Cathelicidins Regulated by Vitamin D3

Written by on May 14, 2008 in research, What Causes Rosacea? with 25 Comments

Another paper stemming from the partly NRS funded research into the role of cathelicidins and its role in rosacea. A lot of publicity and publications have resulted from Dr. Gallo’s research. This avenue of research into rosacea looks promising so lets hope that more resources target involved with this area of research.

Those that interested in the role that Vitamin D3 play in immunity should also read the excellent summary over at RSRP: Vitamin D3 ; “Recent studies suggest the importance of Vitamin D3 (Vit D3) in immunity. Vit D3 has been shown to promote the production of the human antimicrobial peptides, cathelicidins (LL-37), and cathelicidins have been found to have broad spectrum antimicrobial activity. Studies also suggest that it is unusual for bacteria to develop resistance to cathelicidins as they might from standard antibiotics.”

Antimicrobial peptides and the skin immune defense system, Schauber J, Gallo RL., J Allergy Clin Immunol. 2008 Apr 24, Department of Dermatology and Allergology, Ludwig-Maximilians-University, Munich, Germany.

Our skin is constantly challenged by microbes but is rarely infected. Cutaneous production of antimicrobial peptides (AMPs) is a primary system for protection, and expression of some AMPs further increases in response to microbial invasion. Cathelicidins are unique AMPs that protect the skin through 2 distinct pathways: (1) direct antimicrobial activity and (2) initiation of a host response resulting in cytokine release, inflammation, angiogenesis, and reepithelialization. Cathelicidin dysfunction emerges as a central factor in the pathogenesis of several cutaneous diseases, including atopic dermatitis, in which cathelicidin is suppressed; rosacea, in which cathelicidin peptides are abnormally processed to forms that induce inflammation; and psoriasis, in which cathelicidin peptide converts self-DNA to a potent stimulus in an autoinflammatory cascade. Recent work identified vitamin D3 as a major factor involved in the regulation of cathelicidin. Therapies targeting control of cathelicidin and other AMPs might provide new approaches in the management of infectious and inflammatory skin diseases.

Another recent abstract is also promoting the synergy of Vitamin D3 and cathelicidins in opening doors for future research and discovery ; Vitamin D regulation of cathelicidin in the skin: toward a renaissance of vitamin D in dermatology?

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About the Author: David Pascoe started the Rosacea Support Group in October 1998. .

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25 Reader Comments

  1. Alex says:

    There is a more comprehensive abstract of the last paper you mentioned there:

    It is important to emphasize that this research does not imply that increasing Vitamin D3 consumption would improve rosacea.
    Vitamin D3 is likely to increase the production of cathelicidins, which has been demonstrated to be a major inflammation factor for rosacea sufferers. As Vitamin D3 production is induced by sun exposure, this paper mentions that the well-known negative effect of sun on rosaceans skin could be mediated by vitamin D3.

    A lot of evidence therefore suggest Vitamin D3 to be an enemy for the rosacea sufferer, while it could help other inflammatory skin disease.

    This paradox could be explained by rosacea being induced by a defective immune anti-microbial response, as envisaged by previous research covered here.

  2. Todd says:

    The recent papers and discussion about D3 relative to rosacea and skin disorders is interesting to me. About 4 months ago I started a daily regimine of 2000-4000 IU dose Vitamin D3 orally as a wintertime immune boosting effort since I live in a northern climate were defficiencies would be the case in winter when no significant daily sunlight exposure would be adequate to stimulate my body’s natural production of the vitamin. After a couple months I began to notice that despite not using any of my prescribed Rosacea treatments, my rosacea symptoms had nearly completely subsided. I kept wondering in the back of my mind if the D3 could possibly be having any impact. I know this is only one observation and it is not a controlled scientific evaluation that one could draw solid conclusions from, but these results have me very interested and wondering. I get what the previous post is saying about how D3 could actually increase or worsen rosacea symptoms, but I can say that in my case, this has not been true. — that being said, I know it doesnt mean that others skin wouldnt react to it differently. Just wanted to share my observation.

  3. Jeff Todd says:

    This study pretty much tells the story………..vitamin D3 does NOT increase cathelicidins it actually suppresses them. Thus, explains why D3 supplementation has worked for so many Rosacea sufferers.

  4. Dan says:

    Hey Jeff,

    Actually Calcipotriol (also known as Calcipotriene) is an analog of Vitamin D. An analog is a drug whose structure is related to that of another drug but whose chemical and biological properties may be quite different.

    In the case of calciptriol, per the Pharmagenomics Knowledge Base, “it has been shown to have comparable affinity with calcitriol [the potent steroid hormone derived from Vitamin D3] for the Vitamin D receptor, while being less than 1% as active as the calcitriol in regulating calcium metabolism:

    Since it is an analog of Vitamin D and is known to behave differently than the naturally derived (from Vitamin D3) product calcitriol, I don’t believe the study on Calcipotriol you mention really explains the benefits of Vitamin D3 in rosacea.

