Abstract
Immune-mediated inflammatory skin diseases are characterized by a complex multifactorial etiology, in which genetic and environmental factors interact both in genesis and development of the disease. Nutrition is a complex and fascinating scenario, whose pivotal role in induction, exacerbation, or amelioration of several human diseases has already been well documented. However, owing to the complexity of immune-mediated skin disease clinical course and breadth and variability of human nutrition, their correlation still remains an open debate in literature. It is therefore important for dermatologists to be aware about the scientific basis linking nutrition to inflammatory skin diseases such as psoriasis, atopic dermatitis, hidradenitis suppurativa, bullous diseases, vitiligo, and alopecia areata, and whether changes in diet can influence the clinical course of these diseases. The purpose of this narrative review is to address the role of nutrition in immune-mediated inflammatory skin diseases, in light of the most recent and validate knowledge on this topic. Moreover, whether specific dietary modifications could provide meaningful implementation in planning a therapeutic strategy for patients is evaluated, in accordance with regenerative medicine precepts, a healing-oriented medicine that considers the whole person, including all aspects of the lifestyle.
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Affiliation(s)
- Federico Diotallevi
- Dermatological Clinic, Department of Clinical and Molecular Sciences, Polytechnic Marche University, 60100 Ancona, Italy; (F.D.); (A.C.); (G.R.); (M.P.); (A.M.); (E.M.); (M.C.); (A.O.)
| | - Anna Campanati
- Dermatological Clinic, Department of Clinical and Molecular Sciences, Polytechnic Marche University, 60100 Ancona, Italy; (F.D.); (A.C.); (G.R.); (M.P.); (A.M.); (E.M.); (M.C.); (A.O.)
| | - Emanuela Martina
- Dermatological Clinic, Department of Clinical and Molecular Sciences, Polytechnic Marche University, 60100 Ancona, Italy; (F.D.); (A.C.); (G.R.); (M.P.); (A.M.); (E.M.); (M.C.); (A.O.)
| | - Giulia Radi
- Dermatological Clinic, Department of Clinical and Molecular Sciences, Polytechnic Marche University, 60100 Ancona, Italy; (F.D.); (A.C.); (G.R.); (M.P.); (A.M.); (E.M.); (M.C.); (A.O.)
| | - Matteo Paolinelli
- Dermatological Clinic, Department of Clinical and Molecular Sciences, Polytechnic Marche University, 60100 Ancona, Italy; (F.D.); (A.C.); (G.R.); (M.P.); (A.M.); (E.M.); (M.C.); (A.O.)
| | - Andrea Marani
- Dermatological Clinic, Department of Clinical and Molecular Sciences, Polytechnic Marche University, 60100 Ancona, Italy; (F.D.); (A.C.); (G.R.); (M.P.); (A.M.); (E.M.); (M.C.); (A.O.)
| | - Elisa Molinelli
- Dermatological Clinic, Department of Clinical and Molecular Sciences, Polytechnic Marche University, 60100 Ancona, Italy; (F.D.); (A.C.); (G.R.); (M.P.); (A.M.); (E.M.); (M.C.); (A.O.)
| | - Matteo Candelora
- Dermatological Clinic, Department of Clinical and Molecular Sciences, Polytechnic Marche University, 60100 Ancona, Italy; (F.D.); (A.C.); (G.R.); (M.P.); (A.M.); (E.M.); (M.C.); (A.O.)
| | - Marina Taus
- Dietetic Unit and Clinical Nutrition, United Hospitals of Ancona, 60100 Ancona, Italy; (M.T.); (A.N.)
| | - Tiziana Galeazzi
- Department of Pediatrics, Marche Polytechnic University, 60100 Ancona, Italy;
| | - Albano Nicolai
- Dietetic Unit and Clinical Nutrition, United Hospitals of Ancona, 60100 Ancona, Italy; (M.T.); (A.N.)
| | - Annamaria Offidani
- Dermatological Clinic, Department of Clinical and Molecular Sciences, Polytechnic Marche University, 60100 Ancona, Italy; (F.D.); (A.C.); (G.R.); (M.P.); (A.M.); (E.M.); (M.C.); (A.O.)
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14
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Song J, Liu K, Chen W, Liu B, Yang H, Lv L, Sun X, Mao Y, Ye D. Circulating Vitamin D Levels and Risk of Vitiligo: Evidence From Meta-Analysis and Two-Sample Mendelian Randomization. Front Nutr 2022; 8:782270. [PMID: 35004812 PMCID: PMC8727691 DOI: 10.3389/fnut.2021.782270] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Accepted: 11/29/2021] [Indexed: 11/13/2022] Open
Abstract
Background: The association between circulating vitamin D levels and risk of vitiligo was inconsistent among observational studies, and whether these observed associations were causal remained unclear. Therefore, we aimed to evaluate the effect of vitamin D on the risk of vitiigo using meta-analysis and Mendelian randomization (MR). Methods: At the meta-analysis stage, literature search was performed in PubMed and Web of Science to identify eligible observational studies examining the association of circulating 25-hydroxyvitamin D [25(OH)D] or 25-hydroxyvitamin D3 [25(OH)D3] levels with risk of vitiligo up to April 30, 2021. Standardized mean differences (SMDs) with 95% confidence intervals (CIs) of 25(OH)D and 25(OH)D3 in patients with vitiligo relative to controls were pooled. Then at the MR stage, genetic instruments for circulating 25(OH)D (N = 120,618) and 25(OH)D3 (N = 40,562) levels were selected from a meta-analysis of genome-wide association studies (GWAS) of European descent, and summary statistics of vitiligo were obtained from a meta-analysis of three GWASs including 4,680 cases and 39,586 controls. We used inverse-variance weighted (IVW) as main method, followed by weighted-median and likelihood-based methods. Pleiotropic and outlier variants were assessed by MR-Egger regression and MR Pleiotropy RESidual Sum and Outlier (MR-PRESSO) test. Results: In the meta-analysis, patients with vitiligo had a lower level of circulating 25(OH)D compared with controls [SMD = −1.40; 95% confidence interval (CI): −1.91, −0.89; P < 0.001], while no statistically significant difference of 25(OH)D3 between vitiligo cases and controls was found (SMD = −0.63; 95% CI: −1.29, 0.04; P = 0.064). However, in the MR analyses, genetically predicted 25(OH)D [odds ratio (OR) = 0.93, 95% CI = 0.66–1.31, P = 0.66] and 25(OH)D3 levels (OR = 0.95, 95% CI = 0.80–1.14, P = 0.60) had null associations with risk of vitiligo using the IVW method. Sensitivity analyses using alternative MR methods and instrumental variables (IV) sets obtained consistent results, and no evidence of pleiotropy or outliers was observed. Conclusion: Our study provided no convincing evidence for a causal effect of 25(OH)D or 25(OH)D3 levels on the risk of vitiligo. Further longitudinal and experimental studies, as well as functional studies are warranted to elucidate the role of vitamin D in the development of vitiligo.
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Affiliation(s)
- Jie Song
- Department of Epidemiology, School of Public Health, Zhejiang Chinese Medical University, Hangzhou, China
| | - Ke Liu
- Department of Epidemiology, School of Public Health, Zhejiang Chinese Medical University, Hangzhou, China
| | - Weiwei Chen
- Department of Epidemiology, School of Public Health, Zhejiang Chinese Medical University, Hangzhou, China
| | - Bin Liu
- Department of Epidemiology, School of Public Health, Zhejiang Chinese Medical University, Hangzhou, China
| | - Hong Yang
- Department of Epidemiology, School of Public Health, Zhejiang Chinese Medical University, Hangzhou, China
| | - Linshuoshuo Lv
- Department of Epidemiology, School of Public Health, Zhejiang Chinese Medical University, Hangzhou, China
| | - Xiaohui Sun
- Department of Epidemiology, School of Public Health, Zhejiang Chinese Medical University, Hangzhou, China
| | - Yingying Mao
- Department of Epidemiology, School of Public Health, Zhejiang Chinese Medical University, Hangzhou, China
| | - Ding Ye
- Department of Epidemiology, School of Public Health, Zhejiang Chinese Medical University, Hangzhou, China
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15
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Mahmmod Z, Ismael DK. Vitamin D Deficiency in Patients With Vitiligo: A Cross-Sectional Study From Basrah, Iraq. Cureus 2021; 13:e20733. [PMID: 35111426 PMCID: PMC8790802 DOI: 10.7759/cureus.20733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/27/2021] [Indexed: 11/05/2022] Open
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Abstract
Healthy hair results from a combination of good generalized health and mindful health care practices. Many nutritional deficiencies lead to poor hair health and include changes to hair structure, texture, and viability. Although the mechanisms by which individual nutrients contribute to hair growth and maintenance have yet to be fully resolved, there are a variety of risk factors that predispose an individual to a nutritional deficiency; age, malnutrition, malabsorption, and medication use are among the most common. A thorough history should be taken in a patient with a hair disturbance to identify risk factors for a nutritional deficiency, which will then guide directed laboratory testing and treatment.
