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Review
. 2013 Oct;45(2):217-26.
doi: 10.1007/s12016-013-8361-3.

The implication of vitamin D and autoimmunity: a comprehensive review

Chen-Yen Yang  1 , Patrick S C Leung, Iannis E Adamopoulos, M Eric Gershwin
Affiliations
Review

The implication of vitamin D and autoimmunity: a comprehensive review

Chen-Yen Yang et al. Clin Rev Allergy Immunol. 2013 Oct.

Abstract

Historically, vitamin D has been associated with the regulation of bone metabolism. However, increasing evidence demonstrates a strong association between vitamin D signaling and many biological processes that regulate immune responses. The discovery of the vitamin D receptor in multiple immune cell lineages, such as monocytes, dendritic cells, and activated T cells credits vitamin D with a novel role in modulating immunological functions and its subsequent role in the development or prevention of autoimmune diseases. In this review we, discuss five major areas in vitamin D biology of high immunological significance: (1) the metabolism of vitamin D; (2) the significance of vitamin D receptor polymorphisms in autoimmune diseases, such as multiple sclerosis, type 1 diabetes mellitus, and systemic lupus erythematosus; (3) vitamin D receptor transcriptional regulation of immune cell lineages, including Th1, Th17, Th2, regulatory T, and natural killer T cells; (4) the prevalence of vitamin D insufficiency/deficiency in patients with multiple sclerosis, type 1 diabetes mellitus, and systemic lupus erythematosus; and finally, (5) the therapeutic effects of vitamin D supplementation on disease severity and progression.

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Figures

Fig. 1
Fig. 1
The metabolism of vitamin D. 7-Dehydrocholesterol, the derivative of cholesterol in the skin, can be converted to previtamin D3 via UVB irradiation from sunshine, and be thermally isomerized to vitamin D3. Both vitamin D3 spontaneously formed in the skin and absorbed from the digestive tract are further hydroxylated to a major circulating form, 25-OH vitamin D3, in the liver, and finally hydroxylated to a biologically active form, 1,25-(OH)2 vitamin D3, in the kidney
Fig. 2
Fig. 2
The immunomodulatory effects of vitamin D on immune cells. After binding to VDR, the biologically active 1,25-(OH)2 vitamin D3 can induce a conformational change on VDR and increase its affinity to RXR. The VDR-RXR heterodimer becomes a transcriptional factor, interacts with VDREs in the promoter regions of different genes, and ultimately leads to functional changes in multiple immune cell lineages, including Th1, Th17, Th2, Treg, and NKT cells
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