    Unfortunately though studies on these analogs unfortunately seem to confuse not only many of us lay people but also even many medical researchers…

    If you’re the “Todd” above also, I’m certainly glad to hear Vitamin D3 has been helping your rosacea. Stay away from Vitamin D2 and those prescription analogs though…

    Hope this helps…

  5. Jeff Todd says:


    I am not the Todd above, but, yes Vitamin D is doing amazing things for myself as well.

    I am a 46 year old male who has had worsening type 2 since puberty.

    My constantly red face is actually turning a little tan with the little sun I received in the last two weeks.


    I have added Vitamin D to my Omega 3 intake for about 6 weeks now.

    Did you see this line in the conclusion of the article I linked to above.

    “In contrast, cathelicidin antimicrobial peptide expression was increased by calcipotriol.”

    Makes total sense that Vitamin D is going to help our skin (and whole body) fight bacteria.

  6. Doug says:

    I think a lot of people whose symptoms get worse from increasing their Vit D is due to taking oily supplements and possibly increasing their dosage too quickly.

    Any thoughts on this?

  7. Doug says:

    JEFF – how much Omega 3 do you take?

  8. Maureen says:

    Hello To Everyone
    Just had to comment on just how much vit.D-3 has helped me with my Rosacea. I have been taking 5,ooo IU of Vit. D-3 for almost a year now and I just can’t say enough about how much this has helped my Rosacea,cause I have lived with this for over 35 years maybe longer, or maybe born with it.I have often wondered why some people tan easier than others and my own parents never used sun screen went to Hawaii during the winter and got the most beautiful tans ever. They lived to be 90 had some wrinkles which comes with age but never had Rosacea.I’m the only one in my family with Rosacea and I do not tan well at all but mostly burn then tan a little.We all need alittle sun, and I have a nephew who has psorrises and sunlight has a wonderful effect on his skin. But we live in a cold climate not much sun so that is why I take a large dose of vit-D3 everyday and also get a little direct sun with no sunscreen. Maybe the use of all these sunscreensand not getting natural light on your skin may cause more rosacea problems if it is true that Vit. D3 can protect us from bacteria and other problems.

  9. Doug says:

    Maureen – That is great to hear. have you ever had your Vit D levels tested? Also, how much better is your Rosacea? 50%? 75? And how long after you started taking 5000IU did you see improvements in your Rosacea?


  10. Maureen says:

    Hi Doug,
    Sorry I’m just getting back to you. In regards to having my vit.D3 levels checked, yes I did have my levels checked a few years ago, and the results showed that the levels were normal, but what is really normal? When I feel like I’m coming down with something a tech who has a PHD who I’ve seen over the years, told me to take 25,000 to 50,000 IU for about three days. I would not get sick. Then I would go back to my 5,000.
    As far as helping my Rosacea it has helped with the burning, knock on wood haven’t broken out in almost a year but I’m very careful with SUGAR. Sugar is probably the worst thing anyone with Rosacea can put in their bodies, and maybe cause for some strange reason people with Rosacea don’t digest it right or there was talk about a small intestinal bacteria over growth that some of us are dealing with who knows. So my Rosacea I could say is 75% better. I still have the redness and my Derma Dr. at my last visit said after photo’s of my skin were taken that there is a bacteria on my skin but they really don’t care to find out what this bacteria is. I had these photos and a consultation done cause I need to have some laser treatments done on the blood vessels that are on my cheeks, they said this would help. So hopefullycome that time when I do this maybe it will help get rid of this bacteria. After that I willcontinue with my vit. D.
    Sorry this is so long.I’ll do some digging for those test results to see if there is any scale that they go by.

  11. Maureen says:

    Doug, sorry just one other thing, when I started taking VitD-3 I never thought it would help the Rosacea. I was really taking it cause I heard and read that it supports major organs in our bodies.So I would say maybe over a period of a few months it started to improve. I know this is not a cure and I am so tired of the stress of living with this that I will try anything if I can.
    Life could have been so different without this.

  12. Doug says:

    Any other success stories using Vitamin D?

  13. Maureen says:

    Hi Doug,
    Couldn’t find my old test results on my vit-D levels,but just had a new one done. My Western Dr. said that it is higher thannormal at 93 ng/ml. and wants me to cut it back to 800-1000 units a day. After hearing and reading all the benefits of vit-D3 I will continue the 5,000 units daily until I e-mail my Natural-Path Dr. and get his advice on this.
    Go to this web site Doug and read all the benefits on taking vit-D3.
    http://www.vitaminD5000 .com
    Lots of interesting stuff
    I’ll let you know what my NPDr. has to say

  14. Doug says:

    Thanks Maureen! I have read a few people who have kept their Vit D Levels around 100 have shown great improvements in their Rosacea…

    Keep us updated!

