Scientific Online Resource System

Scripta Scientifica Pharmaceutica

How much do we know about the role of vitamin D in the pathogenesis of systemic lupus erythematosus

Maria Atanasova Radanova, Bogdan Roussev, Diana Ivanova

Abstract

Vitamin D is an essential steroid hormone. The role of Vitamin D in mineral metabolism and skeletal health as related to calcium homeostasis is well established. In addition to this role, vitamin D has been recently accepted also as immune modulator and thus it could be possibly implicated in the pathogenesis of system-ic lupus erythematosus (SLE). This review focuses on the question: „Is vitamin D deficiency involved in the pathogenesis of SLE or is it a consequence of the disease state?” and comments the known positive effects of vitamin D supplementation on SLE disease activity.


Keywords

vitamin D; systemic lupus erythematosus (SLE)

Full Text


References

Abou-Raya A, Abou-Raya S, Helmii M. The effect of vitamin D supplementation on inflammatory and hemostatic markers and disease activity in patients with systemic lupus erythematosus: a randomized placebo-controlled trial. J Rheumatol. 2013;40(3):265-72.

Agmon-Levin N, Theodor E, Segal RM, Shoenfeld Y. Vitamin D in Systemic and Organ-Specific Autoimmune Diseases. Clinic Rev Allerg Immunol. 2013;45:256-66.

Amital H, Szekanecz Z, Szücs G, Dankó K, Nagy E, Csépány T, et al. Serum concentrations of 25-OH vitamin D in patients with systemic lupus erythematosus (SLE) are inversely related to disease activity: Is it time to routinely supplement patients with SLE with vitamin D? Ann Rheum Dis. 2010;69(6):1155-7.

Andreoli L, Dall'Ara F, Piantoni S, Zanola A, Piva N, Cutolo M, et al. A 24-month prospective study on the efficacy and safety of two different monthly regimens of vitamin D supplementation in pre-menopausal women with systemic lupus erythematosus. Lupus. 2015;24(4-5):499-506.

Aranow C, Kamen DL, Dall'Era M, Massarotti EM, Mackay MC, Koumpouras F, et al. Randomized, Double-Blind, Placebo-Controlled Trial of the Effect of Vitamin D3 on the Interferon Signature in Patients With Systemic Lupus Erythematosus. Arthritis Rheumatol. 2015;67(7):1848-57.

Attar SM, Siddiqui AM. Vitamin d deficiency in patients with systemic lupus erythematosus. Oman Med J. 2013;28(1):42-7.

Ben-Zvi I, Aranow C, Mackay M, Stanevsky A, Kamen DL, Marinescu LM, et al. (2010) The impact of vitamin D on dendritic cell function in patients with systemic lupus erythematosus. PLoS One. 2010;16;5(2):e9193.

Berer A, Stockl J, Majdic O, Wagner T, Kollars M, Lechner K, et al. 1,25-Dihydroxyvitamin D(3) inhibits dendritic cell differentiation and maturation in vitro. Exp Hematol. 2000; 28(5):575-83.

Bogaczewicz J, Sysa-Jedrzejowska A, Arkuszewska C, Zabek J, Kontny E, McCauliffe D, et al. Vitamin D status in systemic lupus erythematosus patients and its association with selected clinical and laboratory parameters. Lupus 2012;21(5):477-84.

Bonakdar ZS, Jahanshahifar L, Jahanshahifar F, Gholamrezaei A. Vitamin D deficiency and its association with disease activity in new cases of systemic lupus erythematosus. Lupus 2011;20(11):1155-60.

Boonstra A, Barrat FJ, Crain C, Heath VL, Savelkoul HF, O`Garra A. alpha,25-Dihydroxyvitamin d3 has a direct effect on naive CD4(+) T cells to enhance the development of Th2 cells. J Immunol. 2001;167(9):4974-80.

