Vitamin D deficiency is associated with an increased autoimmune response in healthy individuals and in patients with systemic lupus erythematosus

Abstract

Objectives Vitamin D deficiency is widespread and has been associated with many chronic diseases, including autoimmune disorders. A study was undertaken to explore the impact of low vitamin D levels on autoantibody production in healthy individuals, as well as B cell hyperactivity and interferon α (IFNα) activity in patients with systemic lupus erythematosus (SLE). Methods Serum samples from 32 European American female patients with SLE and 32 matched controls were tested for 25-hydroxyvitamin D (25(OH)D) levels, lupus-associated autoantibodies and serum IFNα activity. Isolated peripheral blood mononuclear cells were tested for intracellular phospho-ERK 1/2 as a measure of B cell activation status. Results Vitamin D deficiency (25(OH)D <20 ng/ml) was significantly more frequent among patients with SLE (n=32, 69%) and antinuclear antibody (ANA)-positive controls (n=14, 71%) compared with ANA-negative controls (n=18, 22%) (OR 7.7, 95% CI 2.0 to 29.4, p=0.003 and OR 8.8, 95% CI 1.8 to 43.6, p=0.011, respectively). Patients with high B cell activation had lower mean (SD) 25(OH)D levels than patients with low B cell activation (17.2 (5.1) vs 24.2 (3.9) ng/ml; p=0.009). Patients with vitamin D deficiency also had higher mean (SD) serum IFNα activity than patients without vitamin D deficiency (3.5 (6.6) vs 0.3 (0.3); p=0.02). Conclusions The observation that ANA-positive healthy controls are significantly more likely to be deficient in vitamin D than ANA-negative healthy controls, together with the finding that vitamin D deficiency is associated with certain immune abnormalities in SLE, suggests that vitamin D plays an important role in autoantibody production and SLE pathogenesis.

Depression and Quality of Life in Patients with Systemic Lupus Erythematosus

“…Correction of vitamin D insufficiency was reported to improve the depressive state [15]. Vitamin D deficiency is also associated with autoimmunity and inflammation including antinuclear antibody positivity, increased activity of B cells, and high serum interferon-α activity in patients with SLE [38]. In present study, low serum vitamin D levels were associated with high disease activity in line with previous studies SLE [39].…”

Juvenile onset systemic lupus erythematosus: a possible role for vitamin D in disease status and bone health

“…63 Interestingly, vitamin D deficiency was associated with antinuclear antibodies (ANA) positivity in healthy controls and with higher levels of Interferon-a and higher B cell activation in SLE patients. 64 Also, vitamin D deficient SLE patients have higher levels of anti-dsDNA antibodies. 22 All these laboratory and clinical findings suggest a role for vitamin D in SLE pathogenesis and autoantibody production.…”

Relationship between Serum 25-Hydroxyvitamin D Levels, Disease Activity and Anti-Cyclic Citrullinated Peptide Antibody Levels in Indian Rheumatoid Arthritis Patients

“…Many immune cells containing vitamin D receptors (like monocytes, macrophages, dendritic cells, and activated T and B cells) possess the enzymatic machinery to convert vitamin D into its active form [37].…”