scholarly journals Multiple sclerosis patients have a diminished serologic response to vitamin D supplementation compared to healthy controls

2015 ◽  
Vol 22 (6) ◽  
pp. 753-760 ◽  
Author(s):  
Pavan Bhargava ◽  
Sonya U Steele ◽  
Emmanuelle Waubant ◽  
Nisha R Revirajan ◽  
Jacqueline Marcus ◽  
...  

Background: Vitamin D insufficiency is a risk factor for multiple sclerosis (MS), and patients do not always show the expected response to vitamin D supplementation. Objective: We aimed to determine if vitamin D supplementation leads to a similar increase in serum 25-hydroxyvitamin-D (25(OH)D) levels in patients with MS and healthy controls (HCs). Methods: Participants in this open-label study were female, white, aged 18–60 years, had 25(OH)D levels ⩽ 75 nmol/l at screening, and had relapsing–remitting MS (RRMS) or were HCs. Participants received 5000 IU/day of vitamin D3 for 90 days. Utilizing generalized estimating equations we examined the relationship between the primary outcome (serum 25(OH)D level) and the primary (MS versus HC status) and secondary predictors. Results: For this study 27 MS patients and 30 HCs were enrolled. There was no significant difference in baseline 25(OH)D level or demographics except for higher body mass index (BMI) in the MS group (25.3 vs. 23.6 kg/m2, p=0.035). In total, 24 MS subjects and 29 HCs completed the study. In a multivariate model accounting for BMI, medication adherence, and oral contraceptive use, MS patients had a 16.7 nmol/l (95%CI: 4.2, 29.2, p=0.008) lower increase in 25(OH)D levels compared with HCs. Conclusions: Patients with MS had a lower increase in 25(OH)D levels with supplementation, even after accounting for putative confounders.

2015 ◽  
Vol 2 (2) ◽  
Author(s):  
Jordan E. Lake ◽  
Risa M. Hoffman ◽  
Chi-Hong Tseng ◽  
Holly M. Wilhalme ◽  
John S. Adams ◽  
...  

Abstract Background.  Vitamin D insufficiency is prevalent in human immunodeficiency virus-positive (HIV+) persons. Human immunodeficiency virus and antiretroviral therapy (ART) may create unique risk factors, and the optimal vitamin D repletion and maintenance regimen in HIV+ persons remains unclear. Methods.  Human immunodeficiency virus-positive adults on suppressive ART underwent routine serum 25-hydroxyvitamin D (25OHD) screening. Persons with vitamin D insufficiency (25OHD <30 ng/mL) received open-label, oral vitamin D3 50 000 international units (IU) twice weekly for 5 weeks, then 2000 IU daily to complete 12 weeks. We predicted 70% (95% confidence interval, 60%–80%) repletion to 25OHD ≥30 ng/mL compared with 85% among historical HIV-negative controls. Eighty participants provided 91% power to detect this difference. Ability to maintain 25OHD ≥30 ng/mL after 24 weeks was also assessed. Results.  Baseline characteristics were similar between the 82 vitamin D insufficient and 40 sufficient persons enrolled: 95% male, 60% white, 88% nonsmokers, median age 49 years, body mass index 26 kg/m2, and CD4+ T lymphocyte count 520 cells/mm3. After 12 weeks, 81% (66 of 82) of insufficient persons achieved 25OHD ≥30 ng/mL (P = .32 vs historical controls), with only older age (odds ratio [OR] = 1.06; P = .06), higher baseline 25OHD (OR = 1.14; P < .01), white race (OR = 3.39; P = .04), and current smoking (OR = 0.25; P = .06) associated with successful repletion. After 24 weeks, 73% (48 of 66) maintained 25OHD ≥30 ng/mL, with tenofovir (OR = 5.00; P = .01) and abacavir use (OR = 0.23; P = .02) associated with success and failure, respectively, to maintain 25OHD levels. Conclusions.  The 25OHD repletion rates were comparable between HIV+ adults on suppressive ART and historical HIV-negative controls, indicating that successful oral repletion can be achieved in this population.


