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Bilgin M, Keskin A, Aci R, Baklacioglu HS, Arslanbek Erdem M. Darkness hormone or daylight hormone in women with systemic lupus erythematosus? Clin Rheumatol 2023; 42:93-99. [PMID: 36125575 DOI: 10.1007/s10067-022-06379-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 08/19/2022] [Accepted: 09/13/2022] [Indexed: 01/11/2023]
Abstract
INTRODUCTION In this study, it was aimed to compare the effects of both melatonin and 25-hydroxyvitamin D3, defined as an immune modulator, on laboratory diagnostic criteria parameters and disease activity in patients with systemic lupus erythematosus (SLE). METHODS The study included 56 women with SLE and 40 healthy women (control group). Melatonin and 25-hydroxyvitamin D3 levels of patients and healthy individuals included in the study were examined. In addition, leukocytes, lymphocytes, platelets, C3, C4, anti-double-stranded DNA (Anti-dsDNA), antinuclear antibody, and SLE disease activity index (SLEDAI) were analyzed in women with SLE. Patients were divided into four subgroups according to SLEDAI. RESULTS Melatonin and 25-hydroxyvitamin D3 levels of women with SLE were lower than healthy women (p < 0.001). Both melatonin and 25-hydroxyvitamin D3 levels were not correlated with laboratory diagnostic criteria parameters. Only 25-hydroxyvitamin D3 levels were correlated with leukocyte levels (p < 0.01). There was no significant difference between the melatonin levels of the subgroups. The 25-hydroxyvitamin D3 levels of the subgroup without disease activity were higher than levels of the subgroups with disease activity (p < 0.05). There was a negative correlation between SLEDAI score and 25-hydroxyvitamin D3 levels (p < 0.05). CONCLUSION Women with SLE had lower melatonin and 25-hydroxyvitamin D3 levels than healthy women. On the other hand, parameters of laboratory diagnostic criteria of SLE disease were not related. Only 25-hydroxyvitamin D3 levels were inversely related leukocyte levels. SLE disease activity was not correlated with melatonin levels but negatively correlated with 25-hydroxyvitamin D3 levels. Key Points • Women with SLE have low levels of melatonin and 25-hydroxyvitamin D3. • Melatonin and 25-hydroxyvitamin D3 levels are not related to the laboratory diagnostic criteria parameters for SLE disease. • Low levels of melatonin and 25-hydroxyvitamin D3 may be a factor in the unbalanced immune system of SLE. • Supplementation of melatonin and 25-hydroxyvitamin D3 may be recommended for women patients with SLE.
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Affiliation(s)
- Melek Bilgin
- Department of Microbiology, Samsun Training and Research Hospital, 199 Barıs Boulevard, Kadıkoy Neighborhood, Ilkadım, Samsun, 55090, Turkey.
| | - Adem Keskin
- Department of Medicine Biochemistry, Institute of Health Sciences, Aydin Adnan Menderes University, Aydın, Turkey
| | - Recai Aci
- Department of Biochemistry, Samsun Training and Research Hospital, Samsun, Turkey
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2
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Chen J, Liao S, Pang W, Guo F, Yang L, Liu HF, Pan Q. Life factors acting on systemic lupus erythematosus. Front Immunol 2022; 13:986239. [PMID: 36189303 PMCID: PMC9521426 DOI: 10.3389/fimmu.2022.986239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Accepted: 08/31/2022] [Indexed: 11/25/2022] Open
Abstract
Systemic lupus erythematosus (SLE) is a highly heterogeneous autoimmune disease that primarily affects women. Currently, in the search for the mechanisms of SLE pathogenesis, the association of lifestyle factors such as diet, cigarette smoking, ultraviolet radiation exposure, alcohol and caffeine-rich beverage consumption with SLE susceptibility has been systematically investigated. The cellular and molecular mechanisms mediating lifestyle effects on SLE occurrence, including interactions between genetic risk loci and environment, epigenetic changes, immune dysfunction, hyper-inflammatory response, and cytotoxicity, have been proposed. In the present review of the reports published in reputable peer-reviewed journals and government websites, we consider the current knowledge about the relationships between lifestyle factors and SLE incidence and outline directions of future research in this area. Formulation of practical measures with regard to the lifestyle in the future will benefit SLE patients and may provide potential therapy strategies.
