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Jalil P, Masood S, Sadique M, Jalil MA, Jalil M, Khan L. Filling the Gaps: Vitamin D Status in Diffuse Hair Fall Among Pakistanis. Dermatol Pract Concept 2024; 14:dpc.1404a232. [PMID: 39652934 PMCID: PMC11620017 DOI: 10.5826/dpc.1404a232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/08/2024] [Indexed: 12/12/2024] Open
Abstract
INTRODUCTION Hair loss can happen for various reasons, including emotional stress, physical strain, certain medical issues, and nutritional gaps. When it comes to nutrition, a lack of vitamin D3 could be linked to diffuse hair loss. OBJECTIVES The aim was to look for the frequency of vitamin D3 deficiency with diffuse hair fall, especially in the Pakistani population. METHODS A total of 120 patients of both sexes and all ages presenting to the Dermatology Clinic with complaints of non-scarring alopecia and loss of over 100 strands of hair within a 24-hour period (counted by patient) of any duration and positive hair pull test were advised to take serum vitamin D3. Tests and results were then analyzed by SPSS statistical software package (version 19.0 for Windows). RESULTS The mean age of participants enrolled in the study was 28.56 ± 11.62 years. The majority of the patients, i.e., 77 (63.64%), were ≤30 years of age. Among the 120 patients, 17 were males and 103 were females. Mean serum vitamin D3 levels were 17.33 ± 5.43 ng/ml. 95 (79.17%) patients were found to be vitamin D3 deficient, with 37 patients having female pattern hair loss, seven patients with male pattern hair loss, seven patients with diffuse alopecia areata, and 44 patients with telogen effluvium. CONCLUSIONS This study concluded that there is considerable frequency of vitamin D3 deficiency in individuals with diffuse hair fall. Therefore, we recommend that there should be early recognition and treatment of this condition in these particular patients in order to reduce hair fall.
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Affiliation(s)
- Palwasha Jalil
- Consultant Dermatologist at (Aria Institute of Medical Sciences Quetta)
| | - Sadia Masood
- Associate professor of Dermatology at Aga khan University Hospital Karachi
| | - Muhammad Sadique
- Consultant Nephrologist at Balochistan Institute of Nephrology and Urology Quetta
| | | | - Malghalura Jalil
- Consultant Gynecology and Obstetrics, Aria Institute of Medical Sciences Quetta
| | - Laila Khan
- Consultant Ophthalmologist at Helper Eye institute Quetta
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Yongpisarn T, Tejapira K, Thadanipon K, Suchonwanit P. Vitamin D deficiency in non-scarring and scarring alopecias: a systematic review and meta-analysis. Front Nutr 2024; 11:1479337. [PMID: 39416654 PMCID: PMC11479915 DOI: 10.3389/fnut.2024.1479337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2024] [Accepted: 09/23/2024] [Indexed: 10/19/2024] Open
Abstract
Background Numerous studies have linked vitamin D deficiency (VDD) to the pathogenesis of various alopecia disorders. Objective This study aimed to investigate whether patients with alopecia are more likely to have VDD or lower vitamin D levels than controls, and the prevalence of VDD among patients with certain alopecia disorders. Methods Electronic searches were conducted using PubMed, Embase, Scopus, and Cochrane Library databases from the dates of their inception until September 2024. Studies that reported data allowing for the calculation of odds ratios, mean differences, or correlation coefficients related to vitamin D levels and alopecia were included, while studies without a confirmed diagnosis of alopecia or those involving patients taking vitamin D supplements were excluded. Results It was found that 51.94% of patients with alopecia areata (AA), 50.38% of patients with female pattern hair loss (FPHL), 47.38% of patients with male androgenic alopecia (MAGA), 53.51% of patients with telogen effluvium (TE), and 38.85% of patients with primary scarring alopecia had VDD. Compared to controls, AA patients had a pooled odds ratio (OR) of VDD of 2.84 (95% confidence interval: 1.89-4.26, I2 = 84.29%, p < 0.01) and a pooled unstandardized mean difference (UMD) of vitamin D levels of -8.20 (-10.28 - -6.12, I2 = 74.25%, p < 0.01) ng/mL. For FPHL patients, a pooled OR of VDD of 5.24 (1.50-18.33, I2 = 81.65%, p < 0.01) and a pooled UMD of vitamin D levels of -15.67 (-24.55 - -6.79, I2 = 91.60%, p < 0.01) ng/mL were found. However, for MAGA, a pooled VDD OR of 4.42 (0.53-36.61, I2 = 88.40%, p < 0.01), and a pooled UMD of vitamin D levels of -2.19 ng/mL (-4.07 - -0.31 ng/mL, I2 = 7.64%, p = 0.37) were found. For TE patients, pooled UMD of vitamin D levels of -5.71 (-10.10 - -1.32) ng/mL were found. Conclusion People with alopecia frequently have VDD; however, only in patients with AA or FPHL was the association of VDD and decreased vitamin D levels statistically significant compared to control. The findings indicate screening for vitamin D could benefit patients with AA or FPHL, potentially addressing vitamin D deficiency. Further study on vitamin D supplementation as a treatment for alopecia is recommended.
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Affiliation(s)
- Tanat Yongpisarn
- Division of Dermatology, Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Kasama Tejapira
- Division of Dermatology, Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Kunlawat Thadanipon
- Division of Dermatology, Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
- Department of Clinical Epidemiology and Biostatistics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Poonkiat Suchonwanit
- Division of Dermatology, Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
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Chen Y, Dong X, Wang Y, Li Y, Xiong L, Li L. Serum 25 hydroxyvitamin D in non-scarring alopecia: A systematic review and meta-analysis. J Cosmet Dermatol 2024; 23:1131-1140. [PMID: 38010941 DOI: 10.1111/jocd.16093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 09/18/2023] [Accepted: 11/09/2023] [Indexed: 11/29/2023]
Abstract
INTRODUCTION Non-scarring alopecia mainly includes androgenetic alopecia (AGA), female pattern hair loss (FPHL), alopecia areata (AA), telogen effluvium (TE), anagen effluvium (AE) and so on. Many studies had investigated the serum 25-hydroxyvitamin D level and vitamin D deficiency of patients with these diseases, but opinions varied, and no conclusion was reached. METHODS Relevant articles were retrieved through PubMed, Web of Science, EMBASE, Cochrane Library, China National Knowledge Infrastructure (CNKI) and other databases. Serum 25-hydroxyvitamin D [25(OH) D] levels and vitamin D deficiency were used as our primary outcome. The odds ratio (OR) and the standardized mean difference (SMD) with 95% confidence interval were both examined for vitamin D deficiency and levels. RESULTS Our meta-analysis had included a total of 3374 non-scarring alopecia patients and 7296 healthy controls from 23 studies through the inclusion criteria and exclusion criteria. We found non-scarring alopecia had decreased serum 25(OH)D level (WMD -7.29; 95% CI -9.21, -5.38) and increased vitamin D deficiency incidence (OR 3.11 95% CI 2.29, 4.22), compared with healthy controls. This meta-analysis chose to conduct random-effect model and subgroup analysis, because of the high heterogeneity (serum 25(OH)D level: I2 = 95%, vitamin D deficiency: I2 = 0%). CONCLUSION Patients with non-scarring alopecia (including AA, FPHL, AGA and TE) have insufficient serum level of 25(OH)D and increased incidence of vitamin D deficiency. Vitamin D supplementation and monitoring for vitamin D deficiency may be helpful in treating non-scarring alopecia.
