PBMCs samples collected at M0 and M6 were used. Maintenance treatment was then continued with 50,000 IU once a month up to month 6. Patients were treated as per standard of care in case of Vit D insufficiency with cholecalciferol supplementation (50,000 IU once a week for the first 3 months).
Collagen catabolism full#
A full ophthalmology exam was performed, including measuring (1) best spectacle-corrected visual acuity (BSCVA), (2) maximal keratometry (Kmax), and (3) epithelial and stromal minimal thickness and thinnest corneal thickness (TCT) by corneal tomography and topography. All patients were instructed not to rub regardless of having the habit or not.
At the screening visit, medical history was collected, including the presence of allergies and rubbing habits. The diagnosis of KC was confirmed by corneal tomography/topography (MS-39 AS-OCT CSO, Firenze, Italy). 34 Exclusion criteria included bilateral prior surgical procedures of the cornea (including crosslinking) diagnosis of end-stage KC, defined as corneal thickness less than 300 µm and/or extensive apical leucoma and/or corneal hydrops or diagnosis of active keratitis/conjunctivitis. We recruited 20 patients (age range, 8–19 years) presenting KC and Vit D insufficiency (serum levels < 30 ng/mL). Our findings support that Vit D administration could affect ocular and systemic biomarkers in KC and illuminate a possible mechanism that can be used to develop new treatment alternatives.Īlthough KC therapy currently relies exclusively on surgical procedures, Vit D supplementation may offer a non-invasive and inexpensive alternative with minimal associated side effects. BSCVA, Kmax, and TCT rates remained stable during the observation period. Moreover, stabilization of KC progression was found in 60% of patients (72% of eyes) after 12 months with Vit D supplementation.
Vit D supplementation increased the cell availability of copper. Lower Vit D levels in the plasma were correlated with higher levels of systemic biomarkers of collagen degradation. Blood samples were collected at different time points to evaluate Vit D levels and systemic markers of collagen degradation, inflammation, oxidative stress, and copper metabolism by ELISA or RT-PCR. The primary outcome of the study was the proportion of patients with Kmax progression of less than 1 D throughout the 12-month follow-up time. At each visit, best spectacle-corrected visual acuity (BSCVA), maximal keratometry (Kmax), and thinnest corneal thickness (TCT) were evaluated. Vit D supplementation was prescribed by their general practitioner as per the standard of care. Twenty patients (age range, 16–19 years) presenting KC and Vit D insufficiency (<30 ng/mL) were included. This was a prospective observational pilot study. To evaluate the impact of vitamin D (Vit D) supplementation on systemic biomarkers of collagen degradation, inflammation, oxidative stress, and copper metabolism in adolescent patients with keratoconus (KC).
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