Dualities of the vitamin D in systemic sclerosis: a systematic literature review

Abstract

Background Systemic sclerosis (SSc) is a chronic disease characterized by autoimmunity, vasculopathy, and visceral and cutaneous fibrosis. Vitamin D has several functions in the immunological system, and different studies have suggested a potential role in triggering autoimmune diseases. Patients with SSc may present with low serum levels of vitamin D, but the association between hypovitaminosis D and disease onset or any clinical manifestation is still obscure. Our goal was to verify the causal relationship between hypovitaminosis D and SSc onset or any particular clinical manifestation in the literature. Methods A systematic literature review was performed through February 24th, 2021 on Pubmed, Lilacs/BIREME, and Cochrane databases. The eligible studies were read in full text, and, in the absence of exclusion criteria, were included in this review after consensus between two reviewers. Results Forty articles met the eligibility criteria and the main results of each study are described. In most studies, SSc patients showed a higher prevalence of vitamin D deficiency and insufficiency compared to controls. Additionally, in some reports serum levels of vitamin D were inversely correlated with the severity of SSc. Oral supplementation did not seem to affect serum levels of vitamin D. Four of the included studies were with experimental models. Conclusion In conclusion, vitamin D deficiency seems to have a role in susceptibility to SSc, as well as in the clinical manifestations of the disease.

25-hydroxyvitamin D3 Levels and Their Clinical Associations in a Polish Cohort of Systemic Sclerosis Patients: A Cross-Sectional Study

“…Vitamin D deficiency in SSc has been widely reported [17][18][19][20][21]. In the population studied, its prevalence reached 50%, and the association between vitamin D deficiency and a higher prevalence of arterial hypertension was one of the strongest findings in this study.…”

“…However, the results have not yet been published. A recent systematic review on vitamin D deficiency in SSc confirmed that SSc patients frequently present vitamin D deficiency and that its levels inversely correlate with the disease severity [18]. However, it also emphasized the lack of evidence for the beneficial impact of vitamin D in SSc and highlighted a need for future trials and fundamental research.…”

Fly Me to the Immune: Immunonutrition in Rheumatic Diseases

“…Decreased availability of serum 25-hydroxyvitamin D (25[OH]D) has been postulated to compromise immune cell synthesis of hormonal 1,25-dihydroxyvitamin D, leading to impaired innate immunity and over-exuberant inflammatory adaptive immunity. 42 Patients with SLE, 43 fibromyalgia, 20 SSc, 44 , 45 AS, 46 SS, 47 and psoriasis 48 demonstrate low vitamin D levels, which tend to correlate inversely with disease activity. In rheumatology, vitamin D supplementation is prescribed for the prevention of glucocorticoid-induced osteoporosis, the reduction of fracture-risk, 49 and the management of pain (mainly in fibromyalgia).…”

Vitamin D as a Nutri-Epigenetic Factor in Autoimmunity—A Review of Current Research and Reports on Vitamin D Deficiency in Autoimmune Diseases

“…At the same time, no association was observed between the polymorphisms studied and the clinical picture of SSc [ 70 ]. Thorough research on the clinical effects of vitamin D supplementation in SSc patients as well as the clarification of vitamin D commitment in SSc pathogenesis is still needed [ 71 ].…”