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

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Abstract

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.

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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.

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Authors and Affiliations

  1. Division of Endocrinology and Metabolic Diseases, Institute of Medical Pathology, Catholic University of the Sacred Heart, Rome, Italy

    Barbara Altieri, Alfredo Pontecorvi & Silvia Della Casa

  2. Ios and Coleman Medicina Futura Medical Center, University Federico II, Naples, Italy

    Giovanna Muscogiuri & Luigi Barrea

  3. Clinical and Experimental Endocrinology, KU Leuven, Leuven, Belgium

    Chantal Mathieu

  4. Emergency Department, Fondazione Poliambulanza Istituto Ospedaliero, Brescia, Italy

    Carla V. Vallone

  5. Comando Brigata Alpina Julia/Multinational Land Force, Medical Service, Udine, Italy

    Luca Mascitelli

  6. TSEM med Swiss SA, Lugano, Switzerland

    Giorgia Bizzaro

  7. Department of Urology, Bolognini Hospital, Seriate, Italy

    Vincenzo M. Altieri

  8. Division of Endocrinology, Department of Clinical and Molecular Sciences, Umberto I Hospital, Polytechnic University of Marche, Ancona, Italy

    Giacomo Tirabassi & Giancarlo Balercia

  9. Department of Clinical Medicine and Surgery, University “Federico II”, Naples, Italy

    Silvia Savastano & Annamaria Colao

  10. Laboratory of Clinical Pathology, San Antonio Hospital, Tolmezzo, Italy

    Nicola Bizzaro

  11. Division of Endocrinology and Diabetes, Department of Internal Medicine I, University Hospital of Wuerzburg, Wuerzburg, Germany

    Cristina L. Ronchi

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  1. Barbara Altieri
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  2. Giovanna Muscogiuri
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Correspondence to Barbara Altieri.

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Altieri, B., Muscogiuri, G., Barrea, L. et al. Does vitamin D play a role in autoimmune endocrine disorders? A proof of concept. Rev Endocr Metab Disord 18, 335–346 (2017). https://doi.org/10.1007/s11154-016-9405-9

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