Relationship between vitamin D status and the inflammatory state in patients with chronic spontaneous urticaria
Tóm tắt
Chronic spontaneous urticaria (CSU) is an immune-inflammatory disease, characterized by acute phase response (APR) and immune activation. There has been increasing evidence showing that vitamin D deficiency/insufficiency is associated with increased incidence and/or severity of immune-inflammatory disorders. To assess relationship between vitamin D status and C-reactive protein (CRP), a nonspecific inflammatory marker of CSU activity. Concentrations of CRP and 25-hydroxyvitamin D [25(OH)D], a biomarker of vitamin D status were measured in serum of CSU patients and compared with the healthy controls. Serum 25(OH)D concentration was significantly lower in CSU group as compared with the normal subjects. The prevalence of vitamin D deficiency (< 20 ng/ml) was significantly higher in patients with CSU than among normal population. There were no significant differences in prevalence of 25(OH)D insufficiency between the groups. Serum CRP concentrations were significantly higher in CSU patients as compared with the healthy subjects. There were no significant correlations between CRP and 25(OH)D concentrations in CSU patients. CSU is associated with lower serum 25(OH)D concentration and higher prevalence of its deficiency. The results failed to show any effect of vitamin D status on circulating CRP concentrations in CSU. A potential role of vitamin D in pathogenesis and/or additive therapy of CSU needs to be examined in other cohorts of CSU patients as well as in larger studies.
Tài liệu tham khảo
Kasperska-Zajac A: Acute-phase response in chronic urticaria. J Eur Acad Dermatol Venereol. 2012, 26: 665-672. 10.1111/j.1468-3083.2011.04366.x.
Kasperska-Zając A, Grzanka A, Czecior E, Misiolek M, Rogala B, Machura E: Acute phase inflammatory markers in patients with non-steroidal anti-inflammatory drugs (NSAIDs)-induced acute urticaria/angioedema and after aspirin challenge. J Eur Acad Dermatol Venereol. 2013, 27: 1048-1052. 10.1111/j.1468-3083.2012.04486.x.
Kasperska-Zajac A, Grzanka A, Machura E, Mazur B, Misiolek M, Czecior E, Kasperski J, Jochem J: Analysis of procalcitonin and CRP concentrations in serum of patients with chronic spontaneous urticaria. Inflamm Res. 2013, 62: 309-312. 10.1007/s00011-012-0580-1.
Magen E, Mishal J, Zeldin Y, Feldman V, Kidon M, Schlesinger M, Sthoeger Z: Increased mean platelet volume and C-reactive protein levels in patients with chronic urticaria with a positive autologous serum skin test. Am J Med Sci. 2010, 339: 504-508.
Kasperska-Zajac A, Grzanka A, Machura E, Misiolek M, Mazur B, Jochem J: Increased serum complement C3 and C4 concentrations and their relation to severity of chronic spontaneous urticaria and CRP concentration. J Inflamm. 2013, 24: 22-
Kasperska-Zajac A, Brzoza Z, Rogala B: Sex hormones and urticaria. J Dermatol Sci. 2008, 52: 79-86. 10.1016/j.jdermsci.2008.04.002.
Patel S, Farragher T, Berry J, Bunn D, Silman A, Symmons D: Association between serum vitamin D metabolite levels and disease activity in patients with early inflammatory polyarthritis. Arthritis Rheum. 2007, 56: 2143-2149. 10.1002/art.22722.
Peterson CA, Heffernan ME: Serum tumor necrosis factor-alpha concentrations are negatively correlated with serum 25(OH)D concentrations in healthy women. J Inflamm. 2008, 24: 5-10.
Van den Berghe G, Van Roosbroeck D, Vanhove P, Wouters PJ, De Pourcq L, Bouillon R: Bone turnover in prolonged critical illness: effect of vitamin D. J Clin Endocrinol Metab. 2003, 88: 4623-4632. 10.1210/jc.2003-030358.
Holick MF: Vitamin D deficiency. N Engl J Med. 2007, 357: 266-281. 10.1056/NEJMra070553.
Hollis BW: Assessment of vitamin D status and definition of a normal circulating range of 25-hydroxyvitamin D. Curr Opin Endocrinol Diabetes Obes. 2008, 15: 489-494. 10.1097/MED.0b013e328317ca6c.
