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Disclosure Qiu Qian and Liang Liuqin are co-first authors. Conflict of Interests The authors PDK4 declare that there is no conflict of interests regarding the publication of this paper.""Atopic dermatitis (AD) is a common chronic inflammatory condition characterized clinically by pruritus, eczematous lesions, and a defective epidermal barrier [1]. AD affects mainly children, but it may occur in adults [2]; these patients exhibit both impaired skin barrier function and defects in skin innate immunity [3]. AD is often associated with a personal or family history of type I allergies [4] (allergic rhinitis and asthma) and develops from a complex interplay between environmental, genetic, and immunologic RGFP966 chemical structure factors. Current treatment of severe disease is challenging because the safety profile of available systemic treatments limits its use. 2. Vitamin D Vitamin D (also known as cholecalciferol) is an active steroid hormone. The function of vitamin D, traditionally associated with calcium and phosphate homeostasis, is thought to be highly complex, and its potential roles in cardiovascular, neoplastic, and microbial infections and autoimmune diseases have been investigated in recent studies [5]. Vitamin D deficiency and insufficiency in patients with asthma [6] and allergic diseases [7] have also recently been discussed. Two independent pathways lead to vitamin D synthesis: the photochemical action of solar ultraviolet B (UVB) light in the skin and specific dietary sources. Vitamin D from supplements can be ingested as vitamin D2 from plant sources or vitamin D3 from animal sources [8]. Vitamin D3 is transported to the liver and is converted to 25-hydroxyvitamin D (25(OH)D). 25(OH)D is released into the circulation and is transported to the kidney where it undergoes further hydroxylation to 1,25-dihydroxyvitamin D (1,25(OH)D). This compound subsequently activates the vitamin D receptor (VDR), regulating the expression Pifithrin-�� order of genes involved in calcium metabolism, proliferation, differentiation, apoptosis, and adaptive immunity [9]. Individuals with higher phototypes, whose melanin functions as a natural sunblock, those who extensively use sunblocks, those who stay primarily indoors, and those living at high latitudes show a reduced vitamin D synthesis [10]. An inverse relationship between serum 25(OH)D concentration and age has been highlighted. The reason for this is presently unclear, although some have theorized that older children may take less oral supplementation or spend less time engaged in outdoors activity [11]. Factors such as obesity, gastrointestinal malabsorption, parathyroid hormone, calcium, phosphorus, fibroblast growth factor, and 1,25(OH)D itself can also alter 1,25(OH)D levels. A 25(OH)D level of 20�C30?ng/mL constitutes relative insufficiency and