cholecalciferol and Sjogren-s-Syndrome

Sjogren's syndrome, involving sicca symptoms with xerostomia, stomatitis, and considerable pain is a difficult-to-treat autoimmune disease where the treatment options are limited and, as in the case of methotrexate, have a low therapeutic index.. This case report concerns a male patient, aged 75 years and vegetarian, with Sjogren's syndrome subsequently confirmed by salivary gland biopsy. Serum antinuclear antibodies (ANA) were elevated (1 : 320). Low serum vitamin B12 and iron levels could be improved after 20 days using vitamin B12 and iron oral supplements. Despite symptomatic treatment, xerostomia, glossitis, and glossodynia were still present, at times marked, after 12 months when the ANA titer was unchanged. Following treatment with an anti-inflammatory polyvalent immunoglobulin formulation (Lactobin. This case report demonstrates the satisfactory control of Sjogren's syndrome using oral polyvalent immunoglobulins with vitamin D3. In contrast to treatment options involving antimalarial drugs and methotrexate, there are no safety issues in patients tolerant to milk products.
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Topics: Aged; Antibodies, Antinuclear; Cholecalciferol; Humans; Immunoglobulins; Male; Sjogren's Syndrome; Stomatitis; Vegetarians; Vitamin B 12

Tolerogenic dendritic cells (tDCs) are a promising therapeutic tool for specific induction of immunological tolerance. Human tDCs can be generated ex vivo using various compounds. However, the compound(s) most suitable for clinical application remain undefined. We compared the tolerogenic properties of tDCs treated with protein kinase C inhibitor (PKCI), dexamethasone, vitamin D3 (Vit D3), rapamycin (Rapa), interleukin (IL)-10, transforming growth factor (TGF)-β, and a combination of peroxisome proliferator-activated receptor γ agonist and retinoic acid. All tDCs had a semi-mature DC phenotype. PKCI-, TGF-β-, and Rapa-tDCs showed CCR7 expression and migration to CCL19, but other tDCs showed little or none. PKCI- and IL-10-tDCs induced functional regulatory T cells more strongly than other tDCs. The tolerogenic properties of all tDCs were stable against proinflammatory stimuli. Furthermore, PKCI-tDCs were generated from patients with rheumatoid arthritis and primary Sjögren's syndrome. Therefore, PKCI-tDCs showed the characteristics best suited for tolerance-inducing therapy.

Topics: Adult; Aged; Aged, 80 and over; Arthritis, Rheumatoid; Chemotaxis; Cholecalciferol; Cytokines; Dendritic Cells; Dexamethasone; Female; Humans; Immune Tolerance; Male; Middle Aged; Phagocytosis; PPAR gamma; Protein Kinase C; Protein Kinase Inhibitors; Sirolimus; Sjogren's Syndrome; T-Lymphocytes, Regulatory; Transforming Growth Factor beta; Tretinoin

Therapeutic vaccination with antigen-specific tolerogenic dendritic cells (tolDC) might become a future option of individualized therapy for patients with autoimmune diseases. In this study, we tested the possibility of generating monocyte-derived tolDC from patients with primary Sjögren's syndrome (pSS). We analyzed phenotype, cytokine production and ability to suppress Ro/La-specific immune responses.. Monocyte-derived tolDC from patients with pSS were generated in the presence of dexamethasone, vitamin D3 and lipopolysaccharide (DexVD3 DC). The phenotype was analyzed by flow cytometry and the cytokine profile was investigated using a 25-plex Luminex assay and ELISA. The capacity to both stimulate Ro/La-specific T cells and suppress this response was evaluated by autologous mixed lymphocyte reaction (MLR).. DC generated from patients with pSS had a similar phenotype and cytokine profile to those from healthy controls. DexVD3 DC from pSS patients induced little antigen-specific T cell proliferation, but DexVD3 DC-primed lymphocytes successfully suppressed Ro/La-specific T cell responses.. DexVD3 DC presenting Ro/La antigens might be a promising new therapeutic option for patients with pSS.

Topics: Adult; Aged; Autoantigens; Cells, Cultured; Cholecalciferol; Coculture Techniques; Cytokines; Dendritic Cells; Dexamethasone; Enzyme-Linked Immunosorbent Assay; Female; Flow Cytometry; Humans; Immune Tolerance; Lipopolysaccharides; Lymphocyte Activation; Lymphocyte Culture Test, Mixed; Male; Middle Aged; Monocytes; Ribonucleoproteins; Sjogren's Syndrome; SS-B Antigen; T-Lymphocytes; Vitamins

Recent studies have suggested that vitamin D3 may have an immunoregulatory role in vitro. The vitamin D3 metabolism in 35 patients with primary Sjögren's syndrome was investigated by measuring blood concentrations of 1 alpha,25-dihydroxyvitamin D3 (1 alpha,25-(OH)2D3) and 25-hydroxyvitamin D3 (25-OHD3), as well as phenotypes and blood concentrations of Gc globulin, the main vitamin D3 binding protein in the blood. 25-OHD3 concentrations were diminished, but those of 1 alpha,25-(OH)2D3 were normal. There was no significant difference between the distribution of Gc phenotypes in the patients with primary Sjögren's syndrome and normal controls. Likewise, blood concentrations of Gc globulin corresponded to normal values. Among patients with increased concentrations of IgM rheumatoid factor there was a significant negative correlation between the serum titres of IgM rheumatoid factor and 25-OHD3 concentrations.

Topics: Adult; Aged; Calcifediol; Calcitriol; Cholecalciferol; Female; Humans; Immunoglobulin A; Immunoglobulin M; Middle Aged; Phenotype; Rheumatoid Factor; Sjogren's Syndrome; Vitamin D-Binding Protein