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Ghahramanipour Z, Alipour S, Masoumi J, Rostamlou A, Hatami-Sadr A, Heris JA, Naseri B, Jafarlou M, Baradaran B. Regulation of Dendritic Cell Functions by Vitamins as Promising Therapeutic Strategy for Immune System Disorders. Adv Biol (Weinh) 2023; 7:e2300142. [PMID: 37423961 DOI: 10.1002/adbi.202300142] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Revised: 06/14/2023] [Indexed: 07/11/2023]
Abstract
A functional immune system is crucial for a healthy life, protecting from infections, tumors, or autoimmune disorders; these are accomplished by the interaction between various immune cells. Nourishment, particularly micronutrients, are very important components in the immune system balance, therefore this review emphasizes the vitamins (D, E, A, C) and Dendritic cells' subsets due to vitamins' roles in immune processes, especially on dendritic cells' functions, maturation, and cytokine production. Current studies reveal significant benefits related to vitamins, including vitamin E, which can contribute to the control of dendritic cells' function and maturation. Furthermore, vitamin D plays an immunoregulatory and anti-inflammatory role in the immune system. Metabolite of vitamin A which is called retinoic acid leads to T cells' differentiation to T helper 1 or T helper 17, so low levels of this vitamin exacerbate the menace of infectious diseases, and vitamin C has anti-oxidant effects on dendritic cells and modulate their activation and differentiation program. Additionally, the correlation between the amount of vitamin and the occurrence or progression of allergic diseases and autoimmunity disorders is discussed according to the results of previous studies.
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Affiliation(s)
- Zahra Ghahramanipour
- Immunology Research Center, Tabriz University of Medical Sciences, Tabriz, 5166616471, Iran
| | - Shiva Alipour
- Immunology Research Center, Tabriz University of Medical Sciences, Tabriz, 5166616471, Iran
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, 5165665931, Iran
| | - Javad Masoumi
- Immunology Research Center, Tabriz University of Medical Sciences, Tabriz, 5166616471, Iran
| | - Arman Rostamlou
- Department of Medical Biology, Faculty of Medicine, University of EGE, Izmir, 35040, Turkey
| | | | - Javad Ahmadian Heris
- Immunology Research Center, Tabriz University of Medical Sciences, Tabriz, 5166616471, Iran
| | - Bahar Naseri
- Immunology Research Center, Tabriz University of Medical Sciences, Tabriz, 5166616471, Iran
| | - Mahdi Jafarlou
- Immunology Research Center, Tabriz University of Medical Sciences, Tabriz, 5166616471, Iran
| | - Behzad Baradaran
- Immunology Research Center, Tabriz University of Medical Sciences, Tabriz, 5166616471, Iran
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2
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França R, Cordeiro A, Pereira SE, Saboya CJ, Ramalho A. The Effect of Vitamin D Adequacy on Thyroid Hormones and Inflammatory Markers after Bariatric Surgery. Metabolites 2023; 13:metabo13050603. [PMID: 37233644 DOI: 10.3390/metabo13050603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 04/06/2023] [Accepted: 04/07/2023] [Indexed: 05/27/2023] Open
Abstract
Vitamin D status affects the clinical and corporal outcomes of postoperative patients who undergo a Roux-en-Y gastric bypass (RYGB). The aim of this study was to evaluate the effect of adequate vitamin D serum concentrations on thyroid hormones, body weight, blood cell count, and inflammation after an RYGB. A prospective observational study was conducted with eighty-eight patients from whom we collected blood samples before and 6 months after surgery to evaluate their levels of 25-hydroxyvitamin D 25(OH)D, thyroid hormones, and their blood cell count. Their body weight, body mass index (BMI), total weight loss, and excess weight loss were also evaluated 6 and 12 months after surgery. After 6 months, 58% of the patients achieved an adequate vitamin D nutritional status. Patients in the adequate group showed a decrease in the concentration of thyroid-stimulating hormone (TSH) (3.01 vs. 2.22 µUI/mL, p = 0.017) with lower concentrations than the inadequate group at 6 months (2.22 vs. 2.84 µUI/mL, p = 0.020). Six months after surgery, the group with vitamin D adequacy showed a significantly lower BMI compared with the inadequate group at 12 months (31.51 vs. 35.04 kg/m2, p = 0.018). An adequate vitamin D nutritional status seems to favor a significant improvement in one's thyroid hormone levels, immune inflammatory profile, and weight loss performance after an RYGB.
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Affiliation(s)
- Roberta França
- Faculty of Medicine, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro 21941-598, Brazil
- Micronutrients Research Center (NPqM), Institute of Nutrition, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro 21941-902, Brazil
| | - Adryana Cordeiro
- Micronutrients Research Center (NPqM), Institute of Nutrition, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro 21941-902, Brazil
| | - Silvia Elaine Pereira
- Micronutrients Research Center (NPqM), Institute of Nutrition, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro 21941-902, Brazil
- Multidisciplinary Center of Bariatric and Metabolic Surgery Carlos Saboya, Rio de Janeiro 22280-020, Brazil
| | - Carlos José Saboya
- Multidisciplinary Center of Bariatric and Metabolic Surgery Carlos Saboya, Rio de Janeiro 22280-020, Brazil
| | - Andrea Ramalho
- Micronutrients Research Center (NPqM), Institute of Nutrition, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro 21941-902, Brazil
- Department of Social Applied Nutrition, Institute of Nutrition Josué de Castro, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro 21941-902, Brazil
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3
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Corsello A, Spolidoro GCI, Milani GP, Agostoni C. Vitamin D in pediatric age: Current evidence, recommendations, and misunderstandings. Front Med (Lausanne) 2023; 10:1107855. [PMID: 37007781 PMCID: PMC10060648 DOI: 10.3389/fmed.2023.1107855] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Accepted: 02/24/2023] [Indexed: 03/18/2023] Open
Abstract
In recent years vitamin D has been in the spotlight of many researchers for its possible role in various disorders, including autoimmune and infectious diseases. Even if vitamin D deficiency remains a major public health problem, its symptomatic manifestations are less and less common in clinical practice, and pediatric age represents a “gray area” where vitamin D supplementation is often administered in the absence of an effective evaluation of its status. Moreover, a poor knowledge about different definitions of “deficiency,” “insufficiency,” and similar terms is spread among clinicians, while guidelines are not univocal, especially after the first year of life. The aim of this brief opinion paper is to sum up recent evidence about vitamin D status and its supplementation in pediatrics, in order to better clarify a common definition of its deficiency. The aim of this opinion article is to raise awareness on this topic among clinicians and encourage a discussion on the real need for routine 25-hydroxycholecalciferol serum evaluation and its supplementation.
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Affiliation(s)
- Antonio Corsello
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | | | - Gregorio P. Milani
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
- Pediatric Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
- *Correspondence: Gregorio P. Milani,
| | - Carlo Agostoni
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
- Pediatric Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
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4
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On the Centennial of Vitamin D-Vitamin D, Inflammation, and Autoimmune Thyroiditis: A Web of Links and Implications. Nutrients 2022; 14:nu14235032. [PMID: 36501065 PMCID: PMC9736919 DOI: 10.3390/nu14235032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 11/21/2022] [Accepted: 11/24/2022] [Indexed: 11/29/2022] Open
Abstract
The 100th anniversary of the discovery of vitamin D3 (VitD3) coincides with significant recent advances in understanding its mechanism of action along with accumulating knowledge concerning its genomic and nongenomic activities. A close relationship between VitD3 and the immune system, including both types of immunity, innate and adaptive, has been newly identified, while low levels of VitD3 have been implicated in the development of autoimmune thyroiditis (AIT). Active 1,25(OH)2 D3 is generated in immune cells via 1-α-hydroxylase, subsequently interacting with the VitD3 receptor to promote transcriptional and epigenomic responses in the same or adjacent cells. Despite considerable progress in deciphering the role of VitD3 in autoimmunity, its exact pathogenetic involvement remains to be elucidated. Finally, in the era of coronavirus disease 2019 (COVID-19), brief mention is made of the possible links between VitD3 deficiency and risks for severe COVID-19 disease. This review aims to commemorate the centennial of the discovery of VitD3 by updating our understanding of this important nutrient and by drawing up a framework of guidance for VitD3 supplementation, while emphasizing the necessity for personalized treatment in patients with autoimmune thyroid disease. A tailored approach based on the specific mechanisms underlying VitD3 deficiency in different diseases is recommended.
