On August 2, 2011 Oklahoma researchers published an article in the Annals of Rheumatic Diseases, recommending vitamin D repletion for patients with systemic lupus erythematosus (SLE). Several large studies have previously demonstrated that vitamin D insufficiency and vitamin D deficiency are commonly seen in patients with SLE as well as multiple sclerosis and other autoimmune disorders. Vitamin D insufficiency is defined as a 25-OH vitamin D level less than 30 ng/ml, and vitamin D deficiency is defined as a level less than 20 ng/ml. A 2010 study that compared patients with SLE, rheumatoid arthritis (RA), and diabetes conducted by researchers at the Albert Einstein College of Medicine in New York City showed that vitamin D deficiency is most pronounced in patients with type 2 diabetes and highly prevalent in patients with SLE and RA (Broder, Tobin and Putterman).
Increased Autoantibody Production
The Oklahoma team, led by Lauren Ritterhouse, found that in both lupus patients and patient controls, lower levels of vitamin D were associated with higher inflammatory markers. The researchers measured levels of intracellular phospho-ERK1/2, a marker of B cell lymphocyte activation. This activation leads to the production of autoantibodies. As expected, patients with higher levels of this marker had more severe disease courses, and the healthy control subjects with elevated markers tested positive for antinuclear antibodies (ANAs). ANAs are primarily seen in individuals with connective tissue disorders and other autoimmune conditions.
The researchers concluded that vitamin D is an important factor in autoantibody production and SLE pathogenesis. They recommended that vitamin D repletion be considered for patients with SLE. Autoimmune diseases are caused by a combination of genetic and environmental factors. Previous research has indicated that vitamin D deficiency is a modifiable autoimmune disease risk factor.
Vitamin D Deficiency
Vitamin D deficiency is a controversial topic, with vitamin D researchers worldwide linking vitamin D deficiency to a number of autoimmune and non-autoimmune disorders including cardiovascular disease and cancer. On the opposite end of the spectrum, the Institute of Medicine issued a press release in November, 2010 that reported that most individuals in North America had sufficient vitamin D. This report was issued despite several major studies using data from the National Health and Nutrition Examination Survey (NHANES) conducted by the NIH’s Centers for Disease Control and Prevention (CDC) showing widespread vitamin D deficiency.
A study conducted by researchers at the University of Colorado Medical School in Denver, who had previously confirmed a prevalence of vitamin D insufficiency , showed an increased risk of flu and colds in individuals with low levels of 25-OH vitamin D. Working in collaboration with researchers at Boston Children’s Hospital, the Denver researchers concluded that increasing vitamin D levels may be an important way to arm the immune system.
Sources
Anna Broder, Jonathan Tobin and Chaim Putterman, “Disease-specific definitions of vitamin D deficiency need to be established in autoimmune and non-autoimmune chronic diseases: a retrospective comparison of three chronic diseases,” Arthritis Research Therapy, published online Oct 14, 2010, (accessed June 1, 2011)
Lauren Ritterhouse, Sherry Crowe, Timothy Niewold, et al., “Vitamin D deficiency is associated with an increased autoimmune response in healthy individuals and in patients with systemic lupus erythematosus,” Annals of the Rheumatic Diseases, 2011; 70; 1569-1574 doi:10.1136/ard.2010.14849 (accessed Aug 4, 2011)
Report at a Glance, Report Brief, Institute of Medicine of the National Academies, Nov 30, 2010, (accessed July 1, 2011)
Adit Ginde, “Vitamin D Deficiency May Increase Risk of Colds, Flu,” University of Colorado Press Release, Feb 23, 2009 (accessed Aug 2, 2011)
Elaine Moore - I'm a retired medical technologist and medical writer with more than 30 years experience working in hospital laboratories. Currently, I ...
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