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Vitamin D, cytokine profiles, and disease severity in infants with atopic dermatitis: a single centre,
Wisnu Barlianto1, Desy Wulandari1, Tita Luthfia Sari2
1Division of Allergy and Immunology, Paediatric Department, Faculty of Medicine, Brawijaya University, Malang, East Java, Indonesia.
Insights
Vitamin D deficiency is common in infants with atopic dermatitis (AD). Lower vitamin D levels correlate with increased AD severity, particularly linked to elevated Interleukin-17A (IL-17A) in infants.
Area of Science:
- Pediatric Allergy and Immunology
- Dermatology
- Nutritional Immunology
Background:
- Atopic dermatitis (AD) is a prevalent immune-mediated inflammatory skin condition in infants.
- The role of vitamin D in immune regulation within AD pathogenesis remains incompletely understood, with prior studies yielding varied results.
Purpose of the Study:
- To investigate the association between serum vitamin D levels, specific cytokine profiles, and the severity of atopic dermatitis in infants.
Main Methods:
- A cross-sectional study involved 36 infants (0-12 months) diagnosed with AD.
- Disease severity was quantified using the Scoring of Atopic Dermatitis (SCORAD) index.
- Serum levels of 25-hydroxyvitamin D (25(OH)D), IL-4, IL-17A, and IL-22 were measured.
Main Results:
- A high prevalence of vitamin D deficiency (50%) and insufficiency (25%) was observed in the study cohort.
- Infants with moderate AD exhibited lower mean 25(OH)D levels and higher mean IL-4, IL-17A, and IL-22 levels compared to those with mild AD.
- Lower 25(OH)D levels correlated with higher IL-17A, and the SCORAD index showed significant negative correlation with 25(OH)D and positive correlations with IL-17A and IL-22.
Conclusions:
- Infants with atopic dermatitis frequently present with vitamin D deficiency or insufficiency.
- Reduced vitamin D levels are associated with increased AD severity, with a notable dependence on IL-17A levels.
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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