Vitamin D Levels Associated With Wound Healing in Burns

Patients with higher levels of vitamin D have a better prognosis, with improved wound healing and reduced risk of infection.

Highlights

Patients with severe burns have low levels of Vitamin D which affect recovery.
Low serum Vitamin D3 levels impair antibacterial and wound healing responses in burn patients.
Supplementing with high doses of vitamin D to increase serum 25D3 may greatly improve health outcomes in burns patients.

High levels of Vitamin D in the blood enables recovery from burns compared to those with low vitamin D levels.

According to a study presented at the Society for Endocrinology annual conference in Harrogate, vitamin D supplementation may be a simple and cost-effective treatment to enhance burn healing.

Medical Management of Vitamin Deficiencies
Vitamins are essential for our body to grow and develop normally. Vitamin deficiencies are widespread. Understand the role of dietary sources in vitamin deficiency prevention.

‘Vitamin D is known to have antibacterial actions that may help combat infection and therefore aid in wound healing of burn patients.’

Many patients with burns injury are at risk of poor recovery despite improvements in burn care over the last 10 years. Complications can range from delayed wound healing through to infections. Patients with severe burns are at high risk of infection that may lead to life-threatening sepsis.

Vitamin D Levels in Patients With Burns

Professor Janet Lord and Dr. Khaled Al-Tarrah, at the Institute of Inflammation & Aging in Birmingham, investigated the role of vitamin D in recovery from burn injuries. She assessed the recovery progress in patients with severe burns over one year and correlated this with their vitamin D levels.

Sunlight: An Important Source of Vitamin D
Vitamin D is an essential vitamin necessary for the development of bones. Sunlight helps the body to produce vitamin D. Vitamin D deficiency results in rickets in children and osteomalacia in adults.

Prof Lord comments, "Low vitamin D levels were associated with worse outcomes in burn patients including life-threatening infections, mortality and delayed wound healing. It was also associated with worse scarring but vitamin D levels are something generally overlooked by clinicians."

The study found that :

burns patients tend to have lower levels of vitamin D
patients with higher levels of vitamin D had a better prognosis, with improved wound healing
vitamin D supplementation immediately following burn injury may have potent health benefits to the patient
Vitamin D enhances antimicrobial activity to prevent infection
Supplementing vitamin D also improved wound healing.

Prof Lord states, "Major burn injury severely reduces vitamin D levels and adding this vitamin back may be a simple, safe and cost-effective way to improve outcomes for burns patients, with minimal cost to NHS."

Link between Statins and Vitamin D
Statins, the cholesterol-lowering medications, and vitamin D appear to complement each other’s effects.

An earlier study done on those with sunburn found that vitamin D increases skin levels of an anti-inflammatory enzyme, arginase-1. The enzyme enhances tissue repair after damage and helps activate other anti-inflammatory proteins.

The effectiveness of vitamin D supplementation to improve outcomes in burn patients would need to be verified in clinical trials. Prof Lord and her team are now focused on finding out why there is a rapid loss of vitamin D in patients immediately following burn injury and hope that they may be able to prevent this in future.

High Vitamin D Levels During Infancy Reduces Risk of Type 1 Diabetes
Vitamin D levels in infancy and childhood may induce the risk of islet autoimmunity among children which in turn can lead to type 1 diabetes.

The amount of reduction in patients' vitamin D levels was not related to the severity of the burn, so levels may also be decreased in minor burn injuries.

Vitamin D - The essential vitamin For Skin Health

Vitamin D is an essential nutrient necessary to maintain healthy bones and teeth. It is available in certain foods, and if dietary intake or supplementation is inadequate, symptoms of vitamin D deficiency develop.

vitamin D deficiency or hypovitaminosis D is an independent risk factor for total mortality in the general population. Vitamin D deficiency is associated with increased risk of common cancers, autoimmune diseases, infectious diseases and hypertension.

Two Forms of Vitamin D

Vitamin D exists in two forms:

Vitamin D2 or Ergocalciferol is obtained from the ultraviolet (UV) irradiation of the yeast sterol ergosterol and is found naturally in sun-exposed mushrooms.

Vitamin D3 known as Cholecalciferol, is synthesized by humans when ultraviolet B (UVB) light from the sun strikes the skin, and so it is the most natural form. Both forms are biologically inactive, and are converted in the body to the active form 1,25 dihydroxy vitamin D.

Vitamin D deficiency is determined by measuring serum 25-hydroxyvitamin D [25(OH)D] concentrations which are the major circulating form of vitamin D.

According to the committee of the Institute of Medicine a level of 20 ng/ml to 50 ng/mL is considered adequate for healthy people. A vitamin D level less than 12 ng/mL indicates vitamin D deficiency.

Reference

Khaled Al-Tarrah, Carl Jenkinson, Martin Hewison, Naiem Moiemen, Janet Lord. ‘Influence of Vitamin D on Outcomes Following Burn Injury: An Observational Cohort Study’. Society for Endocrinology Annual Conference (2017).

Source-Medindia