Systemic lupus erythematosus (SLE) is a long-term autoimmune disorder
that may affect the skin, joints, kidneys, brain, and other organs.
Vitamin D Supplements May Benefit Lupus Patients
Preliminary evidence suggests that vitamin D supplementation should be considered as a modifying agent in the treatment of the immune system condition known as systemic lupus erythematosus
A new clinical study published in BioMedCentral's open access journal Arthritis Research and Therapy provides preliminary evidence that vitamin D supplementation could be considered an immunomodulatory agent for systemic lupus erythematosus (SLE).
SLE is a debilitating autoimmune disease characterized not only by skin, joint, neurological and renal symptoms, but also by inflammation of tissue linings in the body.
SLE is a T- and B-cell-dependent disease that causes an appearance of autoantibodies, causing the body to attack itself. Patients present with a depletion of regulatory T cells (Tregs) that normally protect against autoimmune disease, an increase in cytokine-producing T helper (Th) 17 cells and an increase in IFN-inducible genes, which trigger the body's protective responses. Recent studies have shown that vitamin D could ameliorate these effects.
In a prospective clinical trial, Nathalie Costedoat-Chalumeau and colleagues set out to evaluate the safety and immunological effects of vitamin D supplementation in 20 SLE patients with low vitamin D levels. They observed these patients over six months and found that vitamin D was not only well-tolerated but, more importantly, there were no SLE flare-ups during the follow-up period.
Vitamin D supplementation in these six patients
caused an increase in beneficial CD4+ cells
(mature Th cells), an increase in Treg cells
and a decrease of effector Th1 and Th17 cells.
It also decreased memory B cell and anti-DNA
antibodies all beneficial to SLE symptoms.
The authors found that no modification of existing
immunosuppressant drugs was needed,
nor any new drugs initiated.
Although preliminary in nature, these findings suggest
that vitamin D provides beneficial immunological effects
on SLE, with a decrease in B memory cells and
effector T cells, and an increase in Tregs.
Costedoat-Chalumeau added "This should be
confirmed in larger randomized controlled trials."
Costedoat-Chalumeau believes that the findings confirm that vitamin D may also play other roles in the immune system.
Costedoat-Chalumeau: "The study has highlighted interesting pathways to explore. Among the identified signatures, we observed the down-regulation of RNA polymerase functions and histone expression and the up-regulation of the TP53/CDKN1A-related pathway. These deserve further research owing to their possible involvement with a decrease in the accumulation of autoantigens and the activation and proliferation of autoreactive T and B lymphocytes."
"Restoration of regulatory and effector T cell balance and B cell homeostasis in systemic lupus erythematosus patients through vitamin D supplementation"; Benjamin Terrier, Nicolas Derian, Yoland Schoindre, Wahiba Chaara, Guillaume Geri, Noel Zahr, Kuberaka Mariampillai, Michelle Rosenzwajg, Wassila Carpentier, Lucile Musset, Jean-Charles Piette, Adrien Six, David Klatzmann, David Saadoun, Patrice Cacoub and Nathalie Costedoat-Chalumeau. Arthritis Research and Therapy (in press)
Arthritis Research & Therapy is an international, peer-reviewed online journal, publishing original research, reviews, commentaries and reports. The major focus of the journal is on cellular and molecular mechanisms of arthritis, musculoskeletal conditions and systemic autoimmune rheumatic diseases and translation of this knowledge into advances in clinical care. Original basic, translational laboratory and clinical research is considered for publication along with results of therapeutic trials.
BioMed Central is an STM (Science, Technology and Medicine) publisher which has pioneered the open access publishing model. All peer-reviewed research articles published by BioMed Central are made immediately and freely accessible online, and are licensed to allow redistribution and reuse. BioMed Central is part of Springer Science+Business Media, a leading global publisher in the STM sector. @BioMedCentral
Original article: http://www.eurekalert.org/pub_releases/2012-10/bc-vds101512.php