Serum 25-OH vitamin D level in treatment-naïve systemic lupus erythematosus patients: Relation to disease activity, IL-23 and IL-17

Shahin, Doaa; El-Farahaty, Reham M.; Houssen, Maha E.; Machaly, Shereen A.; Sallam, Mohammad M.; Elsaid, Tamer O.; Neseem, Nanis O.

doi:10.1177/0961203316682095

Cited by 33 publications

(38 citation statements)

References 48 publications

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“…In order to detect the source of heterogeneity, a subgroup analysis was conducted. Previous studies revealed that 25(OH)D levels were not significantly correlated with age and disease duration in SLE patients; subgroup analysis revealed that, compared with healthy controls, 25(OH)D levels were significantly reduced in both juvenile SLE patients (age < 18 years) and adult SLE patients (age ≥ 18 years), and in both SLE patients of duration <5 years and ≥5 years, indicating no matter the changes of age and disease duration, the 25(OH)D levels of SLE patients were significantly reduced.…”

Section: Discussionmentioning

confidence: 75%

“…Ultimately, 19 studies were included in our meta‐analysis (Figure ). Sixteen studies compared circulating 25(OH)D levels between SLE patients and healthy controls (Table ); seven Studies provided the information about the deficiency, insufficiency, sufficiency of vitamin D in both SLE patients and healthy controls (Table ); 6 studies explored the correlations between disease activity of SLE and 25(OH)D levels (Table ). The NOS scores of included studies ranged from 6 to 8 stars, indicating each of the studies had high methodological quality (Table ).…”

Section: Resultsmentioning

confidence: 99%

“…Sixteen articles with 17 individual studies reported the circulating 25(OH)D levels of 1434 SLE patients and 1533 healthy controls. Compared with healthy controls, SLE patients had significantly lower 25(OH)D levels (pooled SMD = −1.63, 95% CI: −2.51 to −0.76), and significant heterogeneity was identified among these studies ( I 2 = 98.9%, P < .001) (Figure ).…”

Section: Resultsmentioning

confidence: 99%

“…Atotalof1651studieswereretrievedafteraninitialsearch.After removingduplicatearticles,wereviewedthetitles,abstractsand fulltextsofremainingstudiesaccordingtheinclusionandexclusion criteria.Ultimately,19studieswereincludedinourmeta-analysis ( Figure 1). Sixteen studies compared circulating 25(OH)D levels between SLE patients and healthy controls [21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36] (Table 1); seven Studies provided the information about the deficiency, insufficiency,sufficiencyofvitaminDinbothSLEpatientsandhealthy controls 10,21,22,24,27,28,36 (Table S1-S3); 6 studies explored the correlations between disease activity of SLE and 25(OH)D levels 25,28,34,35,37,38 (Table S4). The NOS scores of included studies rangedfrom6to8stars,indicatingeachofthestudieshadhigh methodologicalquality(TableS5).…”

Section: Study Characteristicsmentioning

confidence: 99%

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Association between circulating 25‐hydroxyvitamin D and systemic lupus erythematosus: A systematic review and meta‐analysis

et al. 2019

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Aim The indicators for measuring vitamin D are various, and 25‐hydroxyvitamin D (25(OH)D) is considered as the optimal indicator of total vitamin D levels. In this study, we aim to deeply explore the 25(OH)D status in systemic lupus erythematosus (SLE) patients, and evaluate its relation to SLE risk and disease severity. Methods Literature about 25(OH)D status and its associations with SLE were searched in Pubmed, Embase and Cochrane Library databases. Standardized mean difference (SMD), odds ratio (OR) and corresponding 95% confidence interval (95% CI) were illustrated by forest plots, and correlation coefficients (r) were combined by generic inverse variance method. Heterogeneity and publication bias were quantified by I‐squared (I2) test, funnel plot and Egger's test, respectively. Sensitivity analyses were further examined by leave‐one‐out method. Results Nineteen articles were included into our meta‐analysis. The overall results showed that compared with the healthy controls, the circulating 25(OH)D levels were significantly lower in SLE patients (pooled SMD = −1.63, 95% CI: −2.51 to −0.76). Subgroup analysis revealed that compared with the healthy controls, SLE patients of Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) ≥ 10, Arab and European ethnicity, all 4 seasons, no vitamin D supplement, had significantly lower circulating 25(OH)D levels; no significant differences were observed in SLE patients of SLEDAI < 10, mixed ethnicity, spring, summer, vitamin D supplement, respectively; no matter the changes of age, disease duration, and the therapy of corticosteroid or immunosuppressive or neither, circulating 25(OH)D levels were significantly reduced in SLE patients. The deficiency, insufficiency and sufficiency of vitamin D could significantly elevate, slightly decrease (not significantly), significantly decrease SLE risk, respectively (pooled OR = 4.37, 95% CI: 1.49 to 12.84; pooled OR = 0.52, 95% CI: 0.22 to 1.26; pooled OR = 0.31, 95% CI: 0.15 to 0.63). Circulating 25(OH)D levels were inversely associated with SLEDAI (pooled correlation coefficient = −0.50, 95% CI: −0.8278 to −0.1689). Conclusions Compared with healthy controls, 25(OH)D levels are significantly lower in SLE patients, which is influenced by disease activity, ethnicity, seasons and vitamin D supplement; no matter the change of age, diseases duration and therapy of corticosteroid or immunosuppressive or neither, 25(OH)D levels are significantly decreased in SLE patients; the deficiency, insufficiency and sufficiency of vitamin D could significantly elevate, slightly decrease, and significantly decrease SLE risk, respectively; and 25(OH)D levels inversely correlate with SLEDAI.