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Corsello A, Milani GP, Giannì ML, Dipasquale V, Romano C, Agostoni C. Different Vitamin D Supplementation Strategies in the First Years of Life: A Systematic Review. Healthcare (Basel) 2022; 10:healthcare10061023. [PMID: 35742074 PMCID: PMC9222934 DOI: 10.3390/healthcare10061023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 05/28/2022] [Accepted: 05/31/2022] [Indexed: 12/04/2022] Open
Abstract
Vitamin D (VD) is an essential micronutrient with multiple functions for human growth, and adequate intake should be guaranteed throughout life. However, VD insufficiency is observed in infants all over the world. Low VD concentration in the breast milk of non-supplemented mothers and low compliance to VD daily supplementation are the main causes of VD insufficiency, especially in the long term. Furthermore, VD supplementation dosages are still debated and differ by country. We conducted a systematic review to compare the most recent evidence on different postnatal VD supplementation strategies, determining whether supplementation given to the mother is as effective as that administered directly to the child, and whether different dosages and administration schedules differ significantly in terms of efficacy and safety. We identified 18 randomized controlled trials (RCTs) addressing the role of infant (n = 961), maternal (n = 652) or combined infant and maternal VD supplementation (n = 260 pairs). In all studies, similar outcomes emerged in terms of efficacy and safety. According to our findings, alternative approaches of VD supplementation may be adopted, especially in cases where the adherence to daily supplementation strategies is poor. This review shows that different dosages and supplementation strategies result in similar VD sufficiency rates. Therefore, international guidelines may be revised in the future to offer multiple and different options of supplementation for specific settings and ages.
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Affiliation(s)
- Antonio Corsello
- Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy; (A.C.); (M.L.G.); (C.A.)
| | - Gregorio Paolo Milani
- Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy; (A.C.); (M.L.G.); (C.A.)
- Pediatric Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
- Correspondence: ; Tel.: +39-349-832-0575
| | - Maria Lorella Giannì
- Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy; (A.C.); (M.L.G.); (C.A.)
- Neonatal Intensive Care Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Valeria Dipasquale
- Pediatric Gastroenterology and Cystic Fibrosis Unit, Department of Human Pathology in Adulthood and Childhood “G. Barresi”, University of Messina, 98125 Messina, Italy; (V.D.); (C.R.)
| | - Claudio Romano
- Pediatric Gastroenterology and Cystic Fibrosis Unit, Department of Human Pathology in Adulthood and Childhood “G. Barresi”, University of Messina, 98125 Messina, Italy; (V.D.); (C.R.)
| | - Carlo Agostoni
- Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy; (A.C.); (M.L.G.); (C.A.)
- Pediatric Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
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6
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Determination of Vitamin D3 in the Fortified Sunflower Oil: Comparison of Two Developed Methods. FOOD ANAL METHOD 2021. [DOI: 10.1007/s12161-021-02124-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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7
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Babić Leko M, Gunjača I, Pleić N, Zemunik T. Environmental Factors Affecting Thyroid-Stimulating Hormone and Thyroid Hormone Levels. Int J Mol Sci 2021; 22:6521. [PMID: 34204586 PMCID: PMC8234807 DOI: 10.3390/ijms22126521] [Citation(s) in RCA: 68] [Impact Index Per Article: 22.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Revised: 06/11/2021] [Accepted: 06/14/2021] [Indexed: 01/09/2023] Open
Abstract
Thyroid hormones are necessary for the normal functioning of physiological systems. Therefore, knowledge of any factor (whether genetic, environmental or intrinsic) that alters the levels of thyroid-stimulating hormone (TSH) and thyroid hormones is crucial. Genetic factors contribute up to 65% of interindividual variations in TSH and thyroid hormone levels, but many environmental factors can also affect thyroid function. This review discusses studies that have analyzed the impact of environmental factors on TSH and thyroid hormone levels in healthy adults. We included lifestyle factors (smoking, alcohol consumption, diet and exercise) and pollutants (chemicals and heavy metals). Many inconsistencies in the results have been observed between studies, making it difficult to draw a general conclusion about how a particular environmental factor influences TSH and thyroid hormone levels. However, lifestyle factors that showed the clearest association with TSH and thyroid hormones were smoking, body mass index (BMI) and iodine (micronutrient taken from the diet). Smoking mainly led to a decrease in TSH levels and an increase in triiodothyronine (T3) and thyroxine (T4) levels, while BMI levels were positively correlated with TSH and free T3 levels. Excess iodine led to an increase in TSH levels and a decrease in thyroid hormone levels. Among the pollutants analyzed, most studies observed a decrease in thyroid hormone levels after exposure to perchlorate. Future studies should continue to analyze the impact of environmental factors on thyroid function as they could contribute to understanding the complex background of gene-environment interactions underlying the pathology of thyroid diseases.
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Affiliation(s)
| | | | | | - Tatijana Zemunik
- Department of Medical Biology, School of Medicine, University of Split, Šoltanska 2, 21000 Split, Croatia; (M.B.L.); (I.G.); (N.P.)
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Kuroda K, Nakagawa K, Horikawa T, Moriyama A, Ojiro Y, Takamizawa S, Ochiai A, Matsumura Y, Ikemoto Y, Yamaguchi K, Sugiyama R. Increasing number of implantation failures and pregnancy losses associated with elevated Th1/Th2 cell ratio. Am J Reprod Immunol 2021; 86:e13429. [PMID: 33835626 DOI: 10.1111/aji.13429] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Revised: 03/01/2021] [Accepted: 04/06/2021] [Indexed: 12/16/2022] Open
Abstract
PROBLEM We aimed to assess whether an imbalance of T-helper (Th) 1 and Th2 cells contributes to implantation failure and pregnancy loss. METHOD OF STUDY In this cross-sectional study, 197 consecutive patients with a history of repeated implantation failure (RIF) after three or more embryo transfer (ET) cycles and/or recurrent pregnancy loss (RPL) after two or more clinical pregnancy losses underwent Th cell testing. After excluding 42 women aged ≥44 and 9 with vitamin D supplementation, we recruited 146 women including 79 with RIF and 81 with RPL. Fourteen women had a history of both RIF and RPL. We also recruited 45 fertile women and 40 general infertile women without a history of in vitro fertilization treatment. This study was approved by the local ethics committee. RESULTS There was no significant difference in IFN-γ-producing Th1 and IL-4-producing Th2 cell levels between the fertile and general infertile women, but Th1 cell levels and the Th1/Th2 cell ratio were significantly higher in the women with ≥4 ET cycles and ≥2 pregnancy losses than in the fertile and general infertile women. In the general infertile women, the total livebirth rates including natural conception after two ET cycles in the normal and high Th1/Th2 groups (Th1/Th2 <11.8 and ≥11.8, respectively) were 66.7% and 87.5%, respectively (p = .395). CONCLUSIONS A high Th1/Th2 cell ratio was linked to ≥4 implantation failure cycles and ≥2 pregnancy losses but not to general infertility.