2003 ◽  
Vol 88 (11) ◽  
pp. 5175-5179 ◽  
Author(s):  
Franck Grados ◽  
Michel Brazier ◽  
Saïd Kamel ◽  
Marc Mathieu ◽  
Nathalie Hurtebize ◽  
...  

Abstract The aim of this study was to determine whether early changes in bone markers could predict long-term response in bone mineral density (BMD) after calcium (500 mg) and vitamin D (400 IU) supplementation twice daily in ambulatory elderly women with vitamin D insufficiency (25-hydroxyvitamin D, <12 ng/ml). One hundred and ninety-two women (mean age, 75 ± 7 yr) were randomized to receive either the supplementation (n = 95) or a placebo (n = 97) in a double-blind, controlled clinical trial for 1 yr. In comparison with the placebo group, supplementation significantly increased BMD, normalized 25-hydroxyvitamin D and significantly decreased intact PTH and bone remodeling markers. The initial values of telopeptide cross-links were correlated with improvement in total body BMD [urinary N-telopeptides (NTX), r = 0.38; C-telopeptides (CTX), r = 0.32; serum CTX, r = 0.28], and the 3-month changes in the same markers were correlated with improvement in total body (urinary N-telopeptides, r = −0.29; serum CTX, r = −0.26) and vertebral BMD (CTX, r = −0.26; all P < 0.05). We concluded that short-term changes in bone resorption markers can predict long-term variations in BMD in elderly women with vitamin D insufficiency receiving calcium and vitamin D supplementation.


2012 ◽  
Vol 5 (4) ◽  
pp. 187-198 ◽  
Author(s):  
Charles Pierrot-Deseilligny ◽  
Sophie Rivaud-Péchoux ◽  
Pierre Clerson ◽  
Raphaël de Paz ◽  
Jean-Claude Souberbielle

2016 ◽  
Vol 2016 ◽  
pp. 1-7
Author(s):  
Sara A. Mohamed ◽  
Ayman Al-Hendy ◽  
Jay Schulkin ◽  
Michael L. Power

Vitamin D deficiency/insufficiency is prevalent among pregnant women. Recommendations for adequate levels of circulating 25-hydroxyvitamin D and appropriate vitamin D supplementation during pregnancy differ between the Institute of Medicine and the Endocrine Society. Obstetrician-gynecologists must make clinical decisions in this environment of uncertain guidance. An online questionnaire regarding physician practice patterns for screening and supplementing pregnant women was administered to 225 randomly selected practicing obstetrician-gynecologists of whom 101 (45%) completed the questionnaire. A majority indicated that vitamin D insufficiency was a problem in their patient population (68.4%) and that most of their pregnant patients would benefit from vitamin D supplementation (66.3%). Half (52.5%) would recommend vitamin D supplementation during pregnancy to some patients, but only 16.8% to all. Only one in four (25.8%) routinely screen their pregnant patients for vitamin D status. Physicians who indicated that vitamin D status was a problem in their patient population were more likely to screen routinely (32.8% versus 9.7%,P=0.002) and believe their patients would benefit from supplementation (91.2% versus 16.1%,P=0.001). Opinion regarding supplementation levels and indicators of adequacy were split between the two competing recommendations, suggesting that clinical practice will likely remain variable across physicians, with uncertain public health consequences.


2016 ◽  
Vol 116 (8) ◽  
pp. 1402-1408 ◽  
Author(s):  
Joshua J. Todd ◽  
Emeir M. McSorley ◽  
L. Kirsty Pourshahidi ◽  
Sharon M. Madigan ◽  
Eamon Laird ◽  
...  