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Affiliation(s)
- Yuling Chen
- Department of Dermatology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Xin Dong
- Department of Dermatology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Yixin Wang
- Department of Dermatology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Yu Li
- Department of Dermatology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Lidan Xiong
- Department of Dermatology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
- Center of Cosmetics Evaluation, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Li Li
- Department of Dermatology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
- Center of Cosmetics Evaluation, West China Hospital, Sichuan University, Chengdu, Sichuan, China
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Tarfeen N, Masoodi SR, Nisa KU, Ali S, Ahmad MB, Ganai BA. VDR downregulation and promoter hypermethylation as one of the causes for triggering type 2 diabetes mellitus: Clinical and molecular studies. J Diabetes Metab Disord 2023; 22:1443-1451. [PMID: 37975142 PMCID: PMC10638154 DOI: 10.1007/s40200-023-01266-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Accepted: 07/17/2023] [Indexed: 11/19/2023]
Abstract
Background Our present study was to investigate the methylation and Gene expression of the vitamin D receptor (VDR) gene in the causing T2DM and to determine the inflammatory biomarkers in exaggerating T2DM in Kashmiri population. Methods In this study, T2DM cases (n = 100) and controls (n = 100) of Kashmiri population were designed. Blood samples were taken from both groups, and serum vitamin D levels, inflammatory biomarkers (TNF-α, IL-6, IL-10, CRP, Leptin and adiponectin) were estimated by ELISA. By using methylation-specific PCR (MS-PCR) and RT-PCR, respectively, the levels of methylation and expression were measured after the extraction of DNA and RNA. Results Studies using RT-PCR demonstrated that patients with diabetes had a lower degree of VDR expression than control subjects (P > 0.05). The T2DM was shown to be strongly correlated with hypermethylation (p-value < 0.001, OR 2.9; 95%CI 1.6-5.54). When compared to control groups, T2DM patients' levels of vitamin D in their serum were considerably lower (p < 0.01). Pro-inflammatory mediators like TNF-α, CRP, IL-6, and leptin levels were discovered to be higher, and concentrations of anti-inflammatory mediators like IL-10 and adiponectin were observed to be lower in people with T2DM than in people without the condition (p < 0.05). Conclusions This study suggests the hypermethylation and down expression of VDR as one of the basis for causing T2DM in kashmiri individuals, exaggerated by enhanced degree of TNF-α, CRP, IL-6 and leptin and diminished concentration of IL-10 and adiponectin in T2DM. Supplementary Information The online version contains supplementary material available at 10.1007/s40200-023-01266-6.
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Affiliation(s)
- Najeebul Tarfeen
- Centre of Research for Development, University of Kashmir, Srinagar, 190006 Jammu and Kashmir India
| | - Shariq Rashid Masoodi
- Division of Endocrinology, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir India
| | - Khair Ul Nisa
- Department of Environmental Science, University of Kashmir, Srinagar, 190006 Jammu and Kashmir India
| | - Shafat Ali
- Centre of Research for Development, University of Kashmir, Srinagar, 190006 Jammu and Kashmir India
| | - Mir Bilal Ahmad
- Department of Biochemistry, University of Kashmir, Srinagar, 190006 Jammu and Kashmir India
| | - Bashir Ahmad Ganai
- Centre of Research for Development, University of Kashmir, Srinagar, 190006 Jammu and Kashmir India
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Tu W, Cao YW, Sun M, Liu Q, Zhao HG. mTOR signaling in hair follicle and hair diseases: recent progress. Front Med (Lausanne) 2023; 10:1209439. [PMID: 37727765 PMCID: PMC10506410 DOI: 10.3389/fmed.2023.1209439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Accepted: 08/23/2023] [Indexed: 09/21/2023] Open
Abstract
Mammalian target of rapamycin (mTOR) signaling pathway is a major regulator of cell proliferation and metabolism, playing significant roles in proliferation, apoptosis, inflammation, and illness. More and more evidences showed that the mTOR signaling pathway affects hair follicle circulation and maintains the stability of hair follicle stem cells. mTOR signaling may be a critical cog in Vitamin D receptor (VDR) deficiency-mediated hair follicle damage and degeneration and related alopecia disorders. This review examines the function of mTOR signaling in hair follicles and hair diseases, and talks about the underlying molecular mechanisms that mTOR signaling regulates.
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Affiliation(s)
| | | | | | | | - Heng-Guang Zhao
- Department of Dermatology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
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Zaaroura H, Gilding AJ, Sibbald C. Biomarkers in alopecia Areata: A systematic review and meta-analysis. Autoimmun Rev 2023; 22:103339. [PMID: 37087083 DOI: 10.1016/j.autrev.2023.103339] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Accepted: 04/13/2023] [Indexed: 04/24/2023]
Abstract
BACKGROUND Alopecia areata (AA) is an autoimmune non-scarring alopecia that affects the scalp or any hair-bearing areas in the body. The pathophysiology of AA is complex, but Th1, Th2, and Th17 cytokines dysregulation, as well as chemokines, immunoglobulins and other biomarkers have been shown to play a role in the pathogenesis of the disease. OBJECTIVE To conduct a systematic review and Meta-analysis to identify biomarkers that reflect AA activity and severity that could be used to better assess disease activity and response in both trials and clinical practice. METHODS A literature search was conducted using the PUBMED, EMBASE and the Cumulative Index to Nursing and Allied Health Literature (CINAHL) from inception to December 2021. Articles reporting on associations between AA and serum clinical biomarkers (cytokines, chemokines, antibodies, immunoglobulins, and others) were included. Serum biomarkers were identified in patients with AA and were correlated with disease severity and patient characteristics (ex. age, sex, comorbidities). The quality of the studies was assessed using the National Heart, Lung, and Blood Institute's Quality Assessment Tool for Case-Control Studies. Meta-analysis pooling of the standardized mean differences (SMD) by the method of Cohen using the common-effect inverse-variance model was performed. For the Meta-analysis, data was pulled for all the markers with a minimum of 4 studies with means and standard deviations. Analysis of data reported as Median with range or inter-quartile range (IQR) revealed that the data was too skewed to recommend calculation and use of mean with standard deviation (SD). If the data were not skewed, mean and SD were calculated. RESULTS One thousand seven hundred fourteen studies were screened, with 91 included, reporting on a total of 52 biomarkers. Meta-analyses revealed pooled SMD that were significant for interleukin 6 (IL6), C-reactive protein (CRP) and vitamin D. CONCLUSIONS Serum IL6 and CRP levels are significantly increased in patients with AA compared to healthy age and sex matched controls. Conversely, serum vitamn D levels are significantly decreased in patients with AA compared to healthy age and sex matched controls. This data has the potenail to influence the clinical guidelines for the diagnostic workup of AA to include testing the serum levels of CRP and vitamin D.
