1
|
Gallo D, Baci D, Kustrimovic N, Lanzo N, Patera B, Tanda ML, Piantanida E, Mortara L. How Does Vitamin D Affect Immune Cells Crosstalk in Autoimmune Diseases? Int J Mol Sci 2023; 24:ijms24054689. [PMID: 36902117 PMCID: PMC10003699 DOI: 10.3390/ijms24054689] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Revised: 02/16/2023] [Accepted: 02/25/2023] [Indexed: 03/05/2023] Open
Abstract
Vitamin D is a secosteroid hormone that is highly involved in bone health. Mounting evidence revealed that, in addition to the regulation of mineral metabolism, vitamin D is implicated in cell proliferation and differentiation, vascular and muscular functions, and metabolic health. Since the discovery of vitamin D receptors in T cells, local production of active vitamin D was demonstrated in most immune cells, addressing the interest in the clinical implications of vitamin D status in immune surveillance against infections and autoimmune/inflammatory diseases. T cells, together with B cells, are seen as the main immune cells involved in autoimmune diseases; however, growing interest is currently focused on immune cells of the innate compartment, such as monocytes, macrophages, dendritic cells, and natural killer cells in the initiation phases of autoimmunity. Here we reviewed recent advances in the onset and regulation of Graves' and Hashimoto's thyroiditis, vitiligo, and multiple sclerosis in relation to the role of innate immune cells and their crosstalk with vitamin D and acquired immune cells.
Collapse
Affiliation(s)
- Daniela Gallo
- Endocrine Unit, Department of Medicine and Surgery, University of Insubria, ASST dei Sette Laghi, 21100 Varese, Italy
| | - Denisa Baci
- Immunology and General Pathology Laboratory, Department of Biotechnology and Life Sciences, University of Insubria, 21100 Varese, Italy
- Molecular Cardiology Laboratory, IRCCS-Policlinico San Donato, San Donato Milanese, 20097 Milan, Italy
| | - Natasa Kustrimovic
- Center for Translational Research on Autoimmune and Allergic Disease—CAAD, Università del Piemonte Orientale, 28100 Novara, Italy
| | - Nicola Lanzo
- Endocrine Unit, Department of Medicine and Surgery, University of Insubria, ASST dei Sette Laghi, 21100 Varese, Italy
| | - Bohdan Patera
- Endocrine Unit, Department of Medicine and Surgery, University of Insubria, ASST dei Sette Laghi, 21100 Varese, Italy
| | - Maria Laura Tanda
- Endocrine Unit, Department of Medicine and Surgery, University of Insubria, ASST dei Sette Laghi, 21100 Varese, Italy
| | - Eliana Piantanida
- Endocrine Unit, Department of Medicine and Surgery, University of Insubria, ASST dei Sette Laghi, 21100 Varese, Italy
| | - Lorenzo Mortara
- Immunology and General Pathology Laboratory, Department of Biotechnology and Life Sciences, University of Insubria, 21100 Varese, Italy
- Correspondence:
| |
Collapse
|
2
|
Muacevic A, Adler JR, Nooh M, Alghamdi N, Alsolami H, Alturkistani R, Marghalani S. Association Between Vitamin D, Zinc, and Thyroid Biomarker Levels With Vitiligo Disease: A Retrospective Cohort Study in a Tertiary Care Center. Cureus 2022; 14:e31774. [PMID: 36569724 PMCID: PMC9773903 DOI: 10.7759/cureus.31774] [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: 11/22/2022] [Indexed: 11/23/2022] Open
Abstract
Objectives Vitiligo is a dermatological autoimmune disease that has been linked with numerous risk factors. There is an elevated level of evidence suggesting a linkage between vitiligo disease and zinc, vitamin D (Vit-D), thyroid hormones, and thyroid antibody levels. Methods This retrospective cohort study included patients of all age groups of both sexes. Patients were investigated for demographics, vitiligo characteristics, and laboratory tests, including zinc, Vit-D, T3 (triiodothyronine), T4 (thyroxine), thyroid-stimulating hormone (TSH), thyroid peroxidase antibody (TPOAb), and thyroglobulin antibody (TGAb). Results Two hundred and ninety-seven patients were retrospectively assessed; they averaged 29 years for segmental vitiligo (SV) and 31 years for nonsegmental vitiligo (NSV). Gender-wise, our study included more females (57.5%) than males (42.5%). Females comprised approximately 51.8% of NSV patients, while males constituted 36.7%. Patients' T3, T4, and TPOAb levels correlated significantly with age (p=0.001, p <0.01, p=0.14), and elevated BMI recorded high TPOAb levels (p<0.001). An increase in TGAb was associated with extensive involvement in the depigmentation of body surface area (BSA). The segmental type had the lowest TGAb and TPOAb titers. The universal subtype of vitiligo recorded the highest TSH, T3, and TGAb levels. However, differences in laboratory test levels were insignificant for the sex, the type of vitiligo, or the subtype of vitiligo. Conclusion In conclusion, neither Vit-D nor zinc had a significant linkage with any of vitiligo's characteristics or treatments. Nonetheless, TGAb had a significant correlation to the BSA involved with vitiligo while T4 and TPOAb had a significant association with age, BMI, and BSA overall. Statistically, T3 was linked with age and BSA overall only. More studies with a higher level of evidence are required to establish the association of Vit-D, zinc, thyroid biomarkers, and thyroid antibodies.