AbstractVitamin D is typically supplied in capsule form, both in trials and in clinical practice. However, little is known regarding the efficacy of vitamin D administered via oral sprays – a method that primarily bypasses the gastrointestinal absorption route. This study aimed to compare the efficacy of vitamin D3liquid capsules and oral spray solution in increasing wintertime total 25-hydroxyvitamin D (25(OH)D) concentrations. In this randomised, open-label, cross-over trial, healthy adults (n22) received 3000 IU (75 µg) vitamin D3daily for 4 weeks in either capsule or oral spray form. Following a 10-week washout phase, participants received the opposite treatment for a final 4 weeks. Anthropometrics and fasted blood samples were obtained before and after supplementation, with samples analysed for total 25(OH)D, creatinine, intact parathyroid hormone and adjusted Ca concentrations. At baseline, vitamin D sufficiency (total 25(OH)D>50 nmol/l), insufficiency (31–49 nmol/l) and clinical deficiency (<30 nmol/l) were evident in 59, 23 and 18 % of the participants, respectively. Overall, baseline total mean 25(OH)D concentration averaged 59·76 (sd29·88) nmol/l, representing clinical sufficiency. ANCOVA revealed no significant difference in the mean and standard deviation change from baseline in total 25(OH)D concentrations between oral spray and capsule supplementation methods (26·15 (sd17·85)v. 30·38 (sd17·91) nmol/l, respectively;F=1·044, adjustedr20·493,P=0·313). Oral spray vitamin D3is an equally effective alternative to capsule supplementation in healthy adults.


2007 ◽  
Vol 13 (5) ◽  
pp. 670-672 ◽  
Author(s):  
M.S. Barnes ◽  
M.P. Bonham ◽  
P.J. Robson ◽  
J.J. Strain ◽  
A.S. Lowe-Strong ◽  
...  

Populations with insufficient ultraviolet exposure and who consume diets low in vitamin D have low vitamin D status (plasma 25-hydroxyvitamin D (25(OH)D) concentrations) and a reported higher incidence of multiple sclerosis (MS). The active form of vitamin D, 1,25-dihydroxyvitamin D3 (1,25(OH)2D3), is an effective anti-inflammatory molecule. No research to date has assessed 1,25(OH)2D3 concentrations in individuals with MS. In this study, plasma concentrations of 25(OH)D, 1,25(OH)2D 3 and parathyroid hormone (PTH) were measured in 29 individuals with MS and 22 age- and sex-matched control volunteers. There were no significant differences in plasma PTH, 25(OH)D and 1,25(OH)2D3 concentrations between individuals with MS and control volunteers. Women with MS had significantly higher 25(OH)D and 1,25(OH)2D3 concentrations than men with MS (79.1 ±45.4 versus 50.2±15.3 nmol/L, P=0.019 and 103.8± 36.8 versus 70.4±28.7 pmol/L, P=0.019, respectively). There was a significant positive correlation between 25(OH)D and 1,25(OH)2D 3 concentrations in all subjects (r=0.564, P=0.000), but secondary analysis revealed that the correlation was driven by women with MS (r=0.677, P= 0.001). Significant sex differences in vitamin D metabolism were observed and were most marked in individuals with MS, suggesting that vitamin D requirements may differ between the sexes, as well as by underlying disease state. Multiple Sclerosis 2007; 13: 670-672. http://msj.sagepub.com


Author(s):  
Gal Dubnov-Raz ◽  
Netachen Livne ◽  
Raanan Raz ◽  
Avner H. Cohen ◽  
Naama W. Constantini

