Efficacy of vitamin D supplementation in depression in adults: a systematic review protocol Effect of vitamin D supplementation on inflammation: protocol for a systematic review Vitamin D supplementation in the treatment of atopic dermatitis: a clinical trial study. Randomized trial of vitamin D supplementation for winter-related atopic dermatitis in children. A systematic review protocol examining the effect of vitamin D supplementation on endothelial function A randomized controlled double-blind investigation of the effects of vitamin D dietary supplementation in subjects with atopic dermatitis. Sources of evidence for systematic reviews of interventions in diabetes. The vitamin E debate: implications for ongoing trials of pre‐eclampsia prevention Randomized controlled trial using vitamins E and D supplementation in atopic dermatitis
Background The role of vitamin D in management of depression is unclear . Results from observational and emerging r and omized controlled trials ( RCTs ) investigating the efficacy of vitamin D in depression lack consistency - with some suggesting a positive association while others show a negative or inconclusive association . Methods / Design The primary aim of this study is to conduct a systematic review of RCTs to assess the effect of oral vitamin D supplementation versus placebo on depression symptoms measured by scales and the proportion of patients with symptomatic improvement according to the authors ’ original definition . Secondary aims include assessing the change in quality of life , adverse events and treatment discontinuation . We will conduct the systematic review and meta- analysis according to the recommendations of the Cochrane H and book for Systematic Review s of Interventions . We will search the Cochrane Central Register of Controlled Trials ( CENTRAL ) , MEDLINE ( 1966 to present ) , EMBASE ( 1980 to present ) , CINAHL ( 1982 to present ) , PsychINFO ( 1967 to present ) and Clinical Trials.gov . Unpublished work will be identified by search ing two major conferences : the International Vitamin Conference , the Anxiety Disorders and Depression Conference , while grey literature will be acquired by contacting authors of included studies . We will use the r and om-effects meta- analysis to synthesize the data by pooling the results of included studies . Discussion The results of this systematic review will be helpful in clarifying the efficacy of vitamin D supplementation and providing evidence to establish guidelines for implementation of vitamin D for depression in general practice and other relevant setting s. Study registration Unique identifier : CRD42013003849 Introduction The extraskeletal role of vitamin D is being increasingly recognised . This has important clinical implication s , as vitamin D deficiency has reached epidemic proportions worldwide . Vitamin D has proposed anti-inflammatory properties , yet the role of vitamin D supplementation in reducing inflammation remains largely unknown . The purpose of this review is to investigate the impact of vitamin D supplementation on inflammation , and to identify relevant knowledge gaps in the field . Methods and analysis Medline , CINAHL , EMBASE and All EBM will be systematic ally search ed for r and omised controlled trials ( RCTs ) and systematic review s of RCTs , comparing vitamin D supplementation with placebo , usual care or other pharmacological or non-pharmacological interventions . One review er will assess articles for eligibility according to prespecified selection criteria , after which 2 independent review ers will perform data extraction and quality appraisal . Meta-analyses will be conducted where appropriate . Ethics and dissemination Formal ethical approval is not required as no primary data is collected . This systematic review will identify potential clinical implication s of vitamin D deficiency and supplementation , and will be disseminated through a peer- review ed publication and at conference meetings , to inform future research on the efficacy of vitamin D supplementation for inflammation and inflammatory diseases . PROSPERO registration number CRD42016037104 BACKGROUND The role of vitamin D in Atopic Dermatitis ( AD ) is ambiguous and clinical trials are needed to assess the role of vitamin D in the treatment of AD . The aim of this clinical trial study to evaluate the effect of vitamin D supplementation on patients with AD . MATERIAL AND METHODS sixty AD patients were included in a r and omized , double-blind , placebo-controlled trial study . They were r and omly divided into two groups and treated for 60 days : group vitamin D ( n=30 ) , and placebo group ( n=30 ) . The two groups were as follows : Group D , 1600 IU cholecalciferol ( vitamin D ) and second group