vitamin-d-2 and Arthritis--Rheumatoid

Vitamin D is an important component of the endocrine system that controls calcium homeostasis and bone mineralization. Because of the very short half-life of free serum vitamin D it is stabilized and transported to target tissues by being bound to the vitamin D binding protein (VDBP). The most common polymorphisms: rs4588 and rs7041 in the vitamin D binding protein gene may correlate with differences in vitamin D status in the serum. This review presents data that relate to the presence of genetic variants in the VDBP gene in correlation with certain diseases, mostly concerning cancers (breast, prostate, pancreatic, lung, colorectal, basal cell carcinoma cancer and cutaneous melanoma) or other related diseases (thyroid autoimmunity disorders, obesity, diabetes mellitus, bone metabolism, rheumatoid arthritis, ankylosing spondylitis, asthma, chronic obstructive pulmonary disease, tuberculosis and coronary artery diseases).

Topics: Arthritis, Rheumatoid; Cholecalciferol; Coronary Artery Disease; Diabetes Mellitus; Ergocalciferols; Female; Genetic Predisposition to Disease; Humans; Male; Neoplasms; Obesity; Polymorphism, Single Nucleotide; Pulmonary Disease, Chronic Obstructive; Tuberculosis; Vitamin D-Binding Protein

This review is an update of a previously published review in the Cochrane Database of Systematic Reviews (Issue 1, 2010) on 'Vitamin D for the treatment of chronic painful conditions in adults'.Vitamin D is produced in the skin after exposure to sunlight and can be obtained through food. Vitamin D deficiency has been linked with a range of conditions, including chronic pain. Observational and circumstantial evidence suggests that there may be a role for vitamin D deficiency in the aetiology of chronic painful conditions.. To assess the efficacy and safety of vitamin D supplementation in chronic painful conditions when tested against placebo or against active comparators.. For this update, we searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, and EMBASE to February 2015. This was supplemented by searching the reference lists of retrieved articles, reviews in the field, and online trial registries.. We included studies if they were randomised double-blind trials of vitamin D supplementation compared with placebo or with active comparators for the treatment of chronic painful conditions in adults.. Two review authors independently selected the studies for inclusion, assessed methodological quality, and extracted data. We did not undertake pooled analysis due to the heterogeneity of the data. Primary outcomes of interest were pain responder outcomes, and secondary outcomes were treatment group average pain outcomes and adverse events.. We included six new studies (517 participants) in this review update, bringing the total of included studies to 10 (811 participants). The studies were heterogeneous with regard to study quality, the chronic painful conditions that were investigated, the dose of vitamin D given, co-interventions, and the outcome measures reported. Only two studies reported responder pain outcomes; the other studies reported treatment group average outcomes only. Overall, there was no consistent pattern that vitamin D treatment was associated with greater efficacy than placebo in any chronic painful condition (low quality evidence). Adverse events and withdrawals were comparatively infrequent, with no consistent difference between vitamin D and placebo (good quality evidence).. The evidence addressing the use of vitamin D for chronic pain now contains more than twice as many studies and participants than were included in the original version of this review. Based on this evidence, a large beneficial effect of vitamin D across different chronic painful conditions is unlikely. Whether vitamin D can have beneficial effects in specific chronic painful conditions needs further investigation.

Topics: Adult; Arthritis, Rheumatoid; Chronic Pain; Ergocalciferols; Humans; Hydroxycholecalciferols; Musculoskeletal Pain; Osteoarthritis, Knee; Polymyalgia Rheumatica; Randomized Controlled Trials as Topic; Vitamin D; Vitamin D Deficiency; Vitamins

Vitamin D is produced in the skin after sun-light exposure and can also be obtained through food. Vitamin D deficiency has recently been linked with a range of diseases including chronic pain. Observational and circumstantial evidence suggests that there may be a role for vitamin D deficiency in the aetiology of chronic pain conditions.. To assess the efficacy and adverse events of vitamin D supplementation in chronic painful conditions.. We searched Cochrane CENTRAL, MEDLINE, EMBASE and the Oxford Pain Relief Database for studies to September 2009. This was supplemented by searching the reference lists of retrieved articles, textbooks and reviews.. Studies were included if they were randomised double blind trials of vitamin D supplementation compared with placebo or with active comparators for the treatment of chronic pain conditions in adults.. Two review authors independently selected the studies for inclusion, assessed methodological quality, and extracted data. Pooled analysis was not undertaken due to paucity and heterogeneity of data.. Four studies, with a total of 294 participants, were included. The studies were heterogeneous with regard to study quality, the chronic painful conditions that were investigated, and the outcome measures reported. Only one study reported a beneficial effect, the others found no benefit of vitamin D over placebo in treating chronic pain.. The evidence base for the use of vitamin D for chronic pain in adults is poor at present. This is due to low quality and insufficient randomised controlled trials in this area of research.