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Affiliation(s)
- Hiba Zaaroura
- Division of Dermatology, Department of Paediatric Medicine, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
| | - Anthony J Gilding
- Canadian Alopecia Areata Foundation, Toronto, ON, Canada.; Department of Chemistry & Biology, Faculty of Science, Toronto Metropolitan University, Toronto, ON, Canada
| | - Cathryn Sibbald
- Division of Dermatology, Department of Paediatric Medicine, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada.
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Zhu B, Zhang L, Wang J, Tan G. Vitamin D supplementation for patients with alopecia areata: A protocol for systematic review and meta-analysis. Medicine (Baltimore) 2022; 101:e31089. [PMID: 36281137 PMCID: PMC10662846 DOI: 10.1097/md.0000000000031089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Accepted: 09/02/2022] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Several studies have reported an association between low Vitamin D (VD) levels and Alopecia areata (AA), and suggested VD preparations as a potential therapy. VD has immunomodulatory function closely associated with a variety of skin diseases, but there is no conclusive evidence to support VD supplementation for patients with AA. Therefore, we will conduct a meta-analysis to collect and evaluate the efficacy and safety of VD supplementation in the treatment of AA. METHODS We will search the following databases according to the developed strategy: Cochrane Library, PubMed, Web of Science, EMBASE, Scopus, Google scholar for Randomized controlled trials related to VD supplementation for AA. The retrieval time is from the establishment of each database to July 2022. Two reviewers will independently complete the literature search and screening, risk of bias assessment and data extraction. Severity of Alopecia Tool, Alopecia Density and Extent, Lesional area and senstivity (score) will be the primary results. RevMan V.5.3 will be used for data analysis and synthesis. For dichotomous outcomes and the continuous outcomes, we will calculate risk ratio with 95% Confidence intervals and mean differences or standardized mean differences with 95% Confidence intervals respectively. The reporting bias will be investigated using funnel plots, and the asymmetry of the funnel plots will be explained using the Harbord modified test or the Egger's regression test. RESULTS The results of the study expect to provide a high-quality, evidence-based recommendation on VD supplementation in the treatment of AA for clinicians. CONCLUSIONS The study will provide scientific and useful evidence for better use of VD supplementation in treating AA.
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Affiliation(s)
- Baohua Zhu
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, 610075, Sichuan Province, China
| | - Lan Zhang
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, 610075, Sichuan Province, China
| | - Jun Wang
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, 610075, Sichuan Province, China
| | - Guiyuan Tan
- Nanjing University of Traditional Chinese Medicine, Nanjing, Jiangsu Province, China
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GOKCE NURIYE, BASGOZ NESLIHAN, KENANOGLU SERCAN, AKALIN HILAL, OZKUL YUSUF, ERGOREN MAHMUTCERKEZ, BECCARI TOMMASO, BERTELLI MATTEO, DUNDAR MUNIS. An overview of the genetic aspects of hair loss and its connection with nutrition. JOURNAL OF PREVENTIVE MEDICINE AND HYGIENE 2022; 63:E228-E238. [PMID: 36479473 PMCID: PMC9710406 DOI: 10.15167/2421-4248/jpmh2022.63.2s3.2765] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Hair loss is a widespread concern in dermatology clinics, affecting both men's and women's quality of life. Hair loss can have many different causes, which are critical to identify in order to provide appropriate treatment. Hair loss can happen due to many variables, such as genetic factors or predisposition, vitamin and mineral deficiencies, skin problems, hair growth disorders, poor diet, hormonal problems, certain internal diseases, drug use, stress and depression, cosmetic factors, childbirth, and the chemotherapy process. Treatment for hair loss varies depending on the type of alopecia, deficiency, or excess of structures such as vitamins and minerals, and also on hair and skin structure. The Mediterranean diet is characterized by low amounts of saturated fat, animal protein, and high amounts of unsaturated fat, fiber, polyphenols, and antioxidants. The main nutrients found in the Mediterranean Diet are rich in antioxidant, anti-inflammatory components. It also has an important place in hair loss treatment, since recently treatment strategies have included polyphenols and unsaturated oils more and more frequently. The goal of this work was to review published articles examining alopecia and its types, the many micronutrients that affect alopecia, and the role of the Mediterranean diet in alopecia. The literature shows that little is known about hair loss, nutritional factors, and diet, and that the data collected are conflicting. Given these differences, research into the function of diet and nutrition in the treatment of baldness is a dynamic and growing topic.
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Affiliation(s)
- NURIYE GOKCE
- Department of Medical Genetics, Faculty of Medicine, Erciyes University, Kayseri, Turkey
| | - NESLIHAN BASGOZ
- Department of Medical Genetics, Faculty of Medicine, Erciyes University, Kayseri, Turkey
| | - SERCAN KENANOGLU
- Department of Medical Genetics, Faculty of Medicine, Erciyes University, Kayseri, Turkey
| | - HILAL AKALIN
- Department of Medical Genetics, Faculty of Medicine, Erciyes University, Kayseri, Turkey
| | - YUSUF OZKUL
- Department of Medical Genetics, Faculty of Medicine, Erciyes University, Kayseri, Turkey
| | - MAHMUT CERKEZ ERGOREN
- Department of Medical Genetics, Faculty of Medicine, Near East University, Nicosia, Cyprus
- DESAM Institute, Near East University, Nicosia, Cyprus
| | - TOMMASO BECCARI
- Department of Pharmaceutical Science, University of Perugia, Perugia, Italy
| | - MATTEO BERTELLI
- MAGISNAT, Peachtree Corners (GA), USA
- MAGI Euregio, Bolzano, Italy
- MAGI’S LAB, Rovereto (TN), Italy
| | - MUNIS DUNDAR
- Department of Medical Genetics, Faculty of Medicine, Erciyes University, Kayseri, Turkey
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Clinical Translation of Microbiome Research in Alopecia Areata: A New Perspective? COSMETICS 2022. [DOI: 10.3390/cosmetics9030055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The continuous research advances in the microbiome field is changing clinicians’ points of view about the involvement of the microbiome in human health and disease, including autoimmune diseases such as alopecia areata (AA). Both gut and cutaneous dysbiosis have been considered to play roles in alopecia areata. A new approach is currently possible owing also to the use of omic techniques for studying the role of the microbiome in the disease by the deep understanding of microorganisms involved in the dysbiosis as well as of the pathways involved. These findings suggest the possibility to adopt a topical approach using either cosmetics or medical devices, to modulate or control, for example, the growth of overexpressed species using specific bacteriocins or postbiotics or with pH control. This will favour at the same time the growth of beneficial bacteria which, in turn, can impact positively both the structure of the scalp ecosystem on the host’s response to internal and external offenders. This approach, together with a “systemic” one, via oral supplementation, diet, or faecal transplantation, makes a reliable translation of microbiome research in clinical practice and should be taken into consideration every time alopecia areata is considered by a clinician.
