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Review
. 2020 Sep;177(18):4113-4133.
doi: 10.1111/bph.15201. Epub 2020 Aug 5.

Immunoregulatory effects and therapeutic potential of vitamin D in multiple sclerosis

Wei Zhen Yeh  1   2 , Melissa Gresle  1   2 , Vilija Jokubaitis  1   2 , Jim Stankovich  1 , Anneke van der Walt  1   2 , Helmut Butzkueven  1   2
Affiliations
Review

Immunoregulatory effects and therapeutic potential of vitamin D in multiple sclerosis

Wei Zhen Yeh et al. Br J Pharmacol. 2020 Sep.

Abstract

Initially recognised as an important factor for bone health, vitamin D is now known to have a range of effects on the immune system. Vitamin D deficiency is associated with an increased risk of multiple sclerosis (MS), a chronic immune-mediated demyelinating disease of the CNS. In this review, we explore the links between vitamin D deficiency, MS risk, and disease activity. We also discuss the known immune effects of vitamin D supplementation and the relevance of these observations to the immunopathology of MS. Finally, we review the existing evidence for vitamin D supplementation as an MS therapy, highlighting several recent clinical studies and trials.

Keywords: cholecalciferol; genetic; immune; multiple sclerosis; supplementation; therapeutic; transcriptome; treatment; vitamin D.

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Conflict of interest statement

Monash University receives compensation for H.B.'s consulting activities including Steering Committees, Presentations, and Advisory Boards from Merck, Roche, Biogen, and Novartis. H.B. receives funding for steering committee activities from IQVIA and Oxford PharmaGenesis and grant support from MS Research Australia and the NHMRC (Australia).

Figures

FIGURE 1
FIGURE 1
Structural formulae of vitamin D2 (ergocalciferol) (a) and vitamin D3 (cholecalciferol) (b), respectively (Wishart et al., 2018)
FIGURE 2
FIGURE 2
Metabolism and mechanism of action of vitamin D. Vitamin D is either synthesised in the skin during UVB exposure or obtained through intake from supplementation or dietary sources. Vitamin D is then metabolised first to 25(OH)D by the liver and then to 1,25(OH)2D, which is its active form, by the kidney. The kidney can also metabolise 1,25(OH)2D to the inactive calcitroic acid by the action of CYP24A1. Many target cells have the metabolic enzymes required to convert vitamin D to its active form. In the target cell, 1,25(OH)2D binds to vitamin D receptor (VDR) and retinoid X receptor (RXR). This complex then binds to the genome at vitamin D response elements to modulate gene expression
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References

    1. Achiron, A. , Givon, U. , Magalashvili, D. , Dolev, M. , Liraz Zaltzman, S. , Kalron, A. , … Barak, Y. (2015). Effect of Alfacalcidol on multiple sclerosis‐related fatigue: A randomized, double‐blind placebo‐controlled study. Multiple Sclerosis Journal, 21, 767–775. 10.1177/1352458514554053 - DOI - PubMed
    1. Åivo, J. , Hänninen, A. , Ilonen, J. , & Soilu‐Hänninen, M. (2015). Vitamin D3 administration to MS patients leads to increased serum levels of latency activated peptide (LAP) of TGF‐beta. Journal of Neuroimmunology, 280, 12–15. 10.1016/j.jneuroim.2015.01.005 - DOI - PubMed
    1. Alexander, S. P. H. , Cidlowski, J. A. , Kelly, E. , Mathie, A. , Peters, J. A. , Veale, E. L. , … CGTP Collaborators . (2019). The Concise Guide to PHARMACOLOGY 2019/20: Nuclear hormone receptors. British Journal of Pharmacology, 176, S229–S246. 10.1111/bph.14750 - DOI - PMC - PubMed
    1. Alexander, S. P. H. , Fabbro, D. , Kelly, E. , Mathie, A. , Peters, J. A. , Veale, E. L. , … CGTP Collaborators . (2019a). The Concise Guide to PHARMACOLOGY 2019/20: Catalytic receptors. British Journal of Pharmacology, 176, S247–S296. 10.1111/bph.14751 - DOI - PMC - PubMed
    1. Alexander, S. P. H. , Fabbro, D. , Kelly, E. , Mathie, A. , Peters, J. A. , Veale, E. L. , … CGTP Collaborators . (2019b). The Concise Guide to PHARMACOLOGY 2019/20: Enzymes. British Journal of Pharmacology, 176, S297–S396. 10.1111/bph.14752 - DOI - PMC - PubMed

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