Topics: Adult; Arthritis, Rheumatoid; Chronic Disease; Ergocalciferols; Humans; Hydroxycholecalciferols; Pain; Randomized Controlled Trials as Topic; Vitamin D; Vitamin D Deficiency; Vitamins

Background Regulatory T cells (Tregs) play an important role in the maintenance of immunological tolerance. Tregs deficiency or suppressor functions reduction may be associated with autoimmune diseases development. Objectives To estimate the effect of vitamin D supplementation on Tregs level in the peripheral blood of active rheumatoid arthritis (RA) patients. Methods 40 active RA patients were randomly assigned into two groups. Group I received methotrexate (MTX) plus hydroxychloroquine, group II received MTX, hydroxychloroquine plus vitamin D supplementation for 3 months, and 30 healthy volunteers as control group. Peripheral blood Tregs were measured at baseline and after 3 months by Flow Cytometry. Results At baseline, Tregs percentage was significantly decreased (p<0.001) in both RA patient groups (13.52±1.95%, 13.65±2.98% respectively), compared to controls (28.44±7.37%) with no significant difference between the two patient groups (p=0.866). After 3 months, there was a significant elevation in Tregs percentage in group II compared to group I (p<0.001). Tregs elevation was associated with significant DAS-28 score reduction (p<0.001). Conclusion Vitamin D appears to have important immunomodulatory functions. Vitamin D supplementation can be combined safely with traditional DMARDs to regulate the immune system. Clinical trial registration Tanta University Protocol Record 33846, Vitamin D Effect in Rheumatoid Arthritis, http://www.clinicaltrials.gov, NCT04472481.

Topics: Adult; Antirheumatic Agents; Arthritis, Rheumatoid; Drug Therapy, Combination; Ergocalciferols; Female; Humans; Hydroxychloroquine; Male; Methotrexate; Middle Aged; T-Lymphocytes, Regulatory

Sufficient levels of vitamin D seem to be essential for proper immune function, and low levels might be associated to disease activity in Rheumatoid Arthritis (RA). Most studies investigate only 25OHD and not the physiologically active vitamin D metabolite, 1,25(OH). To investigate associations between serum level of vitamin D metabolites and disease activity parameters in 160 inflammatory active and treatment naïve early RA patients. Serum level of vitamin D metabolites (25OHD. The vitamin D metabolite 1,25(OH)

Topics: Adult; Aged; Anti-Citrullinated Protein Antibodies; Antirheumatic Agents; Arthritis, Rheumatoid; Biomarkers; Calcitriol; Disease Progression; Ergocalciferols; Female; Humans; Immunity, Humoral; Male; Middle Aged; Severity of Illness Index; Vitamin D; Young Adult

Topics: Adolescent; Adult; Aged; Agglutination Tests; Alpha-Globulins; Animals; Anti-Inflammatory Agents; Arthritis, Rheumatoid; Blood Sedimentation; Calcium; Clinical Trials as Topic; Ergocalciferols; Female; Hemoglobins; Humans; Male; Middle Aged; Placebos; Salicylates; Sheep; Time Factors

Background/aim: The Wnt/ß-catenin pathway has important biological activities, including the differentiation of cells and joint formations. The aim of our study was to determine the effect of paricalcitol on experimentally induced arthritis. Materials and methods: Type II collagen combined with Freund's adjuvant was applied to induce arthritis in Wistar albino female rats. Paricalcitol (0.3 μg/kg daily) was subcutaneously injected starting 1 day after collagen applications (prophylactic group) or 1 day after the onset of arthritis (therapeutic group), until day 29. Results: The 29th day arthritis scores were lower compared to the 13th day scores in the paricalcitol groups (P < 0.05), while they were higher in the arthritis group (P < 0.05). Marked cartilage-bone destruction and extensive perisynovial inflammation were detected in the arthritis group. Decreased cartilage-bone destruction and perisynovial inflammation in the paws were observed in the paricalcitol groups. The tissue mRNA levels of DKK1, Wnt5a, and axin-2 were higher in the arthritis group than in the control group. In the paricalcitol groups, mRNA expressions were lower than in the arthritis group. Conclusion: The present study shows that the Wnt/ß-catenin signaling pathway is active in arthritis. Moreover, paricalcitol ameliorates arthritis via inhibiting the Wnt/ß-catenin pathway. Paricalcitol and the Wnt/ß-catenin pathway are candidates for research in human rheumatoid arthritis.