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Pośpiech E, Karłowska-Pik J, Kukla-Bartoszek M, Woźniak A, Boroń M, Zubańska M, Jarosz A, Bronikowska A, Grzybowski T, Płoski R, Spólnicka M, Branicki W. Overlapping association signals in the genetics of hair-related phenotypes in humans and their relevance to predictive DNA analysis. Forensic Sci Int Genet 2022; 59:102693. [DOI: 10.1016/j.fsigen.2022.102693] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 02/25/2022] [Accepted: 03/22/2022] [Indexed: 01/02/2023]
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Diotallevi F, Campanati A, Martina E, Radi G, Paolinelli M, Marani A, Molinelli E, Candelora M, Taus M, Galeazzi T, Nicolai A, Offidani A. The Role of Nutrition in Immune-Mediated, Inflammatory Skin Disease: A Narrative Review. Nutrients 2022; 14:591. [PMID: 35276950 PMCID: PMC8840467 DOI: 10.3390/nu14030591] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 01/23/2022] [Accepted: 01/27/2022] [Indexed: 11/16/2022] Open
Abstract
Immune-mediated inflammatory skin diseases are characterized by a complex multifactorial etiology, in which genetic and environmental factors interact both in genesis and development of the disease. Nutrition is a complex and fascinating scenario, whose pivotal role in induction, exacerbation, or amelioration of several human diseases has already been well documented. However, owing to the complexity of immune-mediated skin disease clinical course and breadth and variability of human nutrition, their correlation still remains an open debate in literature. It is therefore important for dermatologists to be aware about the scientific basis linking nutrition to inflammatory skin diseases such as psoriasis, atopic dermatitis, hidradenitis suppurativa, bullous diseases, vitiligo, and alopecia areata, and whether changes in diet can influence the clinical course of these diseases. The purpose of this narrative review is to address the role of nutrition in immune-mediated inflammatory skin diseases, in light of the most recent and validate knowledge on this topic. Moreover, whether specific dietary modifications could provide meaningful implementation in planning a therapeutic strategy for patients is evaluated, in accordance with regenerative medicine precepts, a healing-oriented medicine that considers the whole person, including all aspects of the lifestyle.
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Affiliation(s)
- Federico Diotallevi
- Dermatological Clinic, Department of Clinical and Molecular Sciences, Polytechnic Marche University, 60100 Ancona, Italy; (F.D.); (A.C.); (G.R.); (M.P.); (A.M.); (E.M.); (M.C.); (A.O.)
| | - Anna Campanati
- Dermatological Clinic, Department of Clinical and Molecular Sciences, Polytechnic Marche University, 60100 Ancona, Italy; (F.D.); (A.C.); (G.R.); (M.P.); (A.M.); (E.M.); (M.C.); (A.O.)
| | - Emanuela Martina
- Dermatological Clinic, Department of Clinical and Molecular Sciences, Polytechnic Marche University, 60100 Ancona, Italy; (F.D.); (A.C.); (G.R.); (M.P.); (A.M.); (E.M.); (M.C.); (A.O.)
| | - Giulia Radi
- Dermatological Clinic, Department of Clinical and Molecular Sciences, Polytechnic Marche University, 60100 Ancona, Italy; (F.D.); (A.C.); (G.R.); (M.P.); (A.M.); (E.M.); (M.C.); (A.O.)
| | - Matteo Paolinelli
- Dermatological Clinic, Department of Clinical and Molecular Sciences, Polytechnic Marche University, 60100 Ancona, Italy; (F.D.); (A.C.); (G.R.); (M.P.); (A.M.); (E.M.); (M.C.); (A.O.)
| | - Andrea Marani
- Dermatological Clinic, Department of Clinical and Molecular Sciences, Polytechnic Marche University, 60100 Ancona, Italy; (F.D.); (A.C.); (G.R.); (M.P.); (A.M.); (E.M.); (M.C.); (A.O.)
| | - Elisa Molinelli
- Dermatological Clinic, Department of Clinical and Molecular Sciences, Polytechnic Marche University, 60100 Ancona, Italy; (F.D.); (A.C.); (G.R.); (M.P.); (A.M.); (E.M.); (M.C.); (A.O.)
| | - Matteo Candelora
- Dermatological Clinic, Department of Clinical and Molecular Sciences, Polytechnic Marche University, 60100 Ancona, Italy; (F.D.); (A.C.); (G.R.); (M.P.); (A.M.); (E.M.); (M.C.); (A.O.)
| | - Marina Taus
- Dietetic Unit and Clinical Nutrition, United Hospitals of Ancona, 60100 Ancona, Italy; (M.T.); (A.N.)
| | - Tiziana Galeazzi
- Department of Pediatrics, Marche Polytechnic University, 60100 Ancona, Italy;
| | - Albano Nicolai
- Dietetic Unit and Clinical Nutrition, United Hospitals of Ancona, 60100 Ancona, Italy; (M.T.); (A.N.)
| | - Annamaria Offidani
- Dermatological Clinic, Department of Clinical and Molecular Sciences, Polytechnic Marche University, 60100 Ancona, Italy; (F.D.); (A.C.); (G.R.); (M.P.); (A.M.); (E.M.); (M.C.); (A.O.)
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12
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Papadimitriou DT, Bothou C, Dermitzaki E, Alexopoulos A, Mastorakos G. Treatment of alopecia totalis/universalis/focalis with vitamin D and analogs: Three case reports and a literature review. World J Clin Pediatr 2021; 10:192-199. [PMID: 34868895 PMCID: PMC8603638 DOI: 10.5409/wjcp.v10.i6.192] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Revised: 04/18/2021] [Accepted: 07/06/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Alopecia areata (AA) is an inflammatory disease with autoimmune, environmental, and inherited components directed at the hair follicle, either limited to patchy hair loss over the scalp (Focalis, AF), total loss of scalp hair (Totalis, AT), or total loss of both scalp and body hair (Universalis, AU). Despite multiple treatment modalities, no therapy exists. Vitamin D deficiency in patients with AA/AT/AF influences disease severity and duration, inversely correlating with inflammation histologically.
CASE SUMMARY Three girls presented with AT (P1), AU (P2), and AF (P3) at the ages of 1, 5, and 5 years, respectively. For P1-P2, all available treatments implemented for 2 years had failed. We started an initial 6-mo repletion with oral cholecalciferol 2000/4000 IU/d, with no apparent effect. Then we attempted immunomodulation using oral calcitriol and its analog paricalcitol. On calcitriol, 0.5 mcg/d P1 regrew hair within 6 mo. After 4 years, a relapse with loss of eyebrow hair was resolved after doubling the calcitriol dose to 0.5 mcg × 2/d; the results have been maintained for 6 years to date. On calcitriol, 0.25 mcg × 3/d P2 led to the development of asymptomatic hypercalcemia-hypercalciuria, which was immediately resolved by switching to paricalcitol 2 mcg × 3/d; mild tolerable hypercalciuria was maintained. Hair regrowth was observed at 6 mo, stabilizing only as fur at 12 mo. AF in P3 was resolved completely within 3 mo on a daily high dose (8000 IU) of cholecalciferol.