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Affiliation(s)
- Keiji Kuroda
- Center for Reproductive Medicine and Implantation Research, Sugiyama Clinic Shinjuku, Tokyo, Japan.,Department of Obstetrics and Gynecology, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - Koji Nakagawa
- Center for Reproductive Medicine and Implantation Research, Sugiyama Clinic Shinjuku, Tokyo, Japan
| | - Takashi Horikawa
- Center for Reproductive Medicine and Implantation Research, Sugiyama Clinic Shinjuku, Tokyo, Japan
| | - Azusa Moriyama
- Center for Reproductive Medicine and Implantation Research, Sugiyama Clinic Shinjuku, Tokyo, Japan
| | - Yuko Ojiro
- Center for Reproductive Medicine and Implantation Research, Sugiyama Clinic Shinjuku, Tokyo, Japan
| | - Satoru Takamizawa
- Center for Reproductive Medicine and Implantation Research, Sugiyama Clinic Shinjuku, Tokyo, Japan
| | - Asako Ochiai
- Department of Obstetrics and Gynecology, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - Yuko Matsumura
- Department of Obstetrics and Gynecology, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - Yuko Ikemoto
- Department of Obstetrics and Gynecology, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - Koushi Yamaguchi
- Department of Maternal-Fetal Biology, National Center for Child Health and Development, Tokyo, Japan
| | - Rikikazu Sugiyama
- Center for Reproductive Medicine and Implantation Research, Sugiyama Clinic Shinjuku, Tokyo, Japan
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9
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Sulejmanovic M, Begić A, Mujaric-Bousbia F, Salkic S, Ramas A. The Relationship Between Thyroid Antibodies and Vitamin D Level in Primary Hypothyroidism. Med Arch 2020; 74:359-362. [PMID: 33424090 PMCID: PMC7780811 DOI: 10.5455/medarh.2020.74.359-362] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Introduction: Vitamin D deficiency is a global health problem. Its deficiency has been reported to be associated with different autoimmune diseases. Aim: The aim of this study was to evaluate the relationship between vitamin D level and thyroid antibodies in autoimmune hypothyroidism. Methods: A total number of 150 individuals were enrolled in this study. They were divided into the fallowing groups: group I included 50 patients with autoimmune thyroid disease (AITD), group II included 50 patients without autoimmune thyroid disease. Group III included 50 apparently healthy participants representing a control group. All participants underwent a detailed clinical examination and laboratory tests including, 25 (OH) vitamin D, thyroid-stimulating hormone (TSH) and thyroid autoantibodies assessment, including anti-thyroid peroxidase antibodies (anti-TPO) and anti-thyroglobulin antibodies (anti-TG). Results: Serum levels of 25 (OH) vitamin D recorded a highly significant difference between the studies groups (20,76±6,31 ng/ml in group I vs. 24,37±9,05ng/ml in group II vs. 24,57±6,45ng/ml in group III, p<0,01). Moreover, there was a highly significant difference between patients with AITD and patients without AITD (20,76±6,31ng/ml vs. 24,37±9,05ng/ml, respectively; p<0,01). The concentration of anti-TPO and anti-TG antibodies were statistically significant higher in patients with vitamin D deficiency (p< 0,001). Serum TSH were significantly higher in group I (p< 0,001). Conclusion: Significantly low levels of vitamin D were documented in patients with AITD that were related to the presence of anti-thyroid antibodies and higher level thyroid-stimulation hormone (TSH), suggesting the involvement of vitamin D in the pathogenesis of AITD and the advisability of supplementation.
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Affiliation(s)
- Maja Sulejmanovic
- Clinic for Radiology and Nuclear medicine, University Clinical Centre Tuzla, Tuzla, Bosnia and Herzegovina
| | - Amela Begić
- Clinic for Nuclear medicine and Endocrinology, University of Sarajevo Clinical Centre, Sarajevo, Bosnia and Herzegovina
| | - Fatima Mujaric-Bousbia
- Clinic for Radiology and Nuclear medicine, University Clinical Centre Tuzla, Tuzla, Bosnia and Herzegovina
| | - Sabina Salkic
- Family Medical Services, Public Healthcare Institution,Medical Centre Tuzla, Tuzla, Bosnia and Herzegovina
| | - Almedina Ramas
- Clinic for Diseases of Ear, Nose and Throat, University Clinical Centre Tuzla, Tuzla, Bosnia and Herzegovina
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Harrison SR, Li D, Jeffery LE, Raza K, Hewison M. Vitamin D, Autoimmune Disease and Rheumatoid Arthritis. Calcif Tissue Int 2020; 106:58-75. [PMID: 31286174 PMCID: PMC6960236 DOI: 10.1007/s00223-019-00577-2] [Citation(s) in RCA: 106] [Impact Index Per Article: 26.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2018] [Accepted: 06/18/2019] [Indexed: 02/06/2023]
Abstract
Vitamin D has been reported to influence physiological systems that extend far beyond its established functions in calcium and bone homeostasis. Prominent amongst these are the potent immunomodulatory effects of the active form of vitamin D, 1,25-dihydroxyvitamin D3 (1,25-(OH)2D3). The nuclear vitamin D receptor (VDR) for 1,25-(OH)2D3 is expressed by many cells within the immune system and resulting effects include modulation of T cell phenotype to suppress pro-inflammatory Th1 and Th17 CD4+ T cells and promote tolerogenic regulatory T cells. In addition, antigen-presenting cells have been shown to express the enzyme 1α-hydroxylase that converts precursor 25-hydroxyvitamin D3 (25-OHD3) to 1,25-(OH)2D3, so that immune microenvironments are able to both activate and respond to vitamin D. As a consequence of this local, intracrine, system, immune responses may vary according to the availability of 25-OHD3, and vitamin D deficiency has been linked to various autoimmune disorders including rheumatoid arthritis (RA). The aim of this review is to explore the immune activities of vitamin D that impact autoimmune disease, with specific reference to RA. As well as outlining the mechanisms linking vitamin D with autoimmune disease, the review will also describe the different studies that have linked vitamin D status to RA, and the current supplementation studies that have explored the potential benefits of vitamin D for prevention or treatment of RA. The overall aim of the review is to provide a fresh perspective on the potential role of vitamin D in RA pathogenesis and treatment.
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Affiliation(s)
- Stephanie R Harrison
- Institute of Metabolism and Systems Research, The University of Birmingham, Birmingham, B15 2TT, UK
- Department of Rheumatology, Sandwell and West, Birmingham Hospitals NHS Trust, Birmingham, B18 7QH, UK
| | - Danyang Li
- Institute of Metabolism and Systems Research, The University of Birmingham, Birmingham, B15 2TT, UK
| | - Louisa E Jeffery
- Institute of Translation Medicine, The University of Birmingham, Birmingham, B15 2TT, UK
| | - Karim Raza
- Department of Rheumatology, Sandwell and West, Birmingham Hospitals NHS Trust, Birmingham, B18 7QH, UK
- Institute of Inflammation and Ageing, Arthritis Research UK Rheumatoid Arthritis Pathogenesis Centre of Excellence and MRC Arthritis Research UK Centre for Musculoskeletal Ageing Research, University of Birmingham, Birmingham, B15 2TT, UK
| | - Martin Hewison
- Institute of Metabolism and Systems Research, The University of Birmingham, Birmingham, B15 2TT, UK.
- Centre for Endocrinology, Diabetes and Metabolism, Birmingham Health Partners, Birmingham, B15 2TT, UK.
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11
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D'Ippolito S, Ticconi C, Tersigni C, Garofalo S, Martino C, Lanzone A, Scambia G, Di Simone N. The pathogenic role of autoantibodies in recurrent pregnancy loss. Am J Reprod Immunol 2019; 83:e13200. [PMID: 31633847 DOI: 10.1111/aji.13200] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Revised: 10/03/2019] [Accepted: 10/03/2019] [Indexed: 12/20/2022] Open
Abstract
In the present manuscript, we review the recent research investigating the pathogenic association between most studied autoantibodies and recurrent pregnancy loss. Pregnancy loss represents a common obstetric complication occurring in about 15%-25% of all clinically recognized pregnancies. The recurrence of pregnancy loss identifies a distinct clinical entity, that is recurrent pregnancy loss (RPL), affecting about 2%-4% of couples. Several factors, including age, chromosomal abnormalities, uterine anomalies, thrombophilic disorders, endocrinopathies, hormonal and metabolic disorders, infections, sperm quality, and lifestyle issues, are involved in RPL. The role of autoantibodies in RPL is only partially determined. In some cases (antiphospholipid antibodies [aPL]), their involvement is well established. In other cases (anti-thyroid autoantibodies, antinuclear, anti-transglutaminase, and anti-endomysial antibodies), it is still debated, despite multiple, although not fully conclusive, evidences strongly suggest a possible involvement in RPL. Further extensive research is needed to definitively confirm or exclude their actual role.