Collapse
|
3
|
Mohamed AA, Elhussain E, Fawzy N, Sakr Y, Salah El-Dien M, Abbas AM, Hussein MS, Nassar N, Ezzat O, El-Amir RY, Ibrahim S, Bedair NI. Association of rs1544410 and rs7975232 Polymorphisms and Serum Vitamin D Levels with Psoriasis Susceptibility and Severity: A Case-Control Study in Egyptian Patients. Clin Cosmet Investig Dermatol 2022; 15:1271-1281. [PMID: 35832487 PMCID: PMC9272842 DOI: 10.2147/ccid.s364267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2022] [Accepted: 06/17/2022] [Indexed: 11/23/2022]
Abstract
Background Vitamin D is a regulatory factor for skin immune functions through vitamin D receptor, which is expressed on many immune cells. Vitamin D receptor is located on chromosome 12q 13.11 and has many single nucleotide polymorphisms. Some of them were hypothesized to be associated with psoriasis. Psoriasis is a genetic disease that is greatly affected by environmental factors. Methods A total of 135 psoriasis patients and 114 healthy controls were recruited. Both had a measurement of serum vitamin D and two vitamin D receptor variants:, rs1544410: G > A (HGVS:NC_000012.12:g.47846052) and rs7975232: C > A (HGVS: NC_000012.12:g.47845054). We assessed the relationship between vitamin deficiency as well as the two gene polymorphisms with psoriasis susceptibility and severity. Results Serum vitamin D levels were not significantly different between cases and controls. However, a significant association between vitamin D levels and severity was observed. We attributed this to our finding that rs7975232 was more significantly polymorphic among cases than controls, while rs1544410 polymorphism did not show a significant difference among the 2 groups. Conclusion We did not find a significant difference in serum vitamin D levels between cases and controls. Yet, psoriasis severity was significantly associated with serum vitamin D levels. We attributed this to other findings that the vitamin D receptor rs7975232 gene is polymorphic in psoriasis patients. At the same time, rs1544410 was not significantly more polymorphic in psoriasis patients. Both genes’ polymorphisms were associated with severe psoriasis.
Collapse
Affiliation(s)
- Amal Ahmed Mohamed
- Department of Biochemistry and Molecular Biology, National Hepatology and Tropical Medicine Research institute, Cairo, Egypt
| | - Eman Elhussain
- Department of Clinical and Chemical Pathology, Faculty of Medicine, Cairo University, Giza, Egypt
| | - Naglaa Fawzy
- Department of Clinical Pathology, National Institute of Diabetics and Endocrinology, Cairo, Egypt
| | - Yasser Sakr
- Department of Clinical Pathology, National Institute of Diabetics and Endocrinology, Cairo, Egypt
| | - Marwa Salah El-Dien
- Department of Community, Environmental and Occupational Medicine, Faculty of Medicine, Benha university, Banha, Egypt
| | | | - Maha S Hussein
- Department of Dermatology and Andrology, Medical Research and Clinical Studies Institute, National Research Center, Cairo, Egypt
| | - Nourelhuda Nassar
- Department of Clinical Pathology, Elsahel Teaching Hospital, Cairo, Egypt
| | - Omnia Ezzat
- Department of Biochemistry, Faculty of Pharmacy, Egyptian Russian University, Cairo, Egypt
| | | | - Sarah Ibrahim
- Department of Dermatology, Faculty of Medicine, Cairo university, Cairo, Egypt
| | - Nermeen Ibrahim Bedair
- Department of Dermatology, Andrology, Sexual Medicine and STDs, Faculty of Medicine, Helwan University, Cairo, Egypt.,Department of Dermatology and Andrology, Armed Forces College of medicine, Cairo, Egypt
| |
Collapse
|
4
|
Saif GB, Khan IA. Association of genetic variants of the vitamin D receptor gene with vitiligo in a tertiary care center in a Saudi population: a case-control study. Ann Saudi Med 2022; 42:96-106. [PMID: 35380061 PMCID: PMC8982003 DOI: 10.5144/0256-4947.2022.96] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Vitiligo is a common cutaneous disorder of the skin and hair caused by a systemic depigmentation disorder that affects 1% of the population or less due to its onset in early adulthood. Meta-analyses have documented a linkage between vitiligo and the vitamin D receptor (VDR) gene. OBJECTIVE Investigate the relationship between the ApaI, BsmI, FokI and TaqI genetic variants in the VDR gene with vitiligo in a Saudi population. DESIGN Case-control. SETTING Single tertiary care center. PATIENT AND METHODS The case-control study was carried out between January 2015-December 2015 in Saudi vitiligo patients and healthy controls. VDR genetic variants or polymorphisms (ApaI, BsmI, FokI and TaqI) were genotyped by polymerase chain reaction-restriction fragment length analysis followed by 3% agarose gel electrophoresis. Applicable statistical methods were used to assess relationships between vitiligo cases and controls. MAIN OUTCOM MEASURE Effect of genotype distribution among four single nucleotide polymorphisms. SAMPLE SIZE 152 vitiligo (median [IQR] 23 [19] years) patients and 159 healthy controls (45 [28.5] years). RESULTS We found an association of vitiligo with ApaI and BsmI polymorphisms (P<.05). However, a decreased risk was noted in vitiligo patients with FokI and TaqI polymorphisms and in the diplotype and haplotype analysis within males and females. A positive association with vitiligo was observed in ACAC and AC (adjusted by gender) haplotypes (P<.05). The strongest linkage disequilibrium was observed between rs79785232 (ApaI) and rs731236 (TaqI) polymorphisms (r2=.83), followed by rs2228570 (FokI) and rs1544410 (BsmI) polymorphisms (r2=.53). CONCLUSIONS Our results confirm an association of vitiligo with ApaI and BsmI polymorphisms and fail to show an association in TaqI and FokI polymorphism with vitiligo. Additional studies need to be carried out in different Arab populations to determine whether the polymorphisms are present. LIMITATIONS Controls not age matched, small sample size, lack of biochemical parameters. CONFLICT OF INTEREST None.
Collapse
Affiliation(s)
- Ghada Bin Saif
- From the Department of Dermatology, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Imran Ali Khan
- From the Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| |
Collapse
|
5
|
Yuen RCF, Tsao SY. Embracing cancer immunotherapy with vital micronutrients. World J Clin Oncol 2021; 12:712-724. [PMID: 34631438 PMCID: PMC8479349 DOI: 10.5306/wjco.v12.i9.712] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 06/16/2021] [Accepted: 08/03/2021] [Indexed: 02/06/2023] Open
Abstract
Immunotherapy is now commonly prescribed to cancer patients, but autoimmune-related adverse events are considerable. For severe, life-threatening side effects, cessation of therapy seems unavoidable, let alone intensive medical care required for patching up the adverse events. Even without serious adverse events, the response rates are too low and various combinatory regimens have been tried. However, toxicities are also added on, unless the adjuvant agents have remarkably few side effects. Actually, micronutrients are usually taken by a majority of cancer patients as nutritional support or to boost the immune function, let alone hoping to counteract treatment side effects. Recent studies have shown that combinations of micronutrients exert pleiotropic effects in controlling tumor growth and metastasis by modulating the tumor microenvironment, enhancing gut microbiota immune functions, and providing adjunct nutritional support to micronutrient deficient cancer patients. A higher than recommended dietary allowance micronutrient dose is proposed to reduce the toxic free radicals generated as a result of immunotherapy and tumor metabolism. This is not only helpful for managing treatment side effects but also enhancing treatment efficacy. As micronutrient supplementation is also useful to improve patients’ quality of life, prolong survival, and sustain compliance to immunotherapy, further investigations are mandatory.
