Association between hypovitaminosis D and systemic sclerosis: True or fake?

Bivona, Giulia; Agnello, Luisa; Pivetti, Alessia; Milano, Salvatore; Scazzone, Concetta; Sasso, Bruna Lo; Ciaccio, Marcello

doi:10.1016/j.cca.2016.04.026

Cited by 32 publications

(25 citation statements)

References 52 publications

(101 reference statements)

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“…There have been three systemic reviews exploring the association between VDD and SSc, which concluded that hypovitaminosis D is very frequent in SSc and severe in a relevant percentage of patients. 10 – 12 However, a meta-analysis was neither performed, nor did they perform a further analysis based on factors such as vitamin D insufficiency and VDD.…”

Section: Introductionmentioning

confidence: 99%

Vitamin D levels in systemic sclerosis patients: a meta-analysis

Sun

Chen

et al. 2017

DDDT

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PurposeThis study aimed to investigate the association between vitamin D and systemic sclerosis (SSc) by meta-analysis.MethodsA comprehensive search was performed through June 12, 2017. Pooled standardized mean difference (SMD) was used to estimate the mean vitamin D difference between case and control groups (or between diffused- and limited-type SSc). Pooled risk ratios (RRs) with 95% confidence intervals (CIs) were used to assess the impact of vitamin D level on clinical characteristics of SSc patients. All statistical analyses were performed using Revman 5.0 software.ResultsThe search yielded six studies with a total of 554 SSc patients and 321 healthy controls. The meta-analysis showed that SSc patients suffered from decreased vitamin D levels (SMD =−8.72 ng/mL; 95% CI: −10.11 to −7.32) compared with healthy controls. The meta-analysis results of three studies with 240 SSc patients (93 diffused-type and 147 limited-type SSc patients) showed that diffused-type SSc patients exhibited lower vitamin D levels (SMD =−4.71 ng/mL; 95% CI: −8.98 to −0.44) compared with limited-type SSc patients. However, vitamin D level was not found to be associated with Rodnan score (SMD =−2.29 ng/mL, 95% CI: −8.49 to 3.91, P=0.47), systolic pulmonary pressure (SMD =−1.68 ng/mL, 95% CI: −10.79 to 7.43, P=0.72), gastrointestinal ulcer (RR =1.01, 95% CI: 0.53–1.93, P=0.98), or pulmonary involvement (RR =1.01, 95% CI: 0.36–2.86, P=0.99) in SSc patients.ConclusionSSc patients exhibited lower vitamin D levels compared with healthy controls. Vitamin D levels in diffused-type SSc patients were significantly lower than those in limited-type SSc patients. The severity of clinical features was not associated with the extent of vitamin D deficit. Therefore, we hypothesize that SSc patients, especially diffused type, have lower vitamin D levels, and that the decrease of vitamin D levels might not be an accelerating factor of SSc severity.

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Section: Introductionmentioning

confidence: 99%

Vitamin D levels in systemic sclerosis patients: a meta-analysis

Sun

Chen

et al. 2017

DDDT

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“…In humans, vitamin D is mainly synthesized in the skin after ultraviolet (UV) sun radiation exposure and, only a small amount, is obtained through the diet because most common natural foods have a very low vitamin D content (Bivona et al, ). In addition, vitamin D can be obtained from vitamin D supplements, multivitamin tablets, or fortified food products.…”

Section: Introductionmentioning

confidence: 99%

Association of CYP2R1 rs10766197 with MS risk and disease progression

Scazzone

Agnello

Ragonese

et al. 2017

J of Neuroscience Research

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“…Moreover, cutaneous fibrosis, which is an important SSc manifestation, was also negatively correlated with VitD concentration [41]. Despite this strong association between VitD status and disease activity, the role of hypovitaminosis D on the pathogenesis of SSc remains inconclusive [42].…”

Section: Vitamin D Status In Inflammatory Rheumatic Disordersmentioning

confidence: 99%

Vitamin D Deficiency and Rheumatoid Arthritis

Ishikawa

Colavite

Fraga-Silva

et al. 2016

Clinic Rev Allerg Immunol

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Vitamin D (VitD) is a hormone primarily synthesized in human skin under the stimulation of ultraviolet radiation. Beyond its endocrine role in bone metabolism, VitD is endowed with remarkable immunomodulatory properties. The effects of VitD on the immune system include the enhancement of microbicidal ability of monocytes/macrophages and the down-modulation of inflammatory cytokines produced by T lymphocytes. VitD deficiency is involved in many health problems, including immune-mediated diseases such as autoimmune disorders. Rheumatoid arthritis (RA) is a chronic inflammatory systemic autoimmune disease that compromises the joints, causing cartilage destruction and bone erosion. RA treatment usually consists of combined therapies that generally suppress the entire immune response leading to increased susceptibility to infections. This review describes the main effects of VitD on innate and adaptive immune system and also VitD status in inflammatory rheumatic diseases such as RA. Despite some controversies, the majority of reports reinforce the idea that lower VitD levels correlate with more severe clinical manifestations in RA and other rheumatic diseases. Therefore, supplementation with VitD to achieve normal serum levels is worthwhile as an aforethought. Original data concerning the potential applicability of 1,25-dihydroxyvitamin D (VitD3), the active form of vitamin D, as a tolerogenic adjuvant are also included. In this sense, the effect of VitD3 associated with proteoglycan (PG), which is a specific cartilage antigen, was tested in the course of experimental arthritis. This association significantly lowered clinical scores and local histopathological alterations. Even though local analysis of T cell subsets and cytokine production did not reveal any difference between the experimental groups, VitD3+PG association significantly reduced cytokine production by spleen cells. These results suggest that VitD3 played a role as a tolerogenic adjuvant by down-modulating the course of experimental RA. Considering this tolerogenic effect of VitD3+PG association, further investigations will reveal its plausible use in human RA.

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Association between hypovitaminosis D and systemic sclerosis: True or fake?

Cited by 32 publications

References 52 publications

Vitamin D levels in systemic sclerosis patients: a meta-analysis

Vitamin D levels in systemic sclerosis patients: a meta-analysis

Association of CYP2R1 rs10766197 with MS risk and disease progression

Vitamin D Deficiency and Rheumatoid Arthritis

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