CONCLUSION Vitamin D may have immunomodulating therapeutic impact on AT/AU/AF, which needs to be explored with further pilot clinical trials.
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Affiliation(s)
- Dimitrios T Papadimitriou
- Department of Pediatric-Adolescent Endocrinology and Diabetes, Athens Medical Center, Athens 15125, Greece
- Endocrine Unit, Aretaieion University Hospital, Athens 11528, Greece
| | - Christina Bothou
- Department of Endocrinology, Diabetology and Clinical Nutrition, University Hospital Zurich (USZ), University of Zurich (UZH), CH-8091 Zurich, Switzerland
| | - Eleni Dermitzaki
- Department of Pediatric-Adolescent Endocrinology and Diabetes, Athens Medical Center, Athens 15125, Greece
| | - Alexios Alexopoulos
- Special Unit of Dermatology, First Department of Pediatrics, National and Kapodistrian University of Athens Medical School, Agia Sofia Children's Hospital, Athens 11527, Greece
| | - George Mastorakos
- Endocrine Unit, Aretaieion University Hospital, Athens 11528, Greece
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13
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Gao Y, Huo S, Sun M, Zhang C, Wang J, Gao J, Wang N, Lv Y. Evaluation of several immune and inflammatory indicators and their association with alopecia areata. J Cosmet Dermatol 2021; 21:2995-3001. [PMID: 34591347 DOI: 10.1111/jocd.14504] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 09/07/2021] [Accepted: 09/20/2021] [Indexed: 12/29/2022]
Abstract
BACKGROUND Alopecia areata (AA) is an autoimmune disorder and chronic recurrent inflammatory disease that results in non-scarring hair loss. OBJECTIVES Our aim is to investigate several parameters related to autoimmunity and inflammation in AA patients and to evaluate their association with this disease. METHODS This study included a total of 672 eligible AA patients and 580 age- and sex-matched healthy individuals who were treated at a third-class hospital in Hefei from January 2016 to May 2020. Data for serum C-reactive protein (CRP), 25-hydroxy vitamin D (25(OH)D), T3, T4, thyroid-stimulating hormone (TSH), thyroid antibodies (TPOAbs and TGAbs), antinuclear antibodies (ANA), complements (C3, C4), and several immunoglobulins (IgA, IgM, and IgG) were collected in this study. RESULTS Regarding autoimmune-related functional indicators, there were no statistically significant differences between TSH, TGAbs, C3, C4, IgA, IgM, and IgG levels between AA patients and healthy controls. Only T3, T4, TPOAbs, and ANA values were significantly abnormal in the AA group compared with the healthy individuals (p < 0.05). In addition, the mean serum 25(OH)D concentration was significantly lower in the patient group than that in control group (p < 0.05), and serum CRP was significantly increased (p < 0.05). CONCLUSION Although the etiopathogenesis of AA is not clear, the importance of monitoring the levels of T3, T4, TPOAbs, ANA, and 25 (OH)D in AA cases is indispensable.
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Affiliation(s)
- Yamei Gao
- Department of Dermatology, The Second Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Shaohu Huo
- Department of Pediatrics, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Minghui Sun
- Department of Dermatology, The Second Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Chenchen Zhang
- Department of Dermatology, The Second Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Jing Wang
- Department of Dermatology, The Second Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Jing Gao
- Department of Dermatology, The Second Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Na Wang
- Department of Dermatology, The Second Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Yongmei Lv
- Department of Dermatology, The Second Affiliated Hospital of Anhui Medical University, Hefei, China
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14
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Saini K, Mysore V. Role of vitamin D in hair loss: A short review. J Cosmet Dermatol 2021; 20:3407-3414. [PMID: 34553483 DOI: 10.1111/jocd.14421] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Revised: 07/31/2021] [Accepted: 08/20/2021] [Indexed: 12/13/2022]
Abstract
BACKGROUND Vitamin D, a vitamin and hormone, plays an important role in dermatology and dermatotherapeutics, due to its anti-inflammatory and immunomodulatory properties, and regulation of keratinocyte differentiation and proliferation. It also affects the hair cycle, and its role in hair loss is under constant research. OBJECTIVES This review aims to give a brief overview of vitamin D biology within the hair follicle, role in the etiopathogenesis, and rationale for supplementation in various alopecias. METHODS A PubMed literature search was performed to review relevant current literature and studies investigating the role of vitamin D in the etiopathogenesis, as a supplement and a potential therapeutic modality in hair loss. RESULTS AND CONCLUSION Vitamin D is intricately involved in various signaling pathways of growth and differentiation of hair follicles. Most studies show an inverse relationship between serum vitamin D levels and non-scarring alopecias such as telogen effluvium, androgenetic alopecia, alopecia areata, and trichotillomania. Vitamin D deficiency is also associated with scarring alopecia. However, conclusive studies to demonstrate the benefit of vitamin D administration in correcting hair loss and managing these conditions are lacking. Hence, further studies are needed before vitamin D can be routinely recommended as a treatment modality in these conditions.
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Affiliation(s)
- Kriteeka Saini
- Venkat Center for Skin and Plastic Surgery, Bengaluru, India
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15
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Harvey CJ. Combined Diet and Supplementation Therapy Resolves Alopecia Areata in a Paediatric Patient: A Case Study. Cureus 2020; 12:e11371. [PMID: 33304703 PMCID: PMC7721078 DOI: 10.7759/cureus.11371] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Alopecia areata (AA) is a common autoimmune condition resulting in spot baldness and, rarely, more extensive hair loss. There is an association between both the incidence and the severity of AA and several micronutrients, including vitamin D and zinc. This case reports an eight-year-old male diagnosed with AA and treated with a diet and supplemental regimen based on unrefined foods, rich in vitamins A and D, zinc, and supplemented with a multi-nutrient, zinc sulfate, and fish oil with vitamin D. Complete remission of AA was achieved within five months.
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16
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Lower levels of vitamin D are associated with SARS-CoV-2 infection and mortality in the Indian population: An observational study. Int Immunopharmacol 2020; 88:107001. [PMID: 33182040 PMCID: PMC7489890 DOI: 10.1016/j.intimp.2020.107001] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 09/08/2020] [Accepted: 09/09/2020] [Indexed: 02/07/2023]
Abstract
Differential distributions of vitamin D were observed in the Indian population. Vitamin D levels was inversely correlated with SARS-CoV-2 infection rate. COVID-19 mortality rate was negatively associated with mean vitamin D levels. Background The role of vitamin D in the susceptibility and severity of various viral diseases has been well documented. Recently, some reports highlighted the possible importance of vitamin D in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Although India receives adequate sunlight throughout the year, the majority of Indians are deficient in vitamin D levels. In the present study, we hypothesized that vitamin D deficiency would be associated with the SARS-CoV-2 infection rate and mortality in the Indian population. Materials and methods SARS-CoV-2 infection and mortality data were obtained from the Government of India's official website (accessed on 16th August 2020). Various literature databases like PubMed and Google Scholar were searched to find the mean of 25-hydroxyvitamin D [25(OH)D] levels in different states and union territories of India, Pearson correlation was carried out to investigate the possible link between mean 25(OH)D levels and SARS-CoV-2 infection and mortality per million of the population. Results An inverse correlation was observed between the mean level of 25(OH)D and SARS-CoV-2 infection rate (r = −0.43, p = 0.02) and mortality rate (r = −0.42, p = 0.02). Conclusions The present observational study revealed an association of vitamin D with SARS-CoV-2 infection and related mortality. Further studies are required to validate our observations.