Borba VZ, Vieira JG, Kasamatsu T, Radominski SC, Sato EI, Lazaretti-Castro M. Vitamin D deficiency in patients with active systemic lupus erythematosus. Osteoporos Int. 2009;20(3):427-433.

Breslin LC, Magee PJ, Wallace JM, McSorley EM. An evaluation of vitamin D status in individuals with systemic lupus erythematosus. Proc Nutr Soc. 2011;70(4):399-407.

Buckner JH. Mechanisms of impaired regulation by CD4(+)CD25(+)FOXP3(+) regulatory T cells in human autoimmune diseases. Nat Rev Immunol. 2010;10(12):849-59.

Cantorna MT, Mahon BD. Mounting evidence for vitamin D as an environmental factor affecting autoimmune disease prevalence. Exp Biol Med.(Maywood) 2004;229(11):1136-42.

Chen S, Sims GP, Chen XX, Gu YY, Chen S, Lipsky PE. Modulatory Effects of 1,25-Dihydroxyvitamin D3 on Human B Cell Differentiation. J Immunol. 2007;179(3):1634-47.

Cutolo M, Otsa K. Review: vitamin D, immunity and lupus. Lupus. 2008;17(1):6-10.

Haga HJ, Brun JG, Rekvig OP, Wetterberg L. Seasonal variations in activity of systemic lupus erythematosus in a subarctic region. Lupus. 1999;8(4):269-73.

Hamza RT, Awwad KS, Ali MK, Hamed AI. Reduced serum concentrations of 25-hydroxy vitamin D in Egyptian patients with systemic lupus erythematosus: relation to disease activity. Med Sci Monit. 2011;17(12):CR711-8.

Heaney RP, Recker RR, Grote J, Horst RL, Armas LA. Vitamin D(3) is more potent than vitamin D(2) in humans. J Clin Endocrinol Metab. 2011;96(3):E447­52.

Hewison M. Vitamin D and the immune system: new perspectives on an old theme. Endocrinol Metab Clin North Am. 2010;39(2):365-79.

Holick MF. 2011 Chapter 136 Vitamin D Treatment Guidelines. Evaluation treatment and prevention of vitamin D deficiency. Available from: http://www.apiindia.org/medicine_update_2013/chap136.pdf

Iruretagoyena M, Hirigoyen D, Naves R, Burgos PI. Immune response modulation by vitamin D: role in systemic lupus erythematosus. Front Immunol. 2015;6:513.

Kamen DL, Cooper GS, Bouali H, Shaftman SR, Hollis BW, Gilkeson GS. Vitamin D deficiency in systemic lupus erythematosus. Autoimmun Rev. 2006;5(2):114-17.

Kamen DL, Tangpricha V. Vitamin D and molecular actions on the immune system: modulation of innate and autoimmunity. J Mol Med. 2010;88:441-50.

Kamen DL. Vitamin D in Lupus. New Kid on the Block? Bull NYU Hosp Jt Dis. 2010;68(3):218-22.

Kaneko I, Sabir MS, Dussik CM, Whitfield GK, Karrys A, Hsieh JC, et al. 1,25-Dihydroxyvitamin D regulates expression of the tryptophan hydroxylase 2 and leptin genes: implication for behavioral influences of vitamin D. FASEB J. 2015;29(9):4023-35.

Kim HA, Sung JM, Jeon JY, Yoon JM, Suh CH.Kim HA, Sung JM, Jeon JY, Yoon JM, Suh CH. Vitamin D may not be a good marker of disease activity in Korean patients with systemic lupus erythematosus. Rheumatol Int. 2011;31(9):1189-94.

Kochupillai N. The physiology of vitamin D: current concepts. Indian J Med Res. 2008;127(3):256-62.

Kriegel MA, Manson JE, Costenbader KH. Does Vitamin D affect risk of developing autoimmune disease?: A systematic review. Semin Arthritis Rheum. 2011;40:512-53.

