Skip to main content
Top
Published in: Journal of Endocrinological Investigation 6/2015

01-06-2015 | Original Article

Vitamin D and autoimmunity: what happens in autoimmune polyendocrine syndromes?

Authors: G. Bellastella, M. I. Maiorino, M. Petrizzo, A. De Bellis, A. Capuano, K. Esposito, D. Giugliano

Published in: Journal of Endocrinological Investigation | Issue 6/2015

Login to get access

Abstract

Purpose

To evaluate the Vitamin D status of patients with a single autoimmune disease and of patients with several autoimmune diseases.

Methods

We enrolled 35 patients with isolated type 1 diabetes mellitus (T1DM), 60 with autoimmune polyendocrine syndromes (APS) including T1DM and 72 control subjects. Among patients with APS, 10 were classified as type 2 (Addison’s disease + T1DM), whereas the other 50 as type 3 (autoimmune thyroid disease + T1DM + other autoimmune diseases). Vitamin D (25-OHD) levels were assessed by a chemiluminescent immunoassay in all patients and controls on samples drawn in the morning of the same months.

Results

Both groups of APS and T1DM patients showed 25-OHD levels significantly lower than healthy controls (p < 0.001 for both vs controls), without any significant difference between the two groups (p = 0.80). The highest prevalence of vitamin D deficiency (values <20 ng/ml) was observed in APS type 3 subgroup (8 out of 50 patients, 16 %).