It is hypothesized that vitamin D insufficiency in athletes might negatively affect sport performance. The objective of this study was to examine the effect of vitamin D3 supplementation on physical performance of adolescent swimmers with vitamin D insufficiency. Fifty-three adolescent competitive swimmers with vitamin D insufficiency (serum 25-hydroxyvitamin-D concentrations (25(OH)D)<30ng/ml, mean 24.2 ± 4.8ng/ml) were randomized to receive 2,000IU/day of vitamin D3 or placebo for 12 weeks. Swimming performance at several speeds, arm-grip strength, and one-legged balance, were measured before and after supplementation. The age-adjusted changes in performance variables during the study were compared between groups. 25(OH) D concentrations at study end were significantly higher in the vitamin group compared with the placebo group (29.6 ± 6.5ng/ml vs. 20.3 ± 4.2ng/ml, p < .001), yet only 48% of the vitamin group became vitamin D sufficient with this dosing. No between-group differences were found in the changes of the performance variables tested. No significant differences in performance were found between participants that became vitamin D sufficient, and those who did not. No significant correlation was found between the change in serum 25(OH)D and ageadjusted balance, strength or swimming performance at study end. Vitamin D3 supplementation that raised serum 25(OH)D concentrations by a mean of 9.3ng/ml above placebo in adolescent swimmers with vitamin D insufficiency, did not improve physical performance more than placebo.


2021 ◽  
Author(s):  
Tayebeh Latifi ◽  
Majid Teymoori-Rad ◽  
Ahmad Nejati ◽  
Shohreh Shahmahmoodi ◽  
Farhad Rezaei ◽  
...  

Abstract Previous studies have reported that Human endogenous retroviruses (HERVs) such as HERV-K18 is associated with an increased risk of multiple sclerosis (MS). The present study aimed to evaluate the association between the expression of HERV-K18 env, TGF-β, and in vitro effect of EBV infection on the expression level of HERV-K18 env in PBMC of MS patients in both presence and absence of vitamin D (1,25-OHD). The levels of HERV-K18 env was measured in peripheral blood mononuclear cells (PBMCs) from 20 MS patients and 20 healthy controls by quantitative real-time PCR. PBMCs were further treated with EBV in the presence or the absence of vitamin D. After 72 hours, cells were collected for measurement of HERV-K18 env expression using Real-time PCR. While the expression of HERV-K18 env was significantly higher in MS patients than healthy controls, the expression of TGF–β was found to be significantly lower in MS patients compare to healthy controls. Interestingly, an inverse correlation was found between HERV-K18 env expression and TGF-β expression in MS patients but not for healthy controls. Although in vitro stimulated PBMCs with EBV showed no significant differences in terms of HERV-K18 expression, EBV infected cells revealed different patterns in the presence and the absence of vitamin D treatment. These findings not only support the important role of HERV-K18 env expression but also highlight the plausible interactions with different risk factors in MS.


2019 ◽  
Vol 5 (1) ◽  
pp. 205521731982659 ◽  
Author(s):  
Johan Linden ◽  
Gabriel Granåsen ◽  
Jonatan Salzer ◽  
Anders Svenningsson ◽  
Peter Sundström

Background Most multiple sclerosis patients on disease-modifying treatment at Umeå University Hospital are treated with rituximab and the prevalence of vitamin D supplementation has increased over time. Follow-up studies of these off-label treatments are needed. Objective To study inflammatory activity and adverse effects in rituximab-treated multiple sclerosis patients, and associations with 25-hydroxy-vitamin D levels. Methods Retrospectively collected data on repeated estimates of relapses, disability, side effects, magnetic resonance imaging, laboratory measures including 25-hydroxy-vitamin D levels and self-perceived health. Results In 272 multiple sclerosis patients with a mean follow-up of 43 months, we identified seven possible relapses during active rituximab treatment. On magnetic resonance imaging examination, new T2 lesions were seen in 1.3% (10 out of 792 scans), and 0.25% (two out of 785 scans) showed contrast enhancement. Adjusted 25-hydroxy-vitamin D levels in samples drawn close to all magnetic resonance images with new T2 lesions were lower compared to the remainder (62 vs. 81 nmol/l; P = 0.030). Levels of 25-hydroxy-vitamin D were associated with self-perceived health ( r = 0.18, P = 0.041, n = 130) and C-reactive protein ( r = –0.13, P = 0.042) but not with the risk of side effects. Conclusion The inflammatory activity in this rituximab-treated multiple sclerosis population that increasingly used vitamin D supplementation was extremely low. Higher 25-hydroxy-vitamin D levels were associated with beneficial outcomes.


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