title: A randomized controlled double-blind investigation of the effects of vitamin D dietary supplementation in subjects with atopic dermatitis.
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.
authors: Division of Dermatology, Department of Medicine, University of California San Diego and VA Healthcare System, San Diego, CA.
authors: T R
authors: TR
authors: Hata
authors: D
authors: D
authors: Audish
authors: P
authors: P
authors: Kotol
authors: A
authors: A
authors: Coda
authors: F
authors: F
authors: Kabigting
authors: J
authors: J
authors: Miller
authors: D
authors: D
authors: Alexandrescu
authors: M
authors: M
authors: Boguniewicz
authors: P
authors: P
authors: Taylor
authors: L
authors: L
authors: Aertker
authors: K
authors: K
authors: Kesler
authors: J M
authors: JM
authors: Hanifin
authors: D Y M
authors: DY
authors: Leung
authors: R L
authors: RL
authors: Gallo
mesh_terms: D000328:Adult; D002762:Cholecalciferol / Q000627:therapeutic use*; D003876:Dermatitis, Atopic / Q000097:blood / Q000188:drug therapy*; D019587:Dietary Supplements; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D012720:Severity of Illness Index; D014807:Vitamin D / Q000031:analogs & derivatives / Q000097:blood; D014815:Vitamins / Q000627:therapeutic use*
chemical_list: D014815:Vitamins; D014807:Vitamin D; D002762:Cholecalciferol; C104450:25-hydroxyvitamin D
references: J Immunol. 2007 Jul 15;179(2):984-92
references: 17617590
references: Semin Cutan Med Surg. 2008 Jun;27(2):144-50
references: 18620136
references: Sci Transl Med. 2012 May 23;4(135):135ra66
references: 22623742
references: J Invest Dermatol. 2008 Dec;128(12):2880-7
references: 18580964
references: Br J Dermatol. 2008 Jul;159(1):245-7
references: 18489598
references: J Allergy Clin Immunol. 2008 Oct;122(4):829-831
references: 19014773
references: J Immunol. 2004 Sep 1;173(5):2909-12
references: 15322146
references: Photodermatol Photoimmunol Photomed. 2010 Oct;26(5):224-9
references: 20831695
references: N Engl J Med. 2002 Oct 10;347(15):1151-60
references: 12374875
references: Science. 2006 Mar 24;311(5768):1770-3
references: 16497887
references: Br J Dermatol. 2011 May;164(5):1078-82
references: 21087229
references: Gynecol Oncol. 2010 Nov;119(2):314-8
references: 20684976
references: J Clin Endocrinol Metab. 2011 Jan;96(1):53-8
references: 21118827
references: J Immunol. 2003 Sep 15;171(6):3262-9
references: 12960356
references: Am J Clin Nutr. 2008 Dec;88(6):1535-42
references: 19064513
references: J Invest Dermatol. 2007 Apr;127(4):874-80
references: 17082781
references: J Invest Dermatol. 2008 Sep;128(9):2248-58
references: 18385759
references: J Drugs Dermatol. 2012 Mar;11(3):327-30
references: 22395583
references: J Invest Dermatol. 2009 Jun;129(6):1367-78
references: 19052561
references: Obesity (Silver Spring). 2010 Oct;18(10):1906-10
references: 20150902
references: Am J Med. 2009 Nov;122(11):1056-60
references: 19854337
references: Dermatol Ther. 2010 Jan-Feb;23(1):13-22
references: 20136905
references: J Dermatolog Treat. 2011 Jun;22(3):144-50
references: 20653487
references: J Allergy Clin Immunol. 2010 May;125(5):995-1000
references: 20381849
references: N Engl J Med. 2007 Jul 19;357(3):266-81
references: 17634462
references: J Clin Invest. 2007 Mar;117(3):803-11
references: 17290304
references: Br J Dermatol. 2010 Aug;163(2):321-8
references: 20331450
references: Arch Dermatol Res. 2010 Aug;302(6):401-8
references: 20221619