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Affiliation(s)
| | | | | | | | | | | | - Qingjun Pan
- *Correspondence: Hua-feng Liu, ; Qingjun Pan,
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3
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Tang HY, Ko WS, Yan YH, Yu SC, Chiou YL. Relationship between serum 25 hydroxyvitamin D (25(OH)D) levels and mental health in shift female nurses. Sci Rep 2022; 12:14583. [PMID: 36028631 PMCID: PMC9418151 DOI: 10.1038/s41598-022-18721-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Accepted: 08/18/2022] [Indexed: 11/09/2022] Open
Abstract
The nurses work long hours and in various shifts, and often accompanied by depression, fatigue, and sleep disorders. Many studies have found that 25 hydroxyvitamin D (25(OH)D) is related to mental health. We aimed to investigate the relationship between depression, sleep problems, fatigue, and serum 25(OH)D levels in shift nurses. We recruited 34 day-shift, 30 evening-shift and 31 night-shift nurses. The Beck Depression Inventory II (BDI-II), Numerical Rating Scale and General Sleep Disturbance Scale to evaluate the levels of depression, sleep problems, fatigue. Blood samples (20 ml) were collected under a fasting state to determine basic biochemistry and inflammatory parameters. In central of Taiwan, approximately 96.1% of shift nurses had deficient (< 20 ng/ml) (45 females and 1 male) and inadequate (20-29 ng/ml) (39 females and 2 male) 25(OH)D levels. Approximately 84.2% of shift nurses experienced fatigue. In sleep disturbance, night-shift nurses experienced significantly more severe sleep disturbance than day-shift and evening-shift nurses. However, no significant correlation was observed between 25(OH)D levels and mental health when the 25(OH)D level was categorized. 25(OH)D deficiency, sleep disturbance, depression, and fatigue were common in shift female nurses, but it was not possible to demonstrate the impact of 25(OH)D deficiency on the mental health of shift nurses in Taiwan.
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Affiliation(s)
- Hsin-Ya Tang
- Department of Nutrition, Master of Biomedical Nutrition Program, Hungkuang University, No. 1018, Sec. 6, Taiwan Boulevard, Shalu District, 433304, Taichung, Taiwan, Republic of China
| | - Wang-Sheng Ko
- Department of Internal Medicine, Kuang-Tien General Hospital, Taichung, Taiwan
| | - Yuan-Horng Yan
- Department of Medicine Research, Kuang-Tien General Hospital, Taichung, Taiwan
| | - Su-Chen Yu
- Department of Nursing, Kuang-Tien General Hospital, Taichung, Taiwan.
| | - Ya-Ling Chiou
- Department of Nutrition, Master of Biomedical Nutrition Program, Hungkuang University, No. 1018, Sec. 6, Taiwan Boulevard, Shalu District, 433304, Taichung, Taiwan, Republic of China.
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Osman EMA, Abu El Nazar SY, Maharem DA, Al-Jebouri DM, Naga IS. Relation between Vitamin D Level and Cyclin-Dependent Kinase-1 Gene Expression in Egyptian Patients with Lupus Nephritis and their Impact on Disease Activity. Indian J Nephrol 2021; 31:163-168. [PMID: 34267439 PMCID: PMC8240929 DOI: 10.4103/ijn.ijn_359_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Revised: 02/04/2020] [Accepted: 03/08/2020] [Indexed: 11/23/2022] Open
Abstract
Introduction: Lupus nephritis (LN) is a common complication of systemic lupus erythematosus. Vitamin D and cycline-dependent kinase-1 (CDK1) have been implicated in its pathogenesis. The aim of this study was to determine the relation between vitamin D level and CDK-1 in lupus nephritis patients and their impact on disease activity. Patients and Methods: The current study was conducted on 50 LN patients and 20 control subjects from Egyptian population using ELISA to assess vitamin D level in serum and TaqMan assay for CDK1 gene expression. Results: Serum vitamin D level was significantly lower in LN patients and CDK-1 gene was down expressed in the majority of LN patients. A significant inverse correlation was found between vitamin D level and 24 h protein in