Plasma vitamin D and serum total immunoglobulin E levels in patients with seasonal allergic conjunctivitis.
Acta Ophthalmol. 2014 Sep;92(6):e443-6.
Dadaci Z, Borazan M, Kiyici A, Oncel Acir N.
Department of Ophthalmology, Mevlana (Rumi) University School of Medicine, Meram, Konya, Turkey.
PURPOSE: To evaluate plasma 25-hydroxyvitamin D and serum total immunoglobulin E (IgE) levels in patients with seasonal allergic conjunctivitis (SAC).
METHODS: This observational case-control study involved 49 patients with SAC without any other ocular and systemic diseases, and 44 consecutive, age- and sex-matched healthy subjects. Plasma 25-hydroxyvitamin D and serum total IgE levels of all subjects were quantified with electrochemiluminescence technique. Results were compared between the groups, and p values of
RESULTS: No significant differences were found between the groups with respect to age (p = 0.41) and sex (p = 0.98). Plasma vitamin D levels of the subjects with SAC (median 8.03 ng/ml, range 3.00-17.97 ng/ml) were significantly lower than the control group (median 10.52 ng/ml, range 3.30-25.92 ng/ml) (p = 0.007). Serum total IgE levels of patients with SAC (median 48.65 IU/ml, range 1.77-812.00 IU/ml) were significantly higher when compared to the control group (median 32.49 IU/ml, range 0.14-104.60 IU/ml) (p = 0.003).
CONCLUSIONS: We found lower plasma vitamin D levels and higher serum total IgE levels in patients with SAC.
KEYWORDS: allergy; immunoglobulin E; seasonal allergic conjunctivitis; vitamin D
Allergic diseases, which were very rare a century ago, are frequently encountered recently and affect as much as 40% of the population in developed countries. Seasonal allergic conjunctivitis (SAC), besides its being the most common ocular allergy, is also among the most common allergic diseases encountered worldwide. SAC usually has a chronic course with relapsing-remitting intervals and is associated with other allergies, such as allergic rhinitis, in most of the cases.
The rise in the incidence of allergic diseases is attributed to several factors such as industrialization, lifestyle changes, dietary intake, and exposure to environmental factors such as air pollution. Also more recently, especially upon the discovery of the regulatory effects of vitamin D on the immune system,(1) variations in vitamin D status has been implicated in the development of allergic diseases (2). It has been suggested that vitamin D has a significant role, mainly immunomodulatory, in human physiology beyond skeletal health and calcium homeostasis (1). Altered vitamin D status has been linked to a diverse group of diseases such as allergies,(2) cancers,(3) autoimmune (4) and infectious diseases (5). Of these, allergic diseases are of particular interest and association of vitamin D with various allergies such as asthma, food allergy, and allergic rhinitis has been proposed (2,6,7).
Although the most effective means of managing allergic diseases is to identify and avoid exposure to the offending antigen, this is usually not possible for allergic conjunctivitis as most antigens are airborne. Pharmacological treatment of SAC is the mainstay, but it may still have some limitations such as noncompliance to the therapy and ineffectiveness in preventing the relapses. So, understanding the influence of environmental factors to the pathogenesis of allergic diseases, i.e. vitamin D deficiency, could modify our dealing of these diseases.
Therefore, we aimed to investigate plasma vitamin D levels of patients with SAC and compare with healthy controls without any allergies.
Plasma vitamin D levels of the subjects with SAC were significantly lower than the control group (p=0.007) (Figure 1). Serum IgE levels of patients with SAC were significantly higher when compared to the control group (p=0.003) (Figure 2). There was no correlation between vitamin D and IgE levels of patients with SAC (p=0.312) (Figure 3).
The importance of the study
We demonstrated lower plasma vitamin D levels in patients with SAC compared to the control group. Our preliminary study generates valuable hypotheses and provides a basis for future studies. Further studies investigating the effects of vitamin D supplementation on allergic diseases should be performed in the future. According to those results, supplementation of vitamin D might be considered, in case of established deficiency, for the treatment of patients with allergic conjunctivitis in addition to the classic therapy.
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Fig 1. Comparison of plasma 25-hydroxyvitamin D (ng/ml) levels in patients with seasonal allergic conjunctivitis and control subjects (p=0.007). Fig 2. Comparison of serum total immunoglobulin E (IU/ml) levels in patients with seasonal allergic conjunctivitis and control subjects (p=0.003)Fig 3. Correlation between plasma 25-hydroxyvitamin D (ng/ml) and serum total immunoglobulin E (IU/ml) levels of patients with seasonal allergic conjunctivitis.