Restoration of regulatory and effector T cell balance and B cell homeostasis in systemic lupus erythematosus patients through vitamin D supplementation

Arthritis Research & Therapy, 10/18/2012

Recent studies have shown the multifaceted immunomodulatory effects of vitamin D, notably the expansion of Tregs and the decrease of Th1 and Th17 cells. A significant correlation between higher disease activity and lower serum 25–hydroxyvitamin D levels [25(OH)D] was also shown. This preliminary study suggests the beneficial role of vitamin D in SLE patients and needs to be confirmed in randomized controlled trials.

Methods

  • In this prospective study, the authors evaluated the safety and the immunological effects of vitamin D supplementation (100 000 IU of cholecalciferol per week for 4 weeks, followed by 100 000 IU of cholecalciferol per month for 6 months.) in 20 SLE patients with hypovitaminosis D.

Results

  • Serum 25(OH)D levels dramatically increased under vitamin D supplementation from 18.7+/-6.7 at day 0 to 51.4+/-14.1 (p<0.001) at 2 months and 41.5+/-10.1 ng/mL (p<0.001) at 6 months.
  • Vitamin D was well tolerated and induced a preferential increase of naive CD4+ T cells, an increase of regulatory T cells and a decrease of effector Th1 and Th17 cells.
  • Vitamin D also induced a decrease of memory B cells and anti-DNA antibodies.
  • No modification of the prednisone dosage or initiation of new immunosuppressant agents was needed in all patients.
  • The authors did not observe SLE flare during the 6 months follow-up period.

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