title: Is vitamin D a player or not in the pathophysiology of autoimmune thyroid diseases?
abstract: 1,25-Dihydroxyvitamin D is a steroid hormone derived from vitamin D, playing an important role in maintaining an adequate serum level of calcium and phosphorus. It is now clear that vitamin D exerts an endocrine action on the cells of the immune system, generating anti-inflammatory and immunoregulatory effects. The mechanisms underlying the role of vitamin D in autoimmunity are not completely understood. Lower vitamin D levels have been found in several autoimmune diseases, such as rheumatoid arthritis, systemic lupus erythematosus, systemic sclerosis, type 1 diabetes mellitus, multiple sclerosis, inflammatory bowel diseases, autoimmune thyroid diseases (i.e. Hashimoto's thyroiditis and Graves' disease) and autoimmune gastritis. Several genetic studies have demonstrated an association between thyroid autoimmunity susceptibility and gene polymorphisms of vitamin D receptor, vitamin D binding protein, 1-alpha-hydroxylase and 25-hydroxylase. Of note, some papers do not confirm this connection. With regard to the role of vitamin D in autoimmune thyroid diseases, available data remain controversial. Only few reports have analyzed the supposed association between autoimmune thyroid diseases and vitamin D concentration with inconclusive results. In our experience, low serum levels of vitamin D do not correlate either with Hashimoto's thyroiditis or with Graves' disease. The inability to achieve an unambiguous conclusion is in part due to the limitations in study design. In fact, most of the studies are cross-sectional surveys with a small number of subjects. In addition, the heterogeneity of the study population, seasonal variation of blood sampling, inter-method analytical variability of vitamin D assays and different definitions of vitamin D deficiency/insufficiency contribute to contradicting results. Therefore, further randomized, controlled, prospective trials are needed in order to demonstrate the causality of vitD in AITD and consequently the role of vitamin D supplementation in prevention or improvement of AITD, providing also information on the best formulation, dose and timing of supplementation.
authors.affiliation: Clinical Pathology Laboratory, Department of Laboratory Medicine, S. Maria degli Angeli Hospital, Pordenone, Italy.
authors.forename: Federica
authors.initials: F
authors.lastname: D'Aurizio
authors.affiliation: Allergology and Immunology, Department of Laboratory Medicine, S. Maria degli Angeli Hospital, Pordenone, Italy.
authors.forename: Danilo
authors.initials: D
authors.lastname: Villalta
authors.affiliation: Clinical Pathology Laboratory, Department of Laboratory Medicine, S. Maria degli Angeli Hospital, Pordenone, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Metus
authors.affiliation: Clinical Pathology Laboratory, Department of Laboratory Medicine, S. Maria degli Angeli Hospital, Pordenone, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Doretto
authors.affiliation: Clinical Pathology Laboratory, Department of Laboratory Medicine, S. Maria degli Angeli Hospital, Pordenone, Italy. Electronic address: renato.tozzoli@aopn.sanita.fvg.it.
authors.forename: Renato
authors.initials: R
authors.lastname: Tozzoli
mesh_terms: D000818:Animals; D001327:Autoimmune Diseases / Q000276:immunology* / Q000503:physiopathology*; D003430:Cross-Sectional Studies; D006801:Humans; D013959:Thyroid Diseases / Q000276:immunology* / Q000503:physiopathology*; D014807:Vitamin D / Q000502:physiology*; D014808:Vitamin D Deficiency; D014815:Vitamins / Q000502:physiology*
chemical_list: D014815:Vitamins; D014807:Vitamin D
keywords: 1,25-Dihydroxyvitamin D; Autoimmune diseases; Autoimmune thyroid diseases; Thyroid specific autoantibodies; Vitamin D deficiency; Vitamin D receptor polymorphism