A Brief Review of the Effects of Vitamin D on Multiple Sclerosis

Abstract

Multiple sclerosis (MS) is characterized as an autoimmune disease affecting the central nervous system. It is one of the most common neurological disorders in young adults. Over the past decades, increasing evidence suggested that hypovitaminosis D is a contributing factor to the risk of developing MS. From different risk factors contributing to the development of MS, vitamin D status is of particular interest since it is not only a modifiable risk factor but is also associated with MS disease activity. MS patients with lower serum vitamin D concentrations were shown to have higher disease activity. However, this finding does not demonstrate causality. In this regard, prospective vitamin D supplementation studies missed statistical significance in its primary endpoints but showed promising results in secondary outcome measures or post hoc analyses. An explanation for missed primary endpoints may be underpowered trials. Besides vitamin D supplementation as a potential add-on to long-term immunotherapeutic treatment, a recent laboratory study of our group pointed toward a beneficial effect of vitamin D to improve the efficacy of glucocorticoids in relapse therapy. In the following article, we will briefly review the effects of vitamin D on MS by outlining its effects on the immune and nervous system and by reviewing the association between vitamin D and MS risk as well as MS disease activity. We will also review the effects of vitamin D supplementation on MS risk and MS disease activity.

Herpesvirus Antibodies, Vitamin D and Short-Chain Fatty Acids: Their Correlation with Cell Subsets in Multiple Sclerosis Patients and Healthy Controls

“…Thus, untreated MS patients showed significantly higher levels of HHV-6A/B IgG ( p = 0.0005), EBNA-1 IgG ( p = 0.0004), VCA IgG ( p = 0.010) and AA ( p = 0.011) in comparison with HC, but significantly lower levels of 25(OH) ( p = 0.007) and a significant decrease of the PA/AA and BA/AA ratios ( p < 0.0001 in both cases). These results would support the possible involvement of these viruses, the vitamin D and the SCFAs in MS etiopathogenesis, as it has been widely published in recent years [ 1 , 2 , 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 ]. When we analyzed their possible correlations, we found differences between HC and MS patients.…”

“…Viruses have been involved in this pathology by an extent number of published studies, mainly those of the Herpesviridae family [ 2 , 3 ]. But, also, other environmental factors, such as sun exposure, hypovitaminosis D, smoking or more recently the microbiota, have been related to the pathogenesis of the disease as possible modulators of the immune system in MS patients [ 4 , 5 , 6 ]. All these environmental factors would have the ability of changing the proportion of different cell subsets, leading to aberrant immune processes in the disease.…”

Autoimmune Disorders of the Nervous System: Pathophysiology, Clinical Features, and Therapy

“…Apart from its role in calcium homeostasis Vitamin D plays an important immunomodulatory, anti-inflammatory and antioxidant role (56). Several studies suggest that Vitamin D has an effect on the immune system by inhibiting B cell proliferation and antibody production and also by reducing T cell proliferation, Th1 and Th17 differentiation, increasing Treg cells and decreasing the secretion of pro-inflammatory cytokines (57).…”

Epstein-Barr Virus and Multiple Sclerosis

“…MS is most prevalent on the Northern hemisphere, a finding which can most likely be related to the intensity of sun light, which may in turn be explained by levels of vitD synthesis. Actually, vitD concentrations have been found to be correlated with MS incidence/prevalence (39,(41)(42)(43).…”