title: Vitamin D Deficiency and Rheumatoid Arthritis.
abstract: Vitamin D (VitD) is a hormone primarily synthesized in human skin under the stimulation of ultraviolet radiation. Beyond its endocrine role in bone metabolism, VitD is endowed with remarkable immunomodulatory properties. The effects of VitD on the immune system include the enhancement of microbicidal ability of monocytes/macrophages and the down-modulation of inflammatory cytokines produced by T lymphocytes. VitD deficiency is involved in many health problems, including immune-mediated diseases such as autoimmune disorders. Rheumatoid arthritis (RA) is a chronic inflammatory systemic autoimmune disease that compromises the joints, causing cartilage destruction and bone erosion. RA treatment usually consists of combined therapies that generally suppress the entire immune response leading to increased susceptibility to infections. This review describes the main effects of VitD on innate and adaptive immune system and also VitD status in inflammatory rheumatic diseases such as RA. Despite some controversies, the majority of reports reinforce the idea that lower VitD levels correlate with more severe clinical manifestations in RA and other rheumatic diseases. Therefore, supplementation with VitD to achieve normal serum levels is worthwhile as an aforethought. Original data concerning the potential applicability of 1,25-dihydroxyvitamin D3(VitD3), the active form of vitamin D, as a tolerogenic adjuvant are also included. In this sense, the effect of VitD3 associated with proteoglycan (PG), which is a specific cartilage antigen, was tested in the course of experimental arthritis. This association significantly lowered clinical scores and local histopathological alterations. Even though local analysis of T cell subsets and cytokine production did not reveal any difference between the experimental groups, VitD3+PG association significantly reduced cytokine production by spleen cells. These results suggest that VitD3 played a role as a tolerogenic adjuvant by down-modulating the course of experimental RA. Considering this tolerogenic effect of VitD3+PG association, further investigations will reveal its plausible use in human RA.
authors.affiliation: Department of Microbiology and Immunology, Institute of Biosciences of Botucatu, São Paulo State University (UNESP), Botucatu, São Paulo, Brazil. larissalumi@gmail.com.
authors.forename: Larissa Lumi Watanabe
authors.initials: LLW
authors.lastname: Ishikawa
authors.affiliation: Department of Microbiology and Immunology, Institute of Biosciences of Botucatu, São Paulo State University (UNESP), Botucatu, São Paulo, Brazil.
authors.forename: Priscila Maria
authors.initials: PM
authors.lastname: Colavite
authors.affiliation: Department of Microbiology and Immunology, Institute of Biosciences of Botucatu, São Paulo State University (UNESP), Botucatu, São Paulo, Brazil.
authors.forename: Thais Fernanda de Campos
authors.initials: TFC
authors.lastname: Fraga-Silva
authors.affiliation: Department of Microbiology and Immunology, Institute of Biosciences of Botucatu, São Paulo State University (UNESP), Botucatu, São Paulo, Brazil.
authors.forename: Luiza Ayumi Nishiyama
authors.initials: LAN
authors.lastname: Mimura
authors.affiliation: Department of Microbiology and Immunology, Institute of Biosciences of Botucatu, São Paulo State University (UNESP), Botucatu, São Paulo, Brazil.
authors.forename: Thais Graziela Donegá
authors.initials: TGD
authors.lastname: França
authors.affiliation: Department of Microbiology and Immunology, Institute of Biosciences of Botucatu, São Paulo State University (UNESP), Botucatu, São Paulo, Brazil.
authors.forename: Sofia Fernanda Gonçalves
authors.initials: SFG
authors.lastname: Zorzella-Pezavento
authors.affiliation: Department of Microbiology and Immunology, Institute of Biosciences of Botucatu, São Paulo State University (UNESP), Botucatu, São Paulo, Brazil.
authors.forename: Fernanda
authors.initials: F
authors.lastname: Chiuso-Minicucci
authors.affiliation: Department of Pathology, Botucatu Medical School, Botucatu, São Paulo, Brazil.
authors.forename: Larissa Doddi
authors.initials: LD
authors.lastname: Marcolino
authors.affiliation: Flow Cytometry Laboratory, Amaral Carvalho Foundation, Jaú, São Paulo, Brazil.
authors.forename: Marcimara
authors.initials: M
authors.lastname: Penitenti
authors.affiliation: Flow Cytometry Laboratory, Amaral Carvalho Foundation, Jaú, São Paulo, Brazil.
authors.forename: Maura Rosane Valerio
authors.initials: MRV
authors.lastname: Ikoma
authors.affiliation: Department of Microbiology and Immunology, Institute of Biosciences of Botucatu, São Paulo State University (UNESP), Botucatu, São Paulo, Brazil.
authors.forename: Alexandrina
authors.initials: A
authors.lastname: Sartori
mesh_terms: D056704:Adaptive Immunity; D000818:Animals; D000893:Anti-Inflammatory Agents / Q000378:metabolism*; D001169:Arthritis, Experimental / Q000276:immunology* / Q000628:therapy; D001172:Arthritis, Rheumatoid / Q000276:immunology* / Q000628:therapy; D015551:Autoimmunity; D002356:Cartilage / Q000187:drug effects / Q000473:pathology; D006801:Humans; D007108:Immune Tolerance; D007113:Immunity, Innate; D056747:Immunomodulation; D007249:Inflammation; D011509:Proteoglycans / Q000378:metabolism; D014807:Vitamin D / Q000378:metabolism* / Q000627:therapeutic use; D014808:Vitamin D Deficiency / Q000276:immunology* / Q000628:therapy
chemical_list: D000893:Anti-Inflammatory Agents; D011509:Proteoglycans; D014807:Vitamin D
keywords: Experimental arthritis; Immunomodulation; Proteoglycan; Rheumatoid arthritis; Tolerance; Vitamin D