Negativation of type 1 diabetes‐associated autoantibodies to glutamic acid decarboxylase and insulin in children treated with oral calcitriol (口服骨化三醇治疗维持儿童1型糖尿病相关的谷氨酸脱羧酶与胰岛素自身抗体阴性)

Papadimitriou, Dimitrios T; Marakaki, Chrisanthi; Fretzayas, Andrew; Nicolaidou, Polyxeni; Papadimitriou, Anastasios

doi:10.1111/1753-0407.12023

Cited by 18 publications

(15 citation statements)

References 20 publications

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“…Higher doses of cholecalciferol (2000 IU/day, 4000 IU/day, 70 IU/Kg/day, or 14000 IU/month) improved the immunity status in small populations with T1DM [ 386 – 389 ]. Similar data were obtained with calcidiol for 1 year or calcitriol for 6 months in two pilot studies [ 390 , 391 ].…”

Section: Extraskeletal Actions Of Vitamin Dsupporting

confidence: 82%

Vitamin D in pediatric age: consensus of the Italian Pediatric Society and the Italian Society of Preventive and Social Pediatrics, jointly with the Italian Federation of Pediatricians

Vierucci²,

et al. 2018

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Vitamin D plays a pivotal role in the regulation of calcium-phosphorus metabolism, particularly during pediatric age when nutritional rickets and impaired bone mass acquisition may occur.Besides its historical skeletal functions, in the last years it has been demonstrated that vitamin D directly or indirectly regulates up to 1250 genes, playing so-called extraskeletal actions. Indeed, recent data suggest a possible role of vitamin D in the pathogenesis of several pathological conditions, including infectious, allergic and autoimmune diseases. Thus, vitamin D deficiency may affect not only musculoskeletal health but also a potentially wide range of acute and chronic conditions. At present, the prevalence of vitamin D deficiency is high in Italian children and adolescents, and national recommendations on vitamin D supplementation during pediatric age are lacking. An expert panel of the Italian Society of Preventive and Social Pediatrics reviewed available literature focusing on randomized controlled trials of vitamin D supplementation to provide a practical approach to vitamin D supplementation for infants, children and adolescents.

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Section: Extraskeletal Actions Of Vitamin Dsupporting

confidence: 82%

Vitamin D in pediatric age: consensus of the Italian Pediatric Society and the Italian Society of Preventive and Social Pediatrics, jointly with the Italian Federation of Pediatricians

Vierucci²,

et al. 2018

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“…Intervention studies with different doses of vitamin D 3 in autoimmune diseases lead to different outcomes, recently we demonstrated that a bolus of vitamin D 3 (300,000 UI) in patients affected by early rheumatoid arthritis is effective in ameliorating general health, however, we found no effect on disease activity nor on inflammatory markers and T cells subset [ 73 ]. In patients affected by type 1 diabetes clinical intervention studies with vitamin D 3 or hydroxylated analogs have been disappointing, as no clinical study has demonstratedan effect of vitamin D in ameliorating glucose metabolism and insulin secretion [ 113 , 114 ], however, in a small prospective trial in children with type 1 diabetes autoantibodies 1,25(OH) 2 D 3 administration decreased the serum glutamic acid decarboxylase 65 (GAD65) autoantibody, pointing to some immunomodulation of 1,25(OH) 2 D 3 [ 115 ].…”

Section: Vitamin D and Autoimmune Diseasesmentioning

confidence: 99%

Vitamin D: Nutrient, Hormone, and Immunomodulator

2018

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The classical functions of vitamin D are to regulate calcium-phosphorus homeostasis and control bone metabolism. However, vitamin D deficiency has been reported in several chronic conditions associated with increased inflammation and deregulation of the immune system, such as diabetes, asthma, and rheumatoid arthritis. These observations, together with experimental studies, suggest a critical role for vitamin D in the modulation of immune function. This leads to the hypothesis of a disease-specific alteration of vitamin D metabolism and reinforces the role of vitamin D in maintaining a healthy immune system. Two key observations validate this important non-classical action of vitamin D: first, vitamin D receptor (VDR) is expressed by the majority of immune cells, including B and T lymphocytes, monocytes, macrophages, and dendritic cells; second, there is an active vitamin D metabolism by immune cells that is able to locally convert 25(OH)D3 into 1,25(OH)2D3, its active form. Vitamin D and VDR signaling together have a suppressive role on autoimmunity and an anti-inflammatory effect, promoting dendritic cell and regulatory T-cell differentiation and reducing T helper Th 17 cell response and inflammatory cytokines secretion. This review summarizes experimental data and clinical observations on the potential immunomodulating properties of vitamin D.

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“…However, in all the above studies, the vitamin D dose used was particularly low, inadequate even for prophylaxis from hypovitaminosis D, even more so to except a therapeutic effect and the duration too short to show results based on immunomodulation driven by a presumed rise in 1–25 OHD3 levels. Knowing that 25(OH) vitamin D suppresses macrophage adhesion and migration [ 20 ], we decided to use the active hormone calcitriol, whose immunomodulating properties have been shown even in negativating type 1 diabetes-associated autoantibodies [ 21 ], while properly substituting with 4000 IU cholecalciferol daily assured optimal (>40 ng/mL) 25 OHD levels [ 22 ], without any risk for overdosing [ 23 ].…”

Section: Discussionmentioning

confidence: 99%

Successful Treatment of Severe Atopic Dermatitis with Calcitriol and Paricalcitol in an 8-Year-Old Girl

Bothou

Alexopoulos

Dermitzaki

et al. 2018

Case Reports in Pediatrics

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Atopic dermatitis (AD) is a chronic inflammatory disease affecting children and adolescence. The traditional therapeutic options for AD, including emollients topically and immune modulatory agents systemically focusing on reducing skin inflammation and restoring the function of the epidermal barrier, are proven ineffective in many cases. Several studies have linked vitamin D supplementation with either a decreased risk to develop AD or a clinical improvement of the symptoms of AD patients. In this report, we present a girl with severe AD who under adequate supplementation with cholecalciferol was treated with calcitriol and subsequently with paricalcitol. She had significant improvement—almost healing of her skin lesions within 2 months, a result sustained for more than 3 years now. Because of hypercalciuria as a side effect from calcitriol therapy, treatment was continued with paricalcitol, a vitamin D analogue used in secondary hyperparathyroidism in chronic kidney disease. Calcitriol therapy may be considered as a safe and efficacious treatment option for patients with severe AD, particularly for those with refractory AD, under monitoring for possible side effects. Treatment with paricalcitol resolves hypercalciuria, is safe, and should be further investigated as an alternative treatment of atopic dermatitis and possibly other diseases of autoimmune origin.

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Negativation of type 1 diabetes‐associated autoantibodies to glutamic acid decarboxylase and insulin in children treated with oral calcitriol (口服骨化三醇治疗维持儿童1型糖尿病相关的谷氨酸脱羧酶与胰岛素自身抗体阴性)

Cited by 18 publications

References 20 publications

Vitamin D in pediatric age: consensus of the Italian Pediatric Society and the Italian Society of Preventive and Social Pediatrics, jointly with the Italian Federation of Pediatricians

Vitamin D in pediatric age: consensus of the Italian Pediatric Society and the Italian Society of Preventive and Social Pediatrics, jointly with the Italian Federation of Pediatricians

Vitamin D: Nutrient, Hormone, and Immunomodulator

Successful Treatment of Severe Atopic Dermatitis with Calcitriol and Paricalcitol in an 8-Year-Old Girl

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