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Affiliation(s)
- Silvia D'Ippolito
- Dipartimento di Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, U.O.C. di Ostetricia e Patologia Ostetrica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.,Istituto di Clinica Ostetrica e Ginecologica, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Carlo Ticconi
- Section of Gynecology and Obstetrics, Department of Surgical Sciences, University Tor Vergata, Rome, Italy
| | - Chiara Tersigni
- Dipartimento di Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, U.O.C. di Ostetricia e Patologia Ostetrica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.,Istituto di Clinica Ostetrica e Ginecologica, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Serafina Garofalo
- Dipartimento di Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, U.O.C. di Ostetricia e Patologia Ostetrica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Carmelinda Martino
- Dipartimento di Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, U.O.C. di Ostetricia e Patologia Ostetrica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Antonio Lanzone
- Dipartimento di Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, U.O.C. di Ostetricia e Patologia Ostetrica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.,Istituto di Clinica Ostetrica e Ginecologica, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Giovanni Scambia
- Istituto di Clinica Ostetrica e Ginecologica, Università Cattolica del Sacro Cuore, Rome, Italy.,Dipartimento di Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, U.O.C. di Ginecologia Oncologica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Nicoletta Di Simone
- Dipartimento di Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, U.O.C. di Ostetricia e Patologia Ostetrica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.,Istituto di Clinica Ostetrica e Ginecologica, Università Cattolica del Sacro Cuore, Rome, Italy
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Goischke HK. Vitamin D supplementation for the prevention or depletion of side effects of therapy with alemtuzumab in multiple sclerosis. Ther Clin Risk Manag 2019; 15:891-904. [PMID: 31371976 PMCID: PMC6636607 DOI: 10.2147/tcrm.s188941] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Accepted: 06/16/2019] [Indexed: 12/22/2022] Open
Abstract
PURPOSE OF REVIEW Not only the multiple sclerosis specialist but also the general neurologist and primary care practitioner are increasingly aware of possible adverse events (AEs) by treatment with alemtuzumab (over 47% risk of secondary autoimmune-mediated diseases). Vitamin D supplementation's effect (VDS) to reduce these autoimmune AEs is poorly performed in routine practice. This article seeks to justify why this simple, inexpensive, patient-friendly therapy should be seriously discussed. RECENT FINDINGS Patients who have developed autoimmunity also show a high basal level of IL-21, a cytokine which increases the growth of auto-reactive T-cells. For side effects such as thyroid dysfunction, autoimmune thrombocytopenia, autoimmune hemolytic anemia, autoimmune hepatitis, diabetes mellitus type 1, and alopecia areata/alopecia totalis, VDS may have an impact on the immunological mechanism, in particular lowering levels of IL-17 and IL-21. SUMMARY The potential role of vitamin D in influencing autoimmune diseases is evident. If a life-threatening side-effect can be prevented by high-dose VDS, it is ethical to initiate this add-on therapy despite contradictory results in studies on the effectiveness of VDS.
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Affiliation(s)
- Hans-Klaus Goischke
- Independent Research, Internal Medicine, Rehabilitation Medicine, Social Medicine, Bad Brückenau, Bavaria, Germany
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13
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Botelho IMB, Moura Neto A, Silva CA, Tambascia MA, Alegre SM, Zantut-Wittmann DE. Vitamin D in Hashimoto's thyroiditis and its relationship with thyroid function and inflammatory status. Endocr J 2018; 65:1029-1037. [PMID: 30058600 DOI: 10.1507/endocrj.ej18-0166] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Several studies have shown the correlation between vitamin D [25(OH)D] deficiency and thyroid autoimmunity and reducing of thyroid autoantibodies in patients with normal levels of vitamin D combining with thyroid hormone replacement. However, other authors not agree with this association. It is still unclear whether the low 25(OH)D levels are the result of HT disease or a part of its cause. We studied 88 patients with HT regarding vitamin D status and thyroid autoimmunity markers as well as the relationship with cytokines produced by Th1, Th2, and Th17 cells compared with a control group of 71 euthyroid healthy subjects. The present study demonstrated that vitamin D concentrations were similar in patients HT and the control group. The reduction of free T4 levels was a predictor of vitamin D insufficiency for Hashimoto's thyroiditis, but not for the control group. Lower concentrations of TNF-α was a predictor of lower levels of vitamin D. Differences in the association between HT and vitamin D insufficiency remain unresolved in the literature. The thyroid hormone status would play a role in the maintenance of vitamin D sufficiency, and its immunomodulatory role would influence the presence of autoimmune thyroid disease. The positive correlation between free T4 and vitamin D concentrations suggests that adequate levothyroxine replacement in HT would be an essential factor in maintaining vitamin D at sufficient levels.
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Affiliation(s)
- Ilka Mara Borges Botelho
- Endocrinology Division, Department of Internal Medicine, Faculty of Medical Sciences, University of Campinas, Campinas, San Paulo, Brazil
| | - Arnaldo Moura Neto
- Endocrinology Division, Department of Internal Medicine, Faculty of Medical Sciences, University of Campinas, Campinas, San Paulo, Brazil
| | | | - Marcos Antônio Tambascia
- Endocrinology Division, Department of Internal Medicine, Faculty of Medical Sciences, University of Campinas, Campinas, San Paulo, Brazil
| | - Sarah Monte Alegre
- Metabolic Unit, Department of Internal Medicine, Faculty of Medical Sciences, University of Campinas Campinas, San Paulo, Brazil
| | - Denise Engelbrecht Zantut-Wittmann
- Endocrinology Division, Department of Internal Medicine, Faculty of Medical Sciences, University of Campinas, Campinas, San Paulo, Brazil
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Hu MJ, Zhang Q, Liang L, Wang SY, Zheng XC, Zhou MM, Yang YW, Zhong Q, Huang F. Association between vitamin D deficiency and risk of thyroid cancer: a case-control study and a meta-analysis. J Endocrinol Invest 2018; 41:1199-1210. [PMID: 29464660 DOI: 10.1007/s40618-018-0853-9] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2018] [Accepted: 02/13/2018] [Indexed: 01/11/2023]
Abstract
PURPOSE Although vitamin D is reportedly associated with various cancers, the association between vitamin D and thyroid cancer is indefinite. We aimed to investigate whether this association applies to thyroid cancer (TC). METHODS A total of 276 Chinese Han people were recruited in a current matched case-control study. Multivariable conditional logistic regression was computed to estimate the association between plasma 25(OH)D and papillary thyroid cancer (PTC). In addition, we searched relevant studies in PubMed and Web of Science databases before December 2017 to conduct a meta-analysis. RESULTS In our case-control study, plasma 25(OH)D concentration was inversely associated with PTC risk (highest tertile vs lowest tertile: adjusted OR = 0.25; 95% CI 0.10, 0.61; Ptrend = 0.003). This association was independent of body mass index and physical activity (all adjusted Pinteraction > 0.05). A total of 11 studies were included in the meta-analysis, among which ten studies have been published and one was our case-control study. Compared with 25(OH)D non-deficient group, the pooled OR of TC was 1.42 (95% CI 1.17, 1.73) in the deficient group. Similarly, blood 25(OH)D levels in patients with TC were tend to be lower than those in the controls (SMD = - 0.20, 95% CI - 0.36, - 0.03). CONCLUSIONS A high level of circulating 25(OH)D was associated with a decreased TC risk. This association has important significance in public health and should, therefore, be further studied.
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Affiliation(s)
- M-J Hu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Shushan District, Hefei, 230032, Anhui, People's Republic of China
| | - Q Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Shushan District, Hefei, 230032, Anhui, People's Republic of China
| | - L Liang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Shushan District, Hefei, 230032, Anhui, People's Republic of China
| | - S-Y Wang
- Department of Head and Neck, Breast Surgery, Anhui Provincial Cancer Hospital, No. 107 East Lake Road, Hefei, 230032, Anhui, People's Republic of China
| | - X-C Zheng
- Department of Head and Neck, Breast Surgery, Anhui Provincial Cancer Hospital, No. 107 East Lake Road, Hefei, 230032, Anhui, People's Republic of China
| | - M-M Zhou
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Shushan District, Hefei, 230032, Anhui, People's Republic of China
| | - Y-W Yang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Shushan District, Hefei, 230032, Anhui, People's Republic of China
| | - Q Zhong
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Shushan District, Hefei, 230032, Anhui, People's Republic of China
| | - F Huang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Shushan District, Hefei, 230032, Anhui, People's Republic of China.