Lemire JM. Immunomodulatory role of 1,25-dihydroxyvitamin D3. J Cell Biochem. 1992;49(1):26-31.

Lima GL, Paupitz J, Aikawa NE, Takayama L, Bonfa E, Pereira RM. A randomized double-blind placebo-controlled trial of vitamin D supplementation in adolescents and young adults with Juvenile-onset SLE: Improvement in disease activity and fatigue scores. Arthritis Care Res (Hoboken). 2015 May 18. doi: 10.1002/acr.22621. [Epub ahead of print]

Linker-Israeli M, Elstner E, Klinenberg JR, Wallace DJ, Koeffler HP. Vitamin D(3) and its synthetic analogs inhibit the spontaneous in vitro immunoglobulin production by SLE-derived PBMC. Clin Immunol. 2001;99:82-93.

López-Robles C, Rios-Fernández R, Callejas-Rubio JL, Ortego-Centeno N. Vitamin D deficiency in a cohort of patients with systemic lupus erythematous from the South of Spain. Lupus. 2011;20(3):330-1.

Mandal M, Tripathy R, Panda AK, Pattanaik SS, Dakua S, Pradhan AK, et al. VitaminD levels in Indian systemic lupus erythematosus patients: association with disease activity index and interferon alpha. Arthritis Res Ther. 2014;16(1):R49.

Marques CDL, Dantas AT, Fragoso TS, Duarte ÂLBP. The importance of vitamin D levels in autoimmune diseases. Bras J Rheumatol. 2010;50(1):67-80.

Mok CC, Birmingham DJ, Ho LY, Hebert LA, Song H, Rovin BH. Vitamin D deficiency as marker for disease activity and damage in systemic lupus erythematosus: a comparison with anti-dsDNA and anti-C1q. Lupus. 2012;21:36-42.

Mok CC, Birmingham DJ, Leung HW, Hebert LA, Song H, Rovin BH. Vitamin D levels in Chinese patients with systemic lupus erythematosus: relationship with disease activity, vascular risk factors and atherosclerosis. Rheumatology (Oxford). 2012;51(4):644-52.

Munoz-Ortego J, Torrente-Segarra V, Prieto-Alhambra D, Salman-Monte T, Carbonell-Abello J. Prevalence and predictors of vitamin D deficiency in non-supplemented women with systemic lupus erythematosus in the Mediterranean region: a cohort study. Scand J Rheumatol. 2012;41(6):472-5.

Penna G, Adorini L. Alpha,25-dihydroxyvitamin D3 inhibits differentiation, maturation, activation, and survival of dendritic cells leading to impaired alloreactive T cell activation. J Immunol. 2000;164(5):2405-11.

Petri M, Bello KJ, Fang H, Magder LS. Vitamin D in systemic lupus erythematosus: modest association with disease activity and urine protein/creatinine ratio. Arthritis Rheum. 2013;65(7):1865-71.

Piantoni S, Andreoli L, Scarsi M, Zanola A, Dall` Ara F, Pizzorni C, et al. Phenotype modifications of T-cells and their shift toward a Th2 response in patients with systemic lupus erythematosus supplemented with different monthly regimens of vitamin D. Lupus. 2015; 24(4-5):490-8.

Prietl B, Treiber G, Pieber TR, Amrein K. Vitamin D and immune function. Nutrients. 2013;5(7):2502-21.

Reynolds JA, Haque S, Berry JL, Pemberton P, Teh LS, Ho P, et al. 25-Hydroxyvitamin D deficiency is associated with increased aortic stiffness in patients with systemic lupus erythematosus. Rheumatology. 2012;51:544-51.

Ritterhouse LL, Crowe SR, Niewold TB, Kamen DL, Macwana SR, Roberts VC, et al. Vitamin D deficiency is associated with an increased autoimmune response in healthy individuals and in patients with systemic lupus erythematosus. Ann Rheum Dis. 2011;70(9):1569-74.

