Role of vitamin D in flare ups of rheumatoid arthritis

Dehghan, Ali; Rahimpour, Shahab; Soleymani-Salehabadi, Hossein; Owlia, Mohammad Bagher

doi:10.1007/s00393-013-1297-4

Cited by 28 publications

(26 citation statements)

References 19 publications

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“…In a recent study, the prevalence of vitamin D deficiency was reported to be about 51.9%. 19 In another study in Isfahan, this rate was reported to be about 50.8%. 20 Another study in the United States investigated 62 RA patients in terms of vitamin D and DAS28 levels and showed that about 61% of patients had low vitamin D levels (less than 30 ng/mL).…”

Section: Discussionmentioning

confidence: 92%

Serum Vitamin D Level is Inversely Associated With Anti-Cyclic Citrullinated Peptide Antibody Level and Disease Activity in Rheumatoid Arthritis Patients

Wang

Zhang²,

Wang³

et al. 2016

Arch Rheumatol

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Objectives: This study aims to assess the relationship between serum vitamin D and anti-cyclic citrullinated peptide (anti-CCP) antibody levels, as well as disease activity in patients with newly diagnosed rheumatoid arthritis (RA). Patients and methods: These measurements were conducted between January 2014 and June 2014. Serum 25-hydroxy vitamin D (25-OH-D), anti-CCP antibody, and erythrocyte sedimentation rates were measured in a cohort of 154 patients (66 males, 88 females; mean age 53.5±12.4; range 29 to 79 years) with early RA. A control group of 60 healthy participants (25 males, 35 females; mean age 51.4±10.3; range 25 to 75 years) was only evaluated for serum 25-OH-D levels. Disease activity was measured by calculating the 28-Joint Disease Activity Score. Blood samples were drawn from cubital veins. After centrifugation, serum was collected and stored under minus 20 degrees. Results: Vitamin D deficiency was more prevalent in RA group compared with control group (48.70% vs. 30.00%, p<0.05). Serum 25-OH-D levels were lower in RA group (19.46±8.20 ng/mL) than control group (23.18±6.71 ng/mL) (p<0.05). In the RA group, serum 25-OH-D levels were negatively correlated to anti-CCP antibody levels (rs= -0.360, p<0.001), erythrocyte sedimentation rate (rs= -0.270, p<0.001), age of patients (rs= -0.602, p<0.001), and disease activity (rs= -0.249, p<0.05), respectively. Serum 25-OH-D level did not vary according to sex in the RA group. In control group, females had lower serum rs=0.404). In addition, serum 25-OH-D level was also negatively associated with age in control group (p<0.001, rs= -0.578). There were no differences between RA group and control group in terms of age and sex ratio. Conclusion: Serum 25-OH-D level was negatively correlated to anti-CCP antibody level and disease activity, which implied the therapeutic role of serum 25-OH-D in RA.

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Section: Discussionmentioning

confidence: 92%

Serum Vitamin D Level is Inversely Associated With Anti-Cyclic Citrullinated Peptide Antibody Level and Disease Activity in Rheumatoid Arthritis Patients

Wang

Zhang²,

Wang³

et al. 2016

Arch Rheumatol

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“…Although the studies performed by Salesi and Farajzadegan and Dehghan et al suggested a beneficial effect on disease activity and relapse rate, respectively, neither results reach statistical significance (54, 55). However, Dehghan et al pointed out that for every 10 patients treated with cholecalciferol, relapse would be prevented in one patient.…”

Section: Vitamin D As a Therapeutic Agent In Human Autoimmune Diseasesmentioning

confidence: 86%

Vitamin D in Autoimmunity: Molecular Mechanisms and Therapeutic Potential

et al. 2017

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Over the last three decades, it has become clear that the role of vitamin D goes beyond the regulation of calcium homeostasis and bone health. An important extraskeletal effect of vitamin D is the modulation of the immune system. In the context of autoimmune diseases, this is illustrated by correlations of vitamin D status and genetic polymorphisms in the vitamin D receptor with the incidence and severity of the disease. These correlations warrant investigation into the potential use of vitamin D in the treatment of patients with autoimmune diseases. In recent years, several clinical trials have been performed to investigate the therapeutic value of vitamin D in multiple sclerosis, rheumatoid arthritis, Crohn’s disease, type I diabetes, and systemic lupus erythematosus. Additionally, a second angle of investigation has focused on unraveling the molecular pathways used by vitamin D in order to find new potential therapeutic targets. This review will not only provide an overview of the clinical trials that have been performed but also discuss the current knowledge about the molecular mechanisms underlying the immunomodulatory effects of vitamin D and how these advances can be used in the treatment of autoimmune diseases.

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“…That is, vitamin D may decrease inflammation Modern studies of the clinical use of physiological doses of vitamin D are relatively rare (around 5,000 IU/day, see above). At least one RCT of physiological doses shows vitamin D may be clinically helpful as add on treatment in multiple sclerosis, 89 active tuberculosis, 90 rheumatoid arthritis, 91 and lupus, 92 all inflammatory diseases. All clinical treatments decisions are based on a risk/benefit analysis.…”

Section: Discussionmentioning

confidence: 99%

Vitamin D and inflammation

Cannell¹,

Grant

Holick

2014

Dermato-Endocrinology

183

131

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Abbreviations: CRP, C-reactive protein; CXCL9, CXC chemokine ligand 9; E-selectin, ESR, erythrocyte sedimentation rate, F1C2, prothrombin fragment 1C2; IFG, impaired fasting glucose; IL, interleukin; MCP-1, monocyte chemoattractant protein-1; NGAL, neutrophil gelatinase-associated lipocalin; NGT, normal glucose tolerance; ns, not stated; PAI-1, plasminogen activator inhibitor-1; sICAM-1, soluble intracellular adhesion molecule-1; sTNF-R2, soluble tumor necrosis factor a receptor type 2; TAT, thrombin antithrombin complex; TGF-b, transforming growth factor-b; TNF-a, tumor necrosis factor-a Seventeen found significantly reduced inflammatory markers, 19 did not, one was mixed and one showed adverse results. With few exceptions, studies in normal subjects, obesity, type 2 diabetics, and stable cardiovascular disease did not find significant beneficial effects. However, we found that 6 out of 7 RCTS of vitamin D 3 in highly inflammatory conditions (acute infantile congestive heart failure, multiple sclerosis, inflammatory bowel disease, cystic fibrosis, SLE, active TB and evolving myocardial infarction) found significant reductions. We found baseline and final 25(OH)D predicted RCTs with significant reduction in inflammatory markers. Vitamin D tends to modestly lower markers of inflammation in highly inflammatory conditions, when baseline 25(OH)D levels were low and when achieved 25(OH)D levels were higher. Future inquiries should: recruit subjects with low baseline 25(OH)D levels, subjects with elevated markers of inflammation, subjects with inflammatory conditions, achieve adequate final 25(OH)D levels, and use physiological doses of vitamin D. We attempted to identify all extant randomized controlled trials (RCTs) of vitamin D that used inflammatory markers as primary or secondary endpoints.

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Role of vitamin D in flare ups of rheumatoid arthritis

Cited by 28 publications

References 19 publications

Serum Vitamin D Level is Inversely Associated With Anti-Cyclic Citrullinated Peptide Antibody Level and Disease Activity in Rheumatoid Arthritis Patients

Serum Vitamin D Level is Inversely Associated With Anti-Cyclic Citrullinated Peptide Antibody Level and Disease Activity in Rheumatoid Arthritis Patients

Vitamin D in Autoimmunity: Molecular Mechanisms and Therapeutic Potential

Vitamin D and inflammation

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