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Ikemoto Y, Kuroda K, Nakagawa K, Ochiai A, Ozaki R, Murakami K, Jinushi M, Matsumoto A, Sugiyama R, Takeda S. Vitamin D Regulates Maternal T-Helper Cytokine Production in Infertile Women. Nutrients 2018; 10:nu10070902. [PMID: 30011861 PMCID: PMC6073370 DOI: 10.3390/nu10070902] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2018] [Revised: 07/02/2018] [Accepted: 07/10/2018] [Indexed: 12/31/2022] Open
Abstract
Vitamin D (VD) deficiency is associated with reproductive failure. However, the relationship between VD and maternal immunity remains unclear. We investigated the clinical efficacy of VD in maternal T-helper (Th) cytokines in 276 infertile women and examined for Th1 and Th2 cells based on the deficient, insufficient, and sufficient serum 25-hydroxyvitamin D3 (25[OH]VD) levels (<12, 12–30, and >30 ng/mL, respectively). Most infertile women had a low-level of VD (87.3%). Immunological tests of pre-/post-VD supplementation were performed in patients who were deficient and insufficient in VD. Of 23 patients, 11 (47.8%) exhibited sufficient VD levels after supplementation. Th1/Th2 cell ratio in patients with insufficient VD was significantly decreased after supplementation (p = 0.004). After supplementation, serum 25(OH)VD levels of the patients: 11 in the sufficient group showed significant decreases in Th1 cell level and Th1/Th2 cell ratio (p = 0.032 and 0.010, respectively), whereas no significant differences in Th1/Th2 cell ratio were recognized in the insufficient group. Furthermore, mid-luteal endometrial biopsies (n = 18) were processed for primary cultures and measured interferon [IFN]-γ and interleukin [IL]-4 in condition media. Decidualizing cultures with 1,25-dihydroxvitamin D3 (1,25[OH]2VD) decreased IFN-γ. Sufficient VD supplementation in women with insufficient VD may optimize maternal T-helper cytokines during pregnancy via rebalancing the Th1/Th2 cell ratio.
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Affiliation(s)
- Yuko Ikemoto
- Department of Obstetrics and Gynecology, Juntendo University, Faculty of Medicine, Tokyo 1138421, Japan.
| | - Keiji Kuroda
- Department of Obstetrics and Gynecology, Juntendo University, Faculty of Medicine, Tokyo 1138421, Japan.
- Center for Reproductive Medicine and Implantation Research, Sugiyama Clinic Shinjuku, Tokyo 1160023, Japan.
| | - Koji Nakagawa
- Center for Reproductive Medicine and Implantation Research, Sugiyama Clinic Shinjuku, Tokyo 1160023, Japan.
| | - Asako Ochiai
- Department of Obstetrics and Gynecology, Juntendo University, Faculty of Medicine, Tokyo 1138421, Japan.
| | - Rie Ozaki
- Department of Obstetrics and Gynecology, Juntendo University, Faculty of Medicine, Tokyo 1138421, Japan.
| | - Keisuke Murakami
- Department of Obstetrics and Gynecology, Juntendo University, Faculty of Medicine, Tokyo 1138421, Japan.
| | - Makoto Jinushi
- Department of Obstetrics and Gynecology, Juntendo University, Faculty of Medicine, Tokyo 1138421, Japan.
| | - Akemi Matsumoto
- Department of Obstetrics and Gynecology, Juntendo University, Faculty of Medicine, Tokyo 1138421, Japan.
| | - Rikikazu Sugiyama
- Center for Reproductive Medicine and Implantation Research, Sugiyama Clinic Shinjuku, Tokyo 1160023, Japan.
| | - Satoru Takeda
- Department of Obstetrics and Gynecology, Juntendo University, Faculty of Medicine, Tokyo 1138421, Japan.
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Musa IR, Rayis DA, Ahmed MA, Khamis AH, Nasr AM, Adam I. Thyroid Function and 25 (OH) Vitamin D Level among Sudanese Women in Early Pregnancy. Open Access Maced J Med Sci 2018; 6:488-492. [PMID: 29610606 PMCID: PMC5874371 DOI: 10.3889/oamjms.2018.125] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2017] [Revised: 11/19/2017] [Accepted: 02/08/2018] [Indexed: 12/31/2022] Open
Abstract
AIM: A cross-sectional study was conducted at Saad Abualila Hospital (Khartoum, Sudan) to evaluate the vitamin D levels and thyroid function among pregnant Sudanese women (132) in early pregnancy. METHODS: A cross-sectional study was conducted at Saad Abualila hospital (Khartoum, Sudan) during the period from March to July 2015. Women who were in early pregnancy with a singleton pregnancy were approached to participate in the study after signing informed consent. A sample size of 132 participants was calculated guided by the normal interval of thyroid function in Sudanese women in the first trimester and not the level of 25(OH) vitamin D. The 25 - hydroxyvitamin D (25 (OH) vitamins levels were measured using an electrochemiluminescence immunoassay on an Elecsys 2010 Analyzer (Roche Diagnostics, Mannheim, Germany). RESULTS: The mean (SD) of age, gravidity and gestational age was 27.6 (5.5) years, 2.2 (1.6) and 10.4 (2.2) weeks, respectively. The mean (SD) of the body mass index (BMI) and haemoglobin was 27.1 (5.2) kg/m2 and 10.8 (1.1) g/dl, respectively. Median (interquartile) values of TSH, FT3, and FT4 were 1.164 IU/ml (0.079 -2.177 IU/ml), 4.639 nmol/l (3.843 - 6.562 nmol/l), and 16.86 pmol/l (13.02 - 31.48 pmol/l), respectively. There was no significant correlation between vitamin D levels and TSH, FT3 and FT4 CONCLUSION: There is no correlation between 25 (OH) vitamin D levels and thyroid function during early pregnancy among Sudanese pregnant women, despite prevalent vitamin D deficiency among these women.
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Affiliation(s)
- Imad R Musa
- King Abdu Aziz Armed Forces, Hospital at Air Base, Dhahran, Kingdom of Saudi Arabia
| | - Duria A Rayis
- Faculty of Medicine, University of Khartoum, Khartoum, Sudan
| | | | - Ammar H Khamis
- Hamdan Bin Mohammed College of Dental Medicine (HBMCDM), Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
| | - Abubakr M Nasr
- Faculty of Medicine, University of Khartoum, Khartoum, Sudan
| | - Ishag Adam
- Faculty of Medicine, University of Khartoum, Khartoum, Sudan
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17
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Wang S, Wu Y, Zuo Z, Zhao Y, Wang K. The effect of vitamin D supplementation on thyroid autoantibody levels in the treatment of autoimmune thyroiditis: a systematic review and a meta-analysis. Endocrine 2018; 59:499-505. [PMID: 29388046 DOI: 10.1007/s12020-018-1532-5] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2017] [Accepted: 01/13/2018] [Indexed: 12/18/2022]
Abstract
PURPOSE Although observational studies suggested that vitamin D plays a role in autoimmune thyroiditis (AIT), intervention trials yielded inconsistent findings. We therefore conducted a systematic review and a meta-analysis to evaluate the effects of Vitamin D on decreasing autoantibodies in patients with AIT. METHOD We identified all studies that assessed the changes of TPO-Ab and Tg-Ab in patients with AIT under the treatment of vitamin D from PubMed, Embase, The Cochrane Library, Chinese National Knowledge Infrastructure, Wanfang, and VIP Database. RESULTS Six randomized controlled trials (RCTs) were included in this systematic review representing a total of 344 patients with AIT. The results showed that Vitamin D supplementation significantly dropped TPO-Ab titers [three studies, random effects standardized mean difference (SMD): -1.11, 95% CI -1.52 to -0.70, P < 0.01] at six months, but not at no more than 3 months [random effects SMD: -0.12, 95% CI: -0.69 to 0.44, P = 0.67]. As compared with control group, participants who received vitamin D supplementation demonstrated significantly lower Tg-Ab [random effects SMD: -0.55, 95% CI: -1.05 to -0.04, P = 0.033]. In addition, no serious adverse effect was reported. CONCLUSIONS The current evidence suggests that vitamin D supplementation could decrease serum TPO-Ab and Tg-Ab titers of patients with AIT in the short-term (about six months). More high quality studies are needed to further confirm the effects, especially the long-term effects of Vitamin D supplementation on thyroid autoantibodies levels in the treatment of AIT.
