Vitamin D
            <sub>3</sub>
            supplementation and neurofilament light chain in multiple sclerosis

Smolders, Joost; Mimpen, Max; Oechtering, Johanna; Damoiseaux, Jan; Ouweland, Jody van den; Hupperts, Raymond; Kuhle, Jens

doi:10.1111/ane.13185

Cited by 23 publications

(34 citation statements)

References 22 publications

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“…However, our results do not support an effect of rising 25(OH)D levels driven mainly by seasonal alterations in UVR exposure on axonal degeneration in RRMS, as measured by serum NfL levels. This is in line with the finding of no effect of high-dose oral vitamin D 3 supplementation on serum NfL levels in RCTs among RRMS patients with DMT (10,11).…”

Section: Discussionsupporting

confidence: 90%

“…This may support earlier (9). However, we and others did not find an increase in NfL concentration in patients reaching high 25(OH)D levels during vitamin D intervention trials (10,11).…”

Section: Discussionsupporting

confidence: 70%

“…Results from randomized placebo-controlled trials (RCTs) have indicated a relationship between increasing serum levels of 25(OH)D after vitamin D supplementation and reduced inflammatory MRI disease activity in RRMS (9). However, the effect of vitamin D treatment on serum levels of NfL is uncertain, as it has only been investigated in RCTs with a limited number of rather clinically stable patients (10,11).…”

Section: Introductionmentioning

confidence: 99%

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Natural Variation of Vitamin D and Neurofilament Light Chain in Relapsing-Remitting Multiple Sclerosis

Røsjø¹,

Lindstrøm

Holmøy

et al. 2020

Front. Neurol.

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Background: High serum levels of 25-hydroxyvitamin D (25(OH)D) have been found among patients with a favorable disease course in relapsing-remitting MS (RRMS), indicating that this may limit clinical deterioration. Clinical deterioration in RRMS correlates with increasing serum levels of neurofilament light chain (NfL). Objectives: To examine the association between physiological variations in serum 25(OH)D and NfL levels in RRMS patients before and during disease modifying therapy (DMT). Material and Methods: Serum 25(OH)D and NfL concentrations were measured in 85 newly diagnosed RRMS patients enrolled in a 24-month randomized double-blinded placebo-controlled trial of ω-3 fatty acid supplementation without vitamin D. Patients were without DMT until interferon β-1a (IFN-β) initiation at study month 6. Longitudinal serum measurements and brain magnetic resonance imaging (MRI) were obtained. Associations between 25(OH)D and NfL levels were analyzed with linear regression models for the whole study period and the periods before and during IFN-β treatment. Analyses with adjustment for inflammatory MRI disease activity were also performed. Results: No significant associations were found between variations in 25(OH)D and NfL levels during the whole study period (p = 0.95), or the periods without (p = 0.78) or with (p = 0.33) IFN-β therapy. Patients with inflammatory MRI disease activity had significantly higher serum NfL levels than patients without inflammatory MRI disease activity [mean (SD) difference 12.6 (2.0) pg/mL, p < 0.01]. Adjustment for this did not change the relationship between 25(OH)D and NfL concentrations. Conclusion: Natural variations in serum 25(OH)D values do not seem to be associated with alterations in serum NfL concentrations in RRMS patients.

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Section: Discussionsupporting

confidence: 90%

“…This may support earlier (9). However, we and others did not find an increase in NfL concentration in patients reaching high 25(OH)D levels during vitamin D intervention trials (10,11).…”

Section: Discussionsupporting

confidence: 70%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Natural Variation of Vitamin D and Neurofilament Light Chain in Relapsing-Remitting Multiple Sclerosis

Røsjø¹,

Lindstrøm

Holmøy

et al. 2020

Front. Neurol.

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“…After 48 weeks of supplementation, patients who received vitamin D supplementation did exhibit higher vitamin D serum levels compared with the control group (p<0.01); however, NfL levels did not significantly differ between the groups (p=0.74). An increase in NfL levels at 48 weeks was associated with a higher risk of disease progression, but vitamin D did not appear to affect disease severity in this study [29]. Similarly, no correlation between natural (un-supplemented) vitamin D levels and NfL (p=0.95) were reported by another study which monitored participants over a period of 24 months [30].…”

Section: Seasonality and Exacerbations Of Ms In Mri The Possible Concontrasting

confidence: 68%

Correlation between vitamin D and alterations in MRI among patients with multiple sclerosis

Piędel¹,

Rocka²,

Piwek³

et al. 2021

Ann Agric Environ Med.