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Association of Alopecia Areata with Vitamin D and Calcium Levels: A Systematic Review and Meta-analysis. Dermatol Ther (Heidelb) 2020; 10:967-983. [PMID: 32772238 PMCID: PMC7477029 DOI: 10.1007/s13555-020-00433-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2020] [Indexed: 12/13/2022] Open
Abstract
Introduction To investigate the associations of alopecia areata (AA) with serum vitamin D and calcium levels. Methods A systematic review of all relevant articles published up to February 2020 in PubMed, Embase, and Cochrane Library databases was conducted. Primary endpoints were serum 25-hydroxyvitamin D [25(OH)D] levels and vitamin D deficiency, and the secondary endpoint was serum calcium level. Odds ratio (OR) and standardized mean difference (SMD) with 95% CI across studies were analyzed. Results Data on 1585 patients with AA and 1114 controls from 16 case–control studies and three cross-sectional studies were included in this meta-analysis. A pooled meta-analysis was conducted using the random-effects model because of inter-study heterogeneity (vitamin D level, I2 = 87.90%; vitamin D deficiency, I2 = 81.10%; serum calcium level, I2 = 83.80%). A combined analysis revealed that patients with AA had significantly lower mean serum 25(OH)D level compared with control (WMD − 9.08, 95% CI − 11.65, − 6.50, p < 0.001), and were more likely to have vitamin D deficiency (OR 4.14, 95% CI 2.34, 7.35, p < 0.001). However, the pooled analysis revealed that patients with AA did not have significantly lower serum calcium levels compared with control (WMD − 0.17, 95% CI − 0.40, 0.06, p = 0.143). Subgroup analysis suggested that matched control, mean age, and country might contribute to the heterogeneity of serum vitamin D level, while study design, matched control, and country might contribute to the heterogeneity of vitamin D deficiency. Conclusion Deficiency of serum 25(OH)D level, rather than calcium level, was present in patients with AA. Screening for vitamin D deficiency and vitamin D supplementation may be beneficial in the treatment of patients with AA. Electronic supplementary material The online version of this article (10.1007/s13555-020-00433-4) contains supplementary material, which is available to authorized users.
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18
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Sanke S, Samudrala S, Yadav A, Chander R, Goyal R. Study of serum vitamin D levels in men with premature androgenetic alopecia. Int J Dermatol 2020; 59:1113-1116. [PMID: 32516435 DOI: 10.1111/ijd.14982] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Revised: 05/04/2020] [Accepted: 05/05/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND Vitamin D deficiency had been associated with various hair loss disorders, such as telogen effluvium, alopecia areata, and female pattern hair loss. However, previous studies have not found a correlation between serum vitamin D levels and the severity of androgenetic alopecia. METHODS A case-control study was conducted for a period of one year in a public tertiary care hospital. Fifty males clinically diagnosed with androgenetic alopecia and 50 age-matched healthy controls were recruited. Serum vitamin D levels in both cases and controls were measured by radioimmunoassay technique, and the results were compared. RESULTS A total of 50 cases and 50 controls were recruited and analyzed. The mean age of the cases was 23 years and that of controls was 24.2 years. The mean levels of serum vitamin D significantly decreased in cases, compared to controls (20.10 vs. 29.34 ng/mL; P ≤ 0.001). Eighty-six percent of the cases had deficiency of vitamin D (<30 nmol/L), while 14% had insufficient vitamin D levels (31-50 nmol/L). There was a positive correlation between vitamin D deficiency and severity of androgenetic alopecia (AGA), which was statistically significant (P ≤ 0.5). However, there was no correlation between the duration of sun exposure and serum vitamin D levels (2.36 ± 1.2 in cases and 3.23 ± 1.6 in controls, P value = 0.98). CONCLUSION Our study showed a significant correlation between vitamin D deficiency and the severity of androgenetic alopecia. This suggests that vitamin D may play a role in the premature onset of androgenetic alopecia. However, further studies on a larger population and the effect of vitamin D supplementation on the progression of androgenetic alopecia are required to validate the above findings.
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Affiliation(s)
- Sarita Sanke
- Department of Dermatology, Lady Hardinge Medical College, New Delhi, India
| | - Suvarna Samudrala
- Department of Dermatology, Lady Hardinge Medical College, New Delhi, India
| | - Anuja Yadav
- Department of Dermatology, Lady Hardinge Medical College, New Delhi, India
| | - Ram Chander
- Department of Dermatology, Lady Hardinge Medical College, New Delhi, India
| | - Rajeev Goyal
- Department of Biochemistry, Lady Hardinge Medical College, New Delhi, India
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Molinelli E, Campanati A, Brisigotti V, Sapigni C, Paolinelli M, Offidani A. Efficacy and Safety of Topical Calcipotriol 0.005% Versus Topical Clobetasol 0.05% in the Management of Alopecia Areata: An Intrasubject Pilot Study. Dermatol Ther (Heidelb) 2020; 10:515-521. [PMID: 32342443 PMCID: PMC7211771 DOI: 10.1007/s13555-020-00379-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Indexed: 12/31/2022] Open
Abstract
Introduction Alopecia areata (AA) is a chronic inflammatory non-scarring type of hair loss. Current therapies for alopecia areata are rather limited and mainly involve the use of topical, intra-lesional or systemic steroids and topical immunotherapy, with variable benefit. Recent studies have demonstrated that vitamin D analogues could potentially promote hair growth in patients with patchy AA. Methods We investigated the efficacy and safety of treatment with calcipotriol, a synthetic derivative of vitamin D (calcipotriol 0.005% ointment), versus treatment with the corticosteroid clobetasol (topical clobetasol 0.05% formulation), in a series of 35 patients with scalp AA, using an intrasubject design. Results Patches treated with calcipotriol ointment showed greater and faster response rates than did those treated with topical clobetasol, although the differences were not statistically significant. The main strength of the study is its prospective design; the main limitation is the small number of participants. Conclusions Treatment with the calcipotriol would appear to be reasonably effective in patients with mild to moderate patchy AA and was associated with only limited and reversible side effects.