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Affiliation(s)
- Su Wang
- Department of Endocrinology, Affiliated Jiangning Hospital of Nanjing Medical University, Nanjing, China
| | - Yaping Wu
- Department of Endocrinology, Affiliated Jiangning Hospital of Nanjing Medical University, Nanjing, China
| | - Zhihua Zuo
- Department of Endocrinology, Affiliated Jiangning Hospital of Nanjing Medical University, Nanjing, China
| | - Yijing Zhao
- Department of Endocrinology, Affiliated Jiangning Hospital of Nanjing Medical University, Nanjing, China
| | - Kun Wang
- Department of Endocrinology, Affiliated Jiangning Hospital of Nanjing Medical University, Nanjing, China.
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Abstract
PURPOSE OF REVIEW In recent years, there has been a growing interest in the value of vitamin D and its effects on autoimmunity. The aim of this review is to summarize the current knowledge on the association between vitamin D and rheumatoid arthritis (RA) in terms of prevalence, disease activity, clinical expression, serology and gene polymorphisms of vitamin D receptors. RECENT FINDINGS Studies have shown contrasting findings concerning the association between vitamin D levels and RA. Vitamin D seems to have immunomodulatory properties. Therefore, low vitamin D levels could contribute to increased immune activation. However, the potential role of vitamin D supplementation in preventing RA manifestation and its beneficial role as a component of RA treatment remain controversial. The relationship between RA susceptibility and vitamin D polymorphisms is also unclear. SUMMARY Despite advancements synthesized by some recent meta-analyses, the relationship between vitamin D and RA requires further evaluation. Further research is needed to confirm the relationship between RA susceptibility and vitamin D polymorphisms and to determine whether vitamin D plays a role in preventing the manifestation of RA. Finally, additional studies are required to determine the impact and optimal amount of vitamin D supplementation in the treatment of RA patients.
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19
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The association of FokI and ApaI polymorphisms in vitamin D receptor gene with autoimmune thyroid diseases in the northwest of Iran. Med J Islam Repub Iran 2018; 32:4. [PMID: 29977872 PMCID: PMC6025915 DOI: 10.14196/mjiri.32.4] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2017] [Indexed: 11/18/2022] Open
Abstract
Background: Some genetic factors are involved in the etiology of Hashimoto thyroiditis and Graves’ disease as autoimmune thyroid diseases (AITDs). Effects of vitamin D receptor gene polymorphisms in AITDs development have already been investigated in some previous studies. However, no study has been done on the association between VDR FokI and ApaI polymorphisms and AITDs in an Iranian population. In this study, the possible effects of FokI and ApaI polymorphisms on AITDs were investigated in the population of northwest of Iran.
Methods: A total of 121 AITDs adult patients and 117 healthy controls matched by age and sex in the same population were included in this study. FokI and ApaI polymorphisms were genotyped by polymerase chain reaction- restriction fragment length polymorphism (PCR-RFLP). Chi-square test and odds ratio (OR) with 95% CI were used to analyze the data.
Results: FokI and ApaI genotypes frequencies were not significantly different between the 2 groups (p= 0.06, p= 0.73, respectively). However, FokI "CC" and "CT" genotypes were related to AITDs risk (p= 0.03; OR= 3.75; 95% CI, 1.16-12.17 and p= 0.04; OR= 3.41; 95% CI, 1.03-11.28, respectively).
Conclusion: These data suggest that FokI polymorphisms are involved in AITDs susceptibility in the population of northwest of
Iran.
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20
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Yussif NM, El-Mahdi FM, Wagih R. Hypothyrodism as a risk factor of periodontitis and its relation with vitamin D deficiency: mini-review of literature and a case report. CLINICAL CASES IN MINERAL AND BONE METABOLISM 2018; 14:312-316. [PMID: 29354159 DOI: 10.11138/ccmbm/2017.14.3.312] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Objective The purpose of this report is to investigate the role and efficiency of the intra-ligamentary injection of vitamin D and calcium in the treatment of chronic periodontitis associated with hypothyroidism. Design A 43-year-old female with suspected hypothyroidism who revealed severe chronic periodontitis with grade III mobility. Pre-operative periodontal and systemic control preceded the used intervention. After 3 months, intra-ligamentary injectable vitamin D with calcium was introduced. Results Clinical evaluation revealed great improvement of the injected sites. Marked reduction of mobility, pocket depth and bleeding were detected. Conclusions Injectabe vitamin D is an adjunctive treatment modality that needs to be discovered in another way. It may provide further solutions for the periodontal regeneration problem. Clinical studies with large sample sizes and long term follow up are needed.
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Affiliation(s)
- Nermin M Yussif
- Master Degree, Periodontology Department, Faculty of Dentistry, October University of Modern Sciences and Art (MSA), Giza, Egypt
| | - Fatema Mohammed El-Mahdi
- Master degree, Oral Diagnosis, Medicine & Periodontology Dept. Faculty of Dentistry, Sabha University, Egypt
| | - Rasha Wagih
- PhD Degree, Oral Diagnosis, Medicine & Periodontology Dept. Faculty of Oral & Dental Medicine Cairo University, Egypt
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22
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Gao XR, Yu YG. Meta-Analysis of the Association between Vitamin D Receptor Polymorphisms and the Risk of Autoimmune Thyroid Disease. Int J Endocrinol 2018; 2018:2846943. [PMID: 29765404 PMCID: PMC5885334 DOI: 10.1155/2018/2846943] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2017] [Revised: 12/01/2017] [Accepted: 12/17/2017] [Indexed: 01/20/2023] Open
Abstract
The association between vitamin D receptor (VDR) polymorphisms (rs731236, rs1544410, rs2228570, and rs7975232) and the risk of autoimmune thyroid disease (AITD) had been investigated in previous studies. However, the results of these studies remained controversial. Thus, a meta-analysis was performed to derive a more precise conclusion. All related articles were systematically searched by PubMed, Embase, Google Scholar, and Chinese National Knowledge Infrastructure (CNKI). The pooled odds ratios (ORs) with 95% confidence intervals (CIs) were calculated to assess the strength of association. The overall results indicated that VDR rs731236 and rs2228570 polymorphisms were significantly associated with a reduced risk of AITD. However, a stratification analysis based on clinical types showed that VDR rs731236 and rs2228570 polymorphisms were associated only with a reduced risk of HT. A stratification analysis by ethnicity showed that VDR rs731236 polymorphism was significantly associated with a reduced risk of AITD in Asian and African populations. VDR rs2228570 polymorphism was associated with a reduced risk of AITD in Asian populations. VDR rs1544410 polymorphism was associated with a reduced risk of AITD in European and African populations, but with an increased risk of AITD in Asian populations. VDR rs7975232 polymorphism was significantly associated with an increased risk of AITD in African populations. In conclusion, the present study suggested that VDR rs731236, rs1544410, rs2228570, and rs7975232 polymorphisms were significantly associated with AITD risk. However, more well-designed studies should be performed to verify the current results.
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Affiliation(s)
- Xue-Ren Gao
- Department of Pediatric Endocrinology/Genetics, Shanghai Institute for Pediatric Research, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200092, China
| | - Yong-Guo Yu
- Department of Pediatric Endocrinology/Genetics, Shanghai Institute for Pediatric Research, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200092, China
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Vahabi Anaraki P, Aminorroaya A, Amini M, Momeni F, Feizi A, Iraj B, Tabatabaei A. Effect of Vitamin D deficiency treatment on thyroid function and autoimmunity markers in Hashimoto's thyroiditis: A double-blind randomized placebo-controlled clinical trial. JOURNAL OF RESEARCH IN MEDICAL SCIENCES 2017; 22:103. [PMID: 29026419 PMCID: PMC5629831 DOI: 10.4103/jrms.jrms_1048_16] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/16/2017] [Revised: 04/15/2017] [Accepted: 06/20/2017] [Indexed: 12/22/2022]
Abstract
Background: The link between autoimmune thyroid diseases and Vitamin D deficiency has been reported. However, there are controversies in this regard. We conducted a double-blind randomized placebo-controlled clinical trial to investigate the effect of Vitamin D deficiency treatment on thyroid function and autoimmunity marker (thyroid peroxidase antibody [TPO-Ab]) in patients with Hashimoto's thyroiditis. Materials and Methods: Fifty-six patients with Hashimoto's thyroiditis and Vitamin D deficiency (25-hydroxyvitamin D level ≤20 ng/mL) were randomly allocated into two groups to receive Vitamin D (50000 IU/week, orally) or placebo for 12 weeks, as Vitamin D-treated (n = 30) and control (n = 26) groups, respectively. TPO-Ab, thyroid-stimulating hormone (TSH), parathormone, calcium, albumin, and creatinine concentrations were compared before and after trial between and within groups. The data were presented as mean (standard error [SE]) and analyzed by appropriate tests. Results: Mean (SE) of Vitamin D was increased in Vitamin D-treated group (45.5 [1.8] ng/mL vs. 12.7 [0.7] ng/mL, P = 0.01). Mean (SE) of TPO-Ab did not significantly change in both groups (734 [102.93] IU/mL vs. 820.25 [98.92] IU/mL, P = 0.14 in Vitamin D-treated and 750.03 [108.7] [IU/mL] vs. 838.07 [99.4] [IU/mL] in placebo-treated group, P = 0.15). Mean (SE) of TSH was not changed in both groups after trial, P = 0.4 and P = 0.15 for Vitamin D-treated and control groups, respectively. No significant difference was observed between two study groups in none studied variables (P > 0.05). Conclusion: Vitamin D treatment in Vitamin D deficient patients with Hashimoto's thyroiditis could not have significant effect on thyroid function and autoimmunity.
