Reviews in Endocrine and Metabolic Disorders

, Volume 18, Issue 3, pp 335–346 | Cite as

Does vitamin D play a role in autoimmune endocrine disorders? A proof of concept

  • Barbara AltieriEmail author
  • Giovanna Muscogiuri
  • Luigi Barrea
  • Chantal Mathieu
  • Carla V. Vallone
  • Luca Mascitelli
  • Giorgia Bizzaro
  • Vincenzo M. Altieri
  • Giacomo Tirabassi
  • Giancarlo Balercia
  • Silvia Savastano
  • Nicola Bizzaro
  • Cristina L. Ronchi
  • Annamaria Colao
  • Alfredo Pontecorvi
  • Silvia Della Casa


In the last few years, more attention has been given to the “non-calcemic” effect of vitamin D. Several observational studies and meta-analyses demonstrated an association between circulating levels of vitamin D and outcome of many common diseases, including endocrine diseases, chronic diseases, cancer progression, and autoimmune diseases. In particular, cells of the immune system (B cells, T cells, and antigen presenting cells), due to the expression of 1α-hydroxylase (CYP27B1), are able to synthesize the active metabolite of vitamin D, which shows immunomodulatory properties. Moreover, the expression of the vitamin D receptor (VDR) in these cells suggests a local action of vitamin D in the immune response. These findings are supported by the correlation between the polymorphisms of the VDR or the CYP27B1 gene and the pathogenesis of several autoimmune diseases. Currently, the optimal plasma 25-hydroxyvitamin D concentration that is necessary to prevent or treat autoimmune diseases is still under debate. However, experimental studies in humans have suggested beneficial effects of vitamin D supplementation in reducing the severity of disease activity. In this review, we summarize the evidence regarding the role of vitamin D in the pathogenesis of autoimmune endocrine diseases, including type 1 diabetes mellitus, Addison’s disease, Hashimoto’s thyroiditis, Graves’ disease and autoimmune polyendocrine syndromes. Furthermore, we discuss the supplementation with vitamin D to prevent or treat autoimmune diseases.


Vitamin D Autoimmunity Type 1 diabetes mellitus Addison’s disease Hashimoto’s thyroiditis Graves’ disease Autoimmune polyendocrine syndromes Environment Lifestyle 


Authors contribution

B.A. and G.M. designed the study. B.A., G.M., L.B., C.M., C.V.V., L.M. and G.B. participated in the literature search and performed the selection of studies. B.A. wrote the Introduction, Methods and the Conclusion of the review, as well as the paragraphs on Addison’s disease and on vitamin D supplementation. C.V.V. supported B.A. in writing the Introduction and the paragraphs on vitamin D supplementation. G.M., S.S., N.B. and C.L.R. collaborated to the preparation of the manuscript providing relevant suggestions and corrections according to their long-lasting expertise in different research fields. L.B. wrote the paragraph on Grave’s disease and autoimmune polyendocrine syndromes. C.M. wrote the paragraph on diabetes mellitus. L.M. prepared the figure and wrote the paragraph on clinical and basic evidence. G.B. wrote the paragraph on Hashimoto thyroiditis. V.M.A., G.T. and G.B. contributed to the final version of the manuscript. A.C., A.P. and S.D.C. coordinated and supervised the preparation of the manuscript. All the authors reviewed and approved the final version of the manuscript.

Conflict of interest

The authors declare that they have no conflict of interest.


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Copyright information

© Springer Science+Business Media New York 2017

Authors and Affiliations

  • Barbara Altieri
    • 1
    Email author
  • Giovanna Muscogiuri
    • 2
  • Luigi Barrea
    • 2
  • Chantal Mathieu
    • 3
  • Carla V. Vallone
    • 4
  • Luca Mascitelli
    • 5
  • Giorgia Bizzaro
    • 6
  • Vincenzo M. Altieri
    • 7
  • Giacomo Tirabassi
    • 8
  • Giancarlo Balercia
    • 8
  • Silvia Savastano
    • 9
  • Nicola Bizzaro
    • 10
  • Cristina L. Ronchi
    • 11
  • Annamaria Colao
    • 9
  • Alfredo Pontecorvi
    • 1
  • Silvia Della Casa
    • 1
  1. 1.Division of Endocrinology and Metabolic Diseases, Institute of Medical PathologyCatholic University of the Sacred HeartRomeItaly
  2. 2.Ios and Coleman Medicina Futura Medical CenterUniversity Federico IINaplesItaly
  3. 3.Clinical and Experimental EndocrinologyKU LeuvenLeuvenBelgium
  4. 4.Emergency DepartmentFondazione Poliambulanza Istituto OspedalieroBresciaItaly
  5. 5.Comando Brigata Alpina Julia/Multinational Land Force, Medical ServiceUdineItaly
  6. 6.TSEM med Swiss SALuganoSwitzerland
  7. 7.Department of UrologyBolognini HospitalSeriateItaly
  8. 8.Division of Endocrinology, Department of Clinical and Molecular SciencesUmberto I Hospital, Polytechnic University of MarcheAnconaItaly
  9. 9.Department of Clinical Medicine and SurgeryUniversity “Federico II”NaplesItaly
  10. 10.Laboratory of Clinical PathologySan Antonio HospitalTolmezzoItaly
  11. 11.Division of Endocrinology and Diabetes, Department of Internal Medicine IUniversity Hospital of WuerzburgWuerzburgGermany

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