Rolf L, Muris AH, Hupperts R, Damoiseaux J. Vitamin D effects on B cell function in autoimmunity. Ann N Y Acad Sci. 2014;1317:84-91.

Ruiz-Irastorza G, Egurbide MV, Olivares N, Martinez-Berriotxoa A, Aguirre C. Vitamin D deficiency in systemic lupus erythematosus: prevalence, predictors and clinical consequences. Rheumatology. 2008;47:920-3.

Ruiz-Irastorza G, Gordo S, Olivares N, Egurbide MV, Aguirre C. Changes in vitamin D levels in patients with systemic lupus erythematosus: Effects on fatigue, disease activity, and damage. Arthritis Care Res (Hoboken). 2010;62(8):1160-5.

Sakem B, Nock C, Stanga Z, Medina P. Nydegger UE, Risch M. et al., Serum concentrations of 25-hydroxyvitamin D and immunoglobulins in an older Swiss cohort: results of the Senior Labor Study. BMC Med. 2013;11:176.

Schneider L, Colar da Silva AC, Werres Junior LC, Alegretti AP, Pereira dos Santos AS, Santos M, et al. Vitamin D levels and cytokine profiles in patients with systemic lupus erythematosus. Lupus. 2015;24(11):1191-7.

Szodoray P, Tarr T, Bazso A, Poor G, Szegedi G, Kiss E. The immunopathological role of vitamin D in patients with SLE: data from a single centre registry in Hungary. Scand J Rheumatol. 2011;40(2):122-6.

Terrier B, Derian N, Schoindre Y, Chaara W, Geri G, Zahr N, et al. Restoration of regulatory and effector T cell balance and B cell homeostasis in systemic lupus erythematosus patients through vitamin D supplementation. Arthritis Res Ther. 2012;14(5):R221.

Thudi A, Yin S, Wandstrat AE, Li QZ, Olsen NJ. Vitamin D levels and disease status in Texas patients with systemic lupus erythematosus. Am J Med Sci. 2008;335(2):99-104.

Toloza SM, Cole DE, Gladman DD, Ibañez D, Urowitz MB. Vitamin D insufficiency in a large female SLE cohort. Lupus. 2010;19(1):13-9.

Toubi E, Shoenfeld Y. The role of vitamin D in regulating immune responses. Isr Med Assoc J. 2010;12:174-5.

Wright TB, Shults J, Leonard MB, Zemel BS, Burnham JM. Hypovitaminosis D is associated with greater body mass index and disease activity in pediatric systemic lupus erythematosus. J Pediatr. 2009 Aug;155(2):260-5.

Wu PW, Rhew EY, Dyer AR, Dunlop DD, Langman CB, Price H, et al. 25-hydroxyvitamin D and cardiovascular risk factors in women with systemic lupus erythematosus. Arthritis Rheum. 2009;61:1387-95.

Yap KS, Morand EF. VitaminD and systemic lupus erythematosus: continued evolution. Int J Rheum Dis. 2015;18(2):242-9.

Yeap SS, Othman AZ, Zain AA, Chan SP. Vitamin D levels: its relationship to bone mineral density response and disease activity in premenopausal Malaysian systemic lupus erythematosus patients on corticosteroids. Int J Rheum Dis. 2012;15(1):17-24.

Yu S, Cantorna MT. The vitamin D receptor is required for iNKT cell development. Proc Natl Acad Sci USA. 2008;105:5207-12.




DOI: http://dx.doi.org/10.14748/ssp.v2i2.1425

Refbacks

About The Authors

Maria Atanasova Radanova
Medical University of Varna, Department of Biochemistry, Molecular Medicine and Nutrigenomics
Bulgaria

Bogdan Roussev
Medical University of Varna, Department of Biochemistry, Molecular Medicine and Nutrigenomics

Diana Ivanova
Medical University of Varna, Department of Biochemistry, Molecular Medicine and Nutrigenomics

Font Size


|