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Affiliation(s)
- Parichehr Vahabi Anaraki
- Isfahan Endocrine and Metabolism Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ashraf Aminorroaya
- Isfahan Endocrine and Metabolism Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Massoud Amini
- Isfahan Endocrine and Metabolism Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Fatemeh Momeni
- Isfahan Endocrine and Metabolism Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Awat Feizi
- Isfahan Endocrine and Metabolism Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Bijan Iraj
- Isfahan Endocrine and Metabolism Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Azamosadat Tabatabaei
- Isfahan Endocrine and Metabolism Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
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Altieri B, Muscogiuri G, Barrea L, Mathieu C, Vallone CV, Mascitelli L, Bizzaro G, Altieri VM, Tirabassi G, Balercia G, Savastano S, Bizzaro N, Ronchi CL, Colao A, Pontecorvi A, Della Casa S. Does vitamin D play a role in autoimmune endocrine disorders? A proof of concept. Rev Endocr Metab Disord 2017; 18:335-346. [PMID: 28070798 DOI: 10.1007/s11154-016-9405-9] [Citation(s) in RCA: 106] [Impact Index Per Article: 15.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
In the last few years, more attention has been given to the "non-calcemic" effect of vitamin D. Several observational studies and meta-analyses demonstrated an association between circulating levels of vitamin D and outcome of many common diseases, including endocrine diseases, chronic diseases, cancer progression, and autoimmune diseases. In particular, cells of the immune system (B cells, T cells, and antigen presenting cells), due to the expression of 1α-hydroxylase (CYP27B1), are able to synthesize the active metabolite of vitamin D, which shows immunomodulatory properties. Moreover, the expression of the vitamin D receptor (VDR) in these cells suggests a local action of vitamin D in the immune response. These findings are supported by the correlation between the polymorphisms of the VDR or the CYP27B1 gene and the pathogenesis of several autoimmune diseases. Currently, the optimal plasma 25-hydroxyvitamin D concentration that is necessary to prevent or treat autoimmune diseases is still under debate. However, experimental studies in humans have suggested beneficial effects of vitamin D supplementation in reducing the severity of disease activity. In this review, we summarize the evidence regarding the role of vitamin D in the pathogenesis of autoimmune endocrine diseases, including type 1 diabetes mellitus, Addison's disease, Hashimoto's thyroiditis, Graves' disease and autoimmune polyendocrine syndromes. Furthermore, we discuss the supplementation with vitamin D to prevent or treat autoimmune diseases.
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Affiliation(s)
- Barbara Altieri
- Division of Endocrinology and Metabolic Diseases, Institute of Medical Pathology, Catholic University of the Sacred Heart, Rome, Italy.
| | - Giovanna Muscogiuri
- Ios and Coleman Medicina Futura Medical Center, University Federico II, Naples, Italy
| | - Luigi Barrea
- Ios and Coleman Medicina Futura Medical Center, University Federico II, Naples, Italy
| | - Chantal Mathieu
- Clinical and Experimental Endocrinology, KU Leuven, Leuven, Belgium
| | - Carla V Vallone
- Emergency Department, Fondazione Poliambulanza Istituto Ospedaliero, Brescia, Italy
| | - Luca Mascitelli
- Comando Brigata Alpina Julia/Multinational Land Force, Medical Service, Udine, Italy
| | | | | | - Giacomo Tirabassi
- Division of Endocrinology, Department of Clinical and Molecular Sciences, Umberto I Hospital, Polytechnic University of Marche, Ancona, Italy
| | - Giancarlo Balercia
- Division of Endocrinology, Department of Clinical and Molecular Sciences, Umberto I Hospital, Polytechnic University of Marche, Ancona, Italy
| | - Silvia Savastano
- Department of Clinical Medicine and Surgery, University "Federico II", Naples, Italy
| | - Nicola Bizzaro
- Laboratory of Clinical Pathology, San Antonio Hospital, Tolmezzo, Italy
| | - Cristina L Ronchi
- Division of Endocrinology and Diabetes, Department of Internal Medicine I, University Hospital of Wuerzburg, Wuerzburg, Germany
| | - Annamaria Colao
- Department of Clinical Medicine and Surgery, University "Federico II", Naples, Italy
| | - Alfredo Pontecorvi
- Division of Endocrinology and Metabolic Diseases, Institute of Medical Pathology, Catholic University of the Sacred Heart, Rome, Italy
| | - Silvia Della Casa
- Division of Endocrinology and Metabolic Diseases, Institute of Medical Pathology, Catholic University of the Sacred Heart, Rome, Italy
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Nazarpour S, Ramezani Tehrani F, Simbar M, Tohidi M, Alavi Majd H, Azizi F. Effects of levothyroxine treatment on pregnancy outcomes in pregnant women with autoimmune thyroid disease. Eur J Endocrinol 2017; 176:253-265. [PMID: 27879326 DOI: 10.1530/eje-16-0548] [Citation(s) in RCA: 125] [Impact Index Per Article: 17.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2016] [Revised: 10/18/2016] [Accepted: 11/22/2016] [Indexed: 11/08/2022]
Abstract
BACKGROUND Despite some studies indicating that thyroid antibody positivity during pregnancy has been associated with adverse pregnancy outcomes, evidence regarding the effects of levothyroxine (LT4) treatment of euthyroid/subclinical hypothyroid pregnant women with autoimmune thyroid disease on pregnancy outcome is limited. We aimed to assess whether pregnant women with autoimmune thyroid disease, but without overt thyroid dysfunction are affected by higher rates of adverse pregnancy outcomes. In addition, we aimed to explore whether LT4 treatment improves the pregnancy outcome of affected women. METHODS A prospective study was carried out on pregnant women from the first trimester to delivery. The study was conducted among pregnant women receiving prenatal care in centers under coverage of Shahid Beheshti University of Medical Sciences. Of a total of 1746 pregnant women, screened for thyroid dysfunction, 1028 euthyroid TPOAb-negative (TPOAb-) and 131 thyroid peroxidase antibody-positive (TPOAb+) women without overt thyroid dysfunction entered the second phase of the study. TPOAb+ women were randomly divided into two groups: group A (n = 65), treated with LT4 and group B (n = 66), received no treatment. The 1028 TPOAb- women (group C) served as a normal population control group. Primary outcomes were preterm delivery and miscarriage and secondary outcomes included placenta abruption, still birth, neonatal admission and neonatal TSH levels. RESULTS Groups A and C displayed a lower rate of preterm deliveries compared with group B (RR = 0.30, 95% CI: 0.1-0.85, P = 0.0229) and (RR = 0.23, 95% CI: 0.14-0.40, P < 0.001) respectively. There was no statistically significant difference in the rates of preterm labor between groups A and C (RR = 0.79, 95% CI: 0.30-2.09, P = 0.64). The number needed to treat (NNT) for preterm birth was 5.9 (95% CI: 3.33–25.16). CONCLUSIONS Treatment with LT4 decreases the risk of preterm delivery in women who are positive for TPOAb.
