Analysis of vitamin D metabolism, thyroid and autoimmune markers in the vitiligo pathways and their possible interaction with sleep

IF 1.8 4区 医学 Q3 DERMATOLOGY
Ellen M. S. Xerfan, Monica L. Andersen, Sergio Tufik, Jane Tomimori, Anamaria da Silva Facina
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引用次数: 0

Abstract

Vitiligo is an autoimmune skin disease that can be influenced by stress, including that resulting from sleep deprivation and sleep disturbances. Sleep is essential in the regulation of several hormonal, metabolic and autoimmune pathways that may have important roles in vitiligo. This study aimed to investigate the potential interplay between hormonal, metabolic, and autoimmune markers in vitiligo patients, and the possible influence of sleep quality in these vitiligo pathways. A cohort of 30 vitiligo patients and 26 healthy controls were assessed for various laboratory markers, including thyroid-stimulating hormone (TSH), parathyroid hormone (PTH), serum calcium, 1.25(OH)2D, 25(OH)D, anti-thyroid peroxidase (anti-TPO), anti-thyroglobulin (anti-TG), and antinuclear antibodies (ANA). The study evaluated sleep quality using the Pittsburgh Sleep Quality Index (PSQI). Positive anti-TPO were found in the vitiligo group, but did not in the control group. Vitamin D 25(OH)D mean levels were clinically insufficient in both groups (< 30 mg/dL). Reactive ANA was analyzed with 2 variables related to vitiligo: phototherapy and skin activity. No statistical correlation was found in the chi-square test on this relationship. Descriptive findings have shown that the positivity to anti-TPO and anti-TG, associated or not with reactive ANA, was higher in vitiligo group. Great part (85.7%) of vitiligo group were “poor sleepers” (PSQI > 5), which has increased (88.2%) when considering only individuals with signs of vitiligo activity. Autoimmune hypothyroidism and positive anti-TPO are expected in vitiligo, although this marker is not usually measured in the first laboratory screening to this disease. Adequate vitamin D levels may be a key adjuvant in skin pigmentation, and be related to sleep quality and immune regulation, as this vitamin can be related to better sleep and immunomodulation in autoimmune diseases. Evaluating ANA before phototherapy can be controversial, but it should be considered in cases with a poor response to this treatment, or when there is a higher risk of other autoimmune diseases. Poor sleep predominated in the vitiligo group, based on PSQI scores that reported worse subjective sleep in these patients. Worse sleep predominated in individuals with signs of skin activity and reactive autoimmune markers. Screening these components could be important in the management of vitiligo, as maintaining body homeostasis can help to improve the disease course. Sleep should be considered as a potential modulator of several multidirectional vitiligo pathways.

分析白癜风发病途径中的维生素 D 代谢、甲状腺和自身免疫标记物及其与睡眠之间可能存在的相互作用。
白癜风是一种自身免疫性皮肤病,会受到压力的影响,包括睡眠不足和睡眠障碍造成的压力。睡眠对多种激素、新陈代谢和自身免疫途径的调节至关重要,而这些途径可能对白癜风有重要作用。本研究旨在调查白癜风患者体内荷尔蒙、新陈代谢和自身免疫标记物之间的潜在相互作用,以及睡眠质量在这些白癜风通路中可能产生的影响。研究人员对30名白癜风患者和26名健康对照者进行了各种实验室指标的评估,包括促甲状腺激素(TSH)、甲状旁腺激素(PTH)、血清钙、1.25(OH)2D、25(OH)D、抗甲状腺过氧化物酶(抗TPO)、抗甲状腺球蛋白(抗TG)和抗核抗体(ANA)。研究使用匹兹堡睡眠质量指数(PSQI)对睡眠质量进行了评估。在白癜风组中发现了抗血小板生成素阳性,而在对照组中则没有发现。两组患者的维生素D 25(OH)D平均水平在临床上都不足(5),如果只考虑有白癜风活动迹象的个体,这一比例会增加(88.2%)。自身免疫性甲状腺功能减退症和抗-TPO阳性是白癜风的预期症状,尽管这种标记物通常不会在这种疾病的首次实验室筛查中进行测量。充足的维生素D水平可能是皮肤色素沉着的关键辅助因素,并与睡眠质量和免疫调节有关,因为这种维生素与改善睡眠和自身免疫性疾病的免疫调节有关。在光疗前对 ANA 进行评估可能会引起争议,但在光疗反应不佳或有其他自身免疫性疾病的较高风险时,应考虑进行评估。根据 PSQI 评分显示,白癜风组患者的主观睡眠质量较差,睡眠质量较差的患者居多。在有皮肤活动迹象和反应性自身免疫标记物的患者中,睡眠质量较差者居多。筛查这些因素可能对白癜风的治疗很重要,因为保持身体平衡有助于改善病程。睡眠应被视为几种多向性白癜风通路的潜在调节器。
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来源期刊
CiteScore
4.10
自引率
3.30%
发文量
30
审稿时长
4-8 weeks
期刊介绍: Archives of Dermatological Research is a highly rated international journal that publishes original contributions in the field of experimental dermatology, including papers on biochemistry, morphology and immunology of the skin. The journal is among the few not related to dermatological associations or belonging to respective societies which guarantees complete independence. This English-language journal also offers a platform for review articles in areas of interest for dermatologists and for publication of innovative clinical trials.
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