(30-01-15) Vitamin D metabolites as clinical markers in autoimmune and chronic disease

Greg P. Blaney MD,a Paul J. Albert,b and Amy D. Proal c
a Stillpoint Centre
b Weill Cornell Medical College
c Georgetown University

Recent research has implicated vitamin D deficiency (serum levels of 25-hydroxyvitamin D
<50nmol/L) with a number of chronic conditions including autoimmune conditions such
as multiple sclerosis, lupus, psoriasis and chronic conditions such as osteoporosis,
osteoarthritis, metabolic syndrome, fibromyalgia and chronic fatigue syndrome. It has
been assumed that low levels of 25-hydroxyvitamin D (25-D) accurately indicate vitamin D
storage and vitamin D receptor (VDR) mediated control of calcium metabolism and innate
immunity. To evaluate this assumption, 25-D and 1,25-dihydroxyvitamin D3 (1,25-D) levels
were measured in 100 Canadian patients with these conditions. Additionally, other
inflammatory markers (CK, CRP) were measured. Results showed a strong positive
association between these autoimmune conditions and levels of 1,25-D >110 pmol/L.
However, there was little association with vitamin D deficiency or the other inflammatory
markers, meaning the results challenge the assumption that serum levels of 25-D are a
sensitive measure of the autoimmune disease state. Rather, these findings support the use
of 1,25-D as a clinical marker in autoimmune conditions. High levels of 1,25-D may result
when dysregulation of the VDR by bacterial ligands prevents the receptor from expressing
enzymes necessary to keep 1,25-D in a normal range.


Key words: autoimmune disease, 1,25-dihydroxyvitamin D3, 25-hydroxyvitamin D, Creactive
protein, creatinine kinase

Source:
This is a preprint of an article published in Annals of the New York Academy of Sciences (PMID: 19758177)
(c) Copyright, 2009, New York Academy of Sciences

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