A randomized double-blind placebo-controlled trial of vitamin D supplementation in juvenile-onset systemic lupus erythematosus: positive effect on trabecular microarchitecture using HR-pQCT

Lima, Glauce Leão; Paupitz, Juliane Aline; Aikawa, Nádia E.; Alvarenga, Jackeline Couto; Pereira, Rosa Maria Rodrigues

doi:10.1007/s00198-017-4316-5

Cited by 23 publications

(16 citation statements)

References 40 publications

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“…Considering the role of vitamin D deficiency on the development of SLE, Yu et al ( 141 ) recently demonstrated that vitamin D plays a protective role in the autoantibody-induced injury of podocytes (kidney cells that wrap around capillaries of the glomerulus) in patients with lupus nephritis, which could be a potential novel therapeutic target to treat lupus nephritis. From a 24 week double-blind randomized placebo-controlled trial by Lima et al ( 142 ), it was established that supplementation of vitamin D in patients with juvenile-onset SLE effectively improved parameters of bone microarchitecture ( p = 0.024). Bone marrow mesenchymal stem cells from patients with SLE show impaired proliferative capacity compared with that of normal controls ( 143 ).…”

Section: Micronutrientsmentioning

confidence: 99%

Immunomodulatory Effects of Diet and Nutrients in Systemic Lupus Erythematosus (SLE): A Systematic Review

et al. 2020

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Systemic lupus erythematosus (SLE) is an autoimmune disease characterized by multiple organ involvement, including the skin, joints, kidneys, lungs, central nervous system and the haematopoietic system, with a large number of complications. Despite years of study, the etiology of SLE remains unclear; thus, safe and specifically targeted therapies are lacking. In the last 20 years, researchers have explored the potential of nutritional factors on SLE and have suggested complementary treatment options through diet. This study systematically reviews and evaluates the clinical and preclinical scientific evidence of diet and dietary supplementation that either alleviate or exacerbate the symptoms of SLE. For this review, a systematic literature search was conducted using PubMed, Scopus and Google Scholar databases only for articles written in the English language. Based on the currently published literature, it was observed that a low-calorie and low-protein diet with high contents of fiber, polyunsaturated fatty acids, vitamins, minerals and polyphenols contain sufficient potential macronutrients and micronutrients to regulate the activity of the overall disease by modulating the inflammation and immune functions of SLE.

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Section: Micronutrientsmentioning

confidence: 99%

Immunomodulatory Effects of Diet and Nutrients in Systemic Lupus Erythematosus (SLE): A Systematic Review

et al. 2020

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“…The randomized, double-blind study showed that vitamin D supplementation (cholecalciferol 50,000 IU/ week for six months) in patients with juvenile lupus improved bone microarchitecture, with the tibia as parameter. Another advantage of this study was that the treatment of patients with vitamin D supplementation remained stable during the six months of follow-up, thus allowing a more accurate analysis of the effect of this supplementation on this rheumatic condition 18 .…”

Section: Chart 1: Characterization Of the Main Analyzed Studies Continuationmentioning

confidence: 99%

Lúpus Eritematoso Sistêmico: relação entre os diferentes tratamentos e evolução clínica

Macedo

Garcia

Castanheira

et al. 2020

Rev. Med. (São Paulo)