Collapse
Affiliation(s)
- Raymond C-F Yuen
- Department of Occupational and Family Medicine, Hosanna Clinic, Singapore 370051, Singapore
| | - Shiu-Ying Tsao
- Department of Clinical Research, Hong Kong SAR Oncology Centre, Hong Kong, China
| |
Collapse
|
6
|
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.
Collapse
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
| |
Collapse
|
7
|
Alswailmi FK, Shah SIA, Nawaz H. IMMUNOMODULATORY ROLE OF VITAMIN D: CLINICAL IMPLICATIONS IN INFECTIONS AND AUTOIMMUNE DISORDERS. GOMAL JOURNAL OF MEDICAL SCIENCES 2020. [DOI: 10.46903/gjms/18.03.841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
Vitamin D exerts its well-known effects on bone health and calcium-phosphate homeostasis primarily through the vitamin D receptor signaling pathway. Vitamin D also has several extra-skeletal actions and its deficiency is not only implicated in musculoskeletal disorders, but also cardiovascular disorders, diabetes, neurodegenerative conditions and cancers. There is a growing body of research highlighting the link of vitamin D deficiency and alterations in vitamin D signaling with certain infections and autoimmune disorders although the evidence is inconsistent and inconclusive. Vitamin D has been suggested to play a fundamental role in curbing infections and mitigating autoimmune disease processes. The present review was undertaken to explore the promise of vitamin D as a protective agent and a clinically useful therapeutic adjunct against infections and autoimmune diseases and identify knowledge gaps and limitations of the available data for informing future work. An exhaustive search was conducted in established databases including Google Scholar, PubMed, Science Direct and Springer for articles published on vitamin D, immunity, infection and autoimmune disorders. All relevant articles published in the English language between the year 200 and 2020 were retrieved for writing the review. Although a considerable body of evidence highlighting the potential clinical benefits of vitamin D against the development of various autoimmune conditions and for the prevention of infections has emerged over the last decade, the findings are limited by the lack of appropriately designed randomized controlled trials which are needed to formulate precise clinical recommendations.
Collapse
|
8
|
Casini L, Zago D, Cavicchioli E, Tomiazzo C. Serum 25-hydroxyvitamin D concentration in Japanese Akita dogs: A survey. Vet Anim Sci 2020; 10:100139. [PMID: 32875143 PMCID: PMC7451697 DOI: 10.1016/j.vas.2020.100139] [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] [Received: 06/24/2020] [Revised: 08/14/2020] [Accepted: 08/16/2020] [Indexed: 11/23/2022] Open
Abstract
Low serum 25-hydroxyvitamin D levels are detected in Japanese Akita dogs. Healthy Akitas show a higher level of vitamin D than pathological ones. Depigmented skin areas appearance is associated with low levels of vitamin D. Sebaceous adenitis is the prevalent disease recorded among investigated Akitas.
Low serum level of vitamin D has been linked to numerous diseases. The Akita breed of dog shows a high incidence of immune-mediated diseases such as uveodermatologic (UVD) syndrome and sebaceous adenitis (SA). Furthermore, in Japanese Akita dogs, skin depigmentation often appears after birth at different ages, in healthy dogs, and without any other symptoms. In humans poliosis is associated to low vitamin D level. The aim of this survey was to evaluate serum 25-hydroxyvitamin D (25(OH)D) levels in Japanese Akita dogs. One hundred and three Akita blood samples were collected for the 25(OH)D evaluation. Age, sex, current disease, presence and location of skin depigmentation, and diet were reported on a medical record. Based on history and clinical examination, dogs were classified according their health status as healthy (HE) or pathological (PA). The overall mean of 25(OH)D concentration was 82.42 ± 26.14 ng/mL, whereas the concentrations in the healthy dogs were significantly higher (84.90 ± 3.36 ng/mL) in comparison with the dogs with diseases (72.13 ± 4.09 ng/mL) (P < 0.01). In this study, the depigmented healthy dogs showed low level of 25(OH)D and very similar to the sick group. The appearance of depigmented areas associated with low levels of vitamin D could be considered as an alert sign in Akitas as well as in humans. However, clinical trials should also be carried out to establish whether vitamin D supplementation could be an effective preventive treatment to limit the onset of immune-mediated diseases in Japanese Akita dogs.
Collapse
Affiliation(s)
- L Casini
- Department of Veterinary Science, University of Pisa, Viale delle Piagge 2, 56124 Pisa, Italy
| | - D Zago
- Veterinary Clinic San Giacomo, Via Risorgimento 42b, 35020 Albinasego, Padova, Italy
| | - E Cavicchioli
- Veterinary Clinic San Giacomo, Via Risorgimento 42b, 35020 Albinasego, Padova, Italy
| | - C Tomiazzo
- Veterinary Clinic San Giacomo, Via Risorgimento 42b, 35020 Albinasego, Padova, Italy
| |
Collapse
|
9
|
Saudi WM, Swelam MM, El-Barbary RAH, Zakaria L, Gaber DA. Vitamin D receptor (VDR) gene polymorphism in Egyptian vitiligo patients. J Cosmet Dermatol 2020; 20:980-986. [PMID: 32648639 DOI: 10.1111/jocd.13606] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Revised: 07/01/2020] [Accepted: 07/06/2020] [Indexed: 11/27/2022]
Abstract
BACKGROUND Vitiligo is an autoimmune dermatological disorder, precipitated by genetic and nongenetic factors leading to destruction of epidermal melanocytes. In Egypt, it has a prevalence rate of 1.2%. Vitamin D has stimulatory and protective effects on melanocytes and acts through its nuclear vitamin D receptor (VDR) on target cells. The consequences of polymorphisms in VDR have been previously studied for mapping their link with various disorders of autoimmune etiology. AIM OF THIS WORK To study Apa-I and Taq-I VDR single-nucleotide polymorphisms (SNPs) and the risk to develop vitiligo. METHODS Extracted genomic DNA from the venous blood of 60 patients and controls was amplified and analyzed by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) for analysis of VDR gene polymorphisms. Serum 25-hydroxyvitamin D3 (25-OH-D3) level was measured using ELISA technique. RESULTS The most common VDR genotypes were AA and TT among both groups with no significant difference. Analysis of the frequency of combinations of genotypes revealed AATT as the most common among patients (36.7%) while in the control group, AATt is the most common (33.3%) but no significant difference was noted on comparison of both groups. The genotype allele tt appeared to be more expressed in patients with marginal significance value (P 0.053). Serum 25-OH-D3 showed a relatively decreased level among patients and controls with no statistically significant difference. CONCLUSION Although VDR SNPs are not correlated with vitiligo, the elevated frequency of tt genotype among vitiligo patients may suggest the risk to develop the disease.