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Affiliation(s)
- Elisa Molinelli
- Dermatological Unit, Department of Clinical and Molecular Sciences, Polytechnic Marche University, Conca 71 Street, Ancona, Italy.
| | - Anna Campanati
- Dermatological Unit, Department of Clinical and Molecular Sciences, Polytechnic Marche University, Conca 71 Street, Ancona, Italy
| | - Valerio Brisigotti
- Dermatological Unit, Department of Clinical and Molecular Sciences, Polytechnic Marche University, Conca 71 Street, Ancona, Italy
| | - Claudia Sapigni
- Dermatological Unit, Department of Clinical and Molecular Sciences, Polytechnic Marche University, Conca 71 Street, Ancona, Italy
| | - Matteo Paolinelli
- Dermatological Unit, Department of Clinical and Molecular Sciences, Polytechnic Marche University, Conca 71 Street, Ancona, Italy
| | - Annamaria Offidani
- Dermatological Unit, Department of Clinical and Molecular Sciences, Polytechnic Marche University, Conca 71 Street, Ancona, Italy
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20
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Zhao J, Sheng Y, Dai C, Qi S, Hu R, Rui W, Miao Y, Xu F, Zhang Y, Yang Q. Serum 25 hydroxyvitamin D levels in alopecia areata, female pattern hair loss, and male androgenetic alopecia in a Chinese population. J Cosmet Dermatol 2020; 19:3115-3121. [PMID: 32275116 DOI: 10.1111/jocd.13396] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2019] [Revised: 02/29/2020] [Accepted: 03/13/2020] [Indexed: 01/14/2023]
Abstract
BACKGROUND It has been suggested that low vitamin D levels may affect the development of hair loss. AIMS Our aim was to evaluate the serum 25-hydroxy vitamin D [25(OH)D] status in Chinese patients with alopecia areata (AA), female pattern hair loss (FPHL), and male androgenetic alopecia (MAGA) compared with healthy individuals. METHODS We performed a case-control study including 443 AA patients, 657 FPHL patients, 777 MAGA patients, and 2070 normal controls (1064 male and 1006 female healthy individuals) from 2015 to 2017 to analyze the correlation of serum 25(OH)D levels and hair loss in a Chinese population. RESULTS Serum 25(OH)D levels stratified by age, sex, and season were compared between patients and healthy individuals. AA patients' serum 25(OH)D levels were statistically lower than that of controls (P < .0001, α = .05). Serum 25(OH)D levels of FPHL patients (P < .0001, α = .05) and MAGA patients (P = .0005, α = .05) were also significantly lower than counterpart control subjects. CONCLUSION Our findings suggest an association between serum 25(OH)D levels and alopecia areata, female pattern hair loss, or male androgenetic alopecia in a Chinese population.
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Affiliation(s)
- Jun Zhao
- Department of Dermatology, Huashan Hospital, Fudan University, Shanghai, China
| | - Youyu Sheng
- Department of Dermatology, Huashan Hospital, Fudan University, Shanghai, China
| | - Chunyang Dai
- Department of Dermatology, Shanghai Sixth People's Hospital, Shanghai Jiaotong University, Shanghai, China
| | - Sisi Qi
- Department of Dermatology, Huashan Hospital, Fudan University, Shanghai, China
| | - Ruiming Hu
- Department of Dermatology, Huashan Hospital, Fudan University, Shanghai, China
| | - Wenlong Rui
- Department of Dermatology, Huashan Hospital, Fudan University, Shanghai, China
| | - Ying Miao
- Department of Dermatology, Huashan Hospital, Fudan University, Shanghai, China
| | - Feng Xu
- Department of Dermatology, Huashan Hospital, Fudan University, Shanghai, China
| | - Yao Zhang
- Department of Dermatology, Huashan Hospital, Fudan University, Shanghai, China
| | - Qinping Yang
- Department of Dermatology, Huashan Hospital, Fudan University, Shanghai, China
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21
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Bikle D, Christakos S. New aspects of vitamin D metabolism and action - addressing the skin as source and target. Nat Rev Endocrinol 2020; 16:234-252. [PMID: 32029884 DOI: 10.1038/s41574-019-0312-5] [Citation(s) in RCA: 184] [Impact Index Per Article: 36.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/12/2019] [Indexed: 12/19/2022]
Abstract
Vitamin D has a key role in stimulating calcium absorption from the gut and promoting skeletal health, as well as many other important physiological functions. Vitamin D is produced in the skin. It is subsequently metabolized to its hormonally active form, 1,25-dihydroxyvitamin D (1,25(OH)2D), by the 1-hydroxylase and catabolized by the 24-hydroxylase. In this Review, we pay special attention to the effect of mutations in these enzymes and their clinical manifestations. We then discuss the role of vitamin D binding protein in transporting vitamin D and its metabolites from their source to their targets, the free hormone hypothesis for cell entry and HSP70 for intracellular transport. This is followed by discussion of the vitamin D receptor (VDR) that mediates the cellular actions of 1,25(OH)2D. Cell-specific recruitment of co-regulatory complexes by liganded VDR leads to changes in gene expression that result in distinct physiological actions by 1,25(OH)2D, which are disrupted by mutations in the VDR. We then discuss the epidermis and hair follicle, to provide a non-skeletal example of a tissue that expresses VDR that not only makes vitamin D but also can metabolize it to its hormonally active form. This enables vitamin D to regulate epidermal differentiation and hair follicle cycling and, in so doing, to promote barrier function, wound healing and hair growth, while limiting cancer development.
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Affiliation(s)
- Daniel Bikle
- Departments of Medicine and Dermatology, University of California San Francisco, San Francisco, CA, USA.
- VA Medical Center, San Francisco, CA, USA.
| | - Sylvia Christakos
- Departments of Microbiology, Biochemistry and Molecular Genetics, New Jersey Medical School, Rutgers, the State University of New Jersey, Newark, NJ, USA
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22
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Abstract
Although first discovered in 1931, vitamin D has seen an increased interest in the scientific community over the past decades, including the dermatology field. Vitamin D promotes calcium and phosphorus absorption; however, the actions of vitamin D are not confined to bone. Indeed, there is now overwhelming and compelling scientific data that vitamin D plays a crucial role in a plethora of cellular function and in extra-skeletal health. Except for fatty fish livers, very few foods naturally contain vitamin D; and the major source of vitamin D comes from skin exposure to sunlight via ultraviolet B. Keratinocytes are unique in the body as not only do they provide the primary source of vitamin D for the body, but they also possess both the enzymatic machinery to metabolize the vitamin D produced to active metabolites. This has been referred to as the photoendocrine vitamin D system. Vitamin D regulates keratinocytes proliferation and differentiation; and plays a role in the defense against opportunistic infections. Multiple factors are linked to vitamin D status; and a growing number of dermatologic diseases has been linked to vitamin D status such as atopic dermatitis, psoriasis, vitiligo, and cutaneous cancers. In this article, we reviewed the potential determinants of vitamin D status, as its implications in dermatologic diseases.
