A randomized controlled double-blind investigation of the effects of vitamin D dietary supplementation in subjects with atopic dermatitis

T. R. Hata, D. Audish, P. Kotol, A. Coda, F. Kabigting, J. Miller, D. Alexandrescu, M. Boguniewicz, P. Taylor, L. Aertker, K. Kesler, Jon Hanifin, D. Y M Leung, R. L. Gallo

Research output: Contribution to journalArticle

56 Citations (Scopus)

Abstract

Background Subjects with atopic dermatitis (AD) have defects in antimicrobial peptide (AMP) production possibly contributing to an increased risk of infections. In laboratory models, vitamin D can alter innate immunity by increasing AMP production. Objective To determine if AD severity correlates with baseline vitamin D levels, and to test whether supplementation with oral vitamin D alters AMP production in AD skin. Methods This was a multi-centre, placebo-controlled, double-blind study in 30 subjects with AD, 30 non-atopic subjects, and 16 subjects with psoriasis. Subjects were randomized to receive either 4000 IU of cholecalciferol or placebo for 21 days. At baseline and day 21, levels of 25-hydroxyvitamin D (25OHD), cathelicidin, HBD-3, IL-13, and Eczema Area and Severity Index (EASI) and Rajka-Langeland scores were obtained. Results At baseline, 20% of AD subjects had serum 25OHD below 20 ng/mL. Low serum 25OHD correlated with increased Fitzpatrick Skin Type and elevated BMI, but not AD severity. After 21 days of oral cholecalciferol, mean serum 25OHD increased, but there was no significant change in skin cathelicidin, HBD-3, IL-13 or EASI scores. Conclusions This study illustrated that darker skin types and elevated BMI are important risk factors for vitamin D deficiency in subjects with AD, and highlighted the possibility that seasonality and locale may be potent contributors to cathelicidin induction through their effect on steady state 25OHD levels. Given the molecular links between vitamin D and immune function, further study of vitamin D supplementation in subjects with AD is warranted.

Original languageEnglish (US)
Pages (from-to)781-789
Number of pages9
JournalJournal of the European Academy of Dermatology and Venereology
Volume28
Issue number6
DOIs
StatePublished - 2014

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Atopic Dermatitis
Dietary Supplements
Vitamin D
Skin
Interleukin-13
Cholecalciferol
Eczema
Peptides
Serum
Placebos
Vitamin D Deficiency
Psoriasis
Double-Blind Method
Innate Immunity
Infection
CAP18 lipopolysaccharide-binding protein

ASJC Scopus subject areas

  • Dermatology
  • Infectious Diseases
  • Medicine(all)

Cite this

A randomized controlled double-blind investigation of the effects of vitamin D dietary supplementation in subjects with atopic dermatitis. / Hata, T. R.; Audish, D.; Kotol, P.; Coda, A.; Kabigting, F.; Miller, J.; Alexandrescu, D.; Boguniewicz, M.; Taylor, P.; Aertker, L.; Kesler, K.; Hanifin, Jon; Leung, D. Y M; Gallo, R. L.

In: Journal of the European Academy of Dermatology and Venereology, Vol. 28, No. 6, 2014, p. 781-789.

Research output: Contribution to journalArticle

Hata, TR, Audish, D, Kotol, P, Coda, A, Kabigting, F, Miller, J, Alexandrescu, D, Boguniewicz, M, Taylor, P, Aertker, L, Kesler, K, Hanifin, J, Leung, DYM & Gallo, RL 2014, 'A randomized controlled double-blind investigation of the effects of vitamin D dietary supplementation in subjects with atopic dermatitis', Journal of the European Academy of Dermatology and Venereology, vol. 28, no. 6, pp. 781-789. https://doi.org/10.1111/jdv.12176
Hata, T. R. ; Audish, D. ; Kotol, P. ; Coda, A. ; Kabigting, F. ; Miller, J. ; Alexandrescu, D. ; Boguniewicz, M. ; Taylor, P. ; Aertker, L. ; Kesler, K. ; Hanifin, Jon ; Leung, D. Y M ; Gallo, R. L. / A randomized controlled double-blind investigation of the effects of vitamin D dietary supplementation in subjects with atopic dermatitis. In: Journal of the European Academy of Dermatology and Venereology. 2014 ; Vol. 28, No. 6. pp. 781-789.
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abstract = "Background Subjects with atopic dermatitis (AD) have defects in antimicrobial peptide (AMP) production possibly contributing to an increased risk of infections. In laboratory models, vitamin D can alter innate immunity by increasing AMP production. Objective To determine if AD severity correlates with baseline vitamin D levels, and to test whether supplementation with oral vitamin D alters AMP production in AD skin. Methods This was a multi-centre, placebo-controlled, double-blind study in 30 subjects with AD, 30 non-atopic subjects, and 16 subjects with psoriasis. Subjects were randomized to receive either 4000 IU of cholecalciferol or placebo for 21 days. At baseline and day 21, levels of 25-hydroxyvitamin D (25OHD), cathelicidin, HBD-3, IL-13, and Eczema Area and Severity Index (EASI) and Rajka-Langeland scores were obtained. Results At baseline, 20{\%} of AD subjects had serum 25OHD below 20 ng/mL. Low serum 25OHD correlated with increased Fitzpatrick Skin Type and elevated BMI, but not AD severity. After 21 days of oral cholecalciferol, mean serum 25OHD increased, but there was no significant change in skin cathelicidin, HBD-3, IL-13 or EASI scores. Conclusions This study illustrated that darker skin types and elevated BMI are important risk factors for vitamin D deficiency in subjects with AD, and highlighted the possibility that seasonality and locale may be potent contributors to cathelicidin induction through their effect on steady state 25OHD levels. Given the molecular links between vitamin D and immune function, further study of vitamin D supplementation in subjects with AD is warranted.",
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T1 - A randomized controlled double-blind investigation of the effects of vitamin D dietary supplementation in subjects with atopic dermatitis

