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Gopinath S, Sutaria N, Bordeaux ZA, Parthasarathy V, Deng J, Taylor MT, Marani M, Lee K, Pritchard T, Alajmi A, Adawi W, Oladipo OO, Semenov YR, Alphonse M, Kwatra SG. Reduced serum pyridoxine and 25-hydroxyvitamin D levels in adults with chronic pruritic dermatoses. Arch Dermatol Res 2023; 315:1771-1776. [PMID: 35534780 DOI: 10.1007/s00403-022-02357-9] [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: 10/16/2021] [Revised: 03/29/2022] [Accepted: 04/19/2022] [Indexed: 12/01/2022]
Abstract
Little is known about the role nutritional factors play in the pathogenesis of chronic pruritic dermatoses (CPD). In this study, we analyzed nutritional deficiencies in CPD patients compared to matched controls. We conducted a population-based study from the National Health and Nutrition Examination Survey (NHANES) from 2005 to 2006. The main outcomes of the study were laboratory data on serum vitamin levels in participants who answered affirmatively to the questionnaires on CPD as well as matched healthy controls. We identified 877 cases of CPD among 9817 adults in the US aged 20 to 59 years. These findings revealed a slightly higher percentage of females with CPD. Low vitamin B6 (OR 0.697; 95% CI: 0.696-0.699, p = 0.025) and vitamin D (OR 0.794; 95% CI: 0.789-0.799, p = 0.037) levels were associated with a higher rate of CPD compared to healthy controls. Our study suggests that low levels of Vitamin B6 and Vitamin D inversely correlates with the presence of CPD. These vitamin deficiencies suggest further studies on the effect of vitamin supplementation may help in patients with CPD.
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Affiliation(s)
- Shilpa Gopinath
- Department of Dermatology, CRB II, Johns Hopkins University School of Medicine, Suite 206, 1550 Orleans Street, Baltimore, MD, 21231, USA
| | - Nishadh Sutaria
- Department of Dermatology, CRB II, Johns Hopkins University School of Medicine, Suite 206, 1550 Orleans Street, Baltimore, MD, 21231, USA
| | - Zachary A Bordeaux
- Department of Dermatology, CRB II, Johns Hopkins University School of Medicine, Suite 206, 1550 Orleans Street, Baltimore, MD, 21231, USA
| | - Varsha Parthasarathy
- Department of Dermatology, CRB II, Johns Hopkins University School of Medicine, Suite 206, 1550 Orleans Street, Baltimore, MD, 21231, USA
| | - Junwen Deng
- Department of Dermatology, CRB II, Johns Hopkins University School of Medicine, Suite 206, 1550 Orleans Street, Baltimore, MD, 21231, USA
| | - Matthew T Taylor
- Department of Dermatology, CRB II, Johns Hopkins University School of Medicine, Suite 206, 1550 Orleans Street, Baltimore, MD, 21231, USA
| | - Melika Marani
- Department of Dermatology, CRB II, Johns Hopkins University School of Medicine, Suite 206, 1550 Orleans Street, Baltimore, MD, 21231, USA
| | - Kevin Lee
- Department of Dermatology, CRB II, Johns Hopkins University School of Medicine, Suite 206, 1550 Orleans Street, Baltimore, MD, 21231, USA
| | - Thomas Pritchard
- Department of Dermatology, CRB II, Johns Hopkins University School of Medicine, Suite 206, 1550 Orleans Street, Baltimore, MD, 21231, USA
| | - Ali Alajmi
- Department of Dermatology, CRB II, Johns Hopkins University School of Medicine, Suite 206, 1550 Orleans Street, Baltimore, MD, 21231, USA
| | - Waleed Adawi
- Department of Dermatology, CRB II, Johns Hopkins University School of Medicine, Suite 206, 1550 Orleans Street, Baltimore, MD, 21231, USA
| | - Olusola O Oladipo
- Department of Dermatology, CRB II, Johns Hopkins University School of Medicine, Suite 206, 1550 Orleans Street, Baltimore, MD, 21231, USA
| | - Yevgeniy R Semenov
- Department of Dermatology, Massachusetts General Hospital, Boston, MA, USA
| | - Martin Alphonse
- Department of Dermatology, CRB II, Johns Hopkins University School of Medicine, Suite 206, 1550 Orleans Street, Baltimore, MD, 21231, USA
| | - Shawn G Kwatra
- Department of Dermatology, CRB II, Johns Hopkins University School of Medicine, Suite 206, 1550 Orleans Street, Baltimore, MD, 21231, USA.