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Affiliation(s)
- Kelly O'Connor
- Department of Dermatology, Boston University Medical Center, Boston, Massachusetts, USA. kelly.o'
| | - Lynne J Goldberg
- Department of Dermatology, Boston University Medical Center, Boston, Massachusetts, USA
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Papadimitriou DT, Bothou C, Dermitzaki E, Alexopoulos A, Mastorakos G. Treatment of alopecia totalis/universalis/focalis with vitamin D and analogs: Three case reports and a literature review. World J Clin Pediatr 2021; 10:192-199. [PMID: 34868895 PMCID: PMC8603638 DOI: 10.5409/wjcp.v10.i6.192] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Revised: 04/18/2021] [Accepted: 07/06/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Alopecia areata (AA) is an inflammatory disease with autoimmune, environmental, and inherited components directed at the hair follicle, either limited to patchy hair loss over the scalp (Focalis, AF), total loss of scalp hair (Totalis, AT), or total loss of both scalp and body hair (Universalis, AU). Despite multiple treatment modalities, no therapy exists. Vitamin D deficiency in patients with AA/AT/AF influences disease severity and duration, inversely correlating with inflammation histologically.
CASE SUMMARY Three girls presented with AT (P1), AU (P2), and AF (P3) at the ages of 1, 5, and 5 years, respectively. For P1-P2, all available treatments implemented for 2 years had failed. We started an initial 6-mo repletion with oral cholecalciferol 2000/4000 IU/d, with no apparent effect. Then we attempted immunomodulation using oral calcitriol and its analog paricalcitol. On calcitriol, 0.5 mcg/d P1 regrew hair within 6 mo. After 4 years, a relapse with loss of eyebrow hair was resolved after doubling the calcitriol dose to 0.5 mcg × 2/d; the results have been maintained for 6 years to date. On calcitriol, 0.25 mcg × 3/d P2 led to the development of asymptomatic hypercalcemia-hypercalciuria, which was immediately resolved by switching to paricalcitol 2 mcg × 3/d; mild tolerable hypercalciuria was maintained. Hair regrowth was observed at 6 mo, stabilizing only as fur at 12 mo. AF in P3 was resolved completely within 3 mo on a daily high dose (8000 IU) of cholecalciferol.
CONCLUSION Vitamin D may have immunomodulating therapeutic impact on AT/AU/AF, which needs to be explored with further pilot clinical trials.
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Affiliation(s)
- Dimitrios T Papadimitriou
- Department of Pediatric-Adolescent Endocrinology and Diabetes, Athens Medical Center, Athens 15125, Greece
- Endocrine Unit, Aretaieion University Hospital, Athens 11528, Greece
| | - Christina Bothou
- Department of Endocrinology, Diabetology and Clinical Nutrition, University Hospital Zurich (USZ), University of Zurich (UZH), CH-8091 Zurich, Switzerland
| | - Eleni Dermitzaki
- Department of Pediatric-Adolescent Endocrinology and Diabetes, Athens Medical Center, Athens 15125, Greece
| | - Alexios Alexopoulos
- Special Unit of Dermatology, First Department of Pediatrics, National and Kapodistrian University of Athens Medical School, Agia Sofia Children's Hospital, Athens 11527, Greece
| | - George Mastorakos
- Endocrine Unit, Aretaieion University Hospital, Athens 11528, Greece
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ERTUĞRUL G, AKTAŞ H. Serum 25-hydroxy vitamin D level does not reflect the severity of warts: a cross-sectional study. KAHRAMANMARAŞ SÜTÇÜ İMAM ÜNIVERSITESI TIP FAKÜLTESI DERGISI 2021. [DOI: 10.17517/ksutfd.987056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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Elfadil GA, Mohammed NA, Elmugadam A, Ismail M, Altoum AEA, Osman AL. Vitamin D Deficiency among Females with Acne Vulgaris in Relation to Sun Exposure: A Cross-sectional Study. Open Access Maced J Med Sci 2021. [DOI: 10.3889/oamjms.2021.7140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND: Acne vulgaris is a common chronic inflammatory disease of the skin. Vitamin D deficiency has been implicated in various skin diseases, including atopic dermatitis and psoriasis.
AIM: The aim of this study was to evaluate the serum 25-hydroxy Vitamin D levels among patients with acne vulgaris.
METHODS: This was a cross-sectional comparative study performed in Khartoum state at Military hospital, department of dermatology and venerology, 111 blood samples were collected from females to measure serum level of 25-hydroxy Vitamin D by immunoassay analyzer cobas-e-411-2ed generation platform of Electrochemiluminescence binding assay.
RESULTS: In this study, 111 females their age 18–36 years. 57 suffering from acne vulgaris, 61.4% of them had moderate grade of acne. A significant decrease in the serum 25-hydroxy Vitamin D concentrations in acne vulgaris patients when compared to 54 non-acne group (13.3 ± 5.0 ng/mL vs. 24.2 ± 10.3 ng/mL p =0.00). Significant positive correlation between serum 25-OH Vitamin D and exposure to sunlight per day (r = 0.562, p = 0.00), while there was a significant negative correlation between 25-OH Vitamin D and grade of acne, and duration of disease per month (for grade of acne r = –0.641, p = 0.00), (for duration of disease r = –0.696, p = 0.00) among patients with acne vulgaris.
CONCLUSION: The evidence from this study suggests that female with low serum 25- OH Vitamin D had increase risk to develop acne vulgaris. Further studies are needed to confirm this potential relation.
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Determination of serum 25-hydroxyvitamin D levels in patients with alopecia areata and their comparison with levels in healthy controls: A cross-sectional study. JAAD Int 2021; 5:78-84. [PMID: 34622224 PMCID: PMC8484040 DOI: 10.1016/j.jdin.2021.07.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/28/2021] [Indexed: 11/22/2022] Open
Abstract
Background Alopecia areata (AA) has been postulated to be an autoimmune disease affecting the hair follicles. Because vitamin D receptors are present in the immune system and hair follicles, vitamin D has been hypothesized to affect the disease. Objective The aim of this study was to determine serum 25-hydroxyvitamin D levels and the percentage of vitamin D deficiency in AA patients and compare them with those in healthy controls in a Philippine tertiary hospital. Methods This cross-sectional study included 29 AA patients and 29 healthy controls. The serum 25-hydroxyvitamin D levels were determined using the chemiluminescent immunoassay method. Results There was no significant difference in the mean vitamin D levels between AA patients (24.41 ± 6.87 ng/mL) and healthy controls (24.68 ± 6.68 ng/mL) (P = .88). The percentage of patients with vitamin D deficiency, defined as <20 ng/mL, trended to higher among AA patients (34.4%) than among healthy controls (17.2%), with an odds ratio of 2.53 (95% CI 0.73-8.65), though this was not statsitically significant. Limitations This study involved a limited number of patients in an urbanized area in the Philippines, and majority of the AA cases seen had mild AA. Conclusion The trend toward the increased percentage of vitamin D-deficient individuals among AA patients seen in this study may provide insight into the association of vitamin D with AA.
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Gao Y, Huo S, Sun M, Zhang C, Wang J, Gao J, Wang N, Lv Y. Evaluation of several immune and inflammatory indicators and their association with alopecia areata. J Cosmet Dermatol 2021; 21:2995-3001. [PMID: 34591347 DOI: 10.1111/jocd.14504] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 09/07/2021] [Accepted: 09/20/2021] [Indexed: 12/29/2022]
Abstract
BACKGROUND Alopecia areata (AA) is an autoimmune disorder and chronic recurrent inflammatory disease that results in non-scarring hair loss. OBJECTIVES Our aim is to investigate several parameters related to autoimmunity and inflammation in AA patients and to evaluate their association with this disease. METHODS This study included a total of 672 eligible AA patients and 580 age- and sex-matched healthy individuals who were treated at a third-class hospital in Hefei from January 2016 to May 2020. Data for serum C-reactive protein (CRP), 25-hydroxy vitamin D (25(OH)D), T3, T4, thyroid-stimulating hormone (TSH), thyroid antibodies (TPOAbs and TGAbs), antinuclear antibodies (ANA), complements (C3, C4), and several immunoglobulins (IgA, IgM, and IgG) were collected in this study. RESULTS Regarding autoimmune-related functional indicators, there were no statistically significant differences between TSH, TGAbs, C3, C4, IgA, IgM, and IgG levels between AA patients and healthy controls. Only T3, T4, TPOAbs, and ANA values were significantly abnormal in the AA group compared with the healthy individuals (p < 0.05). In addition, the mean serum 25(OH)D concentration was significantly lower in the patient group than that in control group (p < 0.05), and serum CRP was significantly increased (p < 0.05). CONCLUSION Although the etiopathogenesis of AA is not clear, the importance of monitoring the levels of T3, T4, TPOAbs, ANA, and 25 (OH)D in AA cases is indispensable.