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O Lúpus Eritematoso Sistêmico (LES) é uma doença inflamatória crônica de origem autoimune que apresenta manifestações clínicas variáveis, sendo progressiva e potencialmente fatal, se não tratado. Os tratamentos padrões incluem antimaláricos, corticosteroides (CS) e imunossupressores. No entanto, apesar do melhor entendimento do processo da doença, ainda há uma necessidade significativa e não atendida de novo tratamento devido ao alto risco continuado de mortalidade e progressão de danos aos órgãos. Assim, o objetivo do presente estudo foi fazer um levantamento bibliográfico acerca dos diferentes tratamentos publicados para o manejo do LES relacionando com a melhora clínica do paciente. Para tanto, utilizou-se as bases de dados Lilacs, SciELO, PubMed e Google Acadêmico e os Descritores em Ciências da Saúde (DeCS) utilizados foram: “lúpus eritematoso sistêmico”, “terapêutica” e “qualidade de vida”. Os artigos selecionados foram publicados em língua inglesa e portuguesa, entre os anos de 2014 e 2020. As referências encontradas permitiram constatar que os antimaláricos e a infusão de plasma fresco congelado são os recursos terapêuticos com maior eficácia. Além disso, a suplementação com vitamina D apresentou mostrou ter função benéfica sob o quadro clínico de pacientes lúpicos. Outro tratamento efetivo para as lesões dermáticas foi a utilização de laser de corante pulsado. Desse modo, são necessários mais estudos acerca da demonstração da eficácia dos diferentes tratamentos para o LES, a fim de elucidar a eficácia e a segurança das diversas terapias utilizadas.

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“…No significant changes were noted in the distal radius parameters, considering the coefficient of variation (CV) of HR-pQCT from our laboratory (distal tibia: density CV = 0.25%–1.16%, structure CV = 0.78%–6.35%; distal radius: density CV = 0.93%–1.41%, structure CV = 0.78%–6.35%) (Table 2). [17]…”

Section: Case Reportmentioning

confidence: 99%

Improvement of bone microarchitecture parameters after 12 months of treatment with asfotase alfa in adult patient with hypophosphatasia

2018

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Rationale:Hypophosphatasia is an inborn error of metabolism that can appear any time in life, mainly with bone manifestations due to low alkaline phosphatase activity. Asfotase alfa is a specific enzyme reposition treatment that has shown promising results in children; however, there are few reports about the outcomes in adult patients.Patient concerns:A 36-year-old male presented with an early history of craniosynostosis, short stature, and multiple fractures since the age of 13 years—which needed numerous surgical corrections. He was admitted with a previous diagnosis of osteogenesis imperfecta, taking alendronate, calcium carbonate, cholecalciferol, and calcitriol. Bone mineral density was low (lumbar spine Z-score = −3.0 SD), with impairment of all parameters of high-resolution peripheral quantitative computed tomography (HR-pQCT). Kidney impairment was also observed with reduced creatinine clearance, nephrolithiasis, and nephrocalcinosis.Diagnosis:Alkaline phosphatase was unexpectedly low (6 U/L, reference value: 30–120 U/L), with high serum vitamin B6 (260 mcg/L, reference value: 5.2–34.1). Genetic testing showed a homozygous missense mutation in ALPL gene c.443 C>T: p.Thr148Ile.Intervention:Asfotase alfa was requested due to important bone deterioration, ambulatory disability, and kidney impairment. It was given subcutaneously 2 mg/kg per dose, 3 times a week, for 12 months before reassessment.Outcomes:Bone mineral densities of the lumbar spine and whole body, besides almost all HR-pQCT microstructural parameters of the distal tibia, showed improvements and the patient was able to walk without assistant device. Kidney function did not further deteriorate.Lessons:Hypophosphatasia should be considered as a differential diagnosis in young patients with multiple fractures and kidney impairment, since the use of antiresorptive drugs, calcium and vitamin D, commonly used to treat fractures, worsen its symptoms and prognosis. A 12-month asfotase alfa treatment improved bone density and structural parameters even in an adult patient with late diagnosis.

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A randomized double-blind placebo-controlled trial of vitamin D supplementation in juvenile-onset systemic lupus erythematosus: positive effect on trabecular microarchitecture using HR-pQCT

Abstract: NCT01892748.

Cited by 23 publications

References 40 publications

Immunomodulatory Effects of Diet and Nutrients in Systemic Lupus Erythematosus (SLE): A Systematic Review

Immunomodulatory Effects of Diet and Nutrients in Systemic Lupus Erythematosus (SLE): A Systematic Review

Lúpus Eritematoso Sistêmico: relação entre os diferentes tratamentos e evolução clínica

Improvement of bone microarchitecture parameters after 12 months of treatment with asfotase alfa in adult patient with hypophosphatasia

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