Evaluation of Vitamin D status in patients with Atopic Dermatitis (Eczema) in Sulaimani Province, Kurdistan region, Iraq  

Nasrin S. Hamad1, 2 Diary I. Tofiq2

 

1Dental Nursing Department Sulaimani Polytechnic University- Techqnical Institute of Sulaimani, Sulaimani, Kurdistan Region, Iraq

2Chemistry Department, College of Science, University of Sulaimani, Sulaimani, Kurdistan Region, Iraq

Original: 19 September  2019Revised25 October   2019 Accepted17 November 2019Published online20 December 2019



Abstract

Skin inflammation or atopic Dermatitis (AD) is a long-lasting, inflammatory skin condition which generally develops in early life. The aetiology is a complex disorder with genetics, barrier function, immunity, and environmental factors all playing key roles in disease progression. Since vitamin D has immunomodulatory properties and immunologic systems assume a job in the pathogenesis of atopic eczema. The point of the investigation is to correspond vitamin D focuses in patients who have skin inflammation with the clinical and natural elements. Questionnaire population-based study 60 patients and 50 healthy volunteers (control) with age between 17-60 years were used in this study for about 3 months. The diagnosis has based the prevalence and morphology of hand eczema in a patient with atopic dermatitis in 2006 and the blood samples were collected from each patient before filling the questionnaire form, then the level of vitamin D (VD) was measured. The mean estimation of serum vitamin D in AD was greatly of lower than the normal value, and there was a substantial difference found in the mean estimations of vitamin D between AD patients (18.51) and the controls (23.38) with P value 0.001, there is a significant distinction between patients with mild eczema and those with severe eczema, which could lead to a significant increase in vitamin D deficiency as eczema worsens, while there was no significant association among VD subgroups with age, and gender in AD patients. The results from this study indicated that VD is the main factor in the development of AD and its supplementation may help ameliorate medical signs of the disease.


Key WordsEczema, Atopic dermatitis,Severity, Vitamin D, Serum VD level

References

[1] Haienes D, Saravanabhavan G, Werry K, Khoury C, "An overview of human biomonitoring of environmental chemicals in the Canadian Health Measures Survey: 2007-2019". International Journal of Hygiene and Environmental Health. (2017).

[2]  Vestita, M., Filoni, A., Congedo, M., Foti, C. and Bonamonte, D. "Vitamin d and atopic dermatitis in childhood". Journal of immunology research. (2015).

[3]  Samochocki, Z., Bogaczewicz, J., Jeziorkowska, R., Sysa-Jędrzejowska, A., Glińska, O., Karczmarewicz, E., McCauliffe, D. P. and Woźniacka, A. "Vitamin d effects in atopic dermatitis". Journal of the American Academy of Dermatology. Vol. 69, No. 2, pp. 238-244. (2013).

[4]  del Giudice, M. M. and Allegorico, A. "The role of vitamin d in allergic diseases in children". Journal of clinical gastroenterology. Vol. 50, (S133-S135). (2016).

[5]  Benson, A., Toh, J., Vernon, N. and Jariwala, S. P. "The role of vitamin d in the immunopathogenesis of allergic skin diseases". Allergy. Vol. 67, No. 3, pp. 296-301. (2012).

[6]  Huang, C. M., LaraCorrales, I. and Pope, E. "Effects of vitamin d levels and supplementation on atopic dermatitis: A systematic review". Pediatric Dermatology. Vol. 35, No. 6, pp. 754-760. (2018).

[7] Cantorna, M. T. and Mahon, B. D. (2004). Mounting evidence for vitamin d as an environmental factor affecting autoimmune disease prevalence. Experimental biology and medicine. 229(11): 1136-1142.

[8]  Hewison, M, "Vitamin d and innate and adaptive immunity". Vitamins & hormones. Vol. 86, pp. 23-62. (2011).

[9]  Khan, M., Mohammad, A., Ahad, K., Katsoyiannis, A., Malik, S. A., Abdullaha, M., Rashid, A., Fasola, M., Hussain, A. and Bokhari, H. "Cattle egrets as a biosentinels of persistent organic pollutants exposure". Environmental geochemistry and health. Vol. 36, No. 3, pp. 375-384. (2014).