  15. Maureen says:

    Just heard back from mynatural path DR. in regards to taking higher levels of vit D3. His response was that all the fat soluble vits. need too be balanced and too muchof one may be detrimental by causing a relative imbalance of the others. Most of us have been defecient for a long time as the RDA were too low.He said too Rosacea is definitely related to heat and usually too much heatfrom a chinese perspective.
    He recommends testing all the fat soluble vits. (A, E, K) if you are going to maintain such a high dose of vit.D3
    When I looked at the range from my western Drs. report their range is from 30-80.My level right now is 93 and I don’t thinkit is that high away from 80.
    I have a lot of respect for this Dr. and have seen him off and on for the last 10 years.
    I will soon have the others checked and see where they are at, and send that past him.
    If I take two days off from taking vit. D3 like sat. and sun. especially during the summer months, and then do it everday when winter comes again, or if I see that the skin is not doing as well, I’ll go back and continue taking it everday, or until researchers come up with something new. I hope my life is not over before they do.
    Thanks for listening

  16. Doug says:

    thanks Maureen.. if you need someone to listen just email me.


  17. Maureen says:

    Hi Doug,
    Thanks for your e-mail address, I talk too you soon.

  18. Doug says:

    I am wondering if people with Rosacea need higher levels of Vit D to normalize the Vitamin D Receptor activation and to normalize our immune system response. I have read that in a lot of diseases the Vit D Receptor (VDR) activation is not normal and that it might take double the normal vitamin d levels to normalize the VDR. So Rosaceans might need their Vit D levels to be in the 80-100ng range. Also, from the people who have raised their Vit D levels into this range it seems to take about a year or so to see significant improvements. I know we all wished it would go away overnight but it takes time as I am sure it took a lot of time for us to develop this disease.

  19. Maureen says:

    Hi Doug, Tried e-mailing you but didn’t go through.I do agree with you that people living with rosacea could possible benefit from raising their D-3 levels to around 90 to 100 and also benefit from keeping them there. I also agree that it takes about a year to raise them up to these levels. I want mine also around 90 too 100 but maybe no higher. Who knows to much might take a turn for the worst. This is a hormone we are dealing with, and with any hormone you want a balance. It is also fat soluable which means it stays in our cells longer than a water soluable one like vit. C B vitamins they leave the body quicker. My Natural Path Dr. wanted me to have my other fat soluable vits. checked (A, E and K) but my western Dr. said they are hard to check and harder to inturpted. My other screening I do also tells me too not take anymore for a while. I will have my levels checked 3-4 times a year to keep them up near 100.

  20. Doug says:

    Hi Maureen,,, so your email didnt go through… hmmmmmmm…

    I have read it can take 6 months to a year just to “fill up the tank” with Vitamin D. So patience is key! I was first tested in May and my level was 36ng which is insufficient/defficient to some experts. I started taking 10,000 IU per day and was tested again in August. My level was only at 43ng. So my levels only raised by 7 ng which is not very much. I have since changed the way I take it and take the entire dose right after I eat dinner. Before I would take some after breakfast and some after dinner. sometimes I took it on an empty stomach, etc. There are many factors that influence the absorbtion of Vitamin D so I am hoping my changes will increase my levels a lot when I get tested again in November.

    If the Vitamin D will help my burning I would be SO HAPPY! 🙂

  21. Maureen says:

    Hi Doug,Read your e-mail, and again tried to e-mail you didn’t work.
    Glad you had your vit. D-3 levels checked. I agree your levels are low.Please don’t ever take any vitamins or any form of supplements without FOOD.Take it with your biggest meal of the day with Protein, vegs, and your starch,even take it right during your meal.Make sure your vit D-3 is in the form of cholecalicferol.Buy a good quality of it. Maybe you should try taking only 5,000 units of it Doug. 10,000 might be too hard for your body to absorb that amount. And it does take patience.It took me almost a year to get mine up.
    Hang in there and good luck

  22. Doug says:

    Hi Maureen… i wonder why when you send an email it doesnt work.

    So are you still seeing improvements with the Vit D? Also, how long did it take before your burning stopped? I am hoping I can get my levels up to the 90-100 range.

  23. nairi says:

    I have not tried Vit d3 but will. Something I´ll do is to take it together with Kyani NitroFX. ( Read about what it does at It´s a product from the company Kyani. Why I´m going to do this is because I took one of this companies 3 products for one month and my rosacea improved. It contained 400 IU vit d3.

  24. Slade says:

    The Cause of Rosacea is primarily from an overly acidic skin and body according to this article.

  25. Maureen says:

    I know a few people who are overly acidic, drink coffee, alcohol ect. and do not have Rosacea, but very beautiful skin. They might be the lucky ones or their chemistry and that goes for everyone is different.
    But I’m sure getting Rosacea people more alkaline would help.
    Just had too share this

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