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Vitamin D, cytokine profiles, and disease severity in infants with atopic dermatitis: a single centre, cross-sectional study. Postepy Dermatol Alergol 2022; 39:793-799. [PMID: 36090733 PMCID: PMC9454358 DOI: 10.5114/ada.2022.118923] [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: 11/30/2020] [Accepted: 03/29/2021] [Indexed: 11/17/2022] Open
Abstract
Introduction Atopic dermatitis (AD) is an immune-mediated inflammatory skin disease and generally develops in infancy. Studies evaluating the role of vitamin D in immune mechanims in AD showed varying results. Aim To assess the association between serum vitamin D, cytokine profiles, and disease severity in infants with AD. Material and methods A cross-sectional study was conducted on infants aged 0–12 months with AD in the Paediatric Allergy and Immunology Department, Saiful Anwar Hospital, Indonesia. The disease severity was assessed by the Scoring of Atopic Dermatitis (SCORAD) index. Blood was drawn to evaluate the total eosinophil count (TEC), total immunoglobulin E (tIgE), 25-hydroxyvitamin D (25(OH)D), interleukin-4 (IL-4), IL-17A, and IL-22 levels. Results This study enrolled 36 infants including 19 with mild AD and 17 with moderate AD. Vitamin D deficiency and insufficiency were found in 18 (50%) and 9 (25%) subjects, respectively. The mean 25(OH)D level was lower and the mean IL-4, IL-17A, and IL-22 levels were higher in the moderate AD group than in the mild AD group (p < 0.05). A lower level of 25(OH)D was associated with a higher level of IL-17A (r = –0.315, p = 0.041). The SCORAD index was negatively correlated with 25(OH)D (r = –0.714, p < 0.001) and positively correlated with IL-17A (r = 0.522, p = 0.001) and IL-22 (r = 0.612, p < 0.001) but not IL-4 (r = 0.325, p = 0.053). Conclusions There was a high prevalence of vitamin D deficiency and insufficiency in infants with AD, and a low vitamin D level was correlated with the severity of AD, dependently on IL-17A.
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Effect of Vitamin D Serum Levels and Supplementation on Atopic Dermatitis: A Systematic Review and Meta-analysis. Am J Clin Dermatol 2022; 23:267-275. [PMID: 35246808 DOI: 10.1007/s40257-022-00677-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/16/2022] [Indexed: 11/01/2022]
Abstract
BACKGROUND Previous studies have shown that serum 25-hydroxyvitamin D (25(OH)D) may be associated with atopic dermatitis (AD), and that vitamin D (VD) supplementation may decrease AD severity. OBJECTIVE The aim of this study was to investigate the association between serum 25(OH)D level and AD, and the effect of VD supplementation on AD severity, while providing stratified analyses based on latitude and region. METHODS A systematic review was performed on all published studies in MEDLINE, Embase, and Cochrane Library databases that analyzed effects of serum 25(OH)D and VD supplementation on AD. RESULTS This systematic review and meta-analysis includes 20 studies with 1882 cases of AD. We found significantly lower 25(OH)D levels in AD patients compared with healthy controls (HC) (p < 0.001), significantly lower 25(OH)D levels in severe AD compared with both mild and moderate AD (p < 0.001), and VD supplementation improved AD symptoms (p < 0.001). LIMITATIONS Factors like seasonal and environmental changes, sunlight exposure, and cultural practices may confound the relationship between serum 25(OH)D and AD severity. There are limited randomized controlled trials that assess this association. CONCLUSION Overall, lower serum 25(OH)D is associated with more severe AD, and VD supplementation may help lower AD severity. Further research is needed to confirm the presence and direction of causality of the relationship between VD and AD pathogenesis.
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Lipińska-Opałka A, Tomaszewska A, Kubiak JZ, Kalicki B. Vitamin D and Immunological Patterns of Allergic Diseases in Children. Nutrients 2021; 13:E177. [PMID: 33435598 PMCID: PMC7827421 DOI: 10.3390/nu13010177] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Revised: 01/03/2021] [Accepted: 01/05/2021] [Indexed: 01/24/2023] Open
Abstract
Vitamin D, in addition to its superior role as a factor regulating calcium-phosphate metabolism, shows wide effects in other processes in the human body, including key functions of the immune system. This is due to the presence of vitamin D receptors in most cells of the human body. In our study, we aimed to assess whether there is a correlation between vitamin D content and the clinical course of allergic diseases as well as establish their immunological parameters in children. We found that vitamin D deficiency was significantly more frequent in the group of children with an allergic disease than in the control group (p = 0.007). Statistically significant higher vitamin D concentrations in blood were observed in the group of children with a mild course of the disease compared to children with a severe clinical course (p = 0.03). In the group of children with vitamin D deficiency, statistically significant lower percentages of NKT lymphocytes and T-regulatory lymphocytes were detected compared to the group of children without deficiency (respectively, p = 0.02 and p = 0.05), which highlights a potential weakness of the immune system in these patients. Furthermore, statistically higher levels of interleukin-22 were observed in the group of children with vitamin D deficiency (p = 0.01), suggesting a proinflammatory alert state. In conclusion, these results confirm the positive relationship between the optimal content of vitamin D and the lesser severity of allergic diseases in children, establishing weak points in the immune system caused by vitamin D deficiency in children.