Altrichter S, Boodstein N, Maurer M: Matrix metalloproteinase-9: a novel biomarker for monitoring disease activity in patients with chronic urticaria patients?. Allergy. 2009, 64: 652-656. 10.1111/j.1398-9995.2008.01799.x.
Sabroe RA, Grattan CEH, Francis DM, Barr RM, Kobza Black A, Greaves MW: The autologous serum skin test: a screening test for autoantibodies in chronic idiopathic urticatia. Br J Dermatol. 1999, 140: 446-453. 10.1046/j.1365-2133.1999.02707.x.
Thorp WA, Goldner W, Meza J, Poole JA: Reduced vitamin D levels in adult subjects with chronic urticaria. J Allergy Clin Immunol. 2010, 126: 413-
Goetz DW: Idiopathic itch, rash, and urticaria/angioedema merit serum vitamin D evaluation: a descriptive case series. W V Med J. 2011, 107: 14-20.
Arshi S, Ghalehbaghi B, Kamrava SK, Aminlou M: Vitamin D serum levels in allergic rhinitis: any difference from normal population?. Asian Pac J Allergy Immunol. 2012, 2: 45-48. 10.5415/apallergy.2012.2.1.45.
Kennel KA, Drake MT, Hurley DL: Vitamin D deficiency in adults: when to test and how to treat. Mayo Clin Proc. 2010, 85: 752-757. 10.4065/mcp.2010.0138.
Thacher TD, Clarke BL: Vitamin D insufficiency. Mayo Clin Proc. 2011, 86: 50-60. 10.4065/mcp.2010.0567.
Müller K, Kriegbaum NJ, Baslund B, Sørensen OH, Thymann M, Bentzen K: Vitamin D3 metabolism in patients with rheumatic diseases: low serum levels of 25-hydroxyvitamin D3 in patients with systemic lupus erythematosus. Clin Rheumatol. 1995, 14: 397-400. 10.1007/BF02207671.
Kasperska-Zajac A, Sztylc J, Machura E, Jop G: Plasma IL-6 concentration correlates with clinical disease activity and serum C-reactive protein concentration in chronic urticaria patients. Clin Exp Allergy. 2011, 41: 1386-1391. 10.1111/j.1365-2222.2011.03789.x.
Dean DD, Schwartz Z, Schmitz J, Muniz OE, Lu Y, Calderon F, Howell DS, Boyan BD: Vitamin D regulation of metalloproteinase activity in matrix vesicles. Connect Tissue Res. 1996, 35: 331-336. 10.3109/03008209609029208.
Timms PM, Mannan N, Hitman GA, Noonan K, Mills PG, Syndercombe-Court D, Aganna E, Price CP, Boucher BJ: Circulating MMP9, vitamin D and variation in the TIMP-1 response with VDR genotype: mechanisms for inflammatory damage in chronic disorders?. QJM. 2002, 95: 787-796. 10.1093/qjmed/95.12.787.
Tedeschi A, Asero R, Lorini M, Marzano AV, Cugno M: Plasma levels of matrix metalloproteinase-9 in chronic urticaria patients correlate with disease severity and C-reactive protein but not with circulating histamine-releasing factors. Clin Exp Allergy. 2010, 40: 875-881. 10.1111/j.1365-2222.2010.03473.x.
Schwalfenberg GK: A review of the critical role of vitamin D in the functioning of the immune system and the clinical implications of vitamin D deficiency. Mol Nutr Food Res. 2011, 55: 96-108. 10.1002/mnfr.201000174.
Goetz DW: Vitamin D, treatment of idiopathic itch, rash, and urticaria/angioedema. Allergy Asthma Proc. 2010, 31: 158-160. 10.2500/aap.2010.31.3322.
Searing DA, Zhang Y, Murphy JR, Hauk PJ, Goleva E, Leung DY: Decreased serum vitamin D levels in children with asthma are associated with increased corticosteroid use. J Allergy Clin Immunol. 2010, 125: 995-1000. 10.1016/j.jaci.2010.03.008.
Dobnig H, Pilz S, Scharnagl H, Renner W, Seelhorst U, Wellnitz B, Kinkeldei J, Boehm BO, Weihrauch G, Maerz W: Independent association of low serum 25-hydroxyvitamin d and 1,25-dihydroxyvitamin d levels with all-cause and cardiovascular mortality. Arch Intern Med. 2008, 168: 1340-1349. 10.1001/archinte.168.12.1340.