Assessment of CXCL10 and Vitamin D in patients with persistent Pityriasis rosea during Covid-19 pandemic

Authors

  • Sherief Mahdy Hussein Department of Clinical Pathology, Al-Azhar University, Cairo, Egypt
  • Mohammed Abd el Hakim Sorour Department of Clinical Pathology, Al-Azhar University, Cairo, Egypt
  • Hanaa Emam Department of Dermatology and Venereology, National Research Centre, 12622, Dokki, Giza, Egypt
  • Shaimaa Ahmed Abd el Azim Department of Clinical Pharmacology, Maadi Military Hospital, Cairo, Egypt
  • Ahmed Hossain Arab Academy for Science, Technology and Maritime Transport Cairo Campus
  • Ahmed Hossain Arab Academy for Science, Technology and Maritime Transport Cairo Campus
  • Hanan Farouk Aly Professor

DOI:

https://doi.org/10.66344/jpad.v32i1.1853

Abstract

Background Pityriasis rosea (PR) is an exanthematous disorder accompanied by systemic recurrence of HHV 6 and/ or 7.

 

Objective To explain the link between levels of vitamin D and CXCL10 in persistent PR during COVID-19.

 

Methods The study encompassed 25 patients (10 males and 15 females, age range: 10–40 years) with persistent PR more than 12 weeks and 25 control subjects (12 males and 13 females, age range: 11-38 years) examined in the medical Excellence center, Dermatology Outpatient Clinic, National Research Center, Egypt between November 2020 and March 2021. Blood samples were collected from controls and persistent PR patients for more than 12 weeks, 15 days later after topmost clinical symptoms. Assessment of serum CXCL10 was done by ELISA kit. Vitamin D was determined using the chemi-luminescence technique.

 

Results  A student unpaired T- test was done at P<0.05 illustrating a significant increase in levels of CXCL10 while a significant decrease in levels of vitamin D in the sera of both male and female patients in comparison to control ones.

 

Conclusion Our study provided evidence that circulating CXCL10 is elevated in persistent PR patients as well as in COVID-19 where PR is one of clinical symptoms of coronavirus. This highlights the immunological response in PR and contributes to a clear explanation of cutaneous defense mechanism. Vitamin D showed a significant reduction in persistent PR patients and has been shown to be safe and guard against acute respiratory infections as in COVID-19.

 

References

1. Drago F, Ciccarese G, Broccolo F, et al. The Role of Cytokines, Chemokines, and Growth Factors in the Pathogenesis of Pityriasis rosea. Mediators of Inflammation 2015;Article ID 438963: 6 pages.

2. Watanabe T, Kawamura T, Jacob S E .Pityriasisrosea is associated with systemic active infection with both human-6 herpesvirus-7 and human herpesvirus-6. J Invest Dermatol. 2002;119:793–7.

3. Broccolo F, Drago F, CaredduA M. Additional evidence that pityriasis rosea is associated with reactivation of human herpesvirus-6 and -7. J Invest Dermatol. 2005;124:1234–40.

4. Drago FGC. Human herpesvirus‐6, ‐7, and Epstein‐Barr virus reactivation in pityriasis rosea during COVID‐19. Medical Virology.2021;93:1850-1.

5. Neoh CY, Tan AWH, Mohamed K, et al. Characterization of the inflammatory cell infiltrate in herald patches and fully developed eruptions of pityriasis rosea. Clin Exp Dermatol. 2010;35:300–04.

6. Gangemi S, Minciullo PML, Guarneri F. Increased serum levels of interleukin-22 in patients affected by pityriasis rosea. J Eur Acad Dermatol Venereol. 2009;7:858–9.

7. Dandan Wu XO. TH17 responses in cytokine storm of COVID-19: An emerging target of JAK2 inhibitor Fedratinib. J Microbiol Immunol Infect. 2020;53:368-70.

8. Pakpoor J, Ramagopalan S. Evidence for an association between vitamin D and multiple sclerosis. Curr Top Behav Neurosci. 2015; 26:105-15.

9. Laganà AS, Vitale SG, Ban Frangež H, et al. Vitamin D in human reproduction: the more, the better? An evidence-based critical appraisal. Eur Rev Med Pharmacol Sci. 2017;21:4243-51.

10. Pereira LA, Luz FB, de Oliveira Carneiro CMM, et al. Evaluation of vitamin D plasma levels after mild exposure to the sun with photo protection. A Bras Dermatol. 2019;94(1):56-61.

11. Reichrath J, Nürnberg B. Cutaneous vitamin D synthesis versus skin cancer development: The Janus faces of solar UV-radiation. Dermatoendocrinol. 2009;1:253-61.

12. Maeda SS, Borba VZ, Camargo MB. Recommendations of the Brazilian Society of Endocrinology and Metabology (SBEM) for the diagnosis and treatment of hypovitaminosis D. Arquivo Brasileiro de Endocrinologia Metabologia. 2014;58:11-33.

13. Christakos S, Dhawan P, Verstuyf A, et al. Vitamin D: Metabolism, Molecular Mechanism of Action, and Pleiotropic Effects. Physiol Rev. 2016;96:365-408.

14. Kenneth Weir TT. Does vitamin D deficiency increase the severity of COVID-19. Clin Med. 2020;20(4):107-8.

15. Giuseppe Murdaca GP. Vitamin D and COVID 19: an update on evidence and potential therapeutic implications. Clin Mol Allergy. 2020;18-23.

