Vitamin D in rheumatoid arthritis-towards clinical application

Nat Rev Rheumatol. 2016 Apr;12(4):201-10. doi: 10.1038/nrrheum.2015.140. Epub 2015 Oct 13.

Abstract

In addition to its well-documented involvement in mineral homeostasis, vitamin D seems to have broad effects on human health that go beyond the skeletal system. Prominent among these so-called nonclassical effects of vitamin D are its immunomodulatory properties. In vitro studies have shown anti-inflammatory effects of 1,25-dihydroxyvitamin D (1,25(OH)2D), the active form of vitamin D. In addition, epidemiological analysis of patients with established inflammatory disease identified associations between vitamin D deficiency (low serum concentrations of inactive 25-hydroxyvitamin D, abbreviated to 25(OH)D) and inflammatory conditions, including rheumatoid arthritis (RA). The association of vitamin D deficiency with RA severity supports the hypothesis of a role for vitamin D in the initiation or progression of the disease, or possibly both. However, whether 25(OH)D status is a cause or consequence of RA is still incompletely understood and requires further analysis in prospective vitamin D supplementation trials. The characterization of factors that promote the transition from preclinical to clinical phases of RA has become a major focus of research, with the aim to facilitate earlier diagnosis and treatment, and improve therapeutic outcomes. In this Review, we aim to describe the current knowledge of vitamin D and the immune system specifically in RA, and discuss the potential benefits that vitamin D might have on slowing RA progression.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Anti-Inflammatory Agents / pharmacology
  • Antigen-Presenting Cells / physiology
  • Arthritis, Rheumatoid / etiology*
  • Arthritis, Rheumatoid / genetics
  • Arthritis, Rheumatoid / metabolism
  • B-Lymphocytes / physiology
  • Cellular Senescence / physiology
  • Disease Progression
  • Fibroblasts / physiology
  • Humans
  • Immune System Diseases / etiology
  • Immunologic Factors / pharmacology*
  • T-Lymphocytes, Helper-Inducer / physiology
  • Vitamin D / metabolism
  • Vitamin D / pharmacology*
  • Vitamin D / physiology
  • Vitamin D Deficiency / complications

Substances

  • Anti-Inflammatory Agents
  • Immunologic Factors
  • Vitamin D