title: Vitamin D : Autoimmunity and Gender.
abstract: BACKGROUND
  Vitamin D deficiency is considered a risk factor for autoimmune diseases. Vitamin D and its analogues have been proposed as therapeutic tools in autoimmunity considering their exquisite immunoregulatory effect against over-reactivity towards tolerance. Autoimmune diseases, nowadays recognized as emerging non communicable diseases, are characterized by a significant female bias. This sexual dimorphism seems related to sex hormones, which differently affect male and female immune systems. Males show higher immunosuppression, maybe due to androgens; the greater female immunoreactivity and competence, likely related to estrogens, lead to a greater resilience to infections but also to a higher risk for autoimmunity. Higher interest could be given to vitamin D-based supplementation or therapy for autoimmune diseases in relation to gender as well.
  
  
  OBJECTIVE
  This review aims to discuss the role of vitamin D in autoimmune diseases with a view inside gender-related differences, in light of the interplay between vitamin D and sex hormones, especially estrogens.
  
  
  RESULTS
  Some beneficial effects against autoimmune processes seem to be allowed by vitamin D acting in synergy with estrogens. This observation suggests that possible differences of vitamin D effects depend on the context in which this hormone is active.
  
  
  CONCLUSIONS
  Rather sex-related differences of "absolute" vitamin D levels, the role of gender- dependent factors affecting vitamin D action seems to be critical. Gender and sexual hormones could be included as variables when evaluating the potential power of vitamin D receptor agonists as novel pharmacological tools to approach autoimmune diseases.
authors.affiliation: Department of Movement, Human and Health Sciences, Section of Health Sciences, Unit of Endocrinology, University of Rome "Foro Italico", 00135 Rome. Italy.
authors.forename: Clara
authors.initials: C
authors.lastname: Crescioli
authors.affiliation: Department of Internal Medicine and Medical Disciplines, Sapienza University of Rome, Rome. Italy.
authors.forename: Salvatore
authors.initials: S
authors.lastname: Minisola
mesh_terms: D000818:Animals; D015551:Autoimmunity / Q000276:immunology*; D012739:Gonadal Steroid Hormones / Q000276:immunology / Q000378:metabolism; D006801:Humans; D012727:Sex Characteristics; D014807:Vitamin D / Q000276:immunology* / Q000627:therapeutic use
chemical_list: D012739:Gonadal Steroid Hormones; D014807:Vitamin D
keywords: Vitamin D; autoimmunity; gender; personalized medicine; sex hormones; therapy