Vitamin D status in systemic lupus erythematosus patients and its association with selected clinical and laboratory parameters

Abstract

Objectives: To identify relationships between vitamin D serum levels and the presence of autoantibodies directed against vitamin D and levels of interleukin(IL)-17 and IL-23 in patients with systemic lupus erythematosus (SLE). Methods: The study included 49 patients with SLE. Serum concentrations of 25(OH)D 3 were measured with electrochemiluminescence immunoassay (ECLIA). Enzyme-linked immunosorbent assays (ELISA) were used to determine antibodies directed against 1,25(OH) 2 D 3 and levels of IL-17 and IL-23 in serum of SLE patients. In evaluation of vitamin D status, the control group consisted of 49 age and gender matched healthy individuals, whereas in assessment of anti-vitamin D antibodies the control group comprised 30 sera from blood donors. Results: Serum concentration of 25(OH)D 3 in SLE patients during the warm season was 18.47 AE 9.14 ng/ml, which was significantly decreased as compared with that of the control group -31.27 AE 12.65 ng/ml (p ¼ 0.0005). During the cold season a trend toward lower concentration of 25(OH)D 3 in SLE patients was revealed; however, it did not reach statistical significance (11.71 AE 7.21 ng/ml vs. 16.01 AE 8.46 ng/ml; p ¼ 0.054). Results within the recommended range for vitamin D (30-80 ng/ml; 70-200 nmol/l) were observed only in three patients. The 25(OH)D 3 concentration was decreased in SLE patients with renal disease or leucopenia as compared with the levels in patients who did not have either problem (p ¼ 0.006 and p ¼ 0.047, respectively). The cold season was found to be a risk factor for vitamin D deficiency (<20 ng/ml) (odds ratio ¼ 9.25; p ¼ 0.005). Autoantibodies directed against 1,25(OH) 2 D 3 were detected in three SLE patients. No significant difference in 25(OH)D 3 serum concentrations was found between SLE patients with and without these autoantibodies. No link was shown between the existence of autoantibodies against 1,25(OH) 2 D 3 and clinical or laboratory findings, including IL-17 and IL-23 levels. However, serum concentrations of IL-23 were lower in patients with vitamin D deficiency (p ¼ 0.037). Conclusions: SLE patients, especially those with leucopenia or renal involvement, are at high risk of vitamin D deficiency and require vitamin D supplementation. Some SLE patient sera contained 1,25(OH) 2 D 3 antibodies, but these antibodies do not appear to affect vitamin D levels. Lupus (2012) 21, 477-484.

Pathogenic and Therapeutic Role of Vitamin D in Antiphospholipid Syndrome Patients

“…Very interesting was also an observation that serum VitD concentrations showed significant negative correlation with another disease activity score, the British Isles Lupus Assessment Group (BILAG) (r=-0.486, p=0.001), in spite of the short duration of disease [97]. Hypothetical explanation for the low serum concentrations of VitD in SLE patients by the existence of inhibiting anti-VitD antibodies in circulation could not be confirmed by the literature data [97,98]. Their existence could be proven in 4-6% of patients with SLE and 3.5% of APS patients.…”

“…Its association with anti-dsDNA (p=0.0004) could point to its potential role in this condition, but being only one of 116 different antibodies present in SLE patients characterized by the polyclonal B lymphocyte activation, it is still uncertain if it is pathogenic [97]. It seems that their presence did not affect VitD levels in these patients [97,98], and it was speculated that they could be the consequence of high-dose VitD consumption rather than the cause of this vitamin deficiency [99].…”

The role of environmental factors in the etiology of systemic lupus erythematosus

“…Dotyczy to także chorych na TRU [14][15][16]. Niedobór tej witaminy, poza wpływem na metabolizm kości, doprowadza do utraty tolerancji immunologicznej, przy czym zmiana ta jest odwracalna [1].…”

“…Zaburzenie odpowiedzi immunologicznej w stanie niedoboru witaminy D jest konsekwencją zachwiania równowagi pomiędzy komórkami T, B i komórkami dendrytycznymi oraz produkcji cytokin prozapalnych. Wyniki najnowszych badań wskazują, że z uwagi na złożoną rolę, jaką odgrywa witamina D u chorych na TRU, wymagają oni suplementacji tą witaminą [16].…”

Doença óssea em pacientes com nefrite lúpica: aspectos inflamatórios

“…Deste modo, torna-se complexa a tarefa de avaliar a contribuição individual de cada fator. Nos pacientes portadores de Nefrite Lúpica deve-se atentar para um risco adicional para o comprometimento ósseo, uma vez que a proteinúria e/ou disfunção renal podem agravar a deficiência de vitamina D (7,(9)(10)(11).…”