Vaughn Alexandra R, Foolad Negar, Maarouf Melody, Tran Khiem A, Shi Vivian Y
1 Department of Dermatology, University of California-Davis, Sacramento, CA.
2 School of Medicine, University of California-Davis, Sacramento, CA.
J Altern Complement Med. 2019 Jun;25(6):567-577. doi: 10.1089/acm.2018.0363. Epub 2019 Mar 26.
The pathophysiology of atopic dermatitis (AD) involves a complex interplay between immune system dysfunction, genetics, and environmental factors. It is well known that nutritional status is essential to a proper functioning immune system, leading to a highly debated question regarding the role of dietary factors in the pathogenesis of AD. Food allergies and elimination diets have been broadly studied in atopy; however, less consideration has been given to how vitamins, minerals, and other micronutrients influence the risk for AD and severity of symptoms. This systematic review discusses evidence on how various micronutrients, including vitamins (C, E, and D) and trace minerals (zinc, selenium, iron, copper, magnesium, and strontium) are associated with AD, and how supplementation influence disease severity. A systematic search was conducted to identify the role that oral micronutrients have on AD. The authors reviewed 49 studies herein. While there are weak associations between vitamins C or E and AD, there is sufficient evidence to suggest that vitamin D supplementation provides benefit in AD patients. Deficiency of selenium and zinc may exacerbate AD. Current reports are not sufficient to confidently discern the role of other vitamins and trace minerals on AD. Though oral micronutrients may play a role in AD, the current literature is limited, and there is a need for more comprehensive randomized controlled trials (RCTs) to truly decipher the role between oral micronutrients and AD.
特应性皮炎(AD)的病理生理学涉及免疫系统功能障碍、遗传学和环境因素之间的复杂相互作用。众所周知,营养状况对于正常运作的免疫系统至关重要,这引发了一个关于饮食因素在AD发病机制中作用的激烈争论问题。食物过敏和排除饮食在特应性疾病中已得到广泛研究;然而,对于维生素、矿物质和其他微量营养素如何影响AD风险和症状严重程度的关注较少。本系统综述讨论了各种微量营养素,包括维生素(C、E和D)和微量元素(锌、硒、铁、铜、镁和锶)与AD的关联证据,以及补充这些营养素如何影响疾病严重程度。进行了一项系统检索,以确定口服微量营养素在AD中的作用。作者在此回顾了49项研究。虽然维生素C或E与AD之间存在微弱关联,但有充分证据表明补充维生素D对AD患者有益。硒和锌缺乏可能会加重AD。目前的报告不足以确定其他维生素和微量元素在AD中的作用。虽然口服微量营养素可能在AD中起作用,但目前的文献有限,需要更多全面的随机对照试验(RCT)来真正解读口服微量营养素与AD之间的关系。