High frequency of vitamin D insufficiency in primary antiphospolipid syndrome

Klack, Karin; Carvalho, Jozélio Freire de

doi:10.1016/j.jbspin.2010.02.043

Cited by 24 publications

(15 citation statements)

References 9 publications

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“…[9][10][11][12] In all studies, the average value for APS patients was below 30 ng/ml, a cut-off value suggested by international guidelines. 13 Although they lack data on race, seasonality, nutrition and sun exposure, overall these studies suggest that APS patients are comparably as affected by hypovitaminosis D as they are by other systemic autoimmune diseases.…”

Section: Introductionmentioning

confidence: 99%

Vitamin D and antiphospholipid syndrome

Andréoli

Piantoni

Dall’Ara

et al. 2012

Lupus

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Vitamin D (vitD) has been shown to have multiple immunomodulatory properties. Hypovitaminosis D has been described in many systemic autoimmune diseases. Antiphospholipid syndrome (APS), an autoimmune disease characterized by immunemediated thrombosis and pregnancy loss, is a peculiar model for studying vitD, since these patients do not usually have a full-blown autoimmune disease, nor do they have particular restrictions regarding sun exposure. We assessed 25-OH vitD levels in 115 APS and 128 normal healthy donors (NHD) with the LIAISON Õ chemiluminescent immunoassay by DiaSorin (Italy). Median values were lower in APS patients than in NHD, with the greatest difference occurring during summertime (p < 0.01), suggesting that APS patients may be somehow prevented from vitD generation upon sun exposure. In our cohort, APS patients may have been instructed to use sunscreens in the presence of positive antinuclear antibodies (ANA). Comparing patients with positive and negative ANA, we found comparable vitD levels during the summer. By subdividing APS patients according to clinical features, thrombotic APS patients showed significantly lower levels than did pure obstetric APS patients (p < 0.01). In conclusion, our study confirms previous reports of hypovitaminosis D in APS patients, making them more similar to patients with other systemic autoimmune diseases than NHD. Hypovitaminosis D may be part of the mosaic of factors that determine autoimmunity, rather than a consequence of chronic disease and its treatment. The observation that patients with thrombotic APS, an aggressive phenotype, may be more deficient than those with exclusive obstetric manifestations fits well with the beneficial effects of vitD on thrombosis described both in vitro and in vivo. Therefore, there may be a rationale to assess the efficacy of vitD supplementation in APS patients. Lupus (2012) 21, 736-740.

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Section: Introductionmentioning

confidence: 99%

Vitamin D and antiphospholipid syndrome

Andréoli

Piantoni

Dall’Ara

et al. 2012

Lupus

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“…VitD deficiency was found in 11% and insufficiency in 74% of these PAPS patients, resembling the findings of Italian authors [88] which have reported the prevalence of VitD deficiency in 17% and insufficiency in 60% of PAPS patients. It is interesting that Brazilian authors have noticed that VitD insufficient PAPS patients tended to be more overweighed than those with adequate VitD level [87]. Also, it seems that thrombotic APS is characterized with significantly lower concentrations of VitD than purely obstetric clinical syndrome (20.8 vs. 33.3 ng/ml, p<0.01) [88] highlighting once again the role of this vitamin in thrombosis.…”

Section: Role Of Vitamin D In Antiphospholipid Syndromementioning

confidence: 96%

“…One of the first announcements on the prevalence of VitD insufficiency or deficiency in PAPS and their impact on its manifestations dated from 2010 [87]. This letter to the editor presented the results of research conducted by Brazilian investigators in the group of forty-six PAPS patients, younger than 60 years, in whom the VitD levels were assessed in the autumn, when it was expected to be highest.…”

Section: Role Of Vitamin D In Antiphospholipid Syndromementioning

confidence: 99%

Pathogenic and Therapeutic Role of Vitamin D in Antiphospholipid Syndrome Patients

Jelic¹,

Nikolic²,

Marisavljević³

et al. 2017

A Critical Evaluation of Vitamin D - Clinical Overview

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In this chapter, the novel findings on interrelationship between vitamin D status and two well-known prothrombotic states, antiphospholipid syndrome, particularly its thrombotic phenotype, and metabolic syndrome will be reviewed. We shall present the results obtained from patients included in Serbian National Antiphospholipid Syndrome Registry, 68 patients with primary antiphospholipid syndrome (PAPS) and 69 patients with antiphospholipid syndrome associated with certain autoimmune rheumatic disease (sAPS), as well as 50 patients with pure metabolic syndrome (MetS). These results will be analysed and compared with the novel literature data. Prevalence of MetS in APS is high, with the atherogenic dyslipidaemia as its most prevalent characteristic. Prevalence of thrombotic events was significantly higher in APS patients with coexisting MetS, compared with those without MetS. Among APS patients, prevalence of VitD deficiency was significantly higher than in patients with pure MetS.VitD level was also significantly lower in APS patients with coexisting MetS or previous thrombotic events than in those without them. Elucidating interrelationships between VitD deficiency, MetS and thrombotic events in APS patients open up the possibility of distinguishing those subjects with the particularly high cardiovascular risk and ensuing need for the strict control of modifiable risk factors and VitD supplementation.

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“…The antiphospholipid syndrome (APS) is a systemic autoimmune disease characterized by thrombotic manifestations and/or pregnancy-related complications in patients with confirmed antiphospholipid antibodies (aPL). Lower vitamin D levels have been described in APS patients when compared to healthy controls [119][120][121], particularly in patients with thrombotic disease [122]. However, no stringent lifestyle recommendations or dietary restrictions have been expressed for patients with APS with reference with vitamin D deficiency [123].…”

Section: Antiphospholipid Syndromementioning

confidence: 99%

Pathophysiological Role and Therapeutic Implications of Vitamin D in Autoimmunity: Focus on Chronic Autoimmune Diseases

et al. 2020

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Vitamin D is a pleiotropic secosteroid yielding multiple actions in human physiology. Besides the canonical regulatory activity on bone metabolism, several non-classical actions have been described and the ability of vitamin D to partake in the regulation of the immune system is particularly interesting, though far stronger and convincing evidence has been collected in in vitro as compared to in vivo studies. Whether vitamin D is able to regulate at physiological concentrations the human immune system remains unproven to date. Consequently, it is not established if vitamin D status is a factor involved in the pathogenesis of immune-mediated diseases and if cholecalciferol supplementation acts as an adjuvant for autoimmune diseases. The development of autoimmunity is a heterogeneous process, which may involve different organs and systems with a wide range of clinical implications. In the present paper, we reviewed the current evidences regarding vitamin D role in the pathogenesis and management of different autoimmune diseases.

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High frequency of vitamin D insufficiency in primary antiphospolipid syndrome

Cited by 24 publications

References 9 publications

Vitamin D and antiphospholipid syndrome

Vitamin D and antiphospholipid syndrome

Pathogenic and Therapeutic Role of Vitamin D in Antiphospholipid Syndrome Patients

Pathophysiological Role and Therapeutic Implications of Vitamin D in Autoimmunity: Focus on Chronic Autoimmune Diseases

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