urine, ANA, anti-dsDNA, CRP, with a significant positive correlation with renal biopsy indices, eGFR. There was a non-significant inverse correlation between vitamin D and CDK-1 (before RO-3306 addition) and a positive correlation after RO-3306. A significant positive correlation was found between CDK-1 gene expressions with urinary albumin/creatinine ratio. However, a significant positive correlation was found between CDK-1 (after RO-3306 addition) and proteinuria. While a significant positive correlation was found between CDK-1 expression (after RO-3306 addition) and ANA, a significant positive correlation was found between CDK-1 expression (before RO-3306 addition) and anti-dsDNA but CDK-1 is not associated with renal biopsy indices nor with activity indices of SLE. There was a positive correlation between CDK-1 gene expression and CRP before and after RO-3306 addition. Conclusions: Vitamin D deficiency acts as a risk factor for developing LN. CDK-1 may have an association with the diagnosis of LN but its association with the progression of staging of LN is still confusing
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Affiliation(s)
- Eman M A Osman
- Department of Immunology and Allergy Medical Research Institute, Alexandria University, Alexandria, Egypt
| | - Salma Y Abu El Nazar
- Department of Immunology and Allergy Medical Research Institute, Alexandria University, Alexandria, Egypt
| | - Dalia A Maharem
- Internal Medicine, Medical Research Institute, Alexandria University, Alexandria, Egypt
| | | | - Iman S Naga
- Microbiology, Medical Research Institute, Alexandria University, Alexandria, Egypt
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5
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Fakhfakh R, Feki S, Elleuch A, Neifar M, Marzouk S, Elloumi N, Hachicha H, Abida O, Bahloul Z, Ayadi F, Masmoudi H. Vitamin D status and CYP27B1-1260 promoter polymorphism in Tunisian patients with systemic lupus erythematosus. Mol Genet Genomic Med 2021; 9:e1618. [PMID: 33594806 PMCID: PMC8104169 DOI: 10.1002/mgg3.1618] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 01/09/2021] [Accepted: 01/18/2021] [Indexed: 12/15/2022] Open
Abstract
Aim An association between serum vitamin D (Vit D) levels and systemic lupus erythematosus (SLE) has been reported by several studies that suggested the involvement of genetically determined characteristics of enzymes of vitamin D metabolism. Our study aimed to evaluate the relationship between 25 hydroxyvitamin D (25[OH]D) level, the most representative metabolite of VitD status, and polymorphism of the cytochrome P450, CYP27B1 gene, which influence vitamin D metabolism, and serum levels, in SLE Tunisian patients. Material and Methods A cross‐sectional study has been conducted in SLE patients (supplemented and not supplemented patients), matched to healthy controls by age and gender. The 25[OH]D serum level was measured by chemiluminescence assay and CYP27B1‐1260 genetic polymorphism was carried out using PCR‐RFLP methods. Statistical analysis was made using Shesis and SPSS.20 Software. Results Controls and Vit D not supplemented patients’ groups presented the highest percentage of hypovitaminosis D. A significant difference in the mean level of circulating 25[OH]D between Vit D supplemented SLE patients and controls was observed (23.91 ng/ml and 7.18 ng/ml, respectively p = 3.4 105). Our results showed a correlation of high 25[OH]D level with complement component 3 levels and prednisolone drug. Moreover, the analysis of CYP27B1‐1260 polymorphism in SLE patients and controls revealed a nonsignificant allelic or genotypic association. Conclusion Despite the sunny climate, the high prevalence of Vit D deficiency is common in Tunisia. This hypovitaminosis D feature may affect the Vit D levels in our SLE patients but a direct association with the disease or with the genetically determined features remains unclear. More studies are needed to establish thresholds and susceptibility genes according to the characteristics of each population.
