Alemtuzumab-Induced Secondary Autoimmune Skin Disorders as Side Effects of Multiple Sclerosis Therapy: Problem That Can Be Influenced or Fate? A Narrative Overview of The Literature A Neuroprotective Role of Vitamin D?

Abstract

At present, no cure for multiple sclerosis can be made possible with the pharmaceuticals available, nor can a gradual progression of multiple sclerosis be prevented. In the management of multiple sclerosis, it is therefore necessary to determine existing autoimmune diseases through anamnesis before starting alemtuzumab therapy with disease modifying therapy. With previously existing autoimmune diseases or as prophylaxis, comorbidities can be influenced by vitamin D supplementation. Secured pathophysiological and immunological mechanisms of vitamin D on autoimmunological processes support the daily, individually high-dose oral vitamin D intake. This add-on therapy should positively influence the quality of life of persons with multiple sclerosis in the long term. So that the patients do not reject the highly efficient multiple sclerosis therapy for fear of side effects, this therapy offer is a way of avoiding side effects of alemtuzumab administration, such as alopecia, vitiligo, and thyroid diseases, and of decisively influencing the course of MS. This increases the compliance of the persons with multiple sclerosis in therapy. The pathophysiological mechanisms of alopecia and vitiligo are shown. The immunological mechanisms of vitamin D and its influence on autoimmune diseases are described. The previous use of vitamin D in the therapy of these skin diseases is presented and oral supplementation is put up for discussion. The additional neuroprotective effect is evident. Preventing infection with oral vitamin D supplements, particularly in coronavirus disease 2019, may prevent or mitigate multiple sclerosis exacerbations.