Conclusions

Patients with APS present reduced vitamin D circulating levels, but the vitamin D status is not different between patients with single or multiple autoimmune diseases. The kind of autoimmune disease, rather than the association of several autoimmune diseases, may influence negatively the levels of vitamin D. Further prospective studies are needed to clarify if impaired vitamin D level is a causal factor in the pathogenesis of autoimmune diseases or a consequence of them.
Literature
1.
go back to reference Yang CY, Leung PS, Adamopoulos IE, Gershwin ME (2013) The implication of vitamin D and autoimmunity: a comprehensive review. Clin Rev Allerg Immunol 45:217–226CrossRef Yang CY, Leung PS, Adamopoulos IE, Gershwin ME (2013) The implication of vitamin D and autoimmunity: a comprehensive review. Clin Rev Allerg Immunol 45:217–226CrossRef
2.
go back to reference Pludowski P, Holick MF, Pilz S et al (2013) Vitamin D effects on musculoskeletal health, immunity, autoimmunity, cardiovascular disease, cancer, fertility, pregnancy, dementia and mortality––a review of recent evidence. Autoimmun Rev 12:976–989CrossRefPubMed Pludowski P, Holick MF, Pilz S et al (2013) Vitamin D effects on musculoskeletal health, immunity, autoimmunity, cardiovascular disease, cancer, fertility, pregnancy, dementia and mortality––a review of recent evidence. Autoimmun Rev 12:976–989CrossRefPubMed
4.
go back to reference Uitterlinden AG, Fang Y, Van Meurs JB, Pols HA, Van Leeuwen JP (2004) Genetics and biology of vitamin D receptor polymorphism. Gene 338:143–156CrossRefPubMed Uitterlinden AG, Fang Y, Van Meurs JB, Pols HA, Van Leeuwen JP (2004) Genetics and biology of vitamin D receptor polymorphism. Gene 338:143–156CrossRefPubMed
5.
go back to reference Bhalla AK, Amento EP, Clemens TL, Holick MF, Krane SM (1983) Specific high-affinity receptors for 1,25-dihydroxyvitamin D3 in human peripheral blood mononuclear cells: presence in monocytes and induction in T lymphocytes following activation. J Clin Endocrinol Metab 57:1308–1310CrossRefPubMed Bhalla AK, Amento EP, Clemens TL, Holick MF, Krane SM (1983) Specific high-affinity receptors for 1,25-dihydroxyvitamin D3 in human peripheral blood mononuclear cells: presence in monocytes and induction in T lymphocytes following activation. J Clin Endocrinol Metab 57:1308–1310CrossRefPubMed
6.
go back to reference Provvedini DM, Tsoukas CD, Detos LJ, Manolagas SC (1983) 1,25-dihydroxyvitamin D3 receptors in human leukocytes. Science 221:1181–1183CrossRefPubMed Provvedini DM, Tsoukas CD, Detos LJ, Manolagas SC (1983) 1,25-dihydroxyvitamin D3 receptors in human leukocytes. Science 221:1181–1183CrossRefPubMed
7.
go back to reference Veldman CM, Cantorna MT, De Luca HF (2000) Expression of 1,25 dihydroxyvitamin D (3) receptor in the immune system. Arch Biochem Biophys 374:334–338CrossRefPubMed Veldman CM, Cantorna MT, De Luca HF (2000) Expression of 1,25 dihydroxyvitamin D (3) receptor in the immune system. Arch Biochem Biophys 374:334–338CrossRefPubMed
8.
go back to reference De Luca HF, Cantorna MT (2001) Vitamin D: its role and uses in immunology. FASEB J 15:2579–2585CrossRef De Luca HF, Cantorna MT (2001) Vitamin D: its role and uses in immunology. FASEB J 15:2579–2585CrossRef
9.
go back to reference Daniel C, Sartory NA, Zahn N, Radeke HH, Stein JM (2008) Immune modulatory treatment of trinitrobenzene sulfonic acid colitis with calcitriol is associated with a change of a T helper (Th) 1/Th17 to a Th2 and regulatory T cell profile. J Pharmacol Exp Ther 324:23–33CrossRefPubMed Daniel C, Sartory NA, Zahn N, Radeke HH, Stein JM (2008) Immune modulatory treatment of trinitrobenzene sulfonic acid colitis with calcitriol is associated with a change of a T helper (Th) 1/Th17 to a Th2 and regulatory T cell profile. J Pharmacol Exp Ther 324:23–33CrossRefPubMed
10.
go back to reference Saggese G, Federico G, Balestri M, Toniolo A (1989) Calcitriol inhibits the PHA-induced production of IL-2 and IFN-gamma and the proliferation of human peripheral blood leukocytes while enhancing the surface expression of HLA class II molecules. J Endocrinol Invest 12:329–335CrossRefPubMed Saggese G, Federico G, Balestri M, Toniolo A (1989) Calcitriol inhibits the PHA-induced production of IL-2 and IFN-gamma and the proliferation of human peripheral blood leukocytes while enhancing the surface expression of HLA class II molecules. J Endocrinol Invest 12:329–335CrossRefPubMed
11.
go back to reference Wu S, Cantorna MT (2008) The vitamin D receptor is required for iNKT cell development. Proc Nat Acad Sci USA 105:5207–5212CrossRef Wu S, Cantorna MT (2008) The vitamin D receptor is required for iNKT cell development. Proc Nat Acad Sci USA 105:5207–5212CrossRef
12.
go back to reference Tamer G, Arik S, Tamer I, Coksert D (2011) Relative vitamin D insufficiency in Hashimoto’s thyroiditis. Thyroid 21:891–896CrossRefPubMed Tamer G, Arik S, Tamer I, Coksert D (2011) Relative vitamin D insufficiency in Hashimoto’s thyroiditis. Thyroid 21:891–896CrossRefPubMed
13.
go back to reference Camurdan OM, Doger E, Bideci A, Celik N, Cinaz P (2012) Vitamin D status in children with Hashimoto thyroiditis. J Pediatr Endocrinol Metab 25:467–470CrossRefPubMed Camurdan OM, Doger E, Bideci A, Celik N, Cinaz P (2012) Vitamin D status in children with Hashimoto thyroiditis. J Pediatr Endocrinol Metab 25:467–470CrossRefPubMed
14.
go back to reference Ramos Lopez E, Zwermann O, Segni M et al (2004) A promoter polymorphism of the CYP 27B1 gene is associated with Addison’s disease, Hashimoto’s thyroiditis, Graves’ disease and type 1 diabetes mellitus in Germans. Eur J Endocrinol 151:193–197CrossRef Ramos Lopez E, Zwermann O, Segni M et al (2004) A promoter polymorphism of the CYP 27B1 gene is associated with Addison’s disease, Hashimoto’s thyroiditis, Graves’ disease and type 1 diabetes mellitus in Germans. Eur J Endocrinol 151:193–197CrossRef
15.
