Vitamin D as a Marker for Disease Severity in Chronic Urticaria and Its Possible Role in Pathogenesis
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Background: Chronic urticaria is defined as repeated episodes of wheals lasting for 6 weeks or longer. Nowadays, the role of vitamin D in various chronic diseases is a matter of great interest, but limited data is available on the vitamin D status in patients with chronic urticaria. Objective: The goal of this study was to investigate the relationship between vitamin D status and clinical characteristics of chronic urticaria. Methods: The clinical records of 72 patients with chronic urticaria, 26 with acute urticaria and 26 with atopic dermatitis, along with 72 healthy controls, were retrospectively reviewed. Results: The serum 25-(OH)D3 level was found to be significantly reduced in patients with chronic urticaria compared to those in the other groups. In particular, the proportion of patients with critically low vitamin D levels (＜10 ng/ml) was significantly higher in the chronic urticaria group than in the other groups. The serum vitamin D levels showed significant negative associations with urticaria activity score and disease duration. In addition, serum vitamin D levels were significantly lower in subjects with a positive autologous serum skin test than in subjects with a negative result. Conclusion: In conclusion, the serum vitamin D level was more likely to be critically low in patients with chronic urticaria, and an inverse relationship with disease severity and disease duration was observed. These findings may open up the possibility of the clinical use of vitamin D as a contributing factor in the pathogenesis of chronic urticaria and a predictive marker for disease activity in chronic urticaria.
Abstract
Background: Chronic urticaria is defined as repeated episodes of wheals lasting for 6 weeks or longer. Nowadays, the role of vitamin D in various chronic diseases is a matter of great interest, but limited data is available on the vitamin D status in patients with chronic urticaria. Objective: The goal of this study was to investigate the relationship between vitamin D status and clinical characteristics of chronic urticaria. Methods: The clinical records of 72 patients with chronic urticaria, 26 with acute urticaria and 26 with atopic dermatitis, along with 72 healthy controls, were retrospectively reviewed. Results: The serum 25-(OH)D3 level was found to be significantly reduced in patients with chronic urticaria compared to those in the other groups. In particular, the proportion of patients with critically low vitamin D levels (＜10 ng/ml) was significantly higher in the chronic urticaria group than in the other groups. The serum vitamin D levels showed significant negative associations with urticaria activity score and disease duration. In addition, serum vitamin D levels were significantly lower in subjects with a positive autologous serum skin test than in subjects with a negative result. Conclusion: In conclusion, the serum vitamin D level was more likely to be critically low in patients with chronic urticaria, and an inverse relationship with disease severity and disease duration was observed. These findings may open up the possibility of the clinical use of vitamin D as a contributing factor in the pathogenesis of chronic urticaria and a predictive marker for disease activity in chronic urticaria.
참고문헌 (30)
- Sachdeva S, "Chronic urticaria", Indian J Dermatol, 56, pp.622~628 (2011)
- Powell RJ, "British Society for Allergy and Clinical Immunology (BSACI). BSACI guidelines for the management of chronic urticaria and angio-oedema", Clin Exp Allergy, 37, pp.631~650 (2007)
- Greaves MW, "Chronic urticaria", N Engl J Med, 332, pp.1767~1772 (1995)
- Gaig P, "Epidemiology of urticaria in Spain", J Investig Allergol Clin Immunol, 14, pp.214~220 (2004)