[10]  Bäck, O., Blomquist, H. K., Hernell, O. and Stenberg, B. "Does vitamin d intake during infancy promote the development of atopic allergy?" Acta dermato-venereologica. Vol. 89, No. 1, pp. 28-32. (2009).

[11]  Vähävihu, K., AlaHouhala, M., Peric, M., Karisola, P., Kautiainen, H., Hasan, T., Snellman, E., Alenius, H., Schauber, J. and Reunala, T. "Narrowband ultraviolet b treatment improves vitamin d balance and alters antimicrobial peptide expression in skin lesions of psoriasis and atopic dermatitis". British Journal of Dermatology. Vol. 163, No. 2, pp. 321-328. (2010).

[12] Schauber, J., Dorschner, R. A., Coda, A. B., Büchau, A. S., Liu, P. T., Kiken, D., Helfrich, Y. R., Kang, S., Elalieh, H. Z. and Steinmeyer, A. "Injury enhances tlr2 function and antimicrobial peptide expression through a vitamin d–dependent mechanism". The Journal of clinical investigation. Vol. 117, No. 3, pp.  803-811. (2007).

[13] Liu, P. T., Stenger, S., Tang, D. H. and Modlin, R. L. "Cutting edge: Vitamin d-mediated human antimicrobial activity against mycobacterium tuberculosis is dependent on the induction of cathelicidin". The Journal of Immunology. Vol. 179, No. 4, pp. 2060-2063. (2007).

[14] Mutgi, K. and Koo, J. "Update on the role of systemic vitamin d in atopic dermatitis". Pediatric Dermatology. Vol. 30, No. 3, pp. 303-307. (2013).

[15]  Simpson, E. L., Thompson, M. M. and Hanifin, J. M. "Prevalence and morphology of hand eczema in patients with atopic dermatitis". Dermatitis. Vol. 17, No. 3, pp. 123-127. (2006).

[16] Phinney, K. W. "Development of a standard reference material for vitamin d in serum". The American journal of clinical nutrition. Vol. 88, No. 2, pp. 511S-512S. (2008).

[17] Holick, M. F., Binkley, N. C., Bischoff-Ferrari, H. A., Gordon, C. M., Hanley, D. A., Heaney, R. P., Murad, M. H. and Weaver, C. M. "Evaluation, treatment, and prevention of vitamin d deficiency: An endocrine society clinical practice guideline". The Journal of Clinical Endocrinology & Metabolism. Vol. 96, No. 7, pp. 1911-1930. (2011).

[18] van Etten, E. and Mathieu, C. "Immunoregulation by 1, 25-dihydroxyvitamin d3: Basic concepts". The Journal of steroid biochemistry and molecular biology. Vol. 97, No. (1-2), pp. 93-101. (2005).

[19] Bikle, D. D."Vitamin d regulated keratinocyte differentiation". Journal of cellular biochemistry. Vol. 92, No. 3, pp. 436-444. (2004).

[20] Bolland, M. J., Grey, A. B., Ames, R. W., Mason, B. H., Horne, A. M., Gamble, G. D. and Reid, I. R. "The effects of seasonal variation of 25-hydroxyvitamin d and fat mass on a diagnosis of vitamin d sufficiency". The American journal of clinical nutrition. Vol. 86, No. 4, pp. 959-964. (2007).

[21] Maeda, S. S., Kunii, I. S., Hayashi, L. F. and Lazaretti-Castro, M. "Increases in summer serum 25-hydroxyvitamin d (25ohd) concentrations in elderly subjects in são paulo, brazil vary with age, gender and ethnicity". BMC endocrine disorders. Vol. 10, No. 1, pp. 12. (2010).

[22] Chiu, Y. E., Havens, P. L., Siegel, D. H., Ali, O., Wang, T., Holland, K. E., Galbraith, S. S., Lyon, V. B. and Drolet, B. A. "Serum 25-hydroxyvitamin d concentration does not correlate with atopic dermatitis severity". Journal of the American Academy of Dermatology. Vol. 69, No. 1, pp. 40-46. (2013).

[23] Boonen, S., Vanderschueren, D., Haentjens, P. and Lips, P. "Calcium and vitamin d in the prevention and treatment of osteoporosis–a clinical update". Journal of internal medicine. Vol. 259, No. 6, pp. 539-552. (2006).

