Psoriasis.
Psoriasis is a lifelong inflammatory skin disease characterised by sharply demarcated, scaly, erythematous plaques. Effector cells of the innate immune system, such as keratinocytes, have been shown to have a role in the pathogenesis of psoriasis.
The current view of psoriasis pathogenesis proposes that a combination of environmental and genetic factors confers susceptibility to the disease and that a dysregulated immune response leads to a series of linked cellular changes in the skin.[1]
Many people with this chronic skin condition are aware that if they expose the lesions to sunlight (heliotherapy), or UVB light therapy that the skin improves and their well being and psychological status goes up with it.[2] It seems reasonable to assume that this is related to the increased production of Viatmin D which in turn reduces keratinocyte and other epidermal immune cell production of inflammatory cytokines linked to this complaint.[3]
Keratinocytes are central skin sentinels and can recognise foreign and dangerous agents, for example pathogen-associated molecular patterns (PAMPs) of microbial origin and danger-associated molecular pattern (DAMPs), such as irritants and toxins, through Toll-like receptors (TLRs) and the inflammasome machinery. TLRs are transmembrane receptors that are present on the cell surface or on the surface of endosomal compartments.
But is it the vitamin D production that has the benefits? A recent paper out in the Archives of Dermatology suggests that whilst there is a contemporaneous relationship there appears to be no therapeutic benefit. This is because the blood levels of vitamin D are less relevant than the skin conversion where Vitamin D is able to provide immune suppression. Skin application has been found to be moderately effective and is utilised in a number of medicants, does the topical application of Vitamin D3 itself have any therapeutic value? It seems that it does, but it works better when used in combination with UVB therapy or heliotherapy.[4]
Comment
The use of an emulsified Vit D3 and sunlight exposure will increase immune regulation and aid skin recovery.
Early Onset Preeclampsia
A recent study in the American Journal of Obstetrics and Gynaecology finds that women who develop a severe form of pregnancy-related high blood pressure tend to have lower blood levels of vitamin D than healthy pregnant women suggesting the possibility that the vitamin plays a role in preeclampsia.[5] This adds support to an earlier study in 2007 that had identified that maternal vitamin D deficiency may be an independent risk factor for preeclampsia. The authors stated:
Vitamin D supplementation in early pregnancy should be explored for preventing preeclampsia and promoting neonatal well-being.[6]
Preeclampsia is a syndrome marked by a sudden increase in blood pressure and a build up of protein in the urine due to stress on the kidneys. Early-onset severe preeclampsia is a particularly serious form that arises before the 34th week of pregnancy.
In the recent study, researchers found that vitamin D levels were generally lower among 50 women with early severe preeclampsia compared with those of 100 healthy pregnant women. The average vitamin D level in the former group was just 18 nanograms per milliliter (ng/mL), versus 32 ng/mL in the latter group. Both groups levels were lower than the currently recommended 50-70ng/ml.
Whilst this paper does not provide causality, there are many other reasons why pregnant women would be advised to maintain optimal vitamin D levels.
However, the researchers did note:
A simple 10 ng/mL increase in vitamin D was linked to a 63 percent reduction in the odds of the complication.
The possible explanation is that Vitamin D acts as a hormone, affecting the regulation and function of proteins in the placenta; problems in the development of the placenta are believed to be at the roots of preeclampsia.
Comment
The use of Vitamin D in supplemental form is as valid a recommendation for mothers looking to conceive and pregnant at folate. Vit D does not have such a time critical window as folate so at any time during pregnancy supplementation and restoration of optimal levels will impart immune benefit to mother and foetus.
Are you female and drink Beer?
Consumption of regular, but not light, beer is associated with an increased risk for the development of psoriasis among women, but other alcoholic beverages do not increase this risk, according to new research published Online First August 16 in the Archives of Dermatology.
The association between psoriasis and regular beer intake became stronger in a subset of women with a confirmed diagnosis, who had provided more details about their condition on a 7-item self-assessment questionnaire. In this subset, the risk for psoriasis was 2.3 times higher for women who drank 5 or more beers per week than women who did not drink beer (multivariate RR for ≥ 5 drinks per week, 2.29; 95% CI, 1.36 – 3.85).
Nonlight beer was the only alcoholic beverage that increased the risk for psoriasis, suggesting that certain non-alcoholic components of beer, which are not found in wine or liquor, may play an important role in new-onset psoriasis.
One of these components may be the starch source used in making beer. Beer is one of the few nondistilled alcoholic beverages that use a starch source for fermentation, which is commonly barley…Starch sources such as barley contain gluten, which has been shown to be associated with psoriasis.
- Qureshi AA, Dominguez PL, Choi HK, Han J, Curhan G. Alcohol Intake and Risk of Incident Psoriasis in US Women: A Prospective Study. Arch Dermatol. 2010 Aug 16 View Full Paper
References
[1] Nestle, F. O., Kaplan, D. H. & Barker, J. Psoriasis. N. Engl. J. Med. 361, 496–509 (2009). View Abstract
[2] Osmancevic A, Landin-Wilhelmsen K, Larkö O, Krogstad AL. Vitamin D status in psoriasis patients during different treatments with phototherapy. J Photochem Photobiol B. 2010 May 26 View Abstract
[3] Asadullah K, Döcke WD, Volk HD, Sterry W. The pathophysiological role of cytokines in psoriasis. Drugs Today (Barc). 1999 Dec;35(12):913-24. View Abstract
[4] Gorman S, Judge MA, Hart PH. Immune-modifying properties of topical vitamin D: Focus on dendritic cells and T cells. J Steroid Biochem Mol Biol. 2010 Jul;121(1-2):247-9. Epub 2010 Mar 6 View Abstract
[5] Robinson CJ, Alanis MC, Wagner CL, Hollis BW, Johnson DD. Plasma 25-hydroxyvitamin D levels in early-onset severe preeclampsia. Am J Obstet Gynecol. 2010 Aug 6 View Abstract
[6] Bodnar LM, Catov JM, Simhan HN, Holick MF, Powers RW, Roberts JM. Maternal vitamin D deficiency increases the risk of preeclampsia. J Clin Endocrinol Metab. 2007 Sep;92(9):3517-22. Epub 2007 May 29. View Abstract