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Introduction. Multiple sclerosis (MS) is a disease of unknown etiology. Diagnosis of MS is primarily based on detection of myelin damage by magnetic resonance imaging (MRI) and classification of demyelination according to the McDonald Criteria. Cholecalciferol (vitamin D 3) has been shown to affect the onset and progression of MS via its immunomodulating properties. The role of vitamin D in MS pathogenesis and treatment deserves further investigation, as there is sufficient evidence to suggest a correlation between vitamin D blood level and brain MRI lesion load. State of knowledge. Elevated blood vitamin D concentration is linked with demyelination, as determined by T2-weighted and gadolinium-enhanced MRI. Blood vitamin D blood levels are affected by sun exposure, among other factors; however, there is no evident connection between abnormalities in myelination and seasonality. Vitamin D supplementation among MS patients has been associated with a lower probability of new lesions and loss of existing lesion volume, as observed seen in T1-weighted MRI scans (p=0.03). An increase in TGF-beta levels was noted among patients using vitamin D supplementation, which may suggest a mechanism by which cholecalciferol may improve MS prognosis. Patients with clinically isolated syndrome (CIS) exhibited an inverse correlation between vitamin D concentration and risk of new lesions as seen in T2-weighted MRI scans. Moreover, vitamin D intake among these patients lowered the risk of progression to clinically definite multiple sclerosis (CDMS). Daily intake of vitamin D during fingolimod treatment correlated strongly with lower numbers of new lesions. High dose vitamin D supplementation during interferon beta-1a treatment was linked to lower mean percentage of lesions compared with volume pre-treatment seen by T2-weighted MRI. Results. Recent findings advocate for the monitoring of vitamin D blood levels in MS patients. Vitamin D supplementation should be considered in both MS patients and patients with CIS, where other signs of disease may be delayed. Moreover, vitamin D supplementation appears to lower the likelihood of new demyelination changes apparent in MRI examinations.

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“…The majority of TEAEs were unrelated to treatment, and those possibly or probably related to treatment were reported at comparable frequency between the groups. Neurofilament light (NfL) chains were analyzed in a substudy, but supplementation of high-dose vitamin D3 for 48 weeks was not associated with lower NfL levels [45].…”

Section: Randomized-controlled Trials Of Vitamin D As Add-on Therapy mentioning

confidence: 99%

Vitamin D Supplementation in Multiple Sclerosis: A Critical Analysis of Potentials and Threats

et al. 2020

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Multiple sclerosis (MS) is a chronic inflammatory demyelinating and neurodegenerative disease of the central nervous system (CNS). In recent years, vitamin D has gained attention, as low serum levels are suspected to increase the risk for MS. Cholecalciferol supplementation has been tested in several clinical trials, since hypovitaminosis D was linked to higher disease activity and may even play a role in long-term outcome. Here, we review the current understanding of the molecular effects of vitamin D beyond calcium homeostasis, the potential beneficial action in MS and hazards including complications of chronic and high-dose therapy. In clinical trials, doses of up to 40,000 IU/day were tested and appeared safe as add-on therapy for short-term periods. A recent meta-analysis of a randomized, double-blind, placebo-controlled clinical trial investigating vitamin D as add-on therapy in MS, however, suggested that vitamin D had no therapeutic effect on disability or relapse rate. We recognize a knowledge gap for chronic and high-dose therapy, which can lead to life-threatening complications related to vitamin D toxicity including renal failure, cardiac arrythmia and status epilepticus. Moreover, vitamin D toxicity may manifest as fatigue, muscle weakness or urinary dysfunction, which may mimic the natural course of progressive MS. Given these limitations, vitamin D supplementation in MS is a sensitive task which needs to be supervised by physicians. While there is strong evidence for vitamin D deficiency and the development of MS, the risk-benefit profile of dosage and duration of add-on supplementation needs to be further clarified.

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Vitamin D ₃ supplementation and neurofilament light chain in multiple sclerosis

Cited by 23 publications

References 22 publications

Natural Variation of Vitamin D and Neurofilament Light Chain in Relapsing-Remitting Multiple Sclerosis

Natural Variation of Vitamin D and Neurofilament Light Chain in Relapsing-Remitting Multiple Sclerosis

Correlation between vitamin D and alterations in MRI among patients with multiple sclerosis

Vitamin D Supplementation in Multiple Sclerosis: A Critical Analysis of Potentials and Threats

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Vitamin D 3 supplementation and neurofilament light chain in multiple sclerosis

Cited by 23 publications

References 22 publications

Natural Variation of Vitamin D and Neurofilament Light Chain in Relapsing-Remitting Multiple Sclerosis

Natural Variation of Vitamin D and Neurofilament Light Chain in Relapsing-Remitting Multiple Sclerosis

Correlation between vitamin D and alterations in MRI among patients with multiple sclerosis

Vitamin D Supplementation in Multiple Sclerosis: A Critical Analysis of Potentials and Threats

Contact Info

Product

Resources

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Vitamin D ₃ supplementation and neurofilament light chain in multiple sclerosis