go back to reference Bozkurt NC, Karbek B, Ucan B et al (2013) The association between severity of vitamin D deficiency and Hashimoto’s thyroiditis. Endocr Pract 19:479–484CrossRefPubMed Bozkurt NC, Karbek B, Ucan B et al (2013) The association between severity of vitamin D deficiency and Hashimoto’s thyroiditis. Endocr Pract 19:479–484CrossRefPubMed
16.
go back to reference Ramogopalan SV, Goldacre R, Disanto G, Giovannoni G, Goldacre MJ (2013) Hospital admission for vitamin D related conditions and subsequent immune-mediated disease: record-linkage study. BMC Med 11:171CrossRef Ramogopalan SV, Goldacre R, Disanto G, Giovannoni G, Goldacre MJ (2013) Hospital admission for vitamin D related conditions and subsequent immune-mediated disease: record-linkage study. BMC Med 11:171CrossRef
17.
go back to reference Balla B, Tobiás B, Kósa JP et al (2014) Vitamin D-neutralizing CYP24A1 expression, oncogenic mutation states and histological findings of human papillary thyroid cancer. J Endocrinol Invest. doi:10.1007/s40618-014-0165-7 PubMed Balla B, Tobiás B, Kósa JP et al (2014) Vitamin D-neutralizing CYP24A1 expression, oncogenic mutation states and histological findings of human papillary thyroid cancer. J Endocrinol Invest. doi:10.​1007/​s40618-014-0165-7 PubMed
18.
go back to reference Feng M, Li H, Chen SF, Li WF, Zhang FB (2013) Polymorphisms in the vitamin D receptor gene and risk of autoimmune thyroid diseases: a meta-analysis. Endocrine 43:318–326CrossRefPubMed Feng M, Li H, Chen SF, Li WF, Zhang FB (2013) Polymorphisms in the vitamin D receptor gene and risk of autoimmune thyroid diseases: a meta-analysis. Endocrine 43:318–326CrossRefPubMed
19.
go back to reference Kebapcilar AG, Kulaksizoglu M, Kebapcilar L et al (2013) Is there a link between premature ovarian failure and serum concentrations of vitamin D, zinc, and copper? Menopause 20:94–99CrossRefPubMed Kebapcilar AG, Kulaksizoglu M, Kebapcilar L et al (2013) Is there a link between premature ovarian failure and serum concentrations of vitamin D, zinc, and copper? Menopause 20:94–99CrossRefPubMed
21.
go back to reference Orgaz-Molina J, Buendia-Eisman A, Arrabal-Polo MA, Ruiz JC, Arias-Santiago S (2012) Deficiency of serum concentration of 25-hydroxyvitamin D in psoriatic patients. J Am Acad Dermatol 67:931–938CrossRefPubMed Orgaz-Molina J, Buendia-Eisman A, Arrabal-Polo MA, Ruiz JC, Arias-Santiago S (2012) Deficiency of serum concentration of 25-hydroxyvitamin D in psoriatic patients. J Am Acad Dermatol 67:931–938CrossRefPubMed
22.
go back to reference Neufeld M, Blizzard RM (1980) Polyglandular autoimmune diseases. In: Pinchera A, Doniach D, Fenzi GF, Baschieri L (eds) Symposium on autoimmune aspects of endocrine disorders. Academic, New York, pp 357–365 Neufeld M, Blizzard RM (1980) Polyglandular autoimmune diseases. In: Pinchera A, Doniach D, Fenzi GF, Baschieri L (eds) Symposium on autoimmune aspects of endocrine disorders. Academic, New York, pp 357–365
23.
go back to reference Betterle C, Dal Pra C, Mantero F, Zanchetta R (2002) Autoimmune adrenal insufficiency and autoimmune polyendocrine syndromes: autoantibodies, autoantigens, and their applicability in diagnosis and disease prediction. Endocr Rev 23:327–364CrossRefPubMed Betterle C, Dal Pra C, Mantero F, Zanchetta R (2002) Autoimmune adrenal insufficiency and autoimmune polyendocrine syndromes: autoantibodies, autoantigens, and their applicability in diagnosis and disease prediction. Endocr Rev 23:327–364CrossRefPubMed
24.
go back to reference De Bellis A, Pane E, Bellastella G et al (2011) Detection of antipituitary and antihypothalamus antibodies to investigate the role of pituitary or hypothalamic autoimmunity in patients with selective idiopathic hypopituitarism. Clin Endocrinol 75:361–366CrossRef De Bellis A, Pane E, Bellastella G et al (2011) Detection of antipituitary and antihypothalamus antibodies to investigate the role of pituitary or hypothalamic autoimmunity in patients with selective idiopathic hypopituitarism. Clin Endocrinol 75:361–366CrossRef
25.
go back to reference Holick MF, Binkley NC, Bischoff-Ferrari HA et al (2011) An Endocrine Society clinical practice guideline. Evaluation, treatment and prevention of vitamin D deficiency. J Clin Endocrinol Metab 96:1911–1930CrossRefPubMed Holick MF, Binkley NC, Bischoff-Ferrari HA et al (2011) An Endocrine Society clinical practice guideline. Evaluation, treatment and prevention of vitamin D deficiency. J Clin Endocrinol Metab 96:1911–1930CrossRefPubMed
26.
go back to reference Rosen CJ, Abrams SA, Aloia JF et al (2012) IOM committee members respond to Endocrine Society vitamin D guideline. J Clin Endocrinol Metab 97:1146–1152CrossRefPubMed Rosen CJ, Abrams SA, Aloia JF et al (2012) IOM committee members respond to Endocrine Society vitamin D guideline. J Clin Endocrinol Metab 97:1146–1152CrossRefPubMed
27.
go back to reference Buschur E, Sarma AV, Pietropaolo M et al (2014) Self-reported autoimmune disease by sex in the Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications (DCCT/EDIC) study. Diabetes Care 37:e28–e29CrossRefPubMedCentralPubMed Buschur E, Sarma AV, Pietropaolo M et al (2014) Self-reported autoimmune disease by sex in the Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications (DCCT/EDIC) study. Diabetes Care 37:e28–e29CrossRefPubMedCentralPubMed
Metadata
Title
Vitamin D and autoimmunity: what happens in autoimmune polyendocrine syndromes?
Authors
G. Bellastella
M. I. Maiorino
M. Petrizzo
A. De Bellis
A. Capuano
K. Esposito
D. Giugliano
Publication date
01-06-2015
Publisher
Springer International Publishing
Published in
Journal of Endocrinological Investigation / Issue 6/2015
Electronic ISSN: 1720-8386
DOI
https://doi.org/10.1007/s40618-014-0233-z

Other articles of this Issue 6/2015

Journal of Endocrinological Investigation 6/2015 Go to the issue
Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.