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Affiliation(s)
- Yamei Gao
- Department of Dermatology, The Second Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Shaohu Huo
- Department of Pediatrics, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Minghui Sun
- Department of Dermatology, The Second Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Chenchen Zhang
- Department of Dermatology, The Second Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Jing Wang
- Department of Dermatology, The Second Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Jing Gao
- Department of Dermatology, The Second Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Na Wang
- Department of Dermatology, The Second Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Yongmei Lv
- Department of Dermatology, The Second Affiliated Hospital of Anhui Medical University, Hefei, China
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Varikasuvu SR, Aloori S, Varshney S, Bhongir AV. Decreased circulatory levels of Vitamin D in Vitiligo: a meta-analysis. An Bras Dermatol 2021; 96:284-294. [PMID: 33863565 PMCID: PMC8178549 DOI: 10.1016/j.abd.2020.10.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 10/08/2020] [Accepted: 10/08/2020] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND The serum Vitamin D status in patients with vitiligo is ambiguous when compared to controls. A systematic review and updated meta-analysis were conducted to evaluate the association between Vitamin D and vitiligo. METHODS Relevant studies were identified by searching PubMed and other databases. The random effects model was used to obtain standardized mean differences and pooled correlation coefficients. Meta-regression and sub-group analyses were conducted to explore heterogeneity. The presence of publication bias and the study robustness were tested using funnel plot and sensitivity analyses, respectively. RESULTS This meta-analysis finally included 31 studies. Compared with controls, vitiligo patients showed significantly decreased serum Vitamin D levels (standardized mean difference = -1.03; p < 0.0001). The sub-group analysis showed that vitiligo patients with indoor/urban work had a significantly lower Vitamin D level when compared to their outdoor/rural counterparts (standardized mean differences = -0.45; p = 0.03). The sensitivity analysis indicated that no single study had a significant influence on the overall outcome, suggesting the robustness of this meta-analysis. STUDY LIMITATIONS Varied sample sizes and heterogeneous study populations from different countries are the limitations of this study. However, the between-study heterogeneity has been addressed by the random-effects model with meta-regression and sensitivity analyses. CONCLUSIONS This meta-analysis showed significantly decreased Vitamin D level in vitiligo, and its association with indoor/outdoor type of work of vitiligo patients. This study highlights the need to assess Vitamin D status for improving its level in vitiligo.
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Affiliation(s)
| | - Sowjanya Aloori
- Department of Health Education, Telangana State Residential School & College, Choutuppal, India
| | | | - Aparna Varma Bhongir
- Department of Biochemistry, All India Institute of Medical Sciences, Bibinagar, India
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Alamoudi SM, Marghalani SM, Alajmi RS, Aljefri YE, Alafif AF. Association Between Vitamin D and Zinc Levels With Alopecia Areata Phenotypes at a Tertiary Care Center. Cureus 2021; 13:e14738. [PMID: 34079683 PMCID: PMC8162299 DOI: 10.7759/cureus.14738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/28/2021] [Indexed: 11/09/2022] Open
Abstract
Objectives Alopecia areata (AA) is a common immune-mediated hair disorder that presents in different clinical patterns. This study aims to find the association between vitamin D and zinc levels with AA phenotypes, to determine the common comorbidities in AA patients, and to assess the influence of age, gender, and body mass index (BMI) on AA phenotypes. Methods This is a cross-sectional study conducted at King Abdulaziz Medical City (KAMC) in Jeddah, Saudi Arabia. Data were collected through retrospective chart review of the electronic medical record system (BestCare) and by utilizing a structured data collection sheet. Results A total of 177 patients were clinically diagnosed with AA with a mean age of 28.37 ± 12.68 years. The mean vitamin D level was 49.14 ± 29.09 nmol/L. Zinc levels were reported in only 22 patients, among which, only one patient had deficient levels. The mean zinc level was 9.8 ± 1.5 µmol/L. Patchy alopecia areata (60.45%) was the most common phenotype followed by universalis (9%) and totalis (7%). Hypothyroidism (11.8%) was the most prevalent comorbidity followed by atopic diseases (10.7%), then both diabetes and mood disorders (6.2%). Conclusion Deficient serum vitamin D levels were present in 62.7% of patients with AA. Nevertheless, no statistically significant relation was detected between vitamin D status and patterns of alopecia areata (P=0.108). A limited number of our sample had records of zinc levels with a mean serum of 9.8 ± 1.5 µmol/L and only one patient was found to be deficient.
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Affiliation(s)
- Saeed M Alamoudi
- Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, SAU
| | | | - Rakan S Alajmi
- Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, SAU
| | - Yara E Aljefri
- Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, SAU
| | - Abdullah F Alafif
- Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, SAU
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Association of Single Nucleotide Polymorphisms in the VDR and CYP27B1 Genes with Risk of Developing Vitamin D3 Deficiency. JOURNAL OF PURE AND APPLIED MICROBIOLOGY 2021. [DOI: 10.22207/jpam.15.1.15] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
This study was carried out to investigate the relationship between common variants in two vitamin D pathway genes (VDR and CYP27B1) and vitamin D3 serum levels. In this study, serum vitamin D metabolite levels were measured in the blood samples of 200 patients with alopecia areata. Then, single nucleotide polymorphisms (SNPs) in VDR and CYP27B1 were analyzed using polymerase chain reaction (PCR)-sequencing. Sixty-three variations were observed in these genes (42 variations in CYP27B1 and 21 variations in VDR). A significant difference in Rs1544410 (odds ratio: 7, P < 0.0005) and rs4646536 (odds ratio: 4.043, P < 0.0005) variants was found between the patients and controls. The study showed the relationship between the two polymorphisms, Rs1544410 (odds ratio: 7, 95% CI, 1–8) and rs4646536 (odds ratio: 4.043, 95% CI, 3–14.038) on the genes VDR and CYP27B1, respectively, with increased risk of developing vitamin D3 insufficiency in the Iranian population. Therefore, SNPs in the VDR and CYP27B1 genes can be considered as prognostic biomarkers of the risk of developing vitamin D3 deficiency.
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Adelman MJ, Bedford LM, Potts GA. Clinical efficacy of popular oral hair growth supplement ingredients. Int J Dermatol 2020; 60:1199-1210. [DOI: 10.1111/ijd.15344] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 10/27/2020] [Accepted: 11/09/2020] [Indexed: 11/29/2022]
Affiliation(s)
| | - Lisa M. Bedford
- Department of Dermatology Wayne State University Detroit USA
| | - Geoff A. Potts
- Department of Dermatology Wayne State University Detroit USA
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Harvey CJ. Combined Diet and Supplementation Therapy Resolves Alopecia Areata in a Paediatric Patient: A Case Study. Cureus 2020; 12:e11371. [PMID: 33304703 PMCID: PMC7721078 DOI: 10.7759/cureus.11371] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Alopecia areata (AA) is a common autoimmune condition resulting in spot baldness and, rarely, more extensive hair loss. There is an association between both the incidence and the severity of AA and several micronutrients, including vitamin D and zinc. This case reports an eight-year-old male diagnosed with AA and treated with a diet and supplemental regimen based on unrefined foods, rich in vitamins A and D, zinc, and supplemented with a multi-nutrient, zinc sulfate, and fish oil with vitamin D. Complete remission of AA was achieved within five months.
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Association of Alopecia Areata with Vitamin D and Calcium Levels: A Systematic Review and Meta-analysis. Dermatol Ther (Heidelb) 2020; 10:967-983. [PMID: 32772238 PMCID: PMC7477029 DOI: 10.1007/s13555-020-00433-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2020] [Indexed: 12/13/2022] Open
Abstract
Introduction To investigate the associations of alopecia areata (AA) with serum vitamin D and calcium levels. Methods A systematic review of all relevant articles published up to February 2020 in PubMed, Embase, and Cochrane Library databases was conducted. Primary endpoints were serum 25-hydroxyvitamin D [25(OH)D] levels and vitamin D deficiency, and the secondary endpoint was serum calcium level. Odds ratio (OR) and standardized mean difference (SMD) with 95% CI across studies were analyzed. Results Data on 1585 patients with AA and 1114 controls from 16 case–control studies and three cross-sectional studies were included in this meta-analysis. A pooled meta-analysis was conducted using the random-effects model because of inter-study heterogeneity (vitamin D level, I2 = 87.90%; vitamin D deficiency, I2 = 81.10%; serum calcium level, I2 = 83.80%). A combined analysis revealed that patients with AA had significantly lower mean serum 25(OH)D level compared with control (WMD − 9.08, 95% CI − 11.65, − 6.50, p < 0.001), and were more likely to have vitamin D deficiency (OR 4.14, 95% CI 2.34, 7.35, p < 0.001). However, the pooled analysis revealed that patients with AA did not have significantly lower serum calcium levels compared with control (WMD − 0.17, 95% CI − 0.40, 0.06, p = 0.143). Subgroup analysis suggested that matched control, mean age, and country might contribute to the heterogeneity of serum vitamin D level, while study design, matched control, and country might contribute to the heterogeneity of vitamin D deficiency. Conclusion Deficiency of serum 25(OH)D level, rather than calcium level, was present in patients with AA. Screening for vitamin D deficiency and vitamin D supplementation may be beneficial in the treatment of patients with AA. Electronic supplementary material The online version of this article (10.1007/s13555-020-00433-4) contains supplementary material, which is available to authorized users.
