Sizheng Zhao1, Stephen J Duffield1, Robert J Moots1, Nicola J Goodson2. 1. Department of Rheumatology, Aintree University Hospital and School of Medical Education, University of Liverpool, Liverpool, UK. 2. Department of Rheumatology, Aintree University Hospital and School of Medical Education, University of Liverpool, Liverpool, UK. ngoodson@liverpool.ac.uk.
Abstract
OBJECTIVES: Vitamin D appears to have significant effects on both innate and acquired immunity and deficiency may be associated with both susceptibility and disease severity in some autoimmune conditions. There has been little focus on the potential immunomodulatory role of vitamin D in AS. This study systematically reviews the evidence for an association between vitamin D deficiency and disease susceptibility and severity in AS. METHODS: A systematic review was conducted using Medline, EMBASE, Web of Science and conference abstracts of the European League Against Rheumatism (2002-13), British Society for Rheumatology (1993-2013) and ACR (2006-13). RESULTS: Fifteen original articles and five conference abstracts met the criteria for inclusion. All were cross-sectional in design. Seven of 11 studies identified lower concentrations of 25-hydroxyvitamin D (25OHD) in AS patients compared with healthy controls. A significant inverse correlation between 25OHD and disease activity was observed in 5 of 11 studies. The majority of studies that failed to demonstrate significant findings used inappropriate statistical methods. CONCLUSION: Cross-sectional studies using appropriate statistical analyses have highlighted that AS is associated with lower vitamin D concentrations. Within groups of AS patients there is some evidence that low vitamin D concentrations are associated with higher disease activity. However, there are insufficient published data to support an immunomodulatory role for vitamin D in AS. Further study with a longitudinal design is required to understand whether optimizing vitamin D in AS has potential as a disease-modifying intervention.
OBJECTIVES:Vitamin D appears to have significant effects on both innate and acquired immunity and deficiency may be associated with both susceptibility and disease severity in some autoimmune conditions. There has been little focus on the potential immunomodulatory role of vitamin D in AS. This study systematically reviews the evidence for an association between vitamin Ddeficiency and disease susceptibility and severity in AS. METHODS: A systematic review was conducted using Medline, EMBASE, Web of Science and conference abstracts of the European League Against Rheumatism (2002-13), British Society for Rheumatology (1993-2013) and ACR (2006-13). RESULTS: Fifteen original articles and five conference abstracts met the criteria for inclusion. All were cross-sectional in design. Seven of 11 studies identified lower concentrations of 25-hydroxyvitamin D (25OHD) in AS patients compared with healthy controls. A significant inverse correlation between 25OHD and disease activity was observed in 5 of 11 studies. The majority of studies that failed to demonstrate significant findings used inappropriate statistical methods. CONCLUSION: Cross-sectional studies using appropriate statistical analyses have highlighted that AS is associated with lower vitamin D concentrations. Within groups of AS patients there is some evidence that low vitamin D concentrations are associated with higher disease activity. However, there are insufficient published data to support an immunomodulatory role for vitamin D in AS. Further study with a longitudinal design is required to understand whether optimizing vitamin D in AS has potential as a disease-modifying intervention.
Authors: Ana Urruticoechea-Arana; María A Martín-Martínez; Santos Castañeda; Carlos A Sanchez Piedra; Carlos González-Juanatey; Javier Llorca; Federico Díaz-Gonzalez; Miguel A González-Gay Journal: Arthritis Res Ther Date: 2015-08-14 Impact factor: 5.156
Authors: Sang Jin Lee; Hye Jin Oh; Byoong Yong Choi; Yu Jin Jang; Joo Youn Lee; Jin Kyun Park; Yeong Wook Song Journal: J Immunol Res Date: 2016-12-15 Impact factor: 4.818