Ann Dermatol.  2018 Apr;30(2):136-142. 10.5021/ad.2018.30.2.136.

A Study on Vitamin D and Cathelicidin Status in Patients with Rosacea: Serum Level and Tissue Expression

• Park BW
• Ha JM
• Cho EB
• Jin JK
• Park EJ
• Park HR
• Kang HJ
• Ko SH
• Kim KH
• Kim KJ

• KMID: 2414673
• DOI: http://doi.org/10.5021/ad.2018.30.2.136

Abstract

BACKGROUND
Rosacea is a chronic inflammatory disease characterized by centrofacial erythema. Excess cathelicidin is suggested to be important to the pathophysiology of the disease. Recently, presence of a vitamin D response element was revealed in the cathelicidin gene promoter.
OBJECTIVE
The aim of this study was to determine whether vitamin D and cathelicidin are associated with rosacea, both serologically and histopathologically.
METHODS
Subjects with rosacea and without chronic skin disorders were enrolled in the patient and control groups, respectively. Serum 25-hydroxy-vitamin D and cathelicidin levels were measured. Tissue expression of cathelicidin and vitamin D receptor were measured with immunostaining-intensity-distribution index.
RESULTS
The mean serum 25-hydroxyvitamin D level of patients with rosacea was 12.18±5.65 ng/ml, which is lower than that of the controls (17.41±6.75 ng/ml). Mean serum cathelicidin levels in patients with rosacea and the controls were 85.0±26.1 ng/ml and 55.0±23.3 ng/ml, respectively. Cathelicidin expression in rosacea tissue was significantly higher than that in control tissue (5.21 vs. 4.03). No significant difference was observed in vitamin D receptor expression.
CONCLUSION
Higher cathelicidin expression in rosacea supports the hypothesis that an abnormal inflammatory response of the innate immune system is important in pathogenesis of rosacea, but the role of high cathelicidin serum levels is complicated. Serum vitamin D was lower in patients with rosacea, although serum cathelicidin was higher than that of the controls. This suggests that the role of vitamin D level in the pathogenesis of rosacea merits further investigation.

Keyword

Cathelicidin; Rosacea; Vitamin D

MeSH Terms

Erythema
Humans
Immune System
Receptors, Calcitriol
Rosacea*
Skin
Vitamin D Response Element
Vitamin D*
Vitamins*
Receptors, Calcitriol
Vitamin D
Vitamins

Figure

• 

  Fig. 1 Immunohistochemical staining (vitamin D receptor; A, B: ×400) and confocal microscopy (vitamin D receptor; C, D: ×400) results for vitamin D receptor. Vitamin D receptor antibody was stained mainly in the nuclei of keratinocytes. On the immunohistochemical staining result, no significant difference was observed between patient (A) and control (B) groups. On the confocal microscopy, rosacea patient's specimen (C) showed slightly brighter enhancement at the epidermal nuclei than the control specimen (D).

• 

  Fig. 2 Immunohistochemical staining (cathelicidin; A, B: ×400) and confocal microscopy (cathelicidin; C, D: ×400) results for cathelicidin. Cathelicidin antibody was stained mainly in the cytoplasm of keratinocytes. On the patient group (A) was stained more intensely than the control group (B). Also, on the confocal microscopy, rosacea patient's specimen (C) showed brighter enhancement at the epidermal cytoplasm than the control specimen (D).

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