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Soeberdt M, Kilic A, Abels C. Current and emerging treatments targeting the neuroendocrine system for disorders of the skin and its appendages. Exp Dermatol 2020; 29:801-813. [DOI: 10.1111/exd.14145] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Revised: 06/09/2020] [Accepted: 06/25/2020] [Indexed: 12/17/2022]
Affiliation(s)
| | - Ana Kilic
- Dr. August Wolff GmbH & Co. KG Arzneimittel Bielefeld Germany
| | - Christoph Abels
- Dr. August Wolff GmbH & Co. KG Arzneimittel Bielefeld Germany
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Sanke S, Samudrala S, Yadav A, Chander R, Goyal R. Study of serum vitamin D levels in men with premature androgenetic alopecia. Int J Dermatol 2020; 59:1113-1116. [PMID: 32516435 DOI: 10.1111/ijd.14982] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Revised: 05/04/2020] [Accepted: 05/05/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND Vitamin D deficiency had been associated with various hair loss disorders, such as telogen effluvium, alopecia areata, and female pattern hair loss. However, previous studies have not found a correlation between serum vitamin D levels and the severity of androgenetic alopecia. METHODS A case-control study was conducted for a period of one year in a public tertiary care hospital. Fifty males clinically diagnosed with androgenetic alopecia and 50 age-matched healthy controls were recruited. Serum vitamin D levels in both cases and controls were measured by radioimmunoassay technique, and the results were compared. RESULTS A total of 50 cases and 50 controls were recruited and analyzed. The mean age of the cases was 23 years and that of controls was 24.2 years. The mean levels of serum vitamin D significantly decreased in cases, compared to controls (20.10 vs. 29.34 ng/mL; P ≤ 0.001). Eighty-six percent of the cases had deficiency of vitamin D (<30 nmol/L), while 14% had insufficient vitamin D levels (31-50 nmol/L). There was a positive correlation between vitamin D deficiency and severity of androgenetic alopecia (AGA), which was statistically significant (P ≤ 0.5). However, there was no correlation between the duration of sun exposure and serum vitamin D levels (2.36 ± 1.2 in cases and 3.23 ± 1.6 in controls, P value = 0.98). CONCLUSION Our study showed a significant correlation between vitamin D deficiency and the severity of androgenetic alopecia. This suggests that vitamin D may play a role in the premature onset of androgenetic alopecia. However, further studies on a larger population and the effect of vitamin D supplementation on the progression of androgenetic alopecia are required to validate the above findings.
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Affiliation(s)
- Sarita Sanke
- Department of Dermatology, Lady Hardinge Medical College, New Delhi, India
| | - Suvarna Samudrala
- Department of Dermatology, Lady Hardinge Medical College, New Delhi, India
| | - Anuja Yadav
- Department of Dermatology, Lady Hardinge Medical College, New Delhi, India
| | - Ram Chander
- Department of Dermatology, Lady Hardinge Medical College, New Delhi, India
| | - Rajeev Goyal
- Department of Biochemistry, Lady Hardinge Medical College, New Delhi, India
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Zhao J, Sheng Y, Dai C, Qi S, Hu R, Rui W, Miao Y, Xu F, Zhang Y, Yang Q. Serum 25 hydroxyvitamin D levels in alopecia areata, female pattern hair loss, and male androgenetic alopecia in a Chinese population. J Cosmet Dermatol 2020; 19:3115-3121. [PMID: 32275116 DOI: 10.1111/jocd.13396] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2019] [Revised: 02/29/2020] [Accepted: 03/13/2020] [Indexed: 01/14/2023]
Abstract
BACKGROUND It has been suggested that low vitamin D levels may affect the development of hair loss. AIMS Our aim was to evaluate the serum 25-hydroxy vitamin D [25(OH)D] status in Chinese patients with alopecia areata (AA), female pattern hair loss (FPHL), and male androgenetic alopecia (MAGA) compared with healthy individuals. METHODS We performed a case-control study including 443 AA patients, 657 FPHL patients, 777 MAGA patients, and 2070 normal controls (1064 male and 1006 female healthy individuals) from 2015 to 2017 to analyze the correlation of serum 25(OH)D levels and hair loss in a Chinese population. RESULTS Serum 25(OH)D levels stratified by age, sex, and season were compared between patients and healthy individuals. AA patients' serum 25(OH)D levels were statistically lower than that of controls (P < .0001, α = .05). Serum 25(OH)D levels of FPHL patients (P < .0001, α = .05) and MAGA patients (P = .0005, α = .05) were also significantly lower than counterpart control subjects. CONCLUSION Our findings suggest an association between serum 25(OH)D levels and alopecia areata, female pattern hair loss, or male androgenetic alopecia in a Chinese population.
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Affiliation(s)
- Jun Zhao
- Department of Dermatology, Huashan Hospital, Fudan University, Shanghai, China
| | - Youyu Sheng
- Department of Dermatology, Huashan Hospital, Fudan University, Shanghai, China
| | - Chunyang Dai
- Department of Dermatology, Shanghai Sixth People's Hospital, Shanghai Jiaotong University, Shanghai, China
| | - Sisi Qi
- Department of Dermatology, Huashan Hospital, Fudan University, Shanghai, China
| | - Ruiming Hu
- Department of Dermatology, Huashan Hospital, Fudan University, Shanghai, China
| | - Wenlong Rui
- Department of Dermatology, Huashan Hospital, Fudan University, Shanghai, China
| | - Ying Miao
- Department of Dermatology, Huashan Hospital, Fudan University, Shanghai, China
| | - Feng Xu
- Department of Dermatology, Huashan Hospital, Fudan University, Shanghai, China
| | - Yao Zhang
- Department of Dermatology, Huashan Hospital, Fudan University, Shanghai, China
| | - Qinping Yang
- Department of Dermatology, Huashan Hospital, Fudan University, Shanghai, China
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Kemeriz F, Tuncer SÇ, Acar EM, Tuğrul B. Evaluation of 25-hydroxy vitamin D levels and disease severity in patients with acne vulgaris. Dermatol Ther 2020; 33:e13393. [PMID: 32268447 DOI: 10.1111/dth.13393] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Revised: 03/17/2020] [Accepted: 04/04/2020] [Indexed: 12/17/2022]
Abstract
Acne vulgaris is a multifactorial skin disorder. Many etiological factors are speculated to contribute to the pathogenesis of acne, one of these is vitamin D deficiency. Previous studies reported contradictory results about serum 25 hydroxy vitamin D (25-OH vitamin D) levels, its association with acne, some claimed that acne lesion might improve with vitamin D supplementation. We aimed to assess serum 25-OH vitamin D levels in acne patients, identify their relation with disease severity in a larger study group. The study included 134 acne patients, 129 controls. Acne disease severity was identified with Global Acne Grading Scale (GAGS) scores. Serum 25-OH vitamin D levels were measured in all groups. Serum 25-OH vitamin D levels were significantly lower in acne patients than in controls (P < .001). The prevalence of vitamin D deficiency was significantly higher in acne group than in control group (77.6% vs 63.9%; P = .041). There was a negative-strong statistically significant correlation detected between serum 25-OH vitamin D levels and GAGS scores in patient group (P < .001; r = -.910). According to these results, we claim that evaluating serum 25-OH vitamin D levels in acne patients, vitamin D supplementation as a treatment option may be a consideration for further studies.
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Affiliation(s)
- Funda Kemeriz
- Department of Dermatology, Aksaray University Faculty of Medicine, Aksaray, Turkey
| | - Sibel Çiğdem Tuncer
- Department of Biochemistry, Aksaray University Faculty of Medicine, Aksaray, Turkey
| | - Emine Müge Acar
- Department of Dermatology, Ahi Evran University Faculty of Medicine, Kırşehir, Turkey
| | - Burcu Tuğrul
- Department of Dermatology, Health Science University Ankara Oncology Training and Research Hospital, Ankara, Turkey
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Trüeb RM, Jolliffe VML, Régnier AF, Dutra Rezende H, Vañó-Galván S, Kopera D, Ioannides D, Gavazzoni Dias MFR, Macpherson M, Gadzhigoroeva A, Ovcharenko J, Lee WS, Murugusundram S, Kurata S, Chang M, Tanglertsampan C. Precision Medicine and the Practice of Trichiatry: Adapting the Concept. Skin Appendage Disord 2019; 5:338-343. [PMID: 31799259 DOI: 10.1159/000500364] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Accepted: 04/12/2019] [Indexed: 01/06/2023] Open
Abstract
Evidence-based medicine (EBM) aims for the ideal that healthcare professionals make conscientious, explicit, and judicious use of the best available evidence gained from the scientific method to clinical decision-making. It seeks to assess the strength of the evidence for benefits of diagnostic tests and treatments, using techniques from science, engineering, and statistics, such as the systematic review of medical literature, meta-analysis, risk-benefit analysis, and randomized controlled trials. The limited success rate of EBM therapies suggests that the complex nature of hair loss may be inadequately served by the present levels of evidence, and that physicians treating hair loss may have fallen short of adequately researching a robust evidence to underpin their practices. Against this backdrop, the concept of precision medicine (PM) is evolving. PM refers to the customization of medical care to the patient's individual characteristics based on the patient's genetic background and other molecular or cellular analysis, while classifying patients into subpopulations that differ in their susceptibility to a particular medical condition, in the biology or prognosis of those medical conditions, or in their response to a specific treatment. With the advances in hair research, the powerful tools of molecular biology and genetics, and innovative technologies, we have the robust scientific data and tools to adapt the concept of PM to the practice of trichiatry. Finally, databases pertaining to the development and efficacy of PM must be analyzed and be used to form the basis of evidence-based personalized trichiatry.
