{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,13]],"date-time":"2026-01-13T15:46:09Z","timestamp":1768319169694,"version":"3.49.0"},"reference-count":56,"publisher":"Public Library of Science (PLoS)","issue":"6","license":[{"start":{"date-parts":[[2023,6,15]],"date-time":"2023-06-15T00:00:00Z","timestamp":1686787200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosntds.org"],"crossmark-restriction":false},"short-container-title":["PLoS Negl Trop Dis"],"abstract":"<jats:sec id=\"sec001\"><jats:title>Background<\/jats:title><jats:p>CL endemicity was reported worldwide including in Saudi Arabia, imposing a major challenge on the health authorities. Vitamin D and its receptor (VDR) are key modulators of the immune response where the VDR is expressed. A remarkable lack of data exists in humans about the contribution of vitamin D and polymorphisms of the VDR gene in protozoan infections, especially cutaneous leishmaniasis (CL).<\/jats:p><\/jats:sec><jats:sec id=\"sec002\"><jats:title>Objective<\/jats:title><jats:p>This is the first work conducted to assess the relationship between vitamin D status, polymorphisms of the VDR gene (BsmI, ApaI, TaqI, and FokI), and VDR haplotype with parasite tissue load and susceptibility to CL.<\/jats:p><\/jats:sec><jats:sec id=\"sec003\"><jats:title>Methods<\/jats:title><jats:p>Fifty-two patients with confirmed CL (21 patients receiving vitamin D medication and 31 patients not receiving it) and 46 control subjects participated in this cross-sectional investigation. VDR genotyping was determined by restriction fragment length polymorphism analysis. Serum levels of 25-OH vitamin D were assessed using the ELISA method in all participants. The skin biopsy quantified the parasite load based on the Ridley parasitic index.<\/jats:p><\/jats:sec><jats:sec id=\"sec004\"><jats:title>Results<\/jats:title><jats:p>The mean serum level of 25-OH vitamin D in CL patients who were not receiving vitamin D therapy was significantly lower compared to CL patients on vitamin D therapy and controls (p &lt;0.001 for both) and CL patients with no history of vitamin D therapy had a significantly higher frequency of vitamin D deficiency compared to CL patients on vitamin D therapy and controls (p &lt; 0.05). Compared to CL patients with no history of vitamin D therapy, CL patients receiving vitamin D therapy had a significantly lower mean size of the lesion and RPI (p = 0.02, .03 respectively). The frequency of genotype \u201caa\u201d and its \u201ca\u201d allele in ApaI SNP of VDR was significantly lower in CL patients compared to controls (p = 0.006 and 0.03 respectively). However, patients with CL had a considerably greater frequency of the \"A\" allele than the controls (p = 0.03), suggesting its role in CL susceptibility. There was no statistically significant difference between the two groups in the genotype and allele frequency distributions of BsmI, TaqI, and FokI (p &gt; 0.05). When compared to controls, CL cases had a considerably greater frequency of the \"B-A-T-F\" haplotype (p = 0.04), and a significantly lower frequency of the \"B-a-T-F\" haplotype (p = 0.01) suggesting that these haplotypes may have the potential susceptibility or protection against CL respectively. The \"Aa\" genotype in ApaI SNP of VDR had considerably lower levels of vitamin D with higher parasite load compared to the \u201cAA\u201d and: aa\u201d genotypes (p = 0.02,0.02 respectively). A significant negative correlation was found between the parasite load and 25-OH vitamin D levels (r<jats:sup>2<\/jats:sup>= -0.53, p&lt; 0.001).<\/jats:p><\/jats:sec><jats:sec id=\"sec005\"><jats:title>Conclusions<\/jats:title><jats:p>According to these findings, vitamin D levels and \"ApaI\" VDR gene polymorphisms could affect the parasite load and susceptibility to infection, whereas BsmI, FokI, and TaqI polymorphisms did not. Correction of vitamin D levels may aid in CL management.<\/jats:p><\/jats:sec>","DOI":"10.1371\/journal.pntd.0011393","type":"journal-article","created":{"date-parts":[[2023,6,15]],"date-time":"2023-06-15T17:46:36Z","timestamp":1686851196000},"page":"e0011393","update-policy":"https:\/\/doi.org\/10.1371\/journal.pntd.corrections_policy","source":"Crossref","is-referenced-by-count":6,"title":["Vitamin D status, vitamin D receptor gene polymorphism, and haplotype in patients with cutaneous leishmaniasis: Correlation with susceptibility and parasite load index"],"prefix":"10.1371","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8553-6845","authenticated-orcid":true,"given":"Doaa A.","family":"Salem","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohammad A.","family":"Alghamdi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hasan S.","family":"AL-Ghamdi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bakheet A.","family":"Alghamdi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ayman Zaki Elsayed","family":"Elsamanoudi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abdulkarim","family":"Hasan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2023,6,15]]},"reference":[{"issue":"1","key":"pntd.0011393.ref001","doi-asserted-by":"crossref","first-page":"111","DOI":"10.4269\/ajtmh.12-0558","article-title":"Clinco-Epidemiologic Study of Cutaneous Leishmaniasis in Bikaner, Rajasthan, India","volume":"89","author":"N Aara","year":"2013","journal-title":"Am J Trop Med Hyg"},{"issue":"9","key":"pntd.0011393.ref002","first-page":"661","article-title":"Cutaneous leishmaniasis in India: clinical experience with Itraconazole (R51211 Janssen).","volume":"29","author":"J Dogra","journal-title":"Int J Dermatol. 1990"},{"issue":"10","key":"pntd.0011393.ref003","doi-asserted-by":"crossref","first-page":"673","DOI":"10.1089\/vbz.2017.2119","article-title":"Cutaneous Leishmaniasis in Saudi Arabia: A Comprehensive Overview","volume":"17","author":"AA Abuzaid","year":"2017","journal-title":"Vector Borne Zoonotic Dis."},{"issue":"949","key":"pntd.0011393.ref004","first-page":"xii","article-title":"Control of the leishmaniases. report of a meeting of the WHO Expert Committee on the Control of Leishmaniases","author":"World Health Organization","year":"2010"},{"issue":"2","key":"pntd.0011393.ref005","doi-asserted-by":"crossref","first-page":"123","DOI":"10.1111\/j.1365-2567.2011.03482.x","article-title":"Vitamin D3: a helpful immuno-modulator","volume":"134","author":"MD Rosa","year":"2011","journal-title":"Immunology"},{"key":"pntd.0011393.ref006","doi-asserted-by":"crossref","first-page":"1","DOI":"10.4103\/jfcm.JFCM_73_17","article-title":"Vitamin D deficiency in Saudi Arabians: A reality or simply hype: A meta-analysis (2008\u20132015)","volume":"25","author":"H Al-Alyani","year":"2018","journal-title":"J. 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