Collapse
Affiliation(s)
- Wael M Saudi
- Dermatology and Venerology Department, Faculty of Medicine, Misr University for Science and Technology, Cairo, Egypt
| | - Mervat M Swelam
- Dermatology and Venerology Department, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt
| | - Rasha A H El-Barbary
- Dermatology and Venerology Department, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt
| | - Lola Zakaria
- Dermatology and Venerology Department, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt
| | - Dalia A Gaber
- Medical Biochemistry and Molecular Biology Department, Faculty of Medicine, Helwan University, Cairo, Egypt
| |
Collapse
|
10
|
Sirufo MM, De Pietro F, Bassino EM, Ginaldi L, De Martinis M. Osteoporosis in Skin Diseases. Int J Mol Sci 2020; 21:E4749. [PMID: 32635380 PMCID: PMC7370296 DOI: 10.3390/ijms21134749] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 06/30/2020] [Accepted: 07/01/2020] [Indexed: 12/14/2022] Open
Abstract
Osteoporosis (OP) is defined as a generalized skeletal disease characterized by low bone mass and an alteration of the microarchitecture that lead to an increase in bone fragility and, therefore, an increased risk of fractures. It must be considered today as a true public health problem and the most widespread metabolic bone disease that affects more than 200 million people worldwide. Under physiological conditions, there is a balance between bone formation and bone resorption necessary for skeletal homeostasis. In pathological situations, this balance is altered in favor of osteoclast (OC)-mediated bone resorption. During chronic inflammation, the balance between bone formation and bone resorption may be considerably affected, contributing to a net prevalence of osteoclastogenesis. Skin diseases are the fourth cause of human disease in the world, affecting approximately one third of the world's population with a prevalence in elderly men. Inflammation and the various associated cytokine patterns are the basis of both osteoporosis and most skin pathologies. Moreover, dermatological patients also undergo local or systemic treatments with glucocorticoids and immunosuppressants that could increase the risk of osteoporosis. Therefore, particular attention should be paid to bone health in these patients. The purpose of the present review is to take stock of the knowledge in this still quite unexplored field, despite the frequency of such conditions in clinical practice.
Collapse
Affiliation(s)
- Maria Maddalena Sirufo
- Department of Life, Health and Environmental Sciences, University of L’Aquila, 67100 L’Aquila, Italy; (M.M.S.); (F.D.P.); (E.M.B.); (L.G.)
- Allergy and Clinical Immunology Unit, Center for the Diagnosis and Treatment of Osteoporosis, AUSL 04 64100 Teramo, Italy
| | - Francesca De Pietro
- Department of Life, Health and Environmental Sciences, University of L’Aquila, 67100 L’Aquila, Italy; (M.M.S.); (F.D.P.); (E.M.B.); (L.G.)
- Allergy and Clinical Immunology Unit, Center for the Diagnosis and Treatment of Osteoporosis, AUSL 04 64100 Teramo, Italy
| | - Enrica Maria Bassino
- Department of Life, Health and Environmental Sciences, University of L’Aquila, 67100 L’Aquila, Italy; (M.M.S.); (F.D.P.); (E.M.B.); (L.G.)
- Allergy and Clinical Immunology Unit, Center for the Diagnosis and Treatment of Osteoporosis, AUSL 04 64100 Teramo, Italy
| | - Lia Ginaldi
- Department of Life, Health and Environmental Sciences, University of L’Aquila, 67100 L’Aquila, Italy; (M.M.S.); (F.D.P.); (E.M.B.); (L.G.)
- Allergy and Clinical Immunology Unit, Center for the Diagnosis and Treatment of Osteoporosis, AUSL 04 64100 Teramo, Italy
| | - Massimo De Martinis
- Department of Life, Health and Environmental Sciences, University of L’Aquila, 67100 L’Aquila, Italy; (M.M.S.); (F.D.P.); (E.M.B.); (L.G.)
- Allergy and Clinical Immunology Unit, Center for the Diagnosis and Treatment of Osteoporosis, AUSL 04 64100 Teramo, Italy
| |
Collapse
|
11
|
Toychiev A, Mirzoeva M, Davis N, Islamova J, Osipova S. Pityriasis alba: Possible associations with intestinal helminths and pathogenic protozoa. Int J Clin Pract 2020; 74:e13441. [PMID: 31633268 DOI: 10.1111/ijcp.13441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2019] [Revised: 07/22/2019] [Accepted: 10/16/2019] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND The aetiology of pityriasis alba (PA) remains uncertain, and children are at risk for PA and intestinal parasites. AIM To determine the prevalence of intestinal parasites in PA patients and to evaluate their possible role in PA pathogenesis. METHODS Overall, 180 PA patients and 100 healthy individuals were enrolled. Intestinal parasites were diagnosed by triple coproscopy, and the total serum Immunoglobulin E (IgE) levels were determined by ELISA. PA patients with intestinal parasites were treated with conventional antiparasitic drugs. Patient response to antiparasitic therapy was evaluated after 6 weeks. RESULTS The prevalence of intestinal parasites in PA patients and controls was 60 ± 3.6% and 32 ± 4.6%, respectively (P < .0001). Regardless of the parasite species among the PA patients and control individuals, the total IgE levels were significantly higher in PA patients (P ≤ .05). The highest values of IgE were found in PA patients with Hymenolepis nana (641.7 ± 46.3 IU/mL). The total IgE level in PA patients with parasites decreased after antiparasitic therapy, but the reduction was only significant in patients with H. nana (P < .05). Complete disappearance of hypopigmented patches was observed after the elimination of H. nana, Giardia lamblia and Enterobius vermicularis in 65 ± 10.6%, 48.7 ± 8.0% and 33.3 ± 8.2% of cases, respectively. In total, a positive clinical response to antiparasitic therapy was achieved in 60 ± 4.7% of infected PA patients. CONCLUSION A positive clinical response to antiparasitic therapy indicates the role of intestinal parasites in PA pathogenesis. Parasitological examination is justified by the recovery of 60 ± 4.7% of infected PA patients after the elimination of intestinal parasites.