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Affiliation(s)
- Ralph M Trüeb
- Center for Dermatology and Hair Diseases Professor Trüeb, University of Zurich, Zurich, Switzerland
| | | | - Antonia Fellas Régnier
- Center for Dermatology and Hair Diseases Professor Trüeb, University of Zurich, Zurich, Switzerland
| | - Hudson Dutra Rezende
- Center for Dermatology and Hair Diseases Professor Trüeb, University of Zurich, Zurich, Switzerland
| | | | - Daisy Kopera
- Center of Aesthetic Medicine, Department of Dermatology, Medical University Graz, Graz, Austria
| | - Demetrios Ioannides
- 1st Department of Dermatology-Venereology, Aristotle University Medical School, Hospital of Skin and Venereal Diseases, Thessaloniki, Greece
| | - Maria Fernanda Reis Gavazzoni Dias
- Department of Dermatology, Centro de Ciências Médicas, Hospital Universitário Antonia Pedro, Universidade Federal Fluminense, Niterói, Brazil
| | - Melanie Macpherson
- Department of Dermatology and Venereology, San Gabriel Clinic, Lima, Peru
| | - Aida Gadzhigoroeva
- Moscow Scientific and Practical Center of Dermatology and Cosmetology of the Moscow City Health Department, Moscow, Russian Federation
| | - Julya Ovcharenko
- General and Clinical Immunology and Allergology Department, School of Medicine, V.N. Karazin Kharkiv National University, Kharkiv, Ukraine
| | - Won-Soo Lee
- Department of Dermatology, Yonsei University, Wonju College of Medicine, Wonju, Republic of Korea
| | | | - Sotaro Kurata
- Beppu Garden Hill Clinic & Kurata Clinic, Beppu City, Japan
| | - Mimi Chang
- Prince of Wales Hospital and the Chinese University of Hong Kong, Hong Kong, China
| | - Chuchai Tanglertsampan
- Department of Dermatology, Mae Fah Luang University Hospital (Bangkok), Bumrungrad International Hospital, Bangkok, Thailand
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Alam M, Amin SS, Adil M, Arif T, Zahra FT, Varshney I. Comparative Study of Efficacy of Topical Mometasone with Calcipotriol versus Mometasone Alone in the Treatment of Alopecia Areata. Int J Trichology 2019; 11:123-127. [PMID: 31360041 PMCID: PMC6580810 DOI: 10.4103/ijt.ijt_18_19] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Background Alopecia areata is one of the common causes of nonscarring hair loss with autoimmune etiology. This study was designed to evaluate any added benefit of topical calcipotriol when combined with topical mometasone in the treatment of alopecia areata. To the best of our knowledge, no such study has been conducted in the past. Materials and Methods It was a comparative analytical study done over 100 patients of clinically diagnosed alopecia areata. Group A patients (n = 50) were advised to apply topical mometasone 0.1% cream along with topical calcipotriol 0.005% ointment each once daily, whereas patients of Group B (n = 50) were advised to apply only topical mometasone 0.1% cream in the same amount, once a day. Follow-up of all patients was done at 6, 12, and 24 weeks, and the outcome was assessed according to the Severity of Alopecia Tool (SALT) score at every visit. Results Both the groups were statistically comparable in terms of age (P = 0.694) and sex (P = 0.683) distribution. Baseline mean SALT score of Group A and Group B patients was 7.22 and 6.05, respectively (P = 0.145). At the end of 24 weeks, mean SALT score of Group A and Group B patients decreased by 4.24 and 3.39, respectively (P < 0.001). We also found that there was a significant decrease (P < 0.001) in mean SALT score at 24 weeks in patients of both groups when compared with baseline values. Conclusion We found that adding topical calcipotriol 0.005% ointment with topical mometasone 0.1% cream has higher efficacy than topical mometasone alone, in the treatment of alopecia areata.
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Affiliation(s)
- Mahtab Alam
- Department of Dermatology, Jawaharlal Nehru Medical College, Aligarh Muslim University, Aligarh, Uttar Pradesh, India
| | - Syed Suhail Amin
- Department of Dermatology, Jawaharlal Nehru Medical College, Aligarh Muslim University, Aligarh, Uttar Pradesh, India
| | - Mohammad Adil
- Department of Dermatology, Jawaharlal Nehru Medical College, Aligarh Muslim University, Aligarh, Uttar Pradesh, India
| | - Tasleem Arif
- Ellahi Medicare Clinic, Srinagar, Jammu and Kashmir, India
| | - Fatima Tuz Zahra
- Department of Dermatology, Jawaharlal Nehru Medical College, Aligarh Muslim University, Aligarh, Uttar Pradesh, India
| | - Iti Varshney
- Department of Dermatology, Jawaharlal Nehru Medical College, Aligarh Muslim University, Aligarh, Uttar Pradesh, India
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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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Navarro-Triviño F, Arias-Santiago S, Gilaberte-Calzada Y. Vitamin D and the Skin: A Review for Dermatologists. ACTAS DERMO-SIFILIOGRAFICAS 2019. [DOI: 10.1016/j.adengl.2019.04.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Navarro-Triviño FJ, Arias-Santiago S, Gilaberte-Calzada Y. Vitamin D and the Skin: A Review for Dermatologists. ACTAS DERMO-SIFILIOGRAFICAS 2019; 110:262-272. [PMID: 30857638 DOI: 10.1016/j.ad.2018.08.006] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2018] [Revised: 07/28/2018] [Accepted: 08/02/2018] [Indexed: 02/07/2023] Open
Abstract
In recent years, the growing interest in the role played by vitamin D in skin disease has given rise to the publication of many studies of the relationship between this vitamin and certain skin conditions. As dermatologists, we need to understand, among other aspects, how vitamin D is synthesized and the main sources in humans, as well as plasma levels and the factors that can modify them. Of particular interest are the latest discoveries about the role of vitamin D in skin diseases such as lupus erythematosus, ichthyosis, atopic dermatitis, hidradenitis suppurativa, acne, alopecia areata, androgenetic alopecia, melanoma, and nonmelanoma skin cancer. Also of interest is the importance of vitamin D as adjuvant therapy in patients on long-term treatment with corticosteroids. In this review, we provide an overview of the most important and most recent information regarding the relationship between vitamin D and skin disease and discuss the importance of assessing individual vitamin D status and correcting deficiencies.
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Affiliation(s)
- F J Navarro-Triviño
- Unidad de Dermatología Médico-Quirúrgica y Venereología, Hospital Comarcal Alcalá la Real, Jaén, España.
| | - S Arias-Santiago
- Unidad de Gestión Clínica de Dermatología y Venereología, Hospital Universitario Virgen de las Nieves, Granada, España
| | - Y Gilaberte-Calzada
- Servicio de Dermatología, Hospital Universitario Miguel Servet, IIS Aragón, Zaragoza, España
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Almohanna HM, Ahmed AA, Tsatalis JP, Tosti A. The Role of Vitamins and Minerals in Hair Loss: A Review. Dermatol Ther (Heidelb) 2019; 9:51-70. [PMID: 30547302 PMCID: PMC6380979 DOI: 10.1007/s13555-018-0278-6] [Citation(s) in RCA: 99] [Impact Index Per Article: 19.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Indexed: 02/07/2023] Open
Abstract
People commonly inquire about vitamin and mineral supplementation and diet as a means to prevent or manage dermatological diseases and, in particular, hair loss. Answering these queries is frequently challenging, given the enormous and conflicting evidence that exists on this subject. There are several reasons to suspect a role for micronutrients in non-scarring alopecia. Micronutrients are major elements in the normal hair follicle cycle, playing a role in cellular turnover, a frequent occurrence in the matrix cells in the follicle bulb that are rapidly dividing. Management of alopecia is an essential aspect of clinical dermatology given the prevalence of hair loss and its significant impact on patients' quality of life. The role of nutrition and diet in treating hair loss represents a dynamic and growing area of inquiry. In this review we summarize the role of vitamins and minerals, such as vitamin A, vitamin B, vitamin C, vitamin D, vitamin E, iron, selenium, and zinc, in non-scarring alopecia. A broad literature search of PubMed and Google Scholar was performed in July 2018 to compile published articles that study the relationship between vitamins and minerals, and hair loss. Micronutrients such as vitamins and minerals play an important, but not entirely clear role in normal hair follicle development and immune cell function. Deficiency of such micronutrients may represent a modifiable risk factor associated with the development, prevention, and treatment of alopecia. Given the role of vitamins and minerals in the hair cycle and immune defense mechanism, large double-blind placebo-controlled trials are required to determine the effect of specific micronutrient supplementation on hair growth in those with both micronutrient deficiency and non-scarring alopecia to establish any association between hair loss and such micronutrient deficiency.Plain Language Summary: Plain language summary available for this article.
