Decreased Serum 25-(OH)-D Level Associated With Muscle Enzyme and Myositis Specific Autoantibodies in Patients With Idiopathic Inflammatory Myopathy

Abstract

ObjectivesTo determine whether there is serum vitamin D deficiency and the low levels of serum vitamin D are correlated with serological and immunological indexes in patients with idiopathic inflammatory myopathy (IIM).MethodsA total of 63 newly diagnosed patients with IIM, and 55 age- and sex- matched healthy controls were enrolled. Serum levels of 25-(OH)-D were measured by enzyme-linked immunosorbent assay. The correlations of 25-(OH)-D levels with disease indicators and T cell subsets were analyzed.ResultThe levels of serum 25-(OH)-D in IIM were significantly lower than those in healthy controls (9.36 ± 5.56 vs 26.56 ± 5.37 ng/ml, p<0.001). The levels of serum liver enzyme ALT and AST and muscle enzyme CK, CKMB, LDH and HBDH were elevated as deficiency of vitamin D. In addition, the serum 25-(OH)-D levels were negatively correlated to ALT (r = -0.408, p = 0.001) and AST (r = -0.338, p = 0.007). The 25-(OH)-D levels in IIM patients in presence of anti-Jo-1 were significantly lower than those in patients without anti-Jo-1 (5.24 ± 3.17 vs 9.32 ± 5.60 ng/ml; p = 0.037). Similar results were found in patients with or without anti-Mi-2 antibody. The serum 25-(OH)-D levels were positively associated with total T (r = 0.203, p = 0.012) and Treg cells (r = 0.331, p = 0.013). The patients with deficient levels of vitamin D were more likely to have heliotrope, gastrointestinal and liver involvement.ConclusionsVitamin D deficiency existed in IIM patients, which was significantly correlated with muscle enzyme, presence of anti-Jo-1 and anti-Mi-2 antibody, and the absolute numbers of total T and Treg cells in IIM. It is suggested that vitamin D may play an important role in the immunological pathogenesis of IIM.

Lymphocyte immunophenotyping in inflammatory myositis: a review

“…Tregs reduction is observed within the muscle of IBM patients [23], while in juvenile dermatomyositis (JDM) patients muscle Tregs seem to be increased, despite their loss of function in regulation of the immune system [23,24]. In accordance, many studies report functional deficiency of Tregs in all IIM clinical subsets [25].…”

Vitamin D add on the standard treatment for myasthenia gravis symptoms following total gastrectomy: a case report

“…Some studies investigating vitamin D in individuals with MG have reported contradictory findings regarding the prevalence of deficient or insufficient vitamin D levels. Some studies have produced conflicting results and have failed to consider the association between outdoor activities and vitamin D intake [26][27][28][29].…”

Serum 25‐hydroxyvitamin D levels and dermatomyositis: A 2‐sample mendelian randomization study

“…Therefore, these seasonal variations in DM may be driven by different myositis‐specific antibodies (MSAs) 6,22 . For instance, a notable correlation exists between diminished serum 25‐(OH)D levels in IIM patients and the presence of MSAs (such as anti‐Jo − 1 and anti‐Mi‐2 antibodies) 23 . Despite sunlight being the primary means of synthesizing vitamin D in the body, excessive exposure to the sun can elevate the susceptibility to both DM and skin cancer.…”

“…IIM patients and the presence of MSAs (such as anti-Jo − 1 and anti-Mi-2 antibodies). 23 Despite sunlight being the primary means of synthesizing vitamin D in the body, excessive exposure to the sun can elevate the susceptibility to both DM and skin cancer. Some studies suggest that 10 min of sun exposure in spring and summer or 2 h of outdoor activity in winter can achieve optimal vitamin D supplementation.…”