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Affiliation(s)
- Raouia Fakhfakh
- Autoimmunity, Cancer and immunogenetics research laboratory, University hospital Habib Bourguiba of Sfax, Sfax, Tunisia
| | - Sawsan Feki
- Autoimmunity, Cancer and immunogenetics research laboratory, University hospital Habib Bourguiba of Sfax, Sfax, Tunisia
| | - Aida Elleuch
- Biochemistry Department, Habib Bourguiba University Hospital, Sfax, Tunisia
| | - Manel Neifar
- Biochemistry Department, Habib Bourguiba University Hospital, Sfax, Tunisia
| | - Sameh Marzouk
- Internal Medicine Department, HediChaker University Hospital, Sfax, Tunisia
| | - Nesrine Elloumi
- Autoimmunity, Cancer and immunogenetics research laboratory, University hospital Habib Bourguiba of Sfax, Sfax, Tunisia
| | - Hend Hachicha
- Autoimmunity, Cancer and immunogenetics research laboratory, University hospital Habib Bourguiba of Sfax, Sfax, Tunisia
| | - Olfa Abida
- Autoimmunity, Cancer and immunogenetics research laboratory, University hospital Habib Bourguiba of Sfax, Sfax, Tunisia
| | - Zouhir Bahloul
- Internal Medicine Department, HediChaker University Hospital, Sfax, Tunisia
| | - Fatma Ayadi
- Biochemistry Department, Habib Bourguiba University Hospital, Sfax, Tunisia
| | - Hatem Masmoudi
- Autoimmunity, Cancer and immunogenetics research laboratory, University hospital Habib Bourguiba of Sfax, Sfax, Tunisia
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6
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Nerviani A, Mauro D, Gilio M, Grembiale RD, Lewis MJ. To Supplement or not to Supplement? The Rationale of Vitamin D Supplementation in Systemic Lupus Erythematosus. Open Rheumatol J 2018. [DOI: 10.2174/1874312901812010226] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
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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7
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Marinho A, Taveira M, Vasconcelos C. Topics on vitamin D in systemic lupus erythematosus: analysis of evidence and critical literature review. Immunol Res 2018; 65:495-511. [PMID: 28229285 DOI: 10.1007/s12026-017-8903-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Systemic lupus erythematosus (SLE) is a systemic autoimmune disease with multiorgan inflammation, linked to the loss of immune tolerance to self-antigens and the production of a diversity of autoantibodies. The phenotype and progression of SLE have been linked to a combination of environmental, genetic, and hormonal factors. One such environmental factor is vitamin D, a vital hormone with well-established effects on mineral metabolism, skeletal health, and effects on cardiovascular system. The purpose of this article is to make the analysis of evidence and literature review of the pleomorphic effects of Vitamin D in SLE. The article is structured in topics of interest based in the authors' opinion and summarizes the evidence of studies and trials of vitamin D in SLE.
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Affiliation(s)
- António Marinho
- UMIB, Instituto de Ciências Biomédicas de Abel Salazar (ICBAS), U.Porto, 4099-001, Porto, Portugal. .,Unidade Imunologia Clínica, Centro Hospitalar do Porto, Hospital Santo António, Porto, Portugal.
| | - Mariana Taveira
- Serviço de Medicina Interna, ULS Matosinhos, Matosinhos, Portugal
| | - Carlos Vasconcelos
- UMIB, Instituto de Ciências Biomédicas de Abel Salazar (ICBAS), U.Porto, 4099-001, Porto, Portugal.,Unidade Imunologia Clínica, Centro Hospitalar do Porto, Hospital Santo António, Porto, Portugal
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8
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Vitamin D and systemic lupus erythematosus - The hype and the hope. Autoimmun Rev 2017; 17:19-23. [PMID: 29108830 DOI: 10.1016/j.autrev.2017.11.004] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2017] [Accepted: 09/07/2017] [Indexed: 02/07/2023]
Abstract
Over the past 20years, much has been written about the potential role of vitamin D in on adverse health outcomes. In recent years, evidence has accumulated regarding the effect of vitamin D on the immune system, and its different cells. Some studies have noted lower vitamin D concentrations in patients with SLE. These epidemiological data still not answer the question: is vitamin D deficiency the cause or the effect? To answer this, we will discuss the association between vitamin D deficiency and SLE and review the evidence from interventional studies.
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9
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Carter EE, Barr SG, Clarke AE. The global burden of SLE: prevalence, health disparities and socioeconomic impact. Nat Rev Rheumatol 2016; 12:605-20. [PMID: 27558659 DOI: 10.1038/nrrheum.2016.137] [Citation(s) in RCA: 262] [Impact Index Per Article: 32.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Systemic lupus erythematosus (SLE) is a multisystem autoimmune disease that can potentially lead to serious organ complications and even death. Its global burden - in terms of incidence and prevalence, differential impact on populations, economic costs and capacity to compromise health-related quality of life - remains incompletely understood. The reported worldwide incidence and prevalence of SLE vary considerably; this variation is probably attributable to a variety of factors, including ethnic and geographic differences in the populations being studied, the definition of SLE applied, and the methods of case identification. Despite the heterogeneous nature of the disease, distinct patterns of disease presentation, severity and course can often be related to differences in ethnicity, income level, education, health insurance status, level of social support and medication compliance, as well as environmental and occupational factors. Given the potential for the disease to cause such severe and widespread organ damage, not only are the attendant direct costs high, but these costs are sometimes exceeded by indirect costs owing to loss of economic productivity. As an intangible cost, patients with SLE are, not surprisingly, likely to endure considerably reduced health-related quality of life.