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Affiliation(s)
- Hind M. Almohanna
- Department of Dermatology and Dermatologic Surgery, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | - Azhar A. Ahmed
- Department of Dermatology, King Fahad General Hospital, Medina, Saudi Arabia
| | - John P. Tsatalis
- Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, 1475 NW 12th Ave. Suite 2175, Miami, FL 33136 USA
| | - Antonella Tosti
- Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, 1475 NW 12th Ave. Suite 2175, Miami, FL 33136 USA
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Siddappa H, Kumar YHK, Vivekananda N. Evaluation of Association of Vitamin D in Alopecia Areata: A Case-control Study of 100 Patients in a Tertiary Rural Hospital of Southern India. Indian Dermatol Online J 2019; 10:45-49. [PMID: 30775298 PMCID: PMC6362755 DOI: 10.4103/idoj.idoj_84_18] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background: Alopecia areata is a common autoimmune disorder which is characterized by non-scarring hair loss. Vitamin D plays an important role in immune regulation, cell growth, differentiation, and maintenance of hair cycle. Aims and Objectives: (1) To evaluate serum vitamin D levels in alopecia areata. (2) To compare serum vitamin D levels in new versus old cases and with respect to severity of alopecia areata. Materials and Methods: A retrospective case–control study with 100 cases of alopecia areata and 100 age- and sex-matched healthy controls was conducted from December 2014 to November 2015. All subjects underwent complete clinical evaluation and serum vitamin D levels. Results: The mean serum vitamin D level was significantly lower in patients with alopecia areata (18.90 ± 8.32 ng/mL) (64%) as compared to healthy controls (28.21 ± 18.32 ng/mL) (38%) (P < 0.001). The mean serum vitamin D levels was significantly lower in old cases (15.11 ± 4.75 ng/mL) as compared to new cases (20.85 ± 9.09 ng/mL) (P < 0.001). The proportion of subects with vitamin D deficiency was significantly higher among old cases (84.3%) as compared to new cases (53.1%) (P < 0.05). There was a significant inverse correlation between Severity of Alopecia Tool scores and serum vitamin D levels (r = −0.298, P < 0.05). Conclusion: Decreased vitamin D levels were observed in patients with alopecia areata and significant inverse correlation exists between vitamin D levels and duration/severity of the disease. These findings may suggest a causal role of vitamin D deficiency in the pathogenesis and therapeutic role of vitamin D supplementation in the management of alopecia areata.
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Affiliation(s)
- Harsha Siddappa
- Department of Dermatology, Raja Rajeswari Medical College and Hospital, Kambipura, Mysore Road, Bangalore, Karnataka, India
| | - Y Hari Kishan Kumar
- Department of Dermatology, Raja Rajeswari Medical College and Hospital, Kambipura, Mysore Road, Bangalore, Karnataka, India
| | - N Vivekananda
- Department of Dermatology, Raja Rajeswari Medical College and Hospital, Kambipura, Mysore Road, Bangalore, Karnataka, India
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Lee S, Lee H, Lee CH, Lee WS. Comorbidities in alopecia areata: A systematic review and meta-analysis. J Am Acad Dermatol 2019; 80:466-477.e16. [DOI: 10.1016/j.jaad.2018.07.013] [Citation(s) in RCA: 52] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2018] [Revised: 06/01/2018] [Accepted: 07/03/2018] [Indexed: 01/09/2023]
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Yang A, Lv Q, Chen F, Wang D, Liu Y, Shi W. Identification of Recent Trends in Research on Vitamin D: A Quantitative and Co-Word Analysis. Med Sci Monit 2019; 25:643-655. [PMID: 30668558 PMCID: PMC6350455 DOI: 10.12659/msm.913026] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Background In recent years, many studies on vitamin D have been published. We combed these data for hot spot analyses and predicted future research topic trends. Material/Methods Articles (4625) concerning vitamin D published in the past 3 years were selected as a study sample. Bibliographic Items Co-occurrence Matrix Builder (BICOMB) software was used to screen high-frequency Medical Subject Headings (MeSH) terms and construct a MeSH terms-source article matrix and MeSH terms co-occurrence matrix. Then, Graphical Clustering Toolkit (gCLUTO) software was employed to analyze the matrix by double-clustering and visual analysis to detect the trends on the subject. Results Ninety high-frequency major MeSH terms were obtained from 4625 articles and divided into 5 clusters, and we generated a visualized matrix and a mountain map. Strategic coordinates were established by the co-occurrence matrix of the MeSH terms based on the above classification, and the 5 clusters described above were further divided into 7 topics. We classified the vitamin D-related diseases into 12 categories and analyzed their distribution. Conclusions The analysis of strategic coordinates revealed that the epidemiological study of vitamin D deficiency and vitamin D-related diseases is a hot research topic. The use of vitamin D in the prevention and treatment of some diseases, especially diabetes, was found to have a significant potential future research value.
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Affiliation(s)
- Aolin Yang
- Department of Nutrition, The First Hospital of China Medical University, Shenyang, Liaoning, China (mainland)
| | - Qingqing Lv
- Department of Nutrition, The First Hospital of China Medical University, Shenyang, Liaoning, China (mainland)
| | - Feng Chen
- Department of Geriatric Endocrinology, The First Hospital of China Medical University, Shenyang, Liaoning, China (mainland)
| | - Difei Wang
- Department of Geriatric Endocrinology, The First Hospital of China Medical University, Shenyang, Liaoning, China (mainland)
| | - Ying Liu
- Department of Biochemistry and Molecular Biology, China Medical University, Shenyang, Liaoning, China (mainland)
| | - Wanying Shi
- Department of Nutrition, The First Hospital of China Medical University, Shenyang, Liaoning, China (mainland)
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Rehman F, Dogra N, Wani MA. Serum Vitamin D Levels and Alopecia Areata- A Hospital Based Case-Control Study from North-India. Int J Trichology 2019; 11:49-57. [PMID: 31007473 PMCID: PMC6463459 DOI: 10.4103/ijt.ijt_3_19] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Background: Alopecia areata (AA) is an autoimmune disease which is characterized by hair loss and affects any hair-bearing area. Low levels of Vitamin D have been implicated in a variety of autoimmune diseases. This study was conducted to assess the levels of Vitamin D in patients with AA and its correlation with severity, pattern, and extent of the disease. Materials and Methods: This hospital-based study included 135 cases with AA and 135 age- and sex-matched controls. AA cases were grouped according to the severity, pattern, and extent of the disease. The levels of Vitamin D were assessed and compared between cases and controls and among different groups of cases. The data were analyzed, and the correlation was derived. Results: The more number of patients from the case group had deficient and insufficient levels of Vitamin D as compared to controls, the difference being statistically significant (P = 0.01). A highly significant difference was found in mean Vitamin D levels between cases and controls (P = 0.0004). A negative correlation was found between Vitamin D levels and severity of AA as accessed by SALT score. A negative correlation was also found between Vitamin D levels with pattern and extent of the disease. Conclusion: Vitamin D deficiency may be one of the factors having a role either in etiopathogenesis or exacerbation of AA. Supplementation of Vitamin D as a treatment modality may improve the clinical outcome of AA.