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Affiliation(s)
- Sima Nazarpour
- Faculty of Nursing and MidwiferyIslamic Azad University, Varamin-Pishva Branch
- Department of Reproductive Health and MidwiferyFaculty of Nursing and Midwifery
| | | | - Masoumeh Simbar
- Department of Reproductive Health and MidwiferyFaculty of Nursing and Midwifery
| | - Maryam Tohidi
- Prevention of Metabolic Disorders Research CenterResearch Institute for Endocrine Sciences
| | | | - Fereidoun Azizi
- Endocrine Research CenterResearch Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences and Health Services, Tehran, Iran
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Niafar M, Pourafkari L, Aminmozaffari S, Nader ND. Association of Vitamin D Deficiency and Thyroid Function in Postmenopausal Women. Adv Pharm Bull 2017; 6:639-644. [PMID: 28101471 DOI: 10.15171/apb.2016.078] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2016] [Revised: 12/06/2016] [Accepted: 12/08/2016] [Indexed: 12/12/2022] Open
Abstract
Pupose: Although there are reports of vitamin D (VitD) insufficiency in immune-mediated hypothyroidism, an association between VitD and thyroid-stimulating hormone (TSH) levels has yet to be shown. We aim to examine VitD and TSH levels among postmenopausal women, as both conditions are more prevalent in elderly women. Methods: The clinic records of postmenopausal women during their routine maintenance visits were reviewed. All patients were examined for the symptoms related to thyroid function and osteoporosis. Participants were divided into three subgroups according to their TSH levels (below <0.5 mIU/L, 0.51-4.0 mIU/L and >4.0 mIU/L). Patient characteristics and VitD levels were compared between these subgroups. Multivariate linear regression model was constructed using serum VitD and serum TSH as the dependent variables to identify factors independently associated with these laboratory values. Results: Two-hundred and nighty nine postmenopausal women were included. Average age was 62.2±7.5 years old. VitD was insufficient (10-30 ng/mL) in 12.0% and deficient (<10 ng/mL) in 60.9% of the participants. In 11.3%, TSH was low and in 7.6% of women, TSH was high, while the remaining 80.1%, had normal TSH levels. Subjects with low TSH had significantly higher VitD concentrations (34.2±29.1 ng/mL) compared to the other two groups (P-value: 0.039). In multivariate regression analysis, TSH was not a contributing factor, as age was the only significant predictor of VitD levels. Meanwhile, no predictor (including age and VitD) was identified for TSH levels in linear regression analysis. Conclusion: Age was the only independent predictor of serum VitD in this study population. Though suppressed TSH was associated with higher VitD levels, the association was not linear between TSH and VitD in postmenopausal women.
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Affiliation(s)
- Mitra Niafar
- Endocrin Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Leili Pourafkari
- Department of Anesthesiology, University at Buffalo, Buffalo, NY 14214
| | | | - Nader D Nader
- Department of Anesthesiology, University at Buffalo, Buffalo, NY 14214
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Ferrari SM, Fallahi P, Antonelli A, Benvenga S. Environmental Issues in Thyroid Diseases. Front Endocrinol (Lausanne) 2017; 8:50. [PMID: 28373861 PMCID: PMC5357628 DOI: 10.3389/fendo.2017.00050] [Citation(s) in RCA: 94] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2017] [Accepted: 03/03/2017] [Indexed: 02/06/2023] Open
Abstract
Environmental factors are determinant for the appearance of autoimmune thyroid diseases (AITD) in susceptible subjects. Increased iodine intake, selenium, and vitamin D deficiency, exposure to radiation, from nuclear fallout or due to medical radiation, are environmental factors increasing AITD. Cigarette smoking is associated with Graves' disease and Graves' ophthalmopathy, while it decreases the risk of hypothyroidism and thyroid autoimmunity. Viral infections are important environmental factors in the pathogenesis of AITD, too, particularly human parvovirus B19 (EVB19) and hepatitis C virus. Among the many chemical contaminants, halogenated organochlorines and pesticides variably disrupt thyroid function. Polychlorinated biphenyls and their metabolites and polybrominated diethyl ethers bind to thyroid transport proteins, such as transthyretin, displace thyroxine, and disrupt thyroid function. Among drugs, interferon- and iodine-containing drugs have been associated with AITD. Moreover intestinal dysbiosis causes autoimmune thyroiditis. To reduce the risk to populations and also in each patient, it is necessary to comprehend the association between environmental agents and thyroid dysfunction.
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Affiliation(s)
| | - Poupak Fallahi
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Alessandro Antonelli
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
- *Correspondence: Alessandro Antonelli,
| | - Salvatore Benvenga
- Department of Clinical and Experimental Medicine, University of Messina School of Medicine, Messina, Italy
- Master Program of Childhood, Adolescence and Women’s Endocrine Health, University of Messina School of Medicine, Messina, Italy
- Interdepartmental Program of Molecular & Clinical Endocrinology, and Women’s Endocrine Health, University Hospital, Policlinico G. Martino, Messina, Italy
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Abstract
In this review we summarize recent opinions on the possible role of vitamin D in the risk of thyroid diseases development. It may be concluded from the available data that vitamin D deficiency, particularly levels below 12.5 ng/ml should be considered as an additional, but important risk factor for development of thyroid autoimmunity, both chronic autoimmune thyroiditis and Graves' disease. A higher risk of Graves' disease development is also associated with several polymorphisms in the gene encoding for vitamin D binding protein and for the specific receptor of active form of vitamin D - 1,25-(OH)(2)D(3) in the respective target cells. Important for development of thyroid cancer appeared polymorphisms of genes encoding for vitamin D receptors and of genes encoding for the participating hydroxylating enzymes in thyroid tissue, leading to a diminished local 1,25-(OH)(2)D(3) formation capacity with following alteration of antiproliferatory, antiapoptotic and prodifferentiating efficacy of the latter. Whether supplementation with high doses of vitamin D or its analogues possesses preventive or therapeutic effect is an object of intensive studies.
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Affiliation(s)
- K Vondra
- Institute of Endocrinology, Prague, Czech Republic.
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Serum Vitamin D Level is Inversely Associated With Anti-Cyclic Citrullinated Peptide Antibody Level and Disease Activity in Rheumatoid Arthritis Patients. Arch Rheumatol 2015; 31:64-70. [PMID: 29900980 DOI: 10.5606/archrheumatol.2016.5556] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2015] [Accepted: 10/15/2015] [Indexed: 11/21/2022] Open
Abstract
Objectives This study aims to assess the relationship between serum vitamin D and anti-cyclic citrullinated peptide (anti-CCP) antibody levels, as well as disease activity in patients with newly diagnosed rheumatoid arthritis (RA). Patients and methods These measurements were conducted between January 2014 and June 2014. Serum 25-hydroxy vitamin D (25-OH-D), anti- CCP antibody, and erythrocyte sedimentation rates were measured in a cohort of 154 patients (66 males, 88 females; mean age 53.5±12.4; range 29 to 79 years) with early RA. A control group of 60 healthy participants (25 males, 35 females; mean age 51.4±10.3; range 25 to 75 years) was only evaluated for serum 25-OH-D levels. Disease activity was measured by calculating the 28-Joint Disease Activity Score. Blood samples were drawn from cubital veins. After centrifugation, serum was collected and stored under minus 20 degrees. Results Vitamin D deficiency was more prevalent in RA group compared with control group (48.70% vs. 30.00%, p<0.05). Serum 25-OH-D levels were lower in RA group (19.46±8.20 ng/mL) than control group (23.18±6.71 ng/mL) (p<0.05). In the RA group, serum 25-OH-D levels were negatively correlated to anti-CCP antibody levels (rs= -0.360, p<0.001), erythrocyte sedimentation rate (rs= -0.270, p<0.001), age of patients (rs= -0.602, p<0.001), and disease activity (rs= -0.249, p<0.05), respectively. Serum 25-OH-D level did not vary according to sex in the RA group. In control group, females had lower serum 25-OH-D level (p=0.001, rs=0.404). In addition, serum 25-OH-D level was also negatively associated with age in control group (p<0.001, rs= -0.578). There were no differences between RA group and control group in terms of age and sex ratio. Conclusion Serum 25-OH-D level was negatively correlated to anti-CCP antibody level and disease activity, which implied the therapeutic role of serum 25-OH-D in RA.
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