UVR, Vitamin D and Three Autoimmune Diseases—Multiple Sclerosis, Type 1 Diabetes, Rheumatoid Arthritis

Abstract

We review the evidence indicating a possible beneficial role for UVR on three Th1-mediated autoimmune diseases: multiple sclerosis, type 1 diabetes and rheumatoid arthritis in relation to recent developments in photoimmunology. Recent work suggests that UVR exposure may be one factor that can attenuate the autoimmune activity leading to these three diseases through several pathways involving UVB and UVA irradiation, UVR-derived vitamin D synthesis and other routes such as alpha-melanocyte-stimulating hormone, calcitonin gene related peptide and melatonin. Ecological features, particularly a gradient of increasing prevalence of multiple sclerosis and type 1 diabetes with higher latitude, provide some support for a beneficial role of UVR. Analytical studies provide additional support, particularly as low vitamin D has been prospectively associated with disease onset for all three diseases, but are not definitive. Randomized controlled trial data are required. Further, we discuss how associated genetic studies may assist the accumulation of evidence with regard to the possible causal role of low UVR exposure and/or low vitamin D status in the development of these diseases.

Latitude gradients for lymphoid neoplasm subtypes in Australia support an association with ultraviolet radiation exposure

“…45 For instance, vitamin D-related modulation of EBV-specific immunity has been suggested in the etiology of multiple sclerosis, although this remains unresolved. 46 Interestingly, inconsistency between countries in the latitude gradients for NHL are also seen for multiple sclerosis; for both, increases in incidence with distance from the equator are seen for mid-latitude countries like Australia, but not for higher latitude countries such as those of Scandinavia and Northern Europe, 27,47 although this has not been examined systematically.…”

Validity and Reliability of Adult Recall of Past Sun Exposure in a Case-Control Study of Multiple Sclerosis

“…For both the intramethod reliability and intermethod reliability, we compared recall of childhood/ adolescence sun exposure with recall of recent sun exposure. Lastly, because sun exposure is associated with multiple sclerosis in this sample (1), we compared how well sun exposure in both methods (standard questionnaire and lifetime calendar) could statistically predict multiple sclerosis, noting that causality for this association has not been established (24).…”

Role of vitamin D in immune responses and autoimmune diseases, with emphasis on its role in multiple sclerosis

“…[49][50][51][52][53][54][55][56][57][58][59] Cancer breast, prostate, colorectal, lung, endometrial cancers, etc. [10,11] Cardiovascular diseases atherosclerosis, coronary heart disease, congestive heart failure, hypertension, diabetes, etc.…”

“…Both laboratory and clinical studies have provided evidence that vitamin D deficiency is an important environmental factor that can increase the prevalence of certain autoimmune diseases, such as MS [55][56][57] , Crohn disease [58] , diabetes mellitus [59,60] , systemic lupus erythematosus (SLE) [61,62] , asthma [63] , RA [64] , Sjögren's syndrome, systemic vasculitis and antiphospholipid syndrome [65] . A correlation between reduced intake of vitamin D and prevalence of the diseases can be found, which raises the possibility that serum vitamin D level is important for the pathogenesis of autoimmune diseases.…”