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Affiliation(s)
- Fozia Rehman
- Department of Dermatology, Venereology and Leprosy, Government Medical College Jammu, SMGS Hospital, Jammu, Jammu and Kashmir, India
| | - Naina Dogra
- Department of Dermatology, Venereology and Leprosy, Government Medical College Jammu, SMGS Hospital, Jammu, Jammu and Kashmir, India
| | - Mashkoor A Wani
- Department of Dermatology, Venereology and Leprosy, Government Medical College Jammu, SMGS Hospital, Jammu, Jammu and Kashmir, India
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Tuchinda P, Kulthanan K, Chularojanamontri L, Arunkajohnsak S, Sriussadaporn S. Relationship between vitamin D and chronic spontaneous urticaria: a systematic review. Clin Transl Allergy 2018; 8:51. [PMID: 30534360 PMCID: PMC6278169 DOI: 10.1186/s13601-018-0234-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Accepted: 11/16/2018] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Vitamin D has been reported to be associated with many allergic diseases. There are a limited number of the studies of vitamin D supplementation in patients with chronic spontaneous urticaria (CSU). This study aims to study the relationship between vitamin D and CSU in terms of serum vitamin D levels, and the outcomes of vitamin D supplementation. METHODS A literature search of electronic databases for all relevant articles published between 1966 and 2018 was performed. The systematic literature review was done following Preferred Reporting Items for Systematic Reviews and Meta-analysis recommendations. RESULTS Seventeen eligible studies were included. Fourteen (1321 CSU cases and 6100 controls) were concerned with serum vitamin D levels in CSU patients. Twelve studies showed statistically significant lower serum vitamin D levels in CSU patients than the controls. Vitamin D deficiency was reported more commonly for CSU patients (34.3-89.7%) than controls (0.0-68.9%) in 6 studies. Seven studies concerned with vitamin D supplementation in CSU patients showed disease improvement after high-dosages of vitamin D supplementation. CONCLUSION CSU patients had significantly lower serum vitamin D levels than the controls in most studies. However, the results did not prove causation, and the mechanisms were not clearly explained. Despite the scarcity of available studies, this systematic review showed that a high dosage of vitamin D supplementation for 4-12 weeks might help to decrease the disease activity in some CSU patients. Well-designed randomized placebo-controlled studies are needed to determine the cut-off levels of vitamin D for supplementation and treatment outcomes.
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Affiliation(s)
- Papapit Tuchinda
- Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Wanglang Road, Bangkoknoi, Bangkok, 10700 Thailand
| | - Kanokvalai Kulthanan
- Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Wanglang Road, Bangkoknoi, Bangkok, 10700 Thailand
| | - Leena Chularojanamontri
- Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Wanglang Road, Bangkoknoi, Bangkok, 10700 Thailand
| | - Sittiroj Arunkajohnsak
- Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Wanglang Road, Bangkoknoi, Bangkok, 10700 Thailand
| | - Sutin Sriussadaporn
- Division of Endocrinology and Metabolism, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
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Rajabi F, Drake LA, Senna MM, Rezaei N. Alopecia areata: a review of disease pathogenesis. Br J Dermatol 2018; 179:1033-1048. [PMID: 29791718 DOI: 10.1111/bjd.16808] [Citation(s) in RCA: 153] [Impact Index Per Article: 25.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/16/2018] [Indexed: 12/12/2022]
Abstract
BACKGROUND Alopecia areata is a disorder that results in nonscarring hair loss. The psychological impact can be significant, leading to feelings of depression and social isolation. Objectives In this article, we seek to review the pathophysiological mechanisms proposed in recent years in a narrative fashion. METHODS We searched MEDLINE and Scopus for articles related to alopecia areata, with a particular emphasis on its pathogenesis. RESULTS The main theory of alopecia areata pathogenesis is that it is an autoimmune phenomenon resulting from a disruption in hair follicle immune privilege. What causes this breakdown is an issue of debate. Some believe that a stressed hair follicle environment triggers antigen presentation, while others blame a dysregulation in the central immune system entangling the follicles. Evidence for the latter theory is provided by animal studies, as well investigations around the AIRE gene. Different immune-cell lines including plasmacytoid dendritic cells, natural killer cells and T cells, along with key molecules such as interferon-γ, interleukin-15, MICA and NKG2D, have been identified as contributing to the autoimmune process. CONCLUSIONS Alopecia areata remains incurable, although it has been studied for years. Available treatment options at best are beneficial for milder cases, and the rate of relapse is high. Understanding the exact mechanisms of hair loss in alopecia areata is therefore of utmost importance to help identify potential therapeutic targets.
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Affiliation(s)
- F Rajabi
- Department of Dermatology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Network of Immunity in Infection, Malignancy and Autoimmunity (NIIMA), Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - L A Drake
- Massachusetts General Hospital, Harvard Medical School, MA, U.S.A
| | - M M Senna
- Massachusetts General Hospital, Harvard Medical School, MA, U.S.A
| | - N Rezaei
- Research Center for Immunodeficiencies, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
- Department of Immunology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
- Network of Immunity in Infection, Malignancy and Autoimmunity (NIIMA), Universal Scientific Education and Research Network (USERN), Sheffield, U.K
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Trüeb RM, Dias MFRG. Alopecia Areata: a Comprehensive Review of Pathogenesis and Management. Clin Rev Allergy Immunol 2018; 54:68-87. [PMID: 28717940 DOI: 10.1007/s12016-017-8620-9] [Citation(s) in RCA: 87] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Alopecia areata is a common hair loss condition that is characterized by acute onset of non-scarring hair loss in usually sharply defined areas ranging from small patches to extensive or less frequently diffuse involvement. Depending on its acuity and extent, hair loss is an important cause of anxiety and disability. The current understanding is that the condition represents an organ-specific autoimmune disease of the hair follicle with a genetic background. Genome-wide association studies provide evidence for the involvement of both innate and acquired immunity in the pathogenesis, and mechanistic studies in mouse models of alopecia areata have specifically implicated an IFN-γ-driven immune response, including IFNγ, IFNγ-induced chemokines and cytotoxic CD8 T cells as the main drivers of disease pathogenesis. A meta-analysis of published trials on treatment of alopecia areata states that only few treatments have been well evaluated in randomized trials. Nevertheless, depending on patient age, affected surface area and disease duration, an empiric treatment algorithm can be designed with corticosteroids and topical immunotherapy remaining the mainstay of therapy. The obviously limited success of evidence-based therapies points to a more important complexity of hair loss. At the same time, the complexity of pathogenesis offers opportunities for the development of novel targeted therapies. New treatment opportunities based on the results of genome-wide association studies that implicate T cell and natural killer cell activation pathways are paving the way to new approaches in future clinical trials. Currently, there are ongoing studies with the CTLA4-Ig fusion protein abatacept, anti-IL15Rβ monoclonal antibodies and the Janus kinase inhibitors tofacitinib, ruxolitinib and baricitinib. Ultimately, the options available for adapting to the disease rather than treating it in an effort to cure may also be taken into consideration in selected cases of long-standing or recurrent small spot disease.
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Affiliation(s)
- Ralph M Trüeb
- Center for Dermatology and Hair Diseases Professor Trüeb and University of Zurich, Zurich, Switzerland.
| | - Maria Fernanda Reis Gavazzoni Dias
- Department of Dermatology, Universidade Federal Fluminense, Centro de Ciências Médicas, Hospital Universitário Antonio Pedro, Niterói, Rio de Janeiro, Brazil
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Lee S, Kim BJ, Lee CH, Lee WS. Increased prevalence of vitamin D deficiency in patients with alopecia areata: a systematic review and meta-analysis. J Eur Acad Dermatol Venereol 2018; 32:1214-1221. [PMID: 29633370 DOI: 10.1111/jdv.14987] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2017] [Accepted: 03/22/2018] [Indexed: 12/24/2022]
Abstract
BACKGROUND Alopecia areata (AA) is a hair follicle-specific autoimmune disorder. Vitamin D deficiency has been associated with various autoimmune disorders for its immunomodulatory effects. However, in previous studies, there had been inconsistent association found between AA and vitamin D deficiency. OBJECTIVE To demonstrate the differences of the mean serum 25-hydroxyvitamin D level and prevalence of vitamin D deficiency between AA patients and non-AA population. METHODS A systematic review and meta-analysis of observational studies on AA and serum vitamin D levels and/or prevalence of vitamin D deficiency was performed searching MEDLINE, Cochrane, Web of Science and Google Scholar databases. RESULTS In all, 14 studies including a total of 1255 AA subjects and 784 non-AA control were analysed. The mean serum 25-hydroxyvitamin D level was significantly lower in AA subjects (-8.52 ng/dL; 95% confidential interval; -5.50 to -11.53). The AA subjects had higher odds of vitamin D deficiency (odds ratio of 3.89; 2.02 to 7.49, mean prevalence of 73.8%; 59.1 to 84.6%). However, it was difficult to find clear correlation between serum 25-hydroxyvitamin D level and extent of hair loss in AA subjects. CONCLUSION The AA subjects had lower serum 25-hydroxyvitamin D level, and vitamin D deficiency was highly prevalent compared to non-AA controls. Hence, vitamin D deficiency should be assessed in AA patients. Furthermore, nutritional supplementation of vitamin D or topical vitamin D analogues can be considered for AA patients with vitamin D deficiency. The limitation of this study is the highly heterogeneity of the included studies.