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Affiliation(s)
- Erin E Carter
- University of Calgary, Richmond Road Diagnostic and Treatment Centre, 1820 Richmond Road S.W., Calgary, Alberta T2T 5C7, Canada
| | - Susan G Barr
- University of Calgary, Richmond Road Diagnostic and Treatment Centre, 1820 Richmond Road S.W., Calgary, Alberta T2T 5C7, Canada
| | - Ann E Clarke
- University of Calgary, Health Research Innovation Centre, 3280 Hospital Drive N.W., Calgary, Alberta T2N 4N1, Canada
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10
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Titmarsh HF, Cartwright JA, Kilpatrick S, Gaylor D, Milne EM, Berry JL, Bommer NX, Gunn-Moore D, Reed N, Handel I, Mellanby RJ. Relationship between vitamin D status and leukocytes in hospitalised cats. J Feline Med Surg 2016; 19:364-369. [DOI: 10.1177/1098612x15625454] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Objectives Vitamin D deficiency, as assessed by serum 25-hydroxyvitamin D (25[OH]D) concentrations, has been linked to markers of systemic inflammation in human and canine medicine. However, the relationship between vitamin D status and inflammation has not been previously investigated in cats. The aim of this study was to examine the relationship between serum 25(OH)D concentrations and leukocyte counts in hospitalised sick cats. Methods Serum 25(OH)D concentrations and haematology profiles were measured in 170 consecutive hospitalised sick cats. A binary logistical regression model examined the relationship between serum 25(OH)D concentration, age, sex, breed and neutrophil, monocyte, eosinophil and lymphocyte counts. Results Cats with neutrophilia had lower serum 25(OH)D concentrations than cats with neutrophil concentrations below the upper limit of the reference interval (RI). There were no differences in serum 25(OH)D concentrations in cats with monocyte, lymphocyte or eosinophil counts above their respective RI compared with cats with counts below the upper limit of the RI. Conclusions and relevance Hospitalised cats with a neutrophil count above the RI had lower vitamin D status. There is a need to establish whether lower vitamin D status is a cause or consequence of increased neutrophil counts.
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Affiliation(s)
- Helen F Titmarsh
- Royal (Dick) School of Veterinary Studies and The Roslin Institute, The University of Edinburgh, Roslin, UK
| | - Jennifer A Cartwright
- Royal (Dick) School of Veterinary Studies and The Roslin Institute, The University of Edinburgh, Roslin, UK
| | - Scott Kilpatrick
- Royal (Dick) School of Veterinary Studies and The Roslin Institute, The University of Edinburgh, Roslin, UK
| | - Donna Gaylor
- Royal (Dick) School of Veterinary Studies and The Roslin Institute, The University of Edinburgh, Roslin, UK
| | - Elspeth M Milne
- Royal (Dick) School of Veterinary Studies and The Roslin Institute, The University of Edinburgh, Roslin, UK
| | - Jacqueline L Berry
- Specialist Assay Laboratory (Vitamin D), Clinical Biochemistry, Manchester Royal Infirmary, Manchester, UK
| | - Nicholas X Bommer
- Royal (Dick) School of Veterinary Studies and The Roslin Institute, The University of Edinburgh, Roslin, UK
| | - Danièlle Gunn-Moore
- Royal (Dick) School of Veterinary Studies and The Roslin Institute, The University of Edinburgh, Roslin, UK
| | - Nicola Reed
- Royal (Dick) School of Veterinary Studies and The Roslin Institute, The University of Edinburgh, Roslin, UK
- Current address: Wear Referrals, Stockton-on-Tees, UK
| | - Ian Handel
- Royal (Dick) School of Veterinary Studies and The Roslin Institute, The University of Edinburgh, Roslin, UK
| | - Richard J Mellanby
- Royal (Dick) School of Veterinary Studies and The Roslin Institute, The University of Edinburgh, Roslin, UK
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11
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Young KA, Munroe ME, Guthridge JM, Kamen DL, Niewold TB, Gilkeson GS, Weisman MH, Ishimori ML, Kelly J, Gaffney PM, Sivils KH, Lu R, Wallace DJ, Karp DR, Harley JB, James JA, Norris JM. Combined role of vitamin D status and CYP24A1 in the transition to systemic lupus erythematosus. Ann Rheum Dis 2016; 76:153-158. [PMID: 27283331 DOI: 10.1136/annrheumdis-2016-209157] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2016] [Revised: 05/06/2016] [Accepted: 05/14/2016] [Indexed: 12/26/2022]