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Affiliation(s)
- Agnieszka Lipińska-Opałka
- Pediatric, Nephrology and Allergology Clinic, Military Institute of Medicine, 04-141 Warsaw, Poland; (A.T.); (B.K.)
| | - Agata Tomaszewska
- Pediatric, Nephrology and Allergology Clinic, Military Institute of Medicine, 04-141 Warsaw, Poland; (A.T.); (B.K.)
| | - Jacek Z. Kubiak
- Laboratory of Regenerative Medicine and Cell Biology, Military Institute of Hygiene and Epidemiology (WIHE), 04-141 Warsaw, Poland;
- Cell Cycle Group, Faculty of Medicine, Institute of Genetics and Development of Rennes, University of Rennes 1, UMR 6290, CNRS, Rennes, France
| | - Bolesław Kalicki
- Pediatric, Nephrology and Allergology Clinic, Military Institute of Medicine, 04-141 Warsaw, Poland; (A.T.); (B.K.)
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Gorzelanny C, Mess C, Schneider SW, Huck V, Brandner JM. Skin Barriers in Dermal Drug Delivery: Which Barriers Have to Be Overcome and How Can We Measure Them? Pharmaceutics 2020; 12:E684. [PMID: 32698388 PMCID: PMC7407329 DOI: 10.3390/pharmaceutics12070684] [Citation(s) in RCA: 80] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Revised: 07/11/2020] [Accepted: 07/14/2020] [Indexed: 12/13/2022] Open
Abstract
Although, drugs are required in the various skin compartments such as viable epidermis, dermis, or hair follicles, to efficiently treat skin diseases, drug delivery into and across the skin is still challenging. An improved understanding of skin barrier physiology is mandatory to optimize drug penetration and permeation. The various barriers of the skin have to be known in detail, which means methods are needed to measure their functionality and outside-in or inside-out passage of molecules through the various barriers. In this review, we summarize our current knowledge about mechanical barriers, i.e., stratum corneum and tight junctions, in interfollicular epidermis, hair follicles and glands. Furthermore, we discuss the barrier properties of the basement membrane and dermal blood vessels. Barrier alterations found in skin of patients with atopic dermatitis are described. Finally, we critically compare the up-to-date applicability of several physical, biochemical and microscopic methods such as transepidermal water loss, impedance spectroscopy, Raman spectroscopy, immunohistochemical stainings, optical coherence microscopy and multiphoton microscopy to distinctly address the different barriers and to measure permeation through these barriers in vitro and in vivo.
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Affiliation(s)
| | | | | | | | - Johanna M. Brandner
- Department of Dermatology and Venerology, Center for Internal Medicine, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany; (C.G.); (C.M.); (S.W.S.); (V.H.)
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Hattangdi-Haridas SR, Lanham-New SA, Wong WHS, Ho MHK, Darling AL. Vitamin D Deficiency and Effects of Vitamin D Supplementation on Disease Severity in Patients with Atopic Dermatitis: A Systematic Review and Meta-Analysis in Adults and Children. Nutrients 2019; 11:nu11081854. [PMID: 31405041 PMCID: PMC6722944 DOI: 10.3390/nu11081854] [Citation(s) in RCA: 47] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Revised: 08/05/2019] [Accepted: 08/06/2019] [Indexed: 12/16/2022] Open
Abstract
Research has investigated 25-hydroxyvitamin D (25(OH)D) levels in the Atopic Dermatitis (AD) population, as well as changes in AD severity after vitamin D (VitD) supplementation. We performed an up-to-date systematic review and meta-analysis of these findings. Electronic searches of MEDLINE, EMBASE and COCHRANE up to February 2018 were performed. Observational studies comparing 25(OH)D between AD patients and controls, as well as trials documenting baseline serum 25(OH)D levels and clinical severity by either SCORAD/EASI scores, were included. Of the 1085 articles retrieved, sixteen were included. A meta-analysis of eleven studies of AD patients vs. healthy controls (HC) found a mean difference of −14 nmol/L (95% CI −25 to −2) for all studies and −16 nmol/L (95% CI −31 to −1) for the paediatric studies alone. A meta-analysis of three VitD supplementation trials found lower SCORAD by −11 points (95% CI −13 to −9, p < 0.00001). This surpasses the Minimal Clinical Important Difference for AD of 9.0 points (by 22%). There were greater improvements in trials lasting three months and the mean weighted dose of all trials was 1500–1600 IU/daily. Overall, the AD population, especially the paediatric subset, may be at high-risk for lower serum 25(OH)D. Supplementation with around 1600 IU/daily results in a clinically meaningful AD severity reduction.
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Affiliation(s)
- Sonal R Hattangdi-Haridas
- Department of Nutritional Sciences, School of Biosciences and Medicine, Faculty of Health and Medical Sciences, University of Surrey, Guildford, Surrey, GU2 7XH, UK
| | - Susan A Lanham-New
- Department of Nutritional Sciences, School of Biosciences and Medicine, Faculty of Health and Medical Sciences, University of Surrey, Guildford, Surrey, GU2 7XH, UK
| | - Wilfred Hing Sang Wong
- Department of Paediatrics and Adolescent Medicine, Queen Mary Hospital, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Marco Hok Kung Ho
- Department of Paediatrics and Adolescent Medicine, Queen Mary Hospital, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Andrea L Darling
- Department of Nutritional Sciences, School of Biosciences and Medicine, Faculty of Health and Medical Sciences, University of Surrey, Guildford, Surrey, GU2 7XH, UK.
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