Vitamin D, Autoimmune Disease and Rheumatoid Arthritis

被引:139
|
作者
Harrison, Stephanie R. [1 ,2 ]
Li, Danyang [1 ]
Jeffery, Louisa E. [3 ]
Raza, Karim [2 ,4 ,5 ]
Hewison, Martin [1 ,6 ]
机构
[1] Univ Birmingham, Inst Metab & Syst Res, Birmingham B15 2TT, W Midlands, England
[2] Sandwell & West Birmingham Hosp NHS Trust, Dept Rheumatol, Birmingham B18 7QH, W Midlands, England
[3] Univ Birmingham, Inst Translat Med, Birmingham B15 2TT, W Midlands, England
[4] Univ Birmingham, Inst Inflammat & Ageing, Arthrit Res UK Rheumatoid Arthrit Pathogenesis Ct, Birmingham B15 2TT, W Midlands, England
[5] Univ Birmingham, MRC Arthrit Res UK Ctr Musculoskeletal Ageing Res, Birmingham B15 2TT, W Midlands, England
[6] Birmingham Hlth Partners, Ctr Endocrinol Diabet & Metab, Birmingham B15 2TT, W Midlands, England
基金
英国医学研究理事会; 美国国家卫生研究院;
关键词
Vitamin D; Vitamin D receptor; Autoimmune disease; Rheumatoid arthritis; Inflammation; T cell; BETA-CELL FUNCTION; CD4(+) T-CELLS; SYSTEMIC-LUPUS-ERYTHEMATOSUS; TOLEROGENIC DENDRITIC CELLS; SYNOVIAL-FLUID MACROPHAGES; TYPE-1; DIABETES-MELLITUS; PLACEBO-CONTROLLED TRIAL; D-RECEPTOR; 1,25-DIHYDROXYVITAMIN D-3; MULTIPLE-SCLEROSIS;
D O I
10.1007/s00223-019-00577-2
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Vitamin D has been reported to influence physiological systems that extend far beyond its established functions in calcium and bone homeostasis. Prominent amongst these are the potent immunomodulatory effects of the active form of vitamin D, 1,25-dihydroxyvitamin D3 (1,25-(OH)(2)D3). The nuclear vitamin D receptor (VDR) for 1,25-(OH)(2)D3 is expressed by many cells within the immune system and resulting effects include modulation of T cell phenotype to suppress pro-inflammatory Th1 and Th17 CD4+ T cells and promote tolerogenic regulatory T cells. In addition, antigen-presenting cells have been shown to express the enzyme 1 alpha-hydroxylase that converts precursor 25-hydroxyvitamin D3 (25-OHD3) to 1,25-(OH)(2)D3, so that immune microenvironments are able to both activate and respond to vitamin D. As a consequence of this local, intracrine, system, immune responses may vary according to the availability of 25-OHD3, and vitamin D deficiency has been linked to various autoimmune disorders including rheumatoid arthritis (RA). The aim of this review is to explore the immune activities of vitamin D that impact autoimmune disease, with specific reference to RA. As well as outlining the mechanisms linking vitamin D with autoimmune disease, the review will also describe the different studies that have linked vitamin D status to RA, and the current supplementation studies that have explored the potential benefits of vitamin D for prevention or treatment of RA. The overall aim of the review is to provide a fresh perspective on the potential role of vitamin D in RA pathogenesis and treatment.
引用
收藏
页码:58 / 75
页数:18
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