placebo . The severity of AD was evaluated based on SCORAD ( Scoring Atopic Dermatitis ) and TIS ( Three Item Severity score ) value by the same trained physician before and after the trial . RESULTS According to SCORAD and TIS value index in the vitamin D group showed significant improvement in patients with mild , moderate and severe AD ( P<0.05 ) and in patients who the intake placebo , this improvement did n't showed ( P>0.05 ) . CONCLUSION Results mention that supplementation with oral vitamin D dramatically improved disease severity in AD patients BACKGROUND Epidemiologic and pre clinical data , and a small r and omized trial in Boston , suggest that vitamin D supplementation may improve winter-related atopic dermatitis ( AD ) . OBJECTIVE To determine the effect of vitamin D supplementation on winter-related AD . METHODS We performed a r and omized , double-blind , placebo-controlled trial of Mongolian children with winter-related AD ( clinical trials.gov identifier : NCT00879424 ) . Baseline eligibility included age 2 to 17 years , AD score 10 to 72 using the Eczema Area and Severity Index ( EASI ) , and winter-related AD ( eg , history of AD worsening during the fall-to-winter transition ) . Subjects were enrolled in Ulaanbaatar during winter and r and omly assigned to oral cholecalciferol ( 1000 IU/day ) versus placebo for 1 month . All children and parents received emollient and patient education about AD and basic skin care . The main outcomes were changes in EASI score and in Investigator 's Global Assessment . RESULTS The 107 enrolled children had a mean age of 9 years ( SD 5 ) , and 59 % were male . Their median age of AD onset was 3 months ( interquartile range 2 months to 1 year ) and mean EASI score at baseline 21 ( SD 9 ) . One-month follow-up data were available for 104 ( 97 % ) children . Compared with placebo , vitamin D supplementation for 1 month produced a clinical ly and statistically significant improvement in EASI score ( adjusted mean change : -6.5 vs -3.3 , respectively ; P = .04 ) . Moreover , change in Investigator 's Global Assessment favored vitamin D over placebo ( P = .03 ) . There were no adverse effects in either group . CONCLUSION Vitamin D supplementation improved winter-related AD among Mongolian children , a population likely to have vitamin D deficiency in winter Introduction Vitamin D has potential benefits for extraskeletal health . These could include an anti-inflammatory effect as well as a reduction in endothelial dysfunction . We aim to provide quality evidence for the hypothesis that supplementation with vitamin D will improve endothelial function ( EF ) , possibly through the abrogation of systemic inflammation . Methods and analysis We will conduct a systematic review of all r and omised controlled trials on  vitamin D supplementation and EF lasting 12 weeks or more . The search will cover the period 2000–2015 and include studies that describe direct measures of EF  , markers of endothelial cell ( EC ) activation  and if concurrently reported , indicators of systemic inflammation  . Study selection will follow the Preferred Reporting Items for Systematic Review s and Meta-Analyses ( PRISMA ) guidelines and study quality will be assessed by the Jadad score in addition to an evaluation of allocation concealment and data analysis . If sufficient data are available , a meta- analysis will be conducted . The effect sizes will be generated using Hedges ’ g score , for both fixed and r and om effect models . I2 statistics and Galbraith plots will be used to assess heterogeneity and identify their potential sources . Potential publication and small sample size bias will be assessed by visual inspections of funnel plots and also Egger 's test . Meta-regression analysis ( if feasible ) will be conducted with restricted maximum likelihood ( REML ) estimation method , controlling for potential confounders ( demographics , study methods , location , etc ) . A backward elimination process will be applied in the regression modelling procedure . Subgroup analysis , conditional on number of studies retrieved and their sample size , will be stratified on participant disease category , total dose administered , degree of 25(OH)D change and type of supplement used . Ethics and dissemination Formal ethical approval is not required as primary data will not be collected . The results will be disseminated through a peer- review ed publication , conference presentation and the popular press . Trial registration number International Prospect i ve Register for Systematic Review s ( PROSPERO ) number CRD42014013523 BACKGROUND Subjects with atopic dermatitis ( AD ) have defects in antimicrobial peptide ( AMP ) production possibly contributing to an increased risk of infections . In laboratory models , vitamin D can alter innate immunity by increasing AMP production . OBJECTIVE To determine if AD severity correlates with baseline vitamin D levels , and to test whether supplementation with oral vitamin D alters AMP production in AD skin . METHODS This was a multi-centre , placebo-controlled , double-blind study in 30 subjects with AD , 30 non-atopic subjects , and 16 subjects with psoriasis . Subjects were r and omized to receive either 4000 IU of cholecalciferol or placebo for 21 days . At baseline and day 21 , levels of 25-hydroxyvitamin D ( 25OHD ) , cathelicidin , HBD-3 , IL-13 , and Eczema Area and Severity Index ( EASI ) and Rajka-Langel and scores were obtained . RESULTS At baseline , 20 % of AD subjects had serum 25OHD below 20 ng/mL. Low serum 25OHD correlated with increased Fitzpatrick Skin Type and elevated BMI , but not AD severity . After 21 days of oral cholecalciferol , mean serum 25OHD increased , but there was no significant change in skin cathelicidin , HBD-3 , IL-13 or EASI scores . CONCLUSIONS This study illustrated that darker skin types and elevated BMI are important risk factors for vitamin D deficiency in subjects with AD , and highlighted the possibility that seasonality and locale may be potent contributors to cathelicidin induction through their effect on steady state 25OHD levels . Given the molecular links between vitamin D and immune function , further study of vitamin D supplementation in subjects with AD is warranted AIMS To analyse the effect on systematic review s in diabetes interventions of including only trials that are indexed in medline , and to assess the impact of adding trials from other data bases and the grey literature . METHODS All systematic review s of diabetes interventions which included a meta- analysis of r and omized controlled trials , and were published since 1996 , were selected . The impact on the meta- analysis of including only those trials indexed in medline , and the effect of then adding trials from other sources , was assessed . Where possible this was measured quantitatively , by redoing the meta- analysis , otherwise a qualitative estimate was made . RESULTS Forty-four systematic review s met our inclusion criteria . There were 120 articles reporting trial data which were not indexed in medline . These came from 52 % of the review s. In 34 % of the review s , basing a meta- analysis on a search of only medline would miss trials that could affect the result . Sources of non- medline data which had the biggest effect on the meta-analyses were journal articles from central and embase ( mainly in Diabetes , Nutrition and Metabolism ) and unpublished data ( mainly from industry ) . The exceptions were journal articles on herbal medicine , mostly indexed in Chinese language data bases . CONCLUSIONS A search of only the medline data base is insufficient for systematic review s of diabetes , because in about 34 % of review s the missed trials could affect the results of the meta- analysis . It is recommended that central ( on the Cochrane Library ) also be search ed . Scanning meeting abstract s , and seeking unpublished data are also recommended if the intervention has only recently been introduced A potential role for oxidative stress in the pathophysiology of pre-eclampsia was first proposed by Stark in 1993 . Synthesis of free radicals by a dysfunctional placenta , and possibly by maternal leucocytes and endothelium , seems to play a central role in this association . Free radicals , through oxidative damage of biomolecules and lipid peroxidation , can initiate maternal vascular endothelial dysfunction and leucocyte activation . A comprehensive review of the role of oxidative stress in pre-eclampsia has been recently published . Antioxidants such as vitamin C and vitamin E have been proposed as potential therapeutic or prophylactic treatment for pre-eclampsia .  This suggestion was supported by the observation that women with pre-eclampsia have lower plasma vitamin C concentrations . Both in vitro and in vivo studies suggest that there is an interaction between vitamin C and vitamin E , with vitamin C possibly exerting a ‘ redox ’ recycling effect on oxidised vitamin E within lipoproteins and membranes . The vitamin C to E ratio may be of central importance in protecting against the damaging effects of reactive oxygen species . To date , three placebo-controlled trials have assessed the effect of vitamins C and E on  pre-eclampsia .  