Topics: Animals; Anti-Inflammatory Agents; Arthritis, Experimental; Arthritis, Rheumatoid; Ergocalciferols; Female; Humans; Joints; Rats; Rats, Wistar; Wnt Signaling Pathway

Interleukin 17 (IL-17) is a cytokine implicated in the promotion of osteoclastogenesis. Its effect has been believed not to be directly exerted on osteoclast precursors, but rather indirectly carried out via an induction of receptor activator of NF-κB ligand (RANKL), the osteoclast differentiation factor, on osteoclast-supporting cells, which in turn exert an effect on osteoclast precursors. The mechanistic details, however, remain unclear. In this study, we first performed a transcriptome analysis of synoviocytes derived from a patient with rheumatoid arthritis cultured in the presence or absence of IL-17. We discovered that most of the genes significantly induced by IL-17 were chemokines with a chemotactic effect on neutrophils. We confirmed these results by quantitative RT-PCR and ELISA. Unexpectedly, the stimulation with IL-17 alone did not induce the expression of RANKL either at the mRNA or the protein level. The induction of RANKL was observed when IL-17 was added in combination with 1,25-dihydroxyvitamin D3 and prostaglandin E2, well-known inducers of RANKL, although the exact mechanism of this synergistic effect remains unclear. IL-6 and monocyte chemoattractant protein-1 were also significantly induced by IL-17 at both the mRNA and protein levels. Thus, it appears that IL-17 induces the migration of neutrophils and monocytes/macrophages through the activation of synoviocytes, and enhances a positive feedback loop composed of proinflammatory cytokines IL-6 and IL-17.

Topics: Arthritis, Rheumatoid; Cell Lineage; Cell Movement; Chemokine CCL2; Chemokines; Chemotactic Factors; Dinoprostone; Ergocalciferols; Humans; Interleukin-17; Interleukin-6; Neutrophils; Osteoblasts; Osteoclasts; RANK Ligand; Synovial Membrane

Biologic agents, especially TNFα inhibitors, appear to be very effective in treatment of rheumatoid arthritis (RA). Although the use of biologic agents has greatly improved the therapeutic efficacy in management of RA, biologic therapies for RA treatment have several limitations. These agents fail to achieve complete remission in substantial portion of RA patients. Also certain adverse events have been observed, including serious bacterial infections and reactivation of latent tuberculosis. Previous reports demonstrated that TNFα inhibitors are more efficacious in combination with other drugs such as methotrexate. In this report, we suggest that paricalcitol, a synthetic vitamin D analog is another candidate molecule for combination therapy with TNFα inhibitors in RA.

Topics: Arthritis, Rheumatoid; Bone Density Conservation Agents; Drug Therapy, Combination; Ergocalciferols; Humans; Tumor Necrosis Factor-alpha

The etiology of osteoporosis associated with rheumatoid arthritis (RA) is unknown. We studied the calcium and vitamin D metabolism in 143 women with RA (mean age 50.7 years). Albumin corrected serum calcium was normal. Serum alkaline phosphatase was increased in 29 percent of cases. Serum vitamin D levels were frequently very low. In 16 percent of the RA patients serum 25(OH)D concentration was below 12.5 nmol/L, which is arbitrarily considered as the limit of vitamin D deficiency osteomalacia. In the winter season 73 percent of the patients had serum 1,25(OH)2D levels below the seasonally adjusted normal range. The lowest values were found in patients with high disease activity. We suggest that there is a disturbance in vitamin D metabolism in RA. This might play a role in osteoporosis associated with RA.

Topics: 25-Hydroxyvitamin D 2; Adult; Aged; Arthritis, Rheumatoid; Calcium; Ergocalciferols; Female; Humans; Middle Aged; Seasons; Vitamin D

Topics: Adult; Arthritis, Rheumatoid; Bed Rest; Bone and Bones; Bone Resorption; Calcium; Ergocalciferols; Ethinyl Estradiol; Female; Humans; Male; Testosterone

Topics: Arthritis; Arthritis, Rheumatoid; Cholestanes; Ergocalciferols; Vitamin D; Vitamins

Topics: Arthritis; Arthritis, Rheumatoid; Drug-Related Side Effects and Adverse Reactions; Ergocalciferols; Humans; Vitamin D

Topics: Arthritis; Arthritis, Rheumatoid; Ergocalciferols; Ergosterol; Humans