Vitamin D deficiency and multiple sclerosis: a simple epidemiological association or a true causal relationship?

Vitamin D is an important regulator of the immune system in general and multiple sclerosis in particular. Experimentally (i), invariant natural killer T (iNKT) cells have been shown to be important suppressors of autoimmune diseases such as experimental autoimmune encephalomyelitis (EAE; an animal model of multiple sclerosis). Conversely, in experimental allergic asthma iNKT cells are required for disease induction and are therefore pathogenic. The active form of vitamin D (calcitriol) suppresses EAE. The development of EAE symptoms is accelerated in vitamin D deficiency. Interestingly experimental asthma is less severe in vitamin D deficiency although there is no effect of calcitriol on disease severity. The data suggest that an important target of vitamin D in EAE and asthma are the iNKT cells. Vitamin D and/or vitamin D receptor deficiency results in the impaired development of iNKT cells. Vitamin D is critical very early during development of the immune system. Low levels of vitamin D in utero resulted in significantly reduced numbers of iNKT cells that failed to recover when calcitriol was used to supplement neonatal or adult mice. The data suggest that one of the consequences of early vitamin D deficiency is a reduction in the numbers of iNKT cells that develop. The iNKT cells are required for the beneficial effects of calcitriol in EAE. The important role of vitamin D on iNKT cells could impact the development of human immune-mediated diseases including multiple sclerosis and asthma.

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Vitamin D deficiency and liver cancer: More than just an epidemiological association?

Hepatology ◽

10.1002/hep.27178 ◽

2014 ◽

Vol 60 (4) ◽

pp. 1130-1132 ◽

Cited By ~ 8

Author(s):

Massimo Colombo ◽

Angelo Sangiovanni

Keyword(s):

Vitamin D ◽

Liver Cancer ◽

Vitamin D Deficiency ◽

Epidemiological Association

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Vitamin D levels and risk of multiple sclerosis in patients with clinically isolated syndromes

Multiple Sclerosis Journal ◽

10.1177/1352458513494959 ◽

2013 ◽

Vol 20 (2) ◽

pp. 147-155 ◽

Cited By ~ 58

Author(s):

Vittorio Martinelli ◽

Gloria Dalla Costa ◽

Bruno Colombo ◽

Dacia Dalla Libera ◽

Alessandro Rubinacci ◽

...

Keyword(s):

Multiple Sclerosis ◽

Vitamin D ◽

Vitamin D Deficiency ◽

Serum Vitamin ◽

Brain Magnetic Resonance Imaging ◽

Hydroxyvitamin D ◽

Serum Vitamin D ◽

Clinically Isolated Syndromes ◽

Vitamin D Levels ◽

Magnetic Resonance Imaging Mri

Background: Growing evidence suggests that vitamin D deficiency may be one of the most important environmental factors for the development of multiple sclerosis (MS). Objectives: The objectives of this paper are to evaluate serum 25-hydroxyvitamin D (25(OH)D) levels in patients with clinically isolated syndromes (CIS) and to examine whether they are related to MS risk. Methods: This is a retrospective study of 100 CIS patients hospitalized from 2000 to 2009 at San Raffaele Hospital, Milan, Italy. We evaluated baseline 25(OH)D level as well as clinical, brain magnetic resonance imaging (MRI) and cerebrospinal fluid (CSF) data. Results: A total of 52% of CIS patients had vitamin D deficiency (25(OH)D < 50 nmol/l). During follow-up (median: 7.17 years), 55 patients developed clinically definite MS (CDMS). Patients with very low (< 10th percentile) and low (< 25th percentile) 25(OH)D levels were particularly at risk of CDMS (HRs (95% CIs): 2.12 (0.91–4.96) and 1.61 (0.85–3.03), respectively), while no further reduction in the HRs of disease was observed at high levels of 25(OH)D. This association was even stronger after adjustment for additional risk factors for CDMS development (HRs (95% CIs) for 25(OH)D levels < 10th and 25th percentiles: 3.34 (1.32–8.45) and 2.04 (0.96–4.36), respectively). Conclusion: Low serum vitamin D is associated with increased MS risk in patients with CIS.

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Patient-based outcome measures of the impact of disease in patients with multiple sclerosis and vitamin D deficiency

10.26226/morressier.59a3e8b4d462b8028d894457 ◽

2017 ◽

Author(s):

Elena Oana Terecoasă

Keyword(s):

Multiple Sclerosis ◽

Vitamin D ◽

Vitamin D Deficiency ◽

Outcome Measures ◽

The Impact

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Sharp increase in the incidence and prevalence of multiple sclerosis in Isfahan, Iran

Multiple Sclerosis Journal ◽

10.1177/1352458511401460 ◽

2011 ◽

Vol 17 (8) ◽

pp. 1022-1027 ◽

Cited By ~ 66

Author(s):

Masoud Etemadifar ◽

Amir-Hadi Maghzi

Keyword(s):

Multiple Sclerosis ◽

Vitamin D ◽

Environmental Factors ◽

Sex Ratio ◽

Vitamin D Deficiency ◽

Sharp Increase ◽

Isfahan Province ◽

Study Population ◽

Male Sex ◽

Prevalence Figure

Background: The epidemiology of multiple sclerosis (MS) has changed in recent decades. Objectives: This study aimed to give an update on the prevalence and incidence of MS in Isfahan, Iran. Methods: The study population was all residents of Isfahan province during the period from April 2003 to July 2010. In April 2003, a registry of MS patients was created at the Isfahan MS Society (IMSS), which is the only referral center for MS patients in the province. Nearly all MS patients in Isfahan province are now registered with IMSS and were included in the analysis. Results: Among the 3522 registered patients, 2716 were female and 806 were male (sex ratio: 3.37 : 1), and 431 were diagnosed in 2009. This results in a prevalence figure of 73.3 (95% CI: 70.9–75.8) and an incidence of 9.1 (95% CI: 8.3–10.0) per 100,000. Conclusion: The reported prevalence and incidence figures in our study were higher than in our previous report of 2007, in which the prevalence and incidence of MS were reported to be 43.8 and 3.64 per 100,000, respectively. This dramatic increase in the prevalence of MS puts Isfahan amongst the regions with the highest prevalence of MS in Asia and Oceania and is mostly due to changing environmental factors, amongst which vitamin D deficiency seems an important factor in our population.

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