16. Maryam Ebadi1 A JL. Perspective: improving vitamin D status in the management of COVID-19. Eu J Clin Nut. 2020;856-9.

17. lie PC, Stefanescu SS, Smith L. The role of vitamin D in the prevention of coronavirus disease infection and mortality. Aging Clin Exp Res. 2020;32(7):1195-8.

18. Martineau Adrian R, Jollife David A, Richard HL. Vitamin D supplementation to prevent acute respiratory tract infections: systematic review and meta-analysis of individual participant data. BMJ. 2017; 356:i6583.

19. OlivieroA F. COVID-19 Pulmonary and Olfactory Dysfunctions: Is the Chemokine CXCL10 the Common Denominator. The Neuroscientist. 2020:1-8.

20. Zhang NYD. CXCL10 an important chemokine associated with cytokine storm in COVID-19 infected patients. Eur Rev Med Pharmacol Sci. 2020;7497-7505.

21. Mathieu Blot M. CXCL10 could drive longer duration of mechanical ventilation during COVID-19 ARDS. Critical Care. 2020;1-15.

22. Szodoray P, Alex P, Brun JG, et al. Circulating cytokines in primary Sjogren’s syndrome determined by a multiplex cytokine array system. Scandinavian J Immunol. 2004;59(6): 592–9.

23. Trifilo MJ, Montalto-Morrison C, Stiles L N. CXCL10 chemokine ligand 10 controls viral infection in the central nervous system: evidence for a role in innate immune response through recruitment and activation of natural killer cells. J Virol. 2004;78(2): 585–94.

24. Klein R S, Lin E, Zhang B. Neuronal CXCL10 directs CD8+ T-cell recruitment and control of West Nile virus encephalitis. J Virol. 2005;79(17):11457–66.

25. Jiao Y, Zhang T, Wang R. Plasma IP-10 is associated with rapid disease progression in early HIV-1 infection. Viral Immunol. 2012; 25(4):333–7.

26. Drago F, Broccolo F, Rebora A. Pityriasis rosea: an update with a critical appraisal of its possible herpes viral etiology. J Am Acad Dermatol. 2009;61:303-18.

27. Kosuge H, Tanaka-Taya K, Miyoshi H. Epidemiological study of human herpesvirus-6 and human herpesvirus-7 in pityriasis rosea. Br J Dermatol. 2000;143(4):795–8.

28. ChuahSY, ChiaHC, Tan HH. Recurrent and persistent pityriasis rosea: an atypical case presentation. Singapore Med J. 2014;55(1): e4-e6. doi: 10.11622/smedj.2013190.

29. Wood GS, Reizner G. Other papulosquamous disorders. In: Bolognia JL, Jorizzo JL, Rapini RP. Dermatology. 2008; 144-6.

30. Halkier-Sørensen L. Recurrent pityriasis rosea: new episodes every year for five years. A case report. Acta Derm Venereol. 1990;70:179–80.

31. Palacios C, Gonzalez L. Is vitamin D defciency a major global public health problem? J Steroid Biochem Mol Biol. 2014; 144:138–45.

32. Adami S, Bertoldo F, Braga V. 25-Hydroxy vitamin D levels in healthy premenopausal wome: association with bone turnover markers and bone mineral density. Bone 2009;45:423–6.

33. Lips P, Cashman K, Lamberg-Allardt C. Current vitamin D status in European and Middle East countries and strategies to prevent vitamin D deficiency: a position statement of the European Calcifed Tissue Society. Eur J Endocrinol. 2019;180:23–54.

34. Abu-Amer Y, Bar-Shavit Z. Impaired bone marrow-derived macrophage diferentiation in vitamin D deficiency. Cell Immunol. 1993;151:356–68.

35. Gruber-BzuraBM. Vitamin D and infuenza-prevention or therapy? Int J Mol Sci. 2018; 19:2419.

36. Guan W, Ni Z, Hu Y, et al. Clinical characteristics of coronavirus disease 19 in China. N Engl J Med. 2020;382:1708-20.

37. Recalcati S. Cutaneous manifestations in COVID-19: a first perspective. J Eur Acad Dermatol Venereol. 2020;34(5):e212-e213. doi: 10.1111/jdv.16387.

38. Estébanez A, Pérez-Santiago L, Silva E, et al. Cutaneous manifestations in COVID‐19: a new contribution. J Eur Acad Dermatol Venereol. 2020;34(6):e250-e251.

39. Mahé A, Birckel E, Krieger S, et al. A distinctive skin rash associated with Coronavirus Disease 2019? J Eur Acad Dermatol Venereol. 2020;34(6):e246-e247.

40. Su C, Lee CH. Viral exanthem in COVID‐19. a clinical enigma with biological significance. J Eur Acad Dermatol Venereol. 2020;34(6):e251-e252.

41. Chuh AA, Zawar V. Pityriasis rosea. Harper's Textbook of Pediatric Dermatology. 2019;20:416-21.

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Published

29.03.2022

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How to Cite

1.
Assessment of CXCL10 and Vitamin D in patients with persistent Pityriasis rosea during Covid-19 pandemic. J Pak Assoc Dermatol [Internet]. 2022 Mar. 29 [cited 2026 Aug. 27];32(1):117-22. Available from: https://www.jpad.com.pk/index.php/jpad/article/view/1853