Abstract
OBJECTIVE We examined whether measures of vitamin D were associated with transitioning to systemic lupus erythematosus (SLE) in individuals at risk for SLE. METHODS 436 individuals who reported having a relative with SLE but who did not have SLE themselves were evaluated at baseline and again an average of 6.3 (±3.9) years later. Fifty-six individuals transitioned to SLE (≥4 cumulative American College of Rheumatology criteria). 25-Hydroxyvitamin D (25[OH]D) levels were measured by ELISA. Six single-nucleotide polymorphisms in four vitamin D genes were genotyped. Generalised estimating equations, adjusting for correlation within families, were used to test associations between the vitamin D variables and the outcome of transitioning to SLE. RESULTS Mean baseline 25[OH]D levels (p=0.42) and vitamin D supplementation (p=0.65) were not different between those who did and did not transition to SLE. Vitamin D deficiency (25[OH]D <20 ng/mL) was greater in those who transitioned compared with those who did not transition to SLE (46% vs 33%, p=0.05). The association between 25[OH]D and SLE was modified by CYP24A1 rs4809959, where for each additional minor allele increased 25[OH]D was associated with decreased SLE risk: zero minor alleles (adjusted OR: 1.03, CI 0.98 to 1.09), one minor allele (adjusted OR: 1.01, CI 0.97 to 1.05) and two minor alleles (adjusted OR: 0.91, CI 0.84 to 0.98). Similarly, vitamin D deficiency significantly increased the risk of transitioning to SLE in those with two minor alleles at rs4809959 (adjusted OR: 4.90, CI 1.33 to 18.04). CONCLUSIONS Vitamin D status and CYP24A1 may have a combined role in the transition to SLE in individuals at increased genetic risk for SLE.
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Affiliation(s)
| | - Melissa E Munroe
- Oklahoma Medical Research Foundation, Oklahoma City, Oklahoma, USA
| | - Joel M Guthridge
- Oklahoma Medical Research Foundation, Oklahoma City, Oklahoma, USA
| | - Diane L Kamen
- Medical University of South Carolina, Charleston, South Carolina, USA
| | | | - Gary S Gilkeson
- Medical University of South Carolina, Charleston, South Carolina, USA
| | | | | | - Jennifer Kelly
- Oklahoma Medical Research Foundation, Oklahoma City, Oklahoma, USA
| | | | - Kathy H Sivils
- Oklahoma Medical Research Foundation, Oklahoma City, Oklahoma, USA
| | - Rufei Lu
- Oklahoma Medical Research Foundation, Oklahoma City, Oklahoma, USA.,Oklahoma University Health Sciences Center, Oklahoma City, Oklahoma, USA
| | | | - David R Karp
- University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - John B Harley
- Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.,US Department of Veterans Affairs Medical Center, Cincinnati, Ohio, USA
| | - Judith A James
- Oklahoma Medical Research Foundation, Oklahoma City, Oklahoma, USA.,Oklahoma University Health Sciences Center, Oklahoma City, Oklahoma, USA
| | - Jill M Norris
- Colorado School of Public Health, Aurora, Colorado, USA
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12
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Azrielant S, Shoenfeld Y. Eppur Si Muove: vitamin D is essential in preventing and modulating SLE. Lupus 2016; 25:563-572. [DOI: 10.1177/0961203316629001] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/30/2023]
Abstract
Systemic lupus erythematosus (abbreviated SLE or lupus) is a systemic autoimmune disease, with genetic, immunologic, hormonal, and environmental factors. 1 One of the environmental factors that has been studied over the years is vitamin D, which is created in the human body in response to exposure to sunlight and ultraviolet (UV) radiation. This review aims at examining findings from recent years, specifically 2013–2014, regarding the relationship between vitamin D deficiency and SLE flares, severity, and clinical manifestation, as well as to examine the treatment options derived from this relationship.
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Affiliation(s)
- S Azrielant
- The Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel-Hashomer, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Y Shoenfeld
- The Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel-Hashomer, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
- Incumbent of the Laura Schwarz-Kip Chair for Research of Autoimmune Diseases, Tel-Aviv University, Israel
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