Myśliwiec Hanna, Kiluk Paulina, Żelazowska-Rutkowska Beata, Baran Anna, Justyna Milewska Anna, Myśliwiec Piotr, Flisiak Iwona
Przegl Lek. 2016;73(9):610-4.
Recent studies point out the important role of vitamin D in the pathogenesis of many autoimmune diseases, in between psoriasis. Vitamin D regulates function of the dendritic cells, proliferation and maturation of the keratynocytes and lymphocytes T. The aim of the study was to evaluate serum vitamin D (25OHD) concentrations in psoriatic patients in the north-east of Poland and their comparison in the summer and winter period of the year. We also evaluated relationship between 25OHD concentration and disease severity, prevalence of psoriatic comorbidities and laboratory results.
25OHD serum concentration was evaluated by electrochemiluminescent method in 115 patients with exacerbated plaque type psoriasis. 39 patients were evaluated in the summer and 79 in the winter time. 28 patients from winter group were treated with narrow band ultraviolet B radiation (NB-UVB). The results were compared with 38 healthy persons.
25OHD serum concentrations of psoriatic patients were significantly lower than in the control group (p=0,0003). Vitamin D deficiency was diagnosed in 66% of patients in the summer time and in 63% in winter time; in the control group: 24% during the summer and 71% during the winter. After UVB phototherapy we observed reduction of skin lesions, measured as a significant decline in the Psoriasis Area and Severity Index (PASI) (p<0.001). The serum 25OHD concentration increased (p<0.001). After the treatment 65% of the psoriatic patients reached normal range of 25OHD concentration, 35% of patients were still vitamin D insufficient. We demonstrate positive correlation between increase in 25OHD and number of NB-UVB phototherapy sessions (r=0.38).
We have observed vitamin D deficiency both in psoriatic patients and in the control group. Among psoriatic patients the praevalence of deficiency were higher than in the control group, especially during the summer months. Frequent vitamin D defficiency in the groups studied indicates the need of for its supplementation. The 25OHD serum concentrations increased after phototherapy with UVB.
近期研究指出维生素D在多种自身免疫性疾病发病机制中发挥重要作用,其中包括银屑病。维生素D可调节树突状细胞功能、角质形成细胞及T淋巴细胞的增殖与成熟。本研究旨在评估波兰东北部银屑病患者血清维生素D(25羟维生素D)浓度,并比较其在一年中夏季和冬季的情况。我们还评估了25羟维生素D浓度与疾病严重程度、银屑病合并症患病率及实验室检查结果之间的关系。
采用电化学发光法对115例斑块型银屑病病情加重患者的血清25羟维生素D浓度进行评估。其中39例患者在夏季接受评估,79例在冬季接受评估。冬季组的28例患者接受窄谱中波紫外线(NB-UVB)照射治疗。将结果与38名健康人进行比较。
银屑病患者的血清25羟维生素D浓度显著低于对照组(p = 0.0003)。夏季66%的患者及冬季63%的患者被诊断为维生素D缺乏;对照组中,夏季为24%,冬季为71%。经UVB光疗后,我们观察到皮肤病变减轻,以银屑病面积和严重程度指数(PASI)显著下降为衡量标准(p < 0.001)。血清25羟维生素D浓度升高(p < 0.001)。治疗后,65%的银屑病患者25羟维生素D浓度达到正常范围,35%的患者仍存在维生素D不足。我们发现25羟维生素D升高与NB-UVB光疗次数呈正相关(r = 0.38)。
我们观察到银屑病患者及对照组均存在维生素D缺乏。银屑病患者中维生素D缺乏的患病率高于对照组,尤其是在夏季。研究组中维生素D缺乏情况较为常见,提示有必要进行补充。UVB光疗后血清25羟维生素D浓度升高。