Collapse
Affiliation(s)
- Abdurakhim Toychiev
- Department of Immunology of Parasitic Diseases, the Research Institute of Epidemiology, Microbiology and Infectious Diseases, Tashkent, Uzbekistan
| | - Mexriniso Mirzoeva
- Department of Infectious Diseases, Bukhara state medical institute, Bukhara, Uzbekistan
| | - Nikolay Davis
- Department of Immunology of Parasitic Diseases, the Research Institute of Epidemiology, Microbiology and Infectious Diseases, Tashkent, Uzbekistan
| | - Jannat Islamova
- Department of Pharmacology and Toxicology, the Institute of the Chemistry of Plant Substances named acad. S. Yu. Yunusov, Tashkent, Uzbekistan
| | - Svetlana Osipova
- Department of Immunology of Parasitic Diseases, the Research Institute of Epidemiology, Microbiology and Infectious Diseases, Tashkent, Uzbekistan
| |
Collapse
|
12
|
Ahmed Abdel Rahman SH, Hussein MS, Mansour AI. Are Patients with Vitiligo More Prone to Myocardial Infarction?: A Case-control Study. THE JOURNAL OF CLINICAL AND AESTHETIC DERMATOLOGY 2019; 12:28-31. [PMID: 32038754 PMCID: PMC6937161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Background: Vitiligo is a multifactorial polygenic disorder commonly associated with other autoimmune diseases. The reported link between vitiligo and abnormalities of serum interleukin (IL)-17, zinc, calcium, and vitamin D is not fully understood. Objectives: We sought to assess the serum levels of vitamin D, calcium, zinc, and IL-17 in patients with vitiligo and to answer the question of whether patients with vitiligo are more prone to experience myocardial infarction. Design: This was a case-control study and we did not exclude any eligible participants with other systemic autoimmune diseases. Serum vitamin D, calcium, zinc, and IL-17 levels were measured and correlated with disease severity. Setting: The study was conducted at Benha University Hospital in Egypt. Participants: Thirty patients with vitiligo and 30 age- and sex-matched healthy volunteers were included. Measurements: Disease severity was measured using the Vitiligo Extent Tensity Index (VETI) score. Results: Patients with vitiligo showed significantly lower levels of vitamin D (p<0.001), calcium (p<0.001), and zinc (p<0.001), and an insignificantly higher level of IL-17 compared to the control group (p=0.102). Patients with other autoimmune diseases showed significantly lower vitamin D (p=0.0001) and calcium (p<0.0001) levels and higher IL-17 (p=0.0431) and zinc (p=0.0274) compared to controls. Conclusion: The levels of measured markers might make patients with vitiligo, especially those with autoimmune diseases, prone to myocardial infarction; the investigation of myocardial infarction, especially when a patient shows low vitamin D, calcium, and zinc or high IL-17 are recommended.
Collapse
Affiliation(s)
| | - Mohamed Saber Hussein
- Drs. Ahmed, Hussein, and Mansour are with the Faculty of Medicine, Benha University in Banha, Egypt
| | - Amira Ibrahim Mansour
- Drs. Ahmed, Hussein, and Mansour are with the Faculty of Medicine, Benha University in Banha, Egypt
| |
Collapse
|
13
|
Assessment of Serum Vitamin D Levels in Patients with Vitiligo in Jordan: A Case-Control Study. Dermatol Res Pract 2019; 2019:2048409. [PMID: 31687010 PMCID: PMC6811793 DOI: 10.1155/2019/2048409] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Revised: 09/08/2019] [Accepted: 09/21/2019] [Indexed: 01/08/2023] Open
Abstract
Background Low vitamin D serum levels have been associated with many autoimmune disorders and several other skin diseases. Vitiligo is an autoimmune disease characterized by destruction of melanocytes by immune mechanisms. Melanocytes express vitamin D receptors, and their function can be affected by vitamin D status. Objectives The main objective of this study is to compare vitamin D levels in patients with vitiligo vs normal population and whether vitamin D deficiency is associated with vitiligo. Methods A case-control study was conducted. 100 vitiligo patients and 100 as controls were included in this study. Serum vitamin D level was measured for both vitiligo patients and controls, results were compared, and statistical analysis was done to compare the results. Results The median age of vitiligo cases was 23 years (ranges, 2–80). 58% of vitiligo patients were females. The median vitamin D level was not significantly different between the two groups (vitiligo = 14.1 (IQR 9.9–20.4) vs control = 16.5 (IQR 10.3–25.3) (P=0.28)). Most vitiligo cases and controls were found to have low levels of vitamin D (either insufficient 20–30 ng/mL or low <20 ng/mL). Conclusions There was no significant difference in vitamin D levels in vitiligo patients compared to controls. However, vitamin D levels were generally low in both groups.
Collapse
|
14
|
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
|
15
|
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.