[24] Johansson, L., Solvoll, K., Bjørneboe, G. A. and Drevon, C. "Intake of very-long-chain n-3 fatty acids related to social status and lifestyle". European journal of clinical nutrition. Vol. 52, No. 10, pp. 716. (1998).

[25] El Taieb, M. A., Fayed, H. M., Aly, S. S. and Ibrahim, A. K. "Assessment of serum 25-hydroxyvitamin d levels in children with atopic dermatitis: Correlation with scorad index". Dermatitis. Vol. 24, No. 6, pp. 296-301. (2013).

[26] Yang, A.-R., Kim, Y.-N. and Lee, B.-H. "Dietary intakes and lifestyle patterns of korean children and adolescents with atopic dermatitis: Using the fourth and fifth korean national health and nutrition examination survey (knhanes iv, v)".  Ecology of food and nutrition. Vol. 55, No. 1, pp. 50-64. (2016).

[27] Kim, M., Kim, S.-N., Lee, Y., Choe, Y. and Ahn, K. "Vitamin d status and efficacy of vitamin d supplementation in atopic dermatitis: A systematic review and meta-analysis". Nutrients. Vol. 8, No. 12, pp. 789. (2016).

[28] Cheon, B. R., Shin, J. E., Kim, Y. J., Shim, J. W., Kim, D. S., Jung, H. L., Park, M. S. and Shim, J. Y. "Relationship between serum 25-hydroxyvitamin d and interleukin-31 levels, and the severity of atopic dermatitis in children". Korean journal of pediatrics. Vol. 58, No. 3, pp. 96. (2015)

[29] Wang, S. S., Hon, K. L., Kong, A. P. s., Pong, H. N. h., Wong, G. W. k. and Leung, T. F. "Vitamin d deficiency is associated with diagnosis and severity of childhood atopic dermatitis". Pediatric Allergy and Immunology. Vol. 25, No. 1, pp. 30-35. (2014).

                                                                                                     

[30] Solvoll, K., Søyland, E., Sandstad, B. and Drevon, C. (2000). Dietary habits among patients with atopic dermatitis. European journal of clinical nutrition. 54(2): 93.

[31]  Kang, J. W., Kim, J. H., Kim, H. J., Lee, J.-G., Yoon, J.-H. and Kim, C.-H. "Association of serum 25-hydroxyvitamin d with serum ige levels in korean adults". Auris Nasus Larynx. Vol. 43, No. 1, pp. 84-88. (2016).

[32] Peroni, D., Piacentini, G., Cametti, E., Chinellato, I. and Boner, A. "Correlation between serum 25hydroxyvitamin d levels and severity of atopic dermatitis in children". British Journal of Dermatology. Vol. 164, No. 5, pp. 1078-1082. (2011).

[33] Reichrath, J. "Vitamin d and the skin: An ancient friend, revisited". Experimental dermatology. Vol. 16, No. 7, pp. 618-625. (2007).

[34] Cheng, H. M., Kim, S., Park, G.-H., Chang, S. E., Bang, S., Won, C. H., Lee, M. W., Choi, J. H. and Moon, K. C. "Low vitamin d levels are associated with atopic dermatitis, but not allergic rhinitis, asthma, or ige sensitization, in the adult korean population". Journal of Allergy and Clinical Immunology. Vol. 133, No. 4, pp. 1048-1055. (2014).

[35] Thuesen, B., Heede, N., Tang, L., Skaaby, T., Thyssen, J., Friedrich, N. and Linneberg, A, "No association between vitamin d and atopy, asthma, lung function or atopic dermatitis: A prospective study in adults". Allergy. Vol. 70, No. 11, pp. 1501-1504. (2015).

[36] Kim, S. H., Oh, M. K., Namgung, R. and Park, M. J. "Prevalence of 25-hydroxyvitamin d deficiency in korean adolescents: Association with age, season and parental vitamin d status". Public health nutrition. Vol. 17, No. 1, pp. 122-130. (2014).

[37] Hata, T. R., Kotol, P., Jackson, M., Nguyen, M., Paik, A., Udall, D., Kanada, K., Yamasaki, K., Alexandrescu, D. and Gallo, R. L. "Administration of oral vitamin d induces cathelicidin production in atopic individuals". Journal of Allergy and Clinical Immunology. Vol. 122, No. 4, pp. 829-831. (2008).