title: Vitamin D in autoimmune rheumatic diseases: A view inside gender differences.
abstract: A large body of evidence highlights the role for vitamin D deficiency/insufficiency in rheumatic diseases, a group of different pathologies mostly of autoimmune origin. Vitamin D and vitamin D receptor agonists exquisitely modulate the immune system against over-reactivity towards tolerance; on this basis, vitamin D could be a good therapeutic candidate to control autoimmune processes in rheumatic diseases. Similarly, to other autoimmune pathologies, rheumatic diseases show a significant female bias. This sexual dimorphism seems, in part, to rely on the different sex hormone-induced regulation on male and female immune systems. Females, in fact, retain greater immune reactivity and competence likely due to estrogens, which, at variance with androgens, are associated with a greater resilience to infections but also to a higher risk for autoimmunity. In this scenario, there is growing interest on vitamin D supplementation for prevention or therapy in rheumatic diseases in relation to gender and sexual hormones. The purpose of the review is to overview vitamin D status in rheumatic diseases, related to gender and sex hormones. In particular, the main vitamin D immunoregulatory properties are summarized with some sex hormone-driven immune activities, in females and males immune systems. Topics onto vitamin D receptor agonists as potential therapeutic agents in rheumatic disease are addressed, especially in view of the role of vitamin D inadequacy in the pathogenesis of rheumatic diseases. So far, further clinical and basic studies should be encouraged to confirm the high potential power of vitamin D receptor agonists as novel pharmacological tools in rheumatic diseases particularly in light of personalized gender-related therapeutic strategies.
authors.affiliation: Department of Movement, Human and Health Sciences, University of Rome Foro Italico, 00135 Rome, Italy; Department of Internal Medicine and Medical Specialities, Sapienza University of Rome, 00161 Rome, Italy.
authors.forename: Massimiliano
authors.initials: M
authors.lastname: Vasile
authors.affiliation: Department of Movement, Human and Health Sciences, University of Rome Foro Italico, 00135 Rome, Italy; Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK.
authors.forename: Clarissa
authors.initials: C
authors.lastname: Corinaldesi
authors.affiliation: Department of Movement, Human and Health Sciences, University of Rome Foro Italico, 00135 Rome, Italy.
authors.forename: Cristina
authors.initials: C
authors.lastname: Antinozzi
authors.affiliation: Department of Movement, Human and Health Sciences, University of Rome Foro Italico, 00135 Rome, Italy. Electronic address: clara.crescioli@uniroma4.it.
authors.forename: Clara
authors.initials: C
authors.lastname: Crescioli
mesh_terms: D000818:Animals; D001327:Autoimmune Diseases / Q000276:immunology* / Q000378:metabolism*; D012739:Gonadal Steroid Hormones / Q000276:immunology / Q000378:metabolism; D006801:Humans; D018167:Receptors, Calcitriol / Q000276:immunology / Q000378:metabolism; D012216:Rheumatic Diseases / Q000276:immunology* / Q000378:metabolism*; D012727:Sex Characteristics; D014807:Vitamin D / Q000276:immunology* / Q000378:metabolism*; D014808:Vitamin D Deficiency / Q000276:immunology / Q000378:metabolism
chemical_list: D012739:Gonadal Steroid Hormones; D018167:Receptors, Calcitriol; D014807:Vitamin D
keywords: Autoimmunity; Gender; Rheumatic diseases; Sex hormones; Therapy; Vitamin D