Although no benefits were found when supplementation was given to women with diagnosed pre-eclampsia , a combination of 1 g/day of vitamin C and 400 IU/day of vitamin E given as prophylaxis to high risk women demonstrated a reduction in the risk of pre-eclampsia from 17 % in the control group to 8 % in the active treatment group . In this same double-masked r and omised controlled trial , women receiving vitamins C and E showed a reduction in biological markers of oxidative stress . Since this report , a number of multicentre r and omised clinical trials have been initiated both in low risk and in high risk population s , with the goal of testing the hypothesis that antioxidants reduce the incidence of pre-eclampsia ( Table 1 ) . In the UK , a multicentre trial is currently recruiting pregnant women with diabetes . The NIH has funded two antioxidant trials , one that is under way in Brazil and the second that is being conducted among nulliparous women in the NICHD Maternal Fetal Medicine Network . The International Trial of Antioxidants for the Prevention of Preeclampsia ( INTAPP ) , funded by the Canadian Institutes of Health Research , is enrolling nulliparas without additional risk factors ( Stratum I ) and multiparas and nulliparas with clinical risk factors for gestational hypertension ( Stratum II ) . Collectively , these trials should provide an answer to the question of the role of antioxidants in the prevention of pre-eclampsia and its related disorders . Recently , a meta- analysis of 19 clinical trials of  vitamin E  , for the most part secondary prevention trials , conducted in elderly population s at increased risk for a number of diseases ranging from lung or gastrointestinal cancer to cardiovascular disease , Alzheimer ’s disease or cataract , was published in the Annals of Internal Medicine . The authors of the meta- analysis concluded that high doses of vitamin E may be associated with an increased risk of all-cause mortality . What are the implication s of this meta- analysis for the ongoing pre-eclampsia prevention trials ? It is the responsibility of the Principal Investigators , the Steering Committees and Data Safety Monitoring Committees ( DSMC ) of ongoing clinical trials to take into account information generated from studies that arise in the course of their trial . They must assess the quality of the new evidence and determine how this information influences the balance of risks to benefits of the ongoing trials . In the case of the Canadian trial , both the DSMC and the hospital Ethics Committee have review ed the information and made their recommendations to the trial Steering Committee . The following is our evaluation of the quality of the evidence of the meta- analysis by Miller et al. , and its implication s for ongoing clinical trials of antioxidants in the prevention of pre-eclampsia Abstract Background : Atopic dermatitis is a chronically relapsing , highly pruritic and inflammatory skin disease . This study was done to assess the effects of vitamins D and E supplementation on the clinical manifestation of atopic dermatitis . Methods : Forty-five atopic dermatitis patients were included in a r and omized , double-blind , placebo-controlled trial . They were r and omly divided into four groups and treated for 60 days : group P ( n = 11 ) , vitamins D and E placebos ; group D ( n = 12 ) , 1600 IU vitamin D3 plus vitamin E placebo ; group E ( n = 11 ) , 600 IU synthetic all-rac-α-tocopherol plus vitamin D placebo ; and group DE ( n = 11 ) , 1600 IU vitamin D3 plus 600 IU synthetic all-rac-α-tocopherol .  Serum 25(OH ) vitamin D and plasma α-tocopherol were determined before and after the trial . The clinical improvement was evaluated with SCORing Atopic Dermatitis ( SCORAD ) . Data were analyzed by analysis of variance ( ANOVA ) and Kruskal-Wallis tests . Results : SCORAD was reduced after 60 days in groups D , E and DE by 34.8 % , 35.7 % and 64.3 % , respectively ( p = 0.004 ) . Objective SCORAD also showed significant improvement . There was a positive correlation between SCORAD and intensity , objective , subjective and extent ( p < 0.001 ) . We found a significant negative association between plasma α-tocopherol and SCORAD , intensity , objective and extent ( p = 0.02 ) . Conclusion : This study supports the contributing and beneficial effects of vitamins D and E in the treatment of atopic dermatitis
Vitamin D has a potentially significant role for improving the symptoms of AD .
The results from this study suggest that vitamin D supplementation may help ameliorate the severity of AD , and can be considered as a safe and tolerable therapy .
OBJECTIVES Despite the evidence supporting the use of vitamin D supplements for managing atopic dermatitis ( AD ) , no meta- analysis providing definite conclusions in this field has been reported .
The purpose of the present study was to conduct a systematic review and meta- analysis of all controlled studies of vitamin D for treating AD to eluci date the efficacy of vitamin D for alleviating the symptoms of AD .