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Section: Discussionmentioning

confidence: 75%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Study Characteristicsmentioning

confidence: 99%

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Association between circulating 25‐hydroxyvitamin D and systemic lupus erythematosus: A systematic review and meta‐analysis

et al. 2019

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“…Thereafter, a number of larger-scale case-control studies confirmed the relationship between hypovitaminosis D and the prevalence of SLE [75,76,77,78], particularly in patients with lupus nephritis [75]. In our recent age- and gender-matched case-control study of 61 SLE patients and 61 healthy controls, we found that a deficiency of the total 25(OH)D 3 level, as measured by liquid chromatography-tandem mass spectrometry, was significantly more prevalent in the patient group (19.7% vs. 3.3%, p = 0.003) [79].…”

Section: Hypovitaminosis D and Its Impact On Disease Activity And mentioning

confidence: 99%

The Impact of Vitamin D on the Immunopathophysiology, Disease Activity, and Extra-Musculoskeletal Manifestations of Systemic Lupus Erythematosus

Mak

2018

IJMS

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Over the past two decades it has been increasingly recognized that vitamin D, aside from its crucial involvement in calcium and phosphate homeostasis and the dynamics of the musculoskeletal system, exerts its influential impact on the immune system. The mechanistic roles that vitamin D plays regarding immune activation for combating infection, as well as pathologically and mediating autoimmune conditions, have been progressively unraveled. In vitro and in vivo models have demonstrated that the action of vitamin D on various immunocytes is not unidirectional. Rather, how vitamin D affects immunocyte functions depends on the context of the immune response, in the way that its suppressive or stimulatory action offers physiologically appropriate and immunologically advantageous outcomes. In this review, the relationship between various aspects of vitamin D, starting from its adequacy in circulation to its immunological functions, as well as its autoimmune conditions, in particular systemic lupus erythematosus (SLE), a prototype autoimmune condition characterized by immune-complex mediated inflammation, will be discussed. Concurring with other groups of investigators, our group found that vitamin D deficiency is highly prevalent in patients with SLE. Furthermore, the circulating vitamin D levels appear to be correlated with a higher disease activity of SLE as well as extra-musculoskeletal complications of SLE such as fatigue, cardiovascular risk, and cognitive impairment.

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Vitamin D, Autoimmune Disease and Rheumatoid Arthritis

et al. 2019

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Vitamin D has been reported to influence physiological systems that extend far beyond its established functions in calcium and bone homeostasis. Prominent amongst these are the potent immunomodulatory effects of the active form of vitamin D, 1,25-dihydroxyvitamin D3 (1,25-(OH) 2 D3). The nuclear vitamin D receptor (VDR) for 1,25-(OH) 2 D3 is expressed by many cells within the immune system and resulting effects include modulation of T cell phenotype to suppress pro-inflammatory Th1 and Th17 CD4+ T cells and promote tolerogenic regulatory T cells. In addition, antigen-presenting cells have been shown to express the enzyme 1α-hydroxylase that converts precursor 25-hydroxyvitamin D3 (25-OHD3) to 1,25-(OH) 2 D3, so that immune microenvironments are able to both activate and respond to vitamin D. As a consequence of this local, intracrine, system, immune responses may vary according to the availability of 25-OHD3, and vitamin D deficiency has been linked to various autoimmune disorders including rheumatoid arthritis (RA). The aim of this review is to explore the immune activities of vitamin D that impact autoimmune disease, with specific reference to RA. As well as outlining the mechanisms linking vitamin D with autoimmune disease, the review will also describe the different studies that have linked vitamin D status to RA, and the current supplementation studies that have explored the potential benefits of vitamin D for prevention or treatment of RA. The overall aim of the review is to provide a fresh perspective on the potential role of vitamin D in RA pathogenesis and treatment.

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Serum 25-OH vitamin D level in treatment-naïve systemic lupus erythematosus patients: Relation to disease activity, IL-23 and IL-17

Cited by 33 publications

References 48 publications

Association between circulating 25‐hydroxyvitamin D and systemic lupus erythematosus: A systematic review and meta‐analysis

Association between circulating 25‐hydroxyvitamin D and systemic lupus erythematosus: A systematic review and meta‐analysis

The Impact of Vitamin D on the Immunopathophysiology, Disease Activity, and Extra-Musculoskeletal Manifestations of Systemic Lupus Erythematosus

Vitamin D, Autoimmune Disease and Rheumatoid Arthritis

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