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Affiliation(s)
- Christina Bergqvist
- Department of Dermatology, AP-HP, Henri Mondor University Hospital, Université Paris-Est Créteil, Créteil, France
| | - Khaled Ezzedine
- Department of Dermatology, AP-HP, Henri Mondor University Hospital, Université Paris-Est Créteil, Créteil, France - .,EA 7379 EpidermE, Université Paris-Est Créteil, Créteil, France
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23
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Almohanna HM, Ahmed AA, Tsatalis JP, Tosti A. The Role of Vitamins and Minerals in Hair Loss: A Review. Dermatol Ther (Heidelb) 2019; 9:51-70. [PMID: 30547302 PMCID: PMC6380979 DOI: 10.1007/s13555-018-0278-6] [Citation(s) in RCA: 116] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Indexed: 02/07/2023] Open
Abstract
People commonly inquire about vitamin and mineral supplementation and diet as a means to prevent or manage dermatological diseases and, in particular, hair loss. Answering these queries is frequently challenging, given the enormous and conflicting evidence that exists on this subject. There are several reasons to suspect a role for micronutrients in non-scarring alopecia. Micronutrients are major elements in the normal hair follicle cycle, playing a role in cellular turnover, a frequent occurrence in the matrix cells in the follicle bulb that are rapidly dividing. Management of alopecia is an essential aspect of clinical dermatology given the prevalence of hair loss and its significant impact on patients' quality of life. The role of nutrition and diet in treating hair loss represents a dynamic and growing area of inquiry. In this review we summarize the role of vitamins and minerals, such as vitamin A, vitamin B, vitamin C, vitamin D, vitamin E, iron, selenium, and zinc, in non-scarring alopecia. A broad literature search of PubMed and Google Scholar was performed in July 2018 to compile published articles that study the relationship between vitamins and minerals, and hair loss. Micronutrients such as vitamins and minerals play an important, but not entirely clear role in normal hair follicle development and immune cell function. Deficiency of such micronutrients may represent a modifiable risk factor associated with the development, prevention, and treatment of alopecia. Given the role of vitamins and minerals in the hair cycle and immune defense mechanism, large double-blind placebo-controlled trials are required to determine the effect of specific micronutrient supplementation on hair growth in those with both micronutrient deficiency and non-scarring alopecia to establish any association between hair loss and such micronutrient deficiency.Plain Language Summary: Plain language summary available for this article.
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Affiliation(s)
- Hind M. Almohanna
- Department of Dermatology and Dermatologic Surgery, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | - Azhar A. Ahmed
- Department of Dermatology, King Fahad General Hospital, Medina, Saudi Arabia
| | - John P. Tsatalis
- Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, 1475 NW 12th Ave. Suite 2175, Miami, FL 33136 USA
| | - Antonella Tosti
- Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, 1475 NW 12th Ave. Suite 2175, Miami, FL 33136 USA
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24
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Lee S, Lee H, Lee CH, Lee WS. Comorbidities in alopecia areata: A systematic review and meta-analysis. J Am Acad Dermatol 2019; 80:466-477.e16. [DOI: 10.1016/j.jaad.2018.07.013] [Citation(s) in RCA: 52] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2018] [Revised: 06/01/2018] [Accepted: 07/03/2018] [Indexed: 01/09/2023]
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25
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Doutre MS. [What's new in internal medicine?]. Ann Dermatol Venereol 2018; 145 Suppl 7:VIIS24-VIIS31. [PMID: 30583754 DOI: 10.1016/s0151-9638(18)31286-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
What's new in internal medicine will be dedicated to three topics: i) inflammatory myopathies constituting a heterogenous group of diseases whose clinical manifestations, immunological abnormalities, treatment response and outcomes vary widely; ii) alterations of gut microbiota contributing to the occurrence or development of a range of conditions, including autoimmune diseases for which further work is necessary to understand the correlation of dysbiosis with these diseases; iii) the reciprocal relationship between obesity, metabolic syndrome, atherosclerosis and autoimmune diseases. New data concerning systemic sclerosis, cutaneous vasculitis, adult Still's disease, autoantibodies anti DFS70, Epstein Barr virus and autoimmune diseases were also highlighted.
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Affiliation(s)
- M-S Doutre
- Service de dermatologie, hôpital Saint-André, CHU de Bordeaux, 1, rue Jean-Burget, 33000 Bordeaux, France.
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Gade VKV, Mony A, Munisamy M, Chandrashekar L, Rajappa M. An investigation of vitamin D status in alopecia areata. Clin Exp Med 2018; 18:577-584. [PMID: 29869122 DOI: 10.1007/s10238-018-0511-8] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Accepted: 05/29/2018] [Indexed: 11/29/2022]
Abstract
Alopecia areata (AA) is a type of non-scarring, recurrent patchy loss of hair in hair-bearing areas and is mostly of autoimmune origin. Previous studies have suggested that some autoimmune diseases were found to be associated with vitamin D deficiency. The current study was designed to assess the levels of serum 25-hydroxy vitamin D and C-reactive protein in AA, as compared with controls and to further identify the association between vitamin D levels and disease severity in patients with AA. This cross-sectional study included 45 patients with AA and 45 healthy volunteers. Clinical and anthropometric parameters were recorded, according to a pre-designed proforma. Serum 25-hydroxy vitamin D and high-sensitivity C-reactive protein were estimated using ELISA kits. The severity of AA was determined using Severity of Alopecia Tool (SALT) score. We observed a significant rise in systemic inflammation as seen by elevated high-sensitive C-reactive protein levels and lowered 25-hydroxy vitamin D levels in patients with alopecia areata, compared to controls (p = 0.001). The levels of 25-hydroxy vitamin D showed a significant negative correlation with disease severity, while hs-CRP levels showed a significant positive correlation with disease severity (ρ = - 0.714, p = 0.001 and ρ = 0.818, p = 0.001). Our results suggest significant systemic inflammation and vitamin D deficiency in alopecia areata, more so with increasing disease severity. This gains particular importance in the treatment of alopecia areata in future, as supplementing vitamin D to AA patients would result in reducing the disease severity and inducing remission.
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Affiliation(s)
| | - Archana Mony
- Department of Biochemistry, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, 605006, India
| | - Malathi Munisamy
- Department of Dermatology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Laxmisha Chandrashekar
- Department of Dermatology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Medha Rajappa
- Department of Biochemistry, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, 605006, India.
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Tsai TY, Huang YC. Reply to: "Serum vitamin D level and disease severity of alopecia areata: A meta-regression analysis". J Am Acad Dermatol 2018; 79:e51-e52. [PMID: 29753060 DOI: 10.1016/j.jaad.2018.03.058] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2018] [Accepted: 03/18/2018] [Indexed: 12/29/2022]
Affiliation(s)
- Tsung-Yu Tsai
- Department of Dermatology, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Yu-Chen Huang
- Department of Dermatology, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan; Department of Dermatology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
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28
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Yao CA. Serum vitamin D level and disease severity of alopecia areata: A meta-regression analysis. J Am Acad Dermatol 2018; 79:e49-e50. [PMID: 29753061 DOI: 10.1016/j.jaad.2018.05.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2018] [Revised: 03/06/2018] [Accepted: 05/01/2018] [Indexed: 12/12/2022]
Affiliation(s)
- Chun-An Yao
- Department of Dermatology, Cathay General Hospital, Taipei, Taiwan.
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