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Vitamin D in Systemic and Organ-Specific Autoimmune Diseases

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Abstract

Lately, vitamin D has been linked with metabolic and immunological processes, which established its role as an essential component of human health preservation. Vitamin D has been defined as natural immune modulators, and upon activation of its receptors (VDRs), it regulates calcium metabolism, cellular growth, proliferation and apoptosis, and other immunological functions. Epidemiological data underline a strong correlation between poor vitamin D status and higher risk for chronic inflammatory illnesses of various etiologies, including autoimmune diseases. Epidemiological, genetic, and basic studies indicated a potential role of vitamin D in the pathogenesis of certain systemic and organ-specific autoimmune diseases. These studies demonstrate correlation between low vitamin D and prevalence of diseases. In addition, VDRs’ polymorphisms observed in some of these autoimmune diseases may further support a plausible pathogenic link. Notably, for some autoimmune disease, no correlation with vitamin D levels could be confirmed. Thus, in the current review we present the body of evidence regarding the plausible roles of vitamin D and VDR’s polymorphism in the pathogenesis of autoimmunity. We summarize the data regarding systemic (i.e., systemic lupus erythematosus, rheumatoid arthritis, etc.) and organ-specific (i.e., multiple sclerosis, diabetes mellitus, primary biliary cirrhosis, etc.) autoimmune diseases, in which low level of vitamin D was found comparing to healthy subjects. In addition, we discuss the correlations between vitamin D levels and clinical manifestations and/or activity of diseases. In this context, we address the rational for vitamin D supplementation in patients suffering from autoimmune diseases. Further studies addressing the mechanisms by which vitamin D affects autoimmunity and the proper supplementation required are needed.

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Authors and Affiliations

  1. The Zabludowics Center for Autoimmune Diseases, Chaim Sheba Medical Center, Tel Hashomer, 52621, Israel

    Nancy Agmon-Levin, Emanuel Theodor, Ramit Maoz Segal & Yehuda Shoenfeld

  2. Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel

    Nancy Agmon-Levin

  3. Sackler Faculty of Medicine, Incumbent of the Laura Schwartz-Kip Chair for Research of Autoimmune Diseases, Tel-Aviv University, Tel Aviv, Israel

    Yehuda Shoenfeld

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  1. Nancy Agmon-Levin
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  2. Emanuel Theodor
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  3. Ramit Maoz Segal
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  4. Yehuda Shoenfeld
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Correspondence to Yehuda Shoenfeld.

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Nancy Agmon-Levin and Emanuel Theodor contributed equally to this article.

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Agmon-Levin, N., Theodor, E., Segal, R.M. et al. Vitamin D in Systemic and Organ-Specific Autoimmune Diseases. Clinic Rev Allerg Immunol 45, 256–266 (2013). https://doi.org/10.1007/s12016-012-8342-y

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