Collapse
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
| |
Collapse
|
16
|
Niezgoda A, Winnicki A, Kosmalski T, Kowaliszyn B, Krysiński J, Czajkowski R. The Evaluation of Vitiligous lesions Repigmentation after the Administration of Atorvastatin calcium salt and Simvastatin-acid sodium salt in patients with active vitiligo (EVRAAS), a pilot study: study protocol for a randomized controlled trial. Trials 2019; 20:78. [PMID: 30683146 PMCID: PMC6346543 DOI: 10.1186/s13063-018-3168-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2018] [Accepted: 12/30/2018] [Indexed: 12/13/2022] Open
Abstract
Background Vitiligo is a chronic skin disorder presenting with depigmentation, the pathogenesis of which is complex but the autoimmune theory is now preferred. Multiple immunologic processes, including stimulation of the T-helper (Th)1 response, formation of autoreactive melanocyte-specific CD8+ T lymphocytes, a decrease in the blood concentration of T regulatory (Treg) cells, and an increase in interleukin (IL)-17 and interferon (IFN) concentration, have been shown to contribute to vitiligo progression and maintenance. The aim of this study is to evaluate the influence of simvastatin and atorvastatin on vitiligous lesions in patients with nonsegmental vitiligo (NSV). According to available data, statins act through several immunological pathways, potentially reversing undesirable phenomena underlying autoimmune vitiligo pathogenesis. Methods/design A study has been designed as a single-center, randomized, double-blind, placebo-controlled pilot study with the enrollment of at least 24 active NSV patients presenting with vitiligous lesions on both upper and lower limbs. The clinical effects of ointments containing 1% simvastatin-acid sodium salt or 1% atorvastatin calcium salt applied on a preselected limb will be assessed in comparison with vehicle ointment applied on the opposite limb. All study participants will undergo clinical evaluation using body surface area (BSA) and Vitiligo Area Scoring Index (VASI) scales at baseline and at weeks 4, 8, and 12 time points. A precise assessment of skin lesions will be performed using photographic documentation obtained during each study visit and processed with NIS-Elements software. Discussion Currently available vitiligo topical therapeutic approaches including calcineurin inhibitors and corticosteroids remain poorly effective and are associated with either relatively high cost or potentially dangerous adverse effects. The clinical application of orally administrated statins, widely used as systemic cholesterol-lowering agents, in vitiligous patients has only been tested in two clinical trials; however, data on their potential usefulness is scarce. Moreover, due to a high risk of clinically significant toxicity, topical administration was recommended by researchers. This study is the first to evaluate safety and efficacy of the topical use of statins in patients presenting with NSV. Trial registration Clinicaltrials.gov, NCT03247400. Registered on 05 August 2017. Electronic supplementary material The online version of this article (10.1186/s13063-018-3168-4) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Anna Niezgoda
- The Department of Dermatology, Sexually Transmitted Diseased and Immunodermatology, Nicolaus Copernicus University, Collegium Medicum in Bydgoszcz, Bydgoszcz, Poland.
| | - Andrzej Winnicki
- The Department of Pharmaceutical Technology, Nicolaus Copernicus University, Collegium Medicum in Bydgoszcz, Bydgoszcz, Poland
| | - Tomasz Kosmalski
- The Department of Organic Chemistry, Nicolaus Copernicus University, Collegium Medicum in Bydgoszcz, Bydgoszcz, Poland
| | - Bogna Kowaliszyn
- Genetics and Fundamentals of Animal Breeding, Technical and Agricultural Academy in Bydgoszcz, Bydgoszcz, Poland
| | - Jerzy Krysiński
- The Department of Pharmaceutical Technology, Nicolaus Copernicus University, Collegium Medicum in Bydgoszcz, Bydgoszcz, Poland
| | - Rafał Czajkowski
- The Department of Dermatology, Sexually Transmitted Diseased and Immunodermatology, Nicolaus Copernicus University, Collegium Medicum in Bydgoszcz, Bydgoszcz, Poland
| |
Collapse
|
17
|
Shan L, Kang X, Liu F, Cai X, Han X, Shang Y. Expression of vitamin D receptor in bronchial asthma and its bioinformatics prediction. Mol Med Rep 2018; 18:2052-2060. [PMID: 29901144 PMCID: PMC6072178 DOI: 10.3892/mmr.2018.9157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2017] [Accepted: 12/14/2017] [Indexed: 11/06/2022] Open
Abstract
Vitamin D receptors (VDRs) are associated with the occurrence and development of asthma. The aim of the present study was to analyze the secondary structure and B‑cell and T‑cell epitopes of VDR using online prediction software and aid in the future development of a highly efficient epitope‑based vaccine against asthma. Blood samples were collected from peripheral blood of asthmatic children. Reverse transcription quantitative‑polymerase chain reaction (RT‑qPCR) was performed to detect the expression of VDR in the peripheral blood. Mouse models of asthma were established. Hematoxylin and eosin staining was performed to observe the pathological alterations of the lungs of mice. Immunohistochemistry, western blot analysis and RT‑qPCR were performed to detect the expression of VDR in the lungs of asthmatic mice. Online prediction software immune epitope database and analysis resource, SYFPEITHI and linear epitope prediction based on propensity scale and support vector machines were used to predict the B‑cell and T‑cell epitopes and the RasMol and 3DLigandSite were used to analyze the tertiary structure of VDR. RT‑qPCR demonstrated that VDR expression in the peripheral blood of asthmatic children was decreased. Immunohistochemistry, western blotting and RT‑qPCR demonstrated that VDR expression also decreased in the lungs of mouse models of asthma. VDR B‑cell epitopes were identified at 37‑45, 88‑94, 123‑131, 231‑239, 286‑294 and 342‑350 positions of the amino acid sequence and VDR T‑cell epitopes were identified at 125‑130, 231‑239 and 265‑272 positions. A total of six B‑cell epitopes and three T‑cell epitopes for VDR were predicted by bioinformatics, which when validated, may in the future aid in immunological diagnosis and development of a targeted drug therapy for clinical asthma.
Collapse
Affiliation(s)
- Lishen Shan
- Department of Pediatric Pulmonology, Shengjing Hospital Affiliated to China Medical University, Shenyang, Liaoning 110004, P.R. China
| | - Xinyuan Kang
- Department of Orthopedics, Shengjing Hospital Affiliated to China Medical University, Shenyang, Liaoning 110122, P.R. China
| | - Fen Liu
- Department of Pediatric Pulmonology, Shengjing Hospital Affiliated to China Medical University, Shenyang, Liaoning 110004, P.R. China
| | - Xuxu Cai
- Department of Pediatric Pulmonology, Shengjing Hospital Affiliated to China Medical University, Shenyang, Liaoning 110004, P.R. China
| | - Xiaohua Han
- Department of Pediatric Pulmonology, Shengjing Hospital Affiliated to China Medical University, Shenyang, Liaoning 110004, P.R. China
| | - Yunxiao Shang
- Department of Pediatric Pulmonology, Shengjing Hospital Affiliated to China Medical University, Shenyang, Liaoning 110004, P.R. China
| |
Collapse
|
18
|
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.