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Affiliation(s)
- S Lee
- Department of Dermatology and Institute of Hair and Cosmetic Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - B J Kim
- Department of Dermatology and Institute of Hair and Cosmetic Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - C H Lee
- Department of Dermatology and Institute of Hair and Cosmetic Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - W S Lee
- Department of Dermatology and Institute of Hair and Cosmetic Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
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Zhang JZ, Wang M, Ding Y, Gao F, Feng YY, Yakeya B, Wang P, Wu XJ, Hu FX, Xian J, Kang XJ. Vitamin D receptor gene polymorphism, serum 25-hydroxyvitamin D levels, and risk of vitiligo: A meta-analysis. Medicine (Baltimore) 2018; 97:e11506. [PMID: 30024533 PMCID: PMC6086540 DOI: 10.1097/md.0000000000011506] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVES To explore the relationship among the vitamin D receptor (VDR) gene polymorphisms, serum 25-hydroxyvitamin D levels, and vitiligo. METHODS Databases including PubMed, Cochrane Library, Ovid, Web of Science, CNKI, SinoMed, and Wanfang Data were systematically searched. The association was assessed using odds ratios (ORs), standard mean difference (SMD), and 95% confidence intervals (CIs). The statistical tests were performed using Review Manager 5.3.3. RESULTS We identified a total of 17 studies. The relationship between VDR gene polymorphisms (BsmI, ApaI, TaqI, and FokI), serum 25 (OH)D levels, and incidence of vitiligo was investigated. The results of this meta-analysis showed that the dominant genetic model (CC+AC vs AA, P = .007, OR = 1.41, 95% CI = 1.10-1.80), recessive genetic model (CC vs AC+AA, P = .01, OR = 4.10, 95% CI = 1.36-12.35), and allelic contrast model (C vs A, P = .005, OR = 1.87, 95% CI = 1.21-2.90) of VDR Apal locus increased the risk of vitiligo, and BsmI, TaqI, and FokI loci and the risk of vitiligo have no obvious correlation. Serum 25 (OH)D deficiency was positively associated with the incidence of vitiligo (P < .0001, SMD = -0.94, 95% CI = -1.39, -0.48). CONCLUSION This meta-analysis revealed that VDR Apal polymorphism increased the susceptibility risk of vitiligo, and there is a positive correlation between serum 25 (OH)D deficiency and the incidence of vitiligo.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | - Jun Xian
- Department of Gynecology, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang, China
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Lee JH, Song Y, Do Han K, Park YM, Lee JY, Park YG, Lee YB. Cancer risk by the subtype of alopecia. Sci Rep 2018; 8:9748. [PMID: 29950587 PMCID: PMC6021412 DOI: 10.1038/s41598-018-28142-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2018] [Accepted: 06/18/2018] [Indexed: 12/11/2022] Open
Abstract
The cancer risk in patients with alopecia areata (AA) or alopecia totalis (AT)/alopecia universalis (AU) remains unknown. In this study, national statistical data were used to study the association between these forms of alopecia and the risk of cancer. We enrolled 668,604 patients who were treated for alopecia from 2007 to 2014, and age- and sex-matched control subjects. AA and AT/AU patients had slightly higher overall cancer risks (hazard ratio (HR), 1.043; 95% confidence interval (CI), 1.022-1.065 and HR, 1.07; 95% CI, 1.013-1.129, respectively) than controls, after adjusting for confounding factors. The risks of oral cavity, esophagus, liver, biliary tract, pancreas, larynx, lung, kidney, breast, cervix, ovary, uterus, testis, nerve, and skin cancers; and lymphoma, multiple myeloma, and leukemia, were not increased in alopecia patients. In AA or AT/AU patients, the only increased risk was that of thyroid cancer. In AA patients alone, the risks of bladder and prostate cancers were increased. Thus, the cancer risks varied by the alopecia subtype. Careful monitoring is needed to explore if the actual risks of thyroid, bladder, and prostate cancers are increased in alopecia patients.
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Affiliation(s)
- Ji Hyun Lee
- Department of Dermatology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Yumee Song
- Department of Dermatology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Kyung Do Han
- Department of Biostatistics, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Young Min Park
- Department of Dermatology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Jun Young Lee
- Department of Dermatology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Yong-Gyu Park
- Department of Biostatistics, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
| | - Young Bok Lee
- Department of Dermatology, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
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Brankov N, Conic RZ, Atanaskova-Mesinkovska N, Piliang M, Bergfeld WF. Comorbid conditions in lichen planopilaris: A retrospective data analysis of 334 patients. Int J Womens Dermatol 2018; 4:180-184. [PMID: 30175224 PMCID: PMC6116820 DOI: 10.1016/j.ijwd.2018.04.001] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2017] [Revised: 04/04/2018] [Accepted: 04/06/2018] [Indexed: 01/06/2023] Open
Abstract
Background Lichen planopilaris (LPP) is a rare, cicatricial, lymphocyte-mediated alopecia that is thought to have an autoimmune pathogenesis and possibly related to other autoimmune diseases. However, data are limited and studies that examine comorbid conditions are lacking. Objectives We sought to determine the prevalence of systemic comorbid conditions, nutritional deficiencies, psychological problems, and skin cancers in patients with LPP. Methods We identified 334 patients with LPP who were seen in the Department of Dermatology at the Cleveland Clinic Foundation between 2000 and 2016. Patients with LPP were compared with 78 control patients with a diagnosis of seborrheic dermatitis. Results There were more female patients with LPP compared with the controls (93.1% vs. 79.5%; p < .001) but the average age did not differ (54.77 ± 12.83 vs. 52.19 ± 15.37; p = .12). Conditions positively associated with LPP were Hashimoto’s thyroiditis (6.3% vs. 0%; p = .023), hypothyroidism (24.3% vs. 12.8%; p = .028), and hirsutism (11.4% vs. 1.3%; p = .006). Negatively associated conditions were allergic rhinitis (15% vs. 24.4%; p = .046), diabetes mellitus type II (11.7% vs. 21.8%; p = .019), hyperlipidemia (38.6% vs. 52.6%; p = .024), vitamin D deficiency (50% vs. 65.4%; p = .014), depression (15.6% vs. 28.9%; p = .018), and sleep problems (7.5% vs. 29.5%; p < .001). Conclusions Our study further emphasizes that dermatologists should screen patients with LPP for autoimmune disorders that are associated with LPP and complete a full metabolic workup to avoid missing other abnormalities. The importance of atopy, autoimmune disorders, endocrine disorders, nutritional deficiencies, psychological problems, and skin cancers in patients with scarring alopecia should be better understood.
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Affiliation(s)
- N Brankov
- Department of Dermatology and Dermatopathology, Cleveland Clinic Foundation, Cleveland, Ohio
| | - R Z Conic
- Department of Dermatology and Dermatopathology, Cleveland Clinic Foundation, Cleveland, Ohio.,Department of Dermatology, Case Western Reserve University, Cleveland, Ohio
| | - N Atanaskova-Mesinkovska
- Department of Dermatology and Dermatopathology, Cleveland Clinic Foundation, Cleveland, Ohio.,Department of Dermatology and Dermatopathology, University of California Irvine, Irvine, California
| | - M Piliang
- Department of Dermatology and Dermatopathology, Cleveland Clinic Foundation, Cleveland, Ohio
| | - W F Bergfeld
- Department of Dermatology and Dermatopathology, Cleveland Clinic Foundation, Cleveland, Ohio
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Gade VKV, Mony A, Munisamy M, Chandrashekar L, Rajappa M. An investigation of vitamin D status in alopecia areata. Clin Exp Med 2018; 18:577-584. [PMID: 29869122 DOI: 10.1007/s10238-018-0511-8] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Accepted: 05/29/2018] [Indexed: 11/29/2022]
Abstract
Alopecia areata (AA) is a type of non-scarring, recurrent patchy loss of hair in hair-bearing areas and is mostly of autoimmune origin. Previous studies have suggested that some autoimmune diseases were found to be associated with vitamin D deficiency. The current study was designed to assess the levels of serum 25-hydroxy vitamin D and C-reactive protein in AA, as compared with controls and to further identify the association between vitamin D levels and disease severity in patients with AA. This cross-sectional study included 45 patients with AA and 45 healthy volunteers. Clinical and anthropometric parameters were recorded, according to a pre-designed proforma. Serum 25-hydroxy vitamin D and high-sensitivity C-reactive protein were estimated using ELISA kits. The severity of AA was determined using Severity of Alopecia Tool (SALT) score. We observed a significant rise in systemic inflammation as seen by elevated high-sensitive C-reactive protein levels and lowered 25-hydroxy vitamin D levels in patients with alopecia areata, compared to controls (p = 0.001). The levels of 25-hydroxy vitamin D showed a significant negative correlation with disease severity, while hs-CRP levels showed a significant positive correlation with disease severity (ρ = - 0.714, p = 0.001 and ρ = 0.818, p = 0.001). Our results suggest significant systemic inflammation and vitamin D deficiency in alopecia areata, more so with increasing disease severity. This gains particular importance in the treatment of alopecia areata in future, as supplementing vitamin D to AA patients would result in reducing the disease severity and inducing remission.
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Affiliation(s)
| | - Archana Mony
- Department of Biochemistry, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, 605006, India
| | - Malathi Munisamy
- Department of Dermatology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Laxmisha Chandrashekar
- Department of Dermatology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Medha Rajappa
- Department of Biochemistry, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, 605006, India.
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