title: Vitamin D supplementation and systemic inflammation in relapsing-remitting multiple sclerosis.
abstract: Observational studies have suggested that vitamin D may reduce inflammation in relapsing-remitting multiple sclerosis (RRMS), but this has not been clearly confirmed in randomized controlled trials. To further explore the possible anti-inflammatory effects of vitamin D in RRMS, we examined the effect of high-dose oral vitamin D3 on eleven markers of systemic inflammation in 68 RRMS patients enrolled in a double-blinded randomized placebo-controlled trial of vitamin D3 supplementation (20,000 IU/week) (NCT00785473). Serum inflammation markers and 25-hydroxyvitamin D (25(OH)D) were measured at baseline and week 96, and no restrictions were set on additional standard immunomodulatory treatment for RRMS. The mean 25(OH)D level rose from 56 ± 29 to 123 ± 34 nmol/L among patients receiving vitamin D3 supplementation, whereas only a minor increase from 57 ± 22 to 63 ± 24 nmol/L was seen in the placebo group. However, no significant differences appeared between the vitamin D group and the placebo group for any of the inflammation markers. Patients on immunomodulatory therapy had significantly higher levels of interleukin-1 receptor antagonist and chemokine (C-X-C motif) ligand 16 than patients without immunomodulatory treatment, but there were no clear synergistic effects between immunomodulatory therapy and vitamin D3 supplementation on any of the inflammation markers. The rise in 25(OH)D levels after vitamin D3 supplementation was unaffected by immunomodulatory treatment. We conclude that in this study of RRMS patients, high-dose oral vitamin D3 supplementation prominently increased serum 25(OH)D levels without affecting markers of systemic inflammation, while a more anti-inflammatory phenotype was found among patients on immunomodulatory treatment.
authors.affiliation: Department of Neurology, Akershus University Hospital, Lørenskog, Norway. egil.rorvik.rosjo@ahus.no.|Institute of Clinical Medicine, University of Oslo, Oslo, Norway. egil.rorvik.rosjo@ahus.no.
authors.forename: Egil
authors.initials: E
authors.lastname: Røsjø
authors.affiliation: Department of Neurology, University Hospital of North Norway, Tromsø, Norway.|Department of Clinical Medicine, University of Tromsø, Tromsø, Norway.
authors.forename: Linn H
authors.initials: LH
authors.lastname: Steffensen
authors.affiliation: Department of Health and Care Sciences, University of Tromsø, Tromsø, Norway.|Department of Clinical Therapeutic Services, University Hospital of North Norway, Tromsø, Norway.
authors.forename: Lone
authors.initials: L
authors.lastname: Jørgensen
authors.affiliation: Helse Sør-Øst Health Services Research Centre, Akershus University Hospital, Lørenskog, Norway.
authors.forename: Jonas C
authors.initials: JC
authors.lastname: Lindstrøm
authors.affiliation: Institute of Clinical Medicine, University of Oslo, Oslo, Norway.|Helse Sør-Øst Health Services Research Centre, Akershus University Hospital, Lørenskog, Norway.
authors.forename: Jūratė
authors.initials: J
authors.lastname: Šaltytė Benth
authors.affiliation: Institute of Clinical Medicine, University of Oslo, Oslo, Norway.|Research Institute of Internal Medicine, Oslo University Hospital Rikshospitalet, Oslo, Norway.
authors.forename: Annika E
authors.initials: AE
authors.lastname: Michelsen
authors.affiliation: Institute of Clinical Medicine, University of Oslo, Oslo, Norway.|Research Institute of Internal Medicine, Oslo University Hospital Rikshospitalet, Oslo, Norway.|Section for Clinical Immunology and Infectious Diseases, Oslo University Hospital Rikshospitalet, Oslo, Norway.|KG Jebsen Inflammatory Research Center, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
authors.forename: Pål
authors.initials: P
authors.lastname: Aukrust
authors.affiliation: Institute of Clinical Medicine, University of Oslo, Oslo, Norway.|Research Institute of Internal Medicine, Oslo University Hospital Rikshospitalet, Oslo, Norway.
authors.forename: Thor
authors.initials: T
authors.lastname: Ueland
authors.affiliation: Department of Neurology, University Hospital of North Norway, Tromsø, Norway.
authors.forename: Margitta T
authors.initials: MT
authors.lastname: Kampman
authors.affiliation: KG Jebsen MS Research Centre, Department of Clinical Medicine, University of Bergen, Bergen, Norway.|Norwegian Multiple Sclerosis Competence Centre, Department of Neurology, Haukeland University Hospital, Bergen, Norway.
authors.forename: Øivind
authors.initials: Ø
authors.lastname: Torkildsen
authors.affiliation: Department of Neurology, Akershus University Hospital, Lørenskog, Norway.|Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
authors.forename: Trygve
authors.initials: T
authors.lastname: Holmøy
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood; D002762:Cholecalciferol / Q000008:administration & dosage / Q000494:pharmacology*; D019587:Dietary Supplements; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007249:Inflammation / Q000097:blood* / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D020529:Multiple Sclerosis, Relapsing-Remitting / Q000097:blood* / Q000188:drug therapy*; D016896:Treatment Outcome; D014807:Vitamin D / Q000031:analogs & derivatives* / Q000097:blood; D055815:Young Adult
chemical_list: D015415:Biomarkers; D014807:Vitamin D; D002762:Cholecalciferol; C104450:25-hydroxyvitamin D
keywords: Multiple sclerosis; Systemic inflammation; Vitamin D