Collapse
Affiliation(s)
| | | | | | | | | | | | | | | | | | - Jun Xian
- Department of Gynecology, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang, China
| | | |
Collapse
|
19
|
Le Poole IC, Mehrotra S. Replenishing Regulatory T Cells to Halt Depigmentation in Vitiligo. J Investig Dermatol Symp Proc 2018; 18:S38-S45. [PMID: 28941492 DOI: 10.1016/j.jisp.2016.10.023] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2016] [Accepted: 09/19/2016] [Indexed: 02/07/2023]
Abstract
Vitiligo is a cutaneous autoimmune disease, especially devastating to patients with darker skin tones because of the contrast between unaffected and lesional skin. We studied immune cells infiltrating vitiligo skin and found very few regulatory T cells (Tregs). Vitiligo was not associated with a reduced frequency or function of circulating Tregs. To manipulate Treg function, we used mouse models expressing melanocyte-reactive TCRs, following changes in pelage color. We also isolated splenocytes to measure Treg function and evaluated cutaneous Treg abundance. Even small numbers of Tregs transferred into depigmenting mice could effectively interfere with depigmentation. The same holds true for treatment with rapamycin, readily translatable for use in human patients; such treatment may be well tolerated. Because vitiligo skin is relatively devoid of cells that produce the chemokine CCL22, whereas circulating Tregs express normal levels of its receptor CCR4, we overexpressed Ccl22 in the skin of vitiligo-prone mice to assess the resulting levels of depigmentation. Markedly reduced depigmentation was accompanied by Treg infiltration to the skin. With several options available to support a healthy balance between Tregs and effector T cells, the next challenge will be to render such treatment antigen specific and avoid general immunosuppression.
Collapse
Affiliation(s)
- I Caroline Le Poole
- Department of Pathology and Microbiology/Immunology, Oncology Research Institute, Loyola University, Chicago, Illinois, USA.
| | - Shikhar Mehrotra
- Department of Surgery, Medical University of South Carolina, Charleston, South Carolina, USA
| |
Collapse
|
20
|
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.
Collapse
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.
| |
Collapse
|
21
|
Vitamin D status in recurrent aphthous stomatitis. Postepy Dermatol Alergol 2017; 34:612-617. [PMID: 29422828 PMCID: PMC5799753 DOI: 10.5114/pdia.2017.69683] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2016] [Accepted: 03/02/2017] [Indexed: 11/29/2022] Open
Abstract
Introduction Recurrent aphthous stomatitis (RAS) is a common chronic inflammatory oral mucosa disease with an unknown cause. However, dysregulation of the immune response seems to play an important role in this disease. Aim To evaluate the vitamin D status in RAS patients and its effects on RAS severity, given the likely immunomodulatory function of vitamin D in the human organism. Material and methods Sixty-six patients with RAS and 66 controls were examined. Immunomodulatory or immunosuppressive treatment and other ulcerative oral diseases were used as exclusion criteria. The severity of RAS was assessed according to the clinical classification of the disease, the number of lesions per flare-up and the length of intervals between the attacks. The serum vitamin D level was established in each participant. Results The mean serum vitamin D (25(OH)D) levels were found to be 16.81 ng/ml in the study group and 19.22 ng/ml in the control group, with no statistically significant difference between the two groups. In the study group, 5 (7.6%) participants were diagnosed with the “normal” vitamin D levels, while 16 (24.2%) had “insufficient” levels and 45 (68.2%) had “deficient” levels. The corresponding distribution in the control group was 8 (12.1%), 18 (27.3%) and 40 (60.6%), respectively. There was no statistical significance in the difference of vitamin D deficits between the study and the control groups. No correlation was detected between the severity of RAS and the serum vitamin D level. Conclusions Vitamin D does not seem to be a trigger factor for RAS occurrence and does not appear to influence the severity of the disease in the studied group.
Collapse
|
22
|
El-hanbuli HM, Dawoud NM, Mahmoud RH. Narrow-band UVB effects on cutaneous vitamin D receptor expression and serum 25-hydroxyvitamin D in generalized vitiligo. PHOTODERMATOLOGY PHOTOIMMUNOLOGY & PHOTOMEDICINE 2017; 34:175-183. [DOI: 10.1111/phpp.12362] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/18/2017] [Indexed: 12/12/2022]
Affiliation(s)
- Hala M. El-hanbuli
- Department of Pathology; Faculty of Medicine; Fayoum University; Fayoum Egypt
| | - Noha M. Dawoud
- Department of Dermatology, Andrology and STDs; Menoufia University; Shebin Elkoom Egypt
| | - Rania H. Mahmoud
- Department of Biochemistry and molecular biology; Faculty of Medicine; Fayoum University; Fayoum Egypt
| |
Collapse
|
23
|
The relationship between severity of disease and vitamin D levels in children with atopic dermatitis. Postepy Dermatol Alergol 2017; 34:224-227. [PMID: 28670250 PMCID: PMC5471369 DOI: 10.5114/pdia.2017.66054] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2015] [Accepted: 04/29/2016] [Indexed: 01/09/2023] Open
Abstract
Introduction Atopic dermatitis (AD) is a chronic relapsing inflammatory skin disorder. Vitamin D is a liposoluble vitamin synthesized mainly in the skin. Vitamin D has several effects on the skin. Aim To assess the serum level of vitamin D in children with AD and determine its relation to AD severity. Material and methods Sixty patients with AD were enrolled in the study. We evaluated disease severity using the SCORing Atopic Dermatitis (SCORAD) index. The control group consisted of 37 healthy subjects. Results The mean serum concentration of 25(OH)D3 in patients with AD was not statistically different from control subjects (p = 0.065). The vitamin D level was significantly lower in moderate and severe AD compared with mild AD, and this difference was statistically significant (p = 0.001 and p = 0.004). Vitamin D showed a negative correlation with serum total IgE levels (p = 0.007). There was no significant correlation between total IgE levels and SCORAD scores (p = 0.089). Conclusions This study suggests that a low serum vitamin D level is inversely associated with severity of AD in children. Vitamin D has not been included in the routine treatment of AD because of the conflicting results of various studies. Thus, there is a need for more detailed and prospective studies.
