Immunomodulatory Effect of Vitamin D and Its Potential Role in the Prevention and Treatment of Type 1 Diabetes Mellitus—A Narrative Review

Rak, Karolina; Bronkowska, Monika

doi:10.3390/molecules24010053

Cited by 81 publications

(78 citation statements)

References 151 publications

(195 reference statements)

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“…In adolescents, many studies revealed no association between 25(OH)D level and onset of T1DM [102][103][104]. However, there is a clear effect of vitamin D in young adults, as low 25(OH)D levels were significantly associated with developing T1DM [105]. However, according to the available literature, the cause-and-effect relationship is inconclusive.…”

Section: Diabetesmentioning

confidence: 99%

Vitamin D deficiency 2.0: an update on the current status worldwide

et al. 2020

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Vitamin D testing and the use of vitamin D supplements have increased substantially in recent years. Currently, the role of vitamin D supplementation, and the optimal vitamin D dose and status, is a subject of debate, because large interventional studies have been unable to show a clear benefit (in mostly vitamin D replete populations). This may be attributed to limitations in trial design, as most studies did not meet the basic requirements of a nutrient intervention study, including vitamin D-replete populations, too small sample sizes, and inconsistent intervention methods regarding dose and metabolites. Vitamin D deficiency (serum 25-hydroxyvitamin D [25(OH)D] < 50 nmol/L or 20 ng/ml) is associated with unfavorable skeletal outcomes, including fractures and bone loss. A 25(OH)D level of >50 nmol/L or 20 ng/ml is, therefore, the primary treatment goal, although some data suggest a benefit for a higher threshold. Severe vitamin D deficiency with a 25(OH)D concentration below <30 nmol/L (or 12 ng/ml) dramatically increases the risk of excess mortality, infections, and many other diseases, and should be avoided whenever possible. The data on a benefit for mortality and prevention of infections, at least in severely deficient individuals, appear convincing. Vitamin D is clearly not a panacea, and is most likely efficient only in deficiency. Given its rare side effects and its relatively wide safety margin, it may be an important, inexpensive, and safe adjuvant therapy for many diseases, but future large and well-designed studies should evaluate this further. A worldwide public health intervention that includes vitamin D supplementation in certain risk groups, and systematic vitamin D food fortification to avoid severe vitamin D deficiency, would appear to be important. In this narrative review, the current international literature on vitamin D deficiency, its relevance, and therapeutic options is discussed.

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Section: Diabetesmentioning

confidence: 99%

Vitamin D deficiency 2.0: an update on the current status worldwide

et al. 2020

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“…Accumulating evidence has emerged for an association between vitamin D status and T1DM risk [225]. Modulated by activation of the VDR, vitamin D influences several metabolic pathways and affects the immune system.…”

Section: Type 1 Diabetes Mellitusmentioning

confidence: 99%

Role of Vitamin D in Preventing and Treating Selected Extraskeletal Diseases—An Umbrella Review

Maretzke¹,

Bechthold²,

Egert

et al. 2020

Nutrients

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Evidence is accumulating that vitamin D may have beneficial effects on respiratory tract, autoimmune, neuro-degenerative, and mental diseases. The present umbrella review of systematic reviews (SRs) of cohort studies and randomised controlled trials (RCTs), plus single Mendelian randomisation studies aims to update current knowledge on the potential role of vitamin D in preventing and treating these extraskeletal diseases. Altogether, 73 SRs were identified. Observational data on primary prevention suggest an inverse association between vitamin D status and the risk of acute respiratory tract infections (ARI), dementia and cognitive decline, and depression, whereas studies regarding asthma, multiple sclerosis (MS), and type 1 diabetes mellitus (T1DM) are scarce. SRs of RCTs support observational data only for the risk of ARI. No respective RCTs are available for the prevention of chronic obstructive pulmonary disease (COPD), MS, and T1DM. SRs of RCTs indicate beneficial therapeutic effects in vitamin D-deficient patients with asthma and COPD, while effects on major depression and T1DM need to be further elucidated. Mendelian randomisation studies do not consistently support the results of SRs. Since several limitations of the included SRs and existing RCTs do not permit definitive conclusions regarding vitamin D and the selected diseases, further high-quality RCTs are warranted.

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“…A deficit of vitamin D is associated with increased risk of autoimmune diseases, including T1D. Vitamin D has immunomodulatory effects and the relative molecular mechanisms as well as the clinical studies on the use of vitamin D in T1D were extensively reviewed [122,123]. A potential protective effect of vitamin D against the development of T1D was supposed and it may be due to the suppression of insulitis by modification of CD8+ and CD4+ T-cells, B lymphocytes, and macrophage infiltration [124,125].…”

Section: Vitamin Dmentioning

confidence: 99%

Endocrine Disrupting Chemicals and Type 1 Diabetes

Predieri

Bruzzi

Bigi

et al. 2020

IJMS

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Type 1 diabetes (T1D) is the most common chronic metabolic disease in children and adolescents. The etiology of T1D is not fully understood but it seems multifactorial. The genetic background determines the predisposition to develop T1D, while the autoimmune process against β-cells seems to be also determined by environmental triggers, such as endocrine disrupting chemicals (EDCs). Environmental EDCs may act throughout different temporal windows as single chemical agent or as chemical mixtures. They could affect the development and the function of the immune system or of the β-cells function, promoting autoimmunity and increasing the susceptibility to autoimmune attack. Human studies evaluating the potential role of exposure to EDCs on the pathogenesis of T1D are few and demonstrated contradictory results. The aim of this narrative review is to summarize experimental and epidemiological studies on the potential role of exposure to EDCs in the development of T1D. We highlight what we know by animals about EDCs’ effects on mechanisms leading to T1D development and progression. Studies evaluating the EDC levels in patients with T1D were also reported. Moreover, we discussed why further studies are needed and how they should be designed to better understand the causal mechanisms and the next prevention interventions.

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Immunomodulatory Effect of Vitamin D and Its Potential Role in the Prevention and Treatment of Type 1 Diabetes Mellitus—A Narrative Review

Cited by 81 publications

References 151 publications

Vitamin D deficiency 2.0: an update on the current status worldwide

Vitamin D deficiency 2.0: an update on the current status worldwide

Role of Vitamin D in Preventing and Treating Selected Extraskeletal Diseases—An Umbrella Review

Endocrine Disrupting Chemicals and Type 1 Diabetes

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