Vitamin D levels in Indian systemic lupus erythematosus patients: association with disease activity index and interferon alpha

Abstract

IntroductionLow levels of vitamin D have been associated with several autoimmune disorders including multiple sclerosis, rheumatoid arthritis, type 1 diabetes and systemic lupus erythematosus (SLE). The major source of vitamin D is sunlight but exposure of SLE patients to UV rays has been shown to exacerbate disease pathology. Studies in various populations have shown an association between low vitamin D levels and higher SLE disease activity.MethodsWe enrolled 129 patients who fulfilled American College of Rheumatology criteria in the study. There were 79 treatment-naïve cases and 50 patients who were under treatment for underlying SLE. There were 100 healthy subjects from similar geographical areas included as controls. Plasma 25-OH vitamin D3 and interferon (IFN)-α levels were quantified by enzyme-linked immunosorbent assay (ELISA). The gene expression level of IFN-α was determined by quantitative real-time reverse transcriptase polymerase chain reaction (RT-PCR).ResultsPlasma 25-OH vitamin D3 significantly correlated in an inverse manner with systemic lupus erythematosus disease activity index (SLEDAI) scores (P <0.0001, r = -0.42), anti-dsDNA (P <0.0001, r = -0.39), plasma IFN-α (P <0.0001, r = -0.43) and levels of IFN-α gene expression (P = 0.0009, r = -0.45). Further, plasma levels of IFN-α positively correlated with gene expression of IFN-α (P <0.0001, r = 0.84). Treatment-naïve SLE patients displayed significantly higher plasma levels of IFN-α compared to patients under treatment (P <0.001) and controls (P <0.001).ConclusionsThese results suggest an important role of vitamin D in regulating disease activity in SLE patients and the need to supplement vitamin D in their treatment.

Association between vitamin D receptor polymorphisms and systemic lupus erythematosus in an Indian cohort

“…The importance of vitamin D in SLE has been observed in a recent study but over the years it has been seen that lower levels of 25‐OH vitamin D are associated with SLE and furthermore, are inversely correlated with disease activity scores . A recent study in an eastern Indian population by our group showed inverse correlation of vitamin D with anti‐double‐stranded DNA (anti‐ds DNA), SLE Disease Activity Index (SLEDAI) scores and interferon alpha levels . The cause‐effect relationship has been corroborated in a mouse model of SLE: administration of vitamin D or its chemical analogue has been shown to increase survival rates decrease proteinuriaand improve dermatological manifestations …”

“…Based on earlier classification criteria, subjects were divided in to three 25‐OH vitamin D groups: (i) sufficient (>30 ng/mL); (ii) insufficient (10–30 ng/mL); and (iii) deficient (<10 ng/mL). Prevalence of 25‐OH vitamin D status among controls and SLE patients were compared (data not shown).…”

Combined role of vitamin D status and CYP24A1 in the transition to systemic lupus erythematosus

“…1 2 Studies within patients with SLE indicate that lower 25[OH]D levels may correlate with increased disease activity, [3][4][5][6][7][8][9][10][11][12][13][14][15][16] although inconsistently. [17][18][19][20][21][22][23][24] Variation within the vitamin D receptor gene (VDR), the vitamin D receptor protein that binds the active form of vitamin D, 1,25-dihydroxyvitamin D (1,25[OH] 2 D), has been associated with higher SLE disease activity in females 25 and higher damage score.…”

Role of vitamin D in autoimmune rheumatic diseases- hype or real?

“…Kim 14 The direct role of vitamin D in modulating lupus activity has been demonstrated in animal models. 15 Lemire et al showed that supplementation of 25(OH)D for 18 weeks reduced dermatologic lesions, proteinuria, and anti-dsDNA antibodies in the MRL/1 SLE mouse models. 16 The relation between 25 (OH) D and lupus remains unclear.…”