Collapse
|
24
|
25-hydroxyvitamin D status in patients with alopecia areata. Postepy Dermatol Alergol 2017; 34:248-252. [PMID: 28670255 PMCID: PMC5471380 DOI: 10.5114/ada.2017.67847] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2016] [Accepted: 05/23/2016] [Indexed: 01/06/2023] Open
Abstract
Introduction Alopecia areata (AA) is a T cell-mediated autoimmune disease that causes inflammation around anagen-phase hair follicles. Insufficient levels of vitamin D have been implicated in a variety of autoimmune diseases. Aim To investigate the status of serum 25-hydroxyvitamin D (25(OH)D) in patients with AA, serum 25(OH)D concentrations were compared between AA patients and healthy controls and thus determine if a possible association exists between serum 25(OH)D levels and AA. Material and methods The study comprising 41 patients diagnosed with AA and 32 healthy controls was conducted between October 2010 and March 2011. The serum vitamin D levels of the study group were determined by high performance liquid chromatography. Serum levels of calcium, phosphorus, alkaline phosphatase, and parathyroid hormone were also evaluated. Results The study was based on 41 patients aged between 20 and 50 (mean: 32.8 ±7.5). The control group included 32 healthy persons aged between 20 and 51 (mean: 32.7 ±7.5). Serum 25(OH)D levels in patients with AA ranged from 5.0 to 38.6 ng/ml with a mean of 8.1 ng/ml. Serum 25(OH)D levels in healthy controls ranged from 3.6 to 38.5 ng/ml with a mean of 9.8 ng/ml. There was no statistically significant difference in the serum vitamin D level between AA patients and healthy controls (p > 0.05). Conclusions Deficient serum 25(OH)D levels are present in patients with AA. However, considering the high prevalence of vitamin D deficiency in Turkey, no difference was noted between AA patients and controls.
Collapse
|
25
|
Evaluation of the serum zinc level in patients with vitiligo. Postepy Dermatol Alergol 2017; 34:116-119. [PMID: 28507489 PMCID: PMC5420602 DOI: 10.5114/ada.2017.67073] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2015] [Accepted: 03/03/2016] [Indexed: 02/07/2023] Open
Abstract
Introduction Vitiligo is an acquired, idiopathic disorder characterized by circumscribed depigmented macules and patches, which affects approximately 0.1–2% of the general population worldwide. Zinc is an essential trace element that is necessary for growth and development at all stages of life. Some studies have reported an association between serum zinc levels and vitiligo. Aim To measure the serum zinc level in patients with vitiligo compared to healthy subjects. Material and methods One hundred patients with vitiligo and 100 healthy controls were referred to our clinic. The two groups were matched for age and sex. Atomic absorption spectrophotometry was used to measure serum zinc levels. The statistical analysis was performed using SPSS software. Results The mean serum level of zinc in vitiligo patients and controls was 80.11 ±17.10 μg/dl and 96.10 ±16.16 μg/dl, respectively. The serum zinc level in patients with vitiligo was significantly lower than in healthy controls (p = 0.0001). Conclusions The results of our study revealed a significant association between vitiligo and serum zinc levels. A relative decrease in the serum zinc level in vitiligo patients can highlight the role of zinc in the pathogenesis of vitiligo, and large-scale studies need to be conducted to confirm these findings and assess the effect of oral zinc supplements in patients with low zinc levels.
Collapse
|
26
|
Development of Asymmetric Facial Depigmentation in a Patient Treated with Dasatinib with New-Onset Hypovitaminosis D: Case Report and Review of the Literature. Case Rep Dermatol Med 2017; 2017:9359086. [PMID: 28424749 PMCID: PMC5382301 DOI: 10.1155/2017/9359086] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2017] [Accepted: 03/15/2017] [Indexed: 11/18/2022] Open
Abstract
Dasatinib is a second-generation tyrosine kinase inhibitor (TKI) used to treat imatinib-resistant chronic myelogenous leukemia (CML), as well as other Philadelphia chromosome-positive lymphoproliferative disorders. While the most commonly reported cutaneous side effects with this therapy include a morbilliform eruption, skin exfoliation, and skin irritation, pigmentary abnormalities have also been observed, albeit much more rarely. We present the case of a 72-year-old South Asian male with CML who presented with new-onset hypopigmentation of his face and scalp three years after a dose increase of dasatinib therapy, in the setting of newly discovered borderline hypovitaminosis D. Dasatinib and the other TKIs are believed to induce dyschromias via modulation of the c-kit receptor and its associated signaling pathway, which is involved in melanocyte survival, proliferation, and migration.
Collapse
|
27
|
The effect of vitamin D on clinical manifestations and activity of Behçet's disease. Postepy Dermatol Alergol 2017; 34:15-20. [PMID: 28261027 PMCID: PMC5329099 DOI: 10.5114/pdia.2016.57222] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2015] [Accepted: 11/15/2015] [Indexed: 01/01/2023] Open
Abstract
Introduction Immune mechanisms have been implemented to have a role in the pathogenesis of Behçet’s disease (BD) and vitamin D has been shown to have a regulatory role in the immune system function. Aim To evaluate the vitamin D levels of BD patients and its relationship between clinical findings and disease activity of BD. Material and methods Sixty-eight patients with BD and 70 age- and sex-matched controls were examined retrospectively. Demographic features, vitamin D levels for both groups and clinical findings, disease activity, drug usage for BD patients were examined from their medical reports. Disease activity was calculated for each patient according to Krause’s BD activity assessment. Results Mean vitamin D levels of patients and controls were 15.35 ±7.18 ng/ml and 18.44 ±5.79 ng/ml, respectively. Vitamin D levels were significantly lower in BD patients than in controls (p = 0.006). Mean vitamin D levels of active and inactive BD cases were 15.68 ±7.31 ng/ml and 15.08 ±7.17 ng/ml, respectively (p = 0.73). Disease activity of patients using and not using vitamin D was similar (p = 0.51). Conclusions Significantly lower levels of vitamin D were observed in BD patients. Our results indicate that there is no correlation between BD activity and a vitamin D level. Together with these, vitamin D replacement treatment was found to have no effect on disease activity.
Collapse
|