Can vitamin D prevent autoimmune diseases?

Vitamin D, apart from its role in calcium nutrition, has been recently studied for its surprising immunomodulation effects, which could have far implications (1). Not only does the hormone-like vitamin acts on vitamin D receptors, which are present on immune cells such as dentritic cells, but it has also been discovered that activated dentritic cells appear to produce vitamin D (2;3).

Because autoimmune diseases such as systemic lupus erythematosus, multiple sclerosis and rheumatoid arthritis have each been linked to low vitamin D status, vitamin D supplementation is thought to have potential use as a treatment (3-5). Its use for HIV infection and cancer are also being studied (6;7).

Prevention of autoimmune diseases are also associated with immunomodulation from vitamin D. A higher levels of vitamin D is associated with lower risk of multiple sclerosis (8) and with lower risk of type 1 diabetes mellitus (9;10). Vitamin D’s action for preventing type 1 diabetes and other autoimmune diseases is thought to be modulation of dentritic action and modifying T-cell differentiation (10).

Animal studies make the research more exciting. In an older study on mice, vitamin D was able to completely prevent the mouse model of multiple sclerosis (11). Others have also suggested use in preventing encephalomyelitis, rheumatoid arthritis, and systemic lupus erythematosus (12). It should be noted that, in each case, a high-calcium diet was required (12).

Reference List

1. Adams JS, Hewison M. Unexpected actions of vitamin D: new perspectives on the regulation of innate and adaptive immunity. Nat Clin Pract Endocrinol Metab 2008;4:80-90.
2. Adorini L, Penna G. Dendritic cell tolerogenicity: a key mechanism in immunomodulation by vitamin D receptor agonists. Hum Immunol 2009;70:345-52.
3. Cutolo M, Otsa K. Review: vitamin D, immunity and lupus. Lupus 2008;17:6-10.
4. Do JE, Kwon SY, Park S, Lee ES. Effects of vitamin D on expression of Toll-like receptors of monocytes from patients with Behcet’s disease. Rheumatology (Oxford) 2008;47:840-8.
5. Vojinovic S, Vojinovic J, Cosic V, Savic V. [Effects of alfacalcidol therapy on serum cytokine levels in patients with multiple sclerosis]. Srp Arh Celok Lek 2005;133 Suppl 2:124-8.
6. Adorini L, Daniel KC, Penna G. Vitamin D receptor agonists, cancer and the immune system: an intricate relationship. Curr Top Med Chem 2006;6:1297-301.
7. Villamor E. A potential role for vitamin D on HIV infection? Nutr Rev 2006;64:226-33.
8. Correale J, Ysrraelit MC, Gaitan MI. Immunomodulatory effects of Vitamin D in multiple sclerosis. Brain 2009;132:1146-60.
9. Arnson Y, Amital H, Shoenfeld Y. Vitamin D and autoimmunity: new aetiological and therapeutic considerations. Ann Rheum Dis 2007;66:1137-42.
10. Mathieu C, Badenhoop K. Vitamin D and type 1 diabetes mellitus: state of the art. Trends Endocrinol Metab 2005;16:261-6.
11. Hayes CE, Cantorna MT, Deluca HF. Vitamin D and multiple sclerosis. Proc Soc Exp Biol Med 1997;216:21-7.
12. Deluca HF, Cantorna MT. Vitamin D: its role and uses in immunology. FASEB J 2001;15:2579-85.

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