Vitamin D in Systemic Lupus Erythematosus

Diane Kamen; Cynthia Aranow

Disclosures

Curr Opin Rheumatol. 2008;20(5):532-537. 

In This Article

Abstract and Introduction

Abstract

Purpose of Review: There is growing interest in the contribution of vitamin D deficiency to autoimmunity. It is therefore timely to review the immunologic actions of vitamin D and the evidence linking vitamin D deficiency to autoimmune disease in animal models and to systemic lupus erythematosus in epidemiologic studies.
Recent Findings: A number of recent studies have highlighted the association between systemic lupus erythematosus and vitamin D deficiency. Vitamin D deficiency skews the immunologic response towards loss of tolerance. Adding vitamin D in vitro reverses immunologic abnormalities characteristic of systemic lupus erythematosus.
Summary: Multiple systemic lupus erythematosus cohorts have low vitamin D levels. The physiologic and clinical consequences of vitamin D deficiency in systemic lupus erythematosus are not entirely known. Prospective studies of vitamin D in systemic lupus erythematosus are limited, but most cross-sectional studies show an inverse relationship between levels of vitamin D and disease activity. This suggests that repletion of vitamin D may have benefits beyond bone health for patients with systemic lupus erythematosus.

Introduction

Vitamin D is a steroid hormone that plays a crucial role in calcium metabolism and bone homeostasis. It is increasingly recognized that vitamin D also has important roles in multiple other systems, including effects on muscles, vasculature, reproduction, cellular growth and differentiation, malignancy and the immune system. Vitamin D's regulatory role of vitamin D in modulating the immune response includes inhibitory effects on T cells, B cells and dendritic cells. These suppressive immunologic properties have led to considering its role in autoimmune diseases such as systemic lupus erythematosus (SLE). The consequences of vitamin D deficiency on disease susceptibility and severity, as well as vitamin D's potential as an immunomodulatory therapeutic agent, are areas of growing interest among rheumatologists.

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