title: Does vitamin D play a role in autoimmune endocrine disorders? A proof of concept.
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.
authors.affiliation: Division of Endocrinology and Metabolic Diseases, Institute of Medical Pathology, Catholic University of the Sacred Heart, Rome, Italy. altieri.barbara@gmail.com.
authors.forename: Barbara
authors.initials: B
authors.lastname: Altieri
authors.affiliation: Ios and Coleman Medicina Futura Medical Center, University Federico II, Naples, Italy.
authors.forename: Giovanna
authors.initials: G
authors.lastname: Muscogiuri
authors.affiliation: Ios and Coleman Medicina Futura Medical Center, University Federico II, Naples, Italy.
authors.forename: Luigi
authors.initials: L
authors.lastname: Barrea
authors.affiliation: Clinical and Experimental Endocrinology, KU Leuven, Leuven, Belgium.
authors.forename: Chantal
authors.initials: C
authors.lastname: Mathieu
authors.affiliation: Emergency Department, Fondazione Poliambulanza Istituto Ospedaliero, Brescia, Italy.
authors.forename: Carla V
authors.initials: CV
authors.lastname: Vallone
authors.affiliation: Comando Brigata Alpina Julia/Multinational Land Force, Medical Service, Udine, Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Mascitelli
authors.affiliation: TSEM med Swiss SA, Lugano, Switzerland.
authors.forename: Giorgia
authors.initials: G
authors.lastname: Bizzaro
authors.affiliation: Department of Urology, Bolognini Hospital, Seriate, Italy.
authors.forename: Vincenzo M
authors.initials: VM
authors.lastname: Altieri
authors.affiliation: Division of Endocrinology, Department of Clinical and Molecular Sciences, Umberto I Hospital, Polytechnic University of Marche, Ancona, Italy.
authors.forename: Giacomo
authors.initials: G
authors.lastname: Tirabassi
authors.affiliation: Division of Endocrinology, Department of Clinical and Molecular Sciences, Umberto I Hospital, Polytechnic University of Marche, Ancona, Italy.
authors.forename: Giancarlo
authors.initials: G
authors.lastname: Balercia
authors.affiliation: Department of Clinical Medicine and Surgery, University "Federico II", Naples, Italy.
authors.forename: Silvia
authors.initials: S
authors.lastname: Savastano
authors.affiliation: Laboratory of Clinical Pathology, San Antonio Hospital, Tolmezzo, Italy.
authors.forename: Nicola
authors.initials: N
authors.lastname: Bizzaro
authors.affiliation: Division of Endocrinology and Diabetes, Department of Internal Medicine I, University Hospital of Wuerzburg, Wuerzburg, Germany.
authors.forename: Cristina L
authors.initials: CL
authors.lastname: Ronchi
authors.affiliation: Department of Clinical Medicine and Surgery, University "Federico II", Naples, Italy.
authors.forename: Annamaria
authors.initials: A
authors.lastname: Colao
authors.affiliation: Division of Endocrinology and Metabolic Diseases, Institute of Medical Pathology, Catholic University of the Sacred Heart, Rome, Italy.
authors.forename: Alfredo
authors.initials: A
authors.lastname: Pontecorvi
authors.affiliation: Division of Endocrinology and Metabolic Diseases, Institute of Medical Pathology, Catholic University of the Sacred Heart, Rome, Italy.
authors.forename: Silvia
authors.initials: S
authors.lastname: Della Casa
mesh_terms: D015090:25-Hydroxyvitamin D3 1-alpha-Hydroxylase / Q000235:genetics; D000224:Addison Disease / Q000097:blood / Q000453:epidemiology / Q000235:genetics; D000818:Animals; D001327:Autoimmune Diseases / Q000097:blood / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000453:epidemiology / Q000235:genetics; D004700:Endocrine System Diseases / Q000097:blood / Q000453:epidemiology / Q000209:etiology*; D006111:Graves Disease / Q000097:blood / Q000453:epidemiology / Q000235:genetics; D006801:Humans; D011110:Polymorphism, Genetic; D018167:Receptors, Calcitriol / Q000235:genetics; D014807:Vitamin D / Q000008:administration & dosage / Q000097:blood / Q000502:physiology*; D014808:Vitamin D Deficiency / Q000097:blood / Q000150:complications / Q000178:diet therapy / Q000453:epidemiology
chemical_list: D018167:Receptors, Calcitriol; C579457:VDR protein, human; D014807:Vitamin D; D015090:25-Hydroxyvitamin D3 1-alpha-Hydroxylase; C000600378:CYP27B1 protein, human
keywords: Addison’s disease; Autoimmune polyendocrine syndromes; Autoimmunity; Environment; Graves’ disease; Hashimoto’s thyroiditis; Lifestyle; Type 1 diabetes mellitus; Vitamin D