- Khan DA, "Chronic urticaria: diagnosis and management", Allergy Asthma Proc, 29, pp.439~446 (2008)
- Sánchez-Borges M, "WAO Scientific and Clinical Issues Council. Diagnosis and treatment of urticaria and angioedema: a worldwide perspective", World Allergy Organ J, 5, pp.125~147 (2012)
- Kaplan AP, "Pathogenesis of chronic urticaria", Clin Exp Allergy, 39, pp.777~787 (2009)
- Sabroe RA, "Anti-Fc(episilon)RI auto antibodies and basophil histamine releasability in chronic idiopathic urticaria", J Allergy Clin Immunol, 102, pp.651~658 (1998)
- Futata E, "Impaired IFN-α secretion by plasmacytoid dendritic cells induced by TLR9 activation in chronic idiopathic urticaria", Br J Dermatol, 164, pp.1271~1279 (2011)
- Dos Santos JC, "Increased circulating pro-inflammatory cytokines and imbalanced regulatory T-cell cytokines production in chronic idiopathic urticaria", Int Immunopharmacol, 8, pp.1433~1440 (2008)
- Santos JC, "Up-regulation of chemokine C-C ligand 2(CCL2) and C-X-C chemokine 8 (CXCL8) expression by monocytes in chronic idiopathic urticaria", Clin Exp Immunol, 167, pp.129~136 (2012)
- Dickie LJ, "Vitamin D3 down-regulates intracellular Toll-like receptor 9 expression and Toll-like receptor 9-induced IL-6 production in human monocytes", Rheumatology (Oxford), 49, pp.1466~1471 (2010)
- Kasperska-Zajac A, "Plasma IL-6concentration correlates with clinical disease activity and serum C-reactive protein concentration in chronic urticaria patients", Clin Exp Allergy, 41, pp.1386~1391 (2011)
- Hide M, "Autoantibodies against the high-affinity IgE receptor as a cause of histamine release in chronic urticaria", N Engl J Med, 328, pp.1599~1604 (1993)
- Jain S, "Pathogenesis of chronic urticaria: an overview", Dermatol Res Pract, 2014, pp.674709~ (2014)
- Piemonti L, "Vitamin D3 affects differentiation, maturation, and function of human monocyte-derived dendritic cells", J Immunol, 164, pp.4443~4451 (2000)
- Holick MF, "Vitamin D deficiency", N Engl J Med, 357, pp.266~281 (2007)
- Brehm JM, "Serum vitamin D levels and markers of severity of childhood asthma in Costa Rica", Am J Respir Crit Care Med, 179, pp.765~771 (2009)
- Vähävihu K, "Narrowband ultraviolet B treatment improves vitamin D balance and alters antimicrobial peptide expression in skin lesions of psoriasis and atopic dermatitis", Br J Dermatol, 163, pp.321~328 (2010)
- Amestejani M, "Vitamin D supplementation in the treatment of atopic dermatitis: a clinical trial study", J Drugs Dermatol, 11, pp.327~330 (2012)
- Zuberbier T, "EAACI", GA(2)LEN, WAO guideline: definition, classification and diagnosis of urticaria, pp.Allergy, 2009[DOI]
- Kamen DL, "Vitamin D deficiency in systemic lupus erythematosus", Autoimmun Rev, 5, pp.114~117 (2006)
- Searing DA, "Vitamin D in atopic dermatitis, asthma and allergic diseases", Immunol Allergy Clin North Am, 30, pp.397~409 (2010)
- Peroni DG, "Correlation between serum 25-hydroxyvitamin D levels and severity of atopic dermatitis in children", Br J Dermatol, 164, pp.1078~1082 (2011)
- Thorp WA, "Reduced vitamin D levels in adult subjects with chronic urticaria", J Allergy Clin Immunol, 126, pp.413~ (2010)
- Chandrashekar L, "25-Hydroxy vitamin D levels in chronic urticaria and its correlation with disease severity from a tertiary care centre in South India", Clin Chem Lab Med, 52, pp.e115~e118 (2014)
- Grzanka A, "Relationship between vitamin D status and the inflammatory state in patients with chronic spontaneous urticaria", J Inflamm (Lond), 11, pp.2~ (2014)
- Choi HS, "Vitamin D insufficiency in Korea--a greater threat to younger generation: the Korea National Health and Nutrition Examination Survey (KNHANES) 2008", J Clin Endocrinol Metab, 96, pp.643~651 (2011)
- Waldron JL, "Vitamin D: a negative acute phase reactant", J Clin Pathol, 66, pp.620~622 (2013)
- Sindher SB, "Resolution of chronic urticaria coincident with vitamin D supplementation", Ann Allergy Asthma Immunol, 109, pp.359~360 (2012)