AU - Hata, T. R.

AU - Audish, D.

AU - Kotol, P.

AU - Coda, A.

AU - Kabigting, F.

AU - Miller, J.

AU - Alexandrescu, D.

AU - Boguniewicz, M.

AU - Taylor, P.

AU - Aertker, L.

AU - Kesler, K.

AU - Hanifin, Jon

AU - Leung, D. Y M

AU - Gallo, R. L.

PY - 2014

Y1 - 2014

N2 - Background Subjects with atopic dermatitis (AD) have defects in antimicrobial peptide (AMP) production possibly contributing to an increased risk of infections. In laboratory models, vitamin D can alter innate immunity by increasing AMP production. Objective To determine if AD severity correlates with baseline vitamin D levels, and to test whether supplementation with oral vitamin D alters AMP production in AD skin. Methods This was a multi-centre, placebo-controlled, double-blind study in 30 subjects with AD, 30 non-atopic subjects, and 16 subjects with psoriasis. Subjects were randomized to receive either 4000 IU of cholecalciferol or placebo for 21 days. At baseline and day 21, levels of 25-hydroxyvitamin D (25OHD), cathelicidin, HBD-3, IL-13, and Eczema Area and Severity Index (EASI) and Rajka-Langeland scores were obtained. Results At baseline, 20% of AD subjects had serum 25OHD below 20 ng/mL. Low serum 25OHD correlated with increased Fitzpatrick Skin Type and elevated BMI, but not AD severity. After 21 days of oral cholecalciferol, mean serum 25OHD increased, but there was no significant change in skin cathelicidin, HBD-3, IL-13 or EASI scores. Conclusions This study illustrated that darker skin types and elevated BMI are important risk factors for vitamin D deficiency in subjects with AD, and highlighted the possibility that seasonality and locale may be potent contributors to cathelicidin induction through their effect on steady state 25OHD levels. Given the molecular links between vitamin D and immune function, further study of vitamin D supplementation in subjects with AD is warranted.

AB - Background Subjects with atopic dermatitis (AD) have defects in antimicrobial peptide (AMP) production possibly contributing to an increased risk of infections. In laboratory models, vitamin D can alter innate immunity by increasing AMP production. Objective To determine if AD severity correlates with baseline vitamin D levels, and to test whether supplementation with oral vitamin D alters AMP production in AD skin. Methods This was a multi-centre, placebo-controlled, double-blind study in 30 subjects with AD, 30 non-atopic subjects, and 16 subjects with psoriasis. Subjects were randomized to receive either 4000 IU of cholecalciferol or placebo for 21 days. At baseline and day 21, levels of 25-hydroxyvitamin D (25OHD), cathelicidin, HBD-3, IL-13, and Eczema Area and Severity Index (EASI) and Rajka-Langeland scores were obtained. Results At baseline, 20% of AD subjects had serum 25OHD below 20 ng/mL. Low serum 25OHD correlated with increased Fitzpatrick Skin Type and elevated BMI, but not AD severity. After 21 days of oral cholecalciferol, mean serum 25OHD increased, but there was no significant change in skin cathelicidin, HBD-3, IL-13 or EASI scores. Conclusions This study illustrated that darker skin types and elevated BMI are important risk factors for vitamin D deficiency in subjects with AD, and highlighted the possibility that seasonality and locale may be potent contributors to cathelicidin induction through their effect on steady state 25OHD levels. Given the molecular links between vitamin D and immune function, further study of vitamin D supplementation in subjects with AD is warranted.

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