Vitamin D treatment for connective tissue diseases: hope beyond the hype?

Reynolds, John A.; Bruce, Ian N.

doi:10.1093/rheumatology/kew212

Cited by 23 publications

(19 citation statements)

References 93 publications

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“…The inclusion of healthy controls as comparator group is mandatory to rightly interpret data on vitamin D deficiency/insufficiency because of its broad diffusion and the high variability of its prevalence worldwide. Among 14 controlled studies reviewed by Reynolds and Bruce in 2017 [40], 12 of them showed significantly lower levels of serum vitamin D in SLE, while only two failed to detect different average values between cases and controls [11,41]. Hence, despite a prevailing consensus that SLE patients have significantly lower levels of vitamin D, variations in assay techniques, cut-off values, seasonality, ethnicity, age, sex, disease duration and latitude, all contribute to making the frequency of vitamin D deficiency/insufficiency challenging to compare between different studies.…”

Section: Prevalence Of Hypovitaminosis D In Diseasementioning

confidence: 99%

To Supplement or not to Supplement? The Rationale of Vitamin D Supplementation in Systemic Lupus Erythematosus

Nerviani¹,

Mauro²,

Gilio³

et al. 2018

TORJ

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Background: Systemic Lupus Erythematosus (SLE) is a systemic autoimmune disease characterised by abnormal activation of the immune system, chronic inflammation and organ damage. Lupus patients are more prone to be vitamin D deficient. However, current evidence is not conclusive with regards to the role played by vitamin D in SLE development, progression, and clinical manifestations. Objective: Here, we will summarise the current knowledge about vitamin D deficiency prevalence, risk factors, molecular effects, and potential pathogenic role in SLE. We will focus on the link between vitamin D deficiency and lupus clinical manifestations, and on the clinical trials assessing the effects of vitamin D supplementation in SLE. Method: A detailed literature search was performed exploiting the available databases, using “vitamin D and lupus/SLE” as keywords. The relevant interventional trials published over the last decade have been considered and the results are reported here. Conclusion: Several immune cells express vitamin D receptors. Thus, an immunomodulatory role for vitamin D in lupus is plausible. Numerous observational studies have investigated the relationship between vitamin D levels and clinical/serological manifestations of SLE with contrasting results. Negative correlations between vitamin D levels and disease activity, fatigue, renal and cardiovascular disease, and anti-dsDNA titres have been described but not conclusively accepted. In experimental models of lupus, vitamin D supplementation can improve the disease. Interventional trials have assessed the potential therapeutic value of vitamin D in SLE, but further larger studies are needed.

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Section: Prevalence Of Hypovitaminosis D In Diseasementioning

confidence: 99%

To Supplement or not to Supplement? The Rationale of Vitamin D Supplementation in Systemic Lupus Erythematosus

Nerviani¹,

Mauro²,

Gilio³

et al. 2018

TORJ

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“…Research has claimed that its dysregulation can lead to the development of numerous diseases, affecting the cardiovascular system, musculoskeletal system, and nervous system. [35][36][37][38][39] Optimal health benefits of exogenous and endogenous vitamin D might not be achieved without the adequate presence of magnesium, as the bioactivity of vitamin D is a magnesium-dependent process. 33,34 The purpose of this review article is to present the biological significance of magnesium in vitamin D metabolism and its therapeutic importance to minimize complications related to vitamin D deficiency.…”

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confidence: 99%

Role of Magnesium in Vitamin D Activation and Function

Uwitonze¹,

Razzaque²

2018

J Am Osteopath Assoc

269

207

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Nutrients usually act in a coordinated manner in the body. Intestinal absorption and subsequent metabolism of a particular nutrient, to a certain extent, is dependent on the availability of other nutrients. Magnesium and vitamin D are 2 essential nutrients that are necessary for the physiologic functions of various organs. Magnesium assists in the activation of vitamin D, which helps regulate calcium and phosphate homeostasis to influence the growth and maintenance of bones. All of the enzymes that metabolize vitamin D seem to require magnesium, which acts as a cofactor in the enzymatic reactions in the liver and kidneys. Deficiency in either of these nutrients is reported to be associated with various disorders, such as skeletal deformities, cardiovascular diseases, and metabolic syndrome. It is therefore essential to ensure that the recommended amount of magnesium is consumed to obtain the optimal benefits of vitamin D.

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“…Vitamin D is a secosteroid hormone that contributes to calcium and phosphorus metabolism for healthy bone mineralization [12]. Vitamin D includes vitamin D 2 (derived from plants) and vitamin D 3 (derived from animals) as well as vitamin D metabolites.…”

Section: Introductionmentioning

confidence: 99%

“…In humans, ~90% of vitamin D arises from endogenous synthesis by conversion of 7-dehydroxycholesterol into previtamin D by ultraviolet B radiations and then to vitamin D by a nonenzymatic transformation. Considering that vitamin D is biologically inactive, it is activated in a two-stage hydroxylation process: first, hepatic hydroxylation that results in 25-hydroxyvitamin D (25[OH]D) and, second, hydroxylation of 25(OH)D in the kidneys, resulting in 1,25-(OH) 2 D which is the active form of vitamin D [12, 14]. …”

Section: Introductionmentioning

confidence: 99%

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Are Systematic Screening for Vitamin D Deficiency and Vitamin D Supplementation Currently Feasible for Ankylosing Spondylitis Patients?

Essouma

Noubiap

2017

International Journal of Inflammation

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Beyond its role in calcium and phosphorus metabolism for healthy bone mineralization, there is increasing awareness for vitamin D contribution in modulation of immune reactions. Given that ankylosing spondylitis (AS) is a chronic inflammatory disease involving excess immune/inflammatory activity and posing great therapeutic challenges, it is conceivable to claim that vitamin D treatment may be a safe and effective treatment to influence or modify the primary disease and its related comorbidities. Nevertheless, consistent body of research supporting this hypothesis is still lacking. In this paper, we examine whether systematic screening and treatment for vitamin D deficiency are feasible at present. We will review the immunomodulatory role of vitamin D and its contribution in initiation and progression of AS, as well as how they would determine the occurrence of comorbid conditions. Our conclusion is that despite the overwhelmed interest about vitamin D treatment in AS patients, systematic screening and treatment for vitamin D deficiency of all AS patients are not feasible as yet. This stresses the need for further extensive well-designed research to prove vitamin D efficacy in AS beyond bone protection. And if utility is proven, personalized treatment regimes, duration of treatment, and threshold values for vitamin D should be provided.

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Vitamin D treatment for connective tissue diseases: hope beyond the hype?

Cited by 23 publications

References 93 publications

To Supplement or not to Supplement? The Rationale of Vitamin D Supplementation in Systemic Lupus Erythematosus

To Supplement or not to Supplement? The Rationale of Vitamin D Supplementation in Systemic Lupus Erythematosus

Role of Magnesium in Vitamin D Activation and Function

Are Systematic Screening for Vitamin D Deficiency and Vitamin D Supplementation Currently Feasible for Ankylosing Spondylitis Patients?

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