Trace Elements and Risk of Immune-Mediated Skin Disease: A Systematic Review and Meta-analysis

Area of Science:

• Dermatology
• Nutritional Science
• Immunology

Background:

• Inconsistent evidence exists regarding the link between serum trace element levels and immune-mediated inflammatory skin diseases (IMSDs).
• Understanding these associations is crucial for potential diagnostic and therapeutic advancements in dermatology.

Purpose of the Study:

• To systematically review and meta-analyze the association between serum levels of key trace elements (zinc, copper, iron, selenium, calcium) and various IMSDs.
• To evaluate these associations in conditions including psoriasis, vitiligo, atopic dermatitis, and alopecia areata.

Main Methods:

• A comprehensive systematic search of multiple major scientific databases was conducted up to May 2, 2024.
• Included studies measured serum, plasma, or whole-blood trace element levels in patients with IMSDs compared to healthy controls.
• Meta-analysis followed established guidelines (MOOSE, PRISMA) with independent data extraction and analysis of standardized mean differences.

Main Results:

• The meta-analysis included 113 studies with 7014 patients with IMSDs.
• Significantly decreased serum zinc levels were observed in vitiligo, psoriasis, and alopecia areata.
• Elevated serum copper and decreased serum selenium and iron levels were noted in specific IMSDs like psoriasis and atopic dermatitis.

Conclusions:

• Serum trace element levels exhibit significant alterations in patients with IMSDs compared to healthy individuals.
• These findings suggest a potential role for trace element dysregulation in the pathogenesis, progression, and prognosis of IMSDs.
• Further research into trace element modulation could offer new therapeutic strategies for inflammatory skin conditions.