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J Clin Endocrinol Metab. 2011 Sep;96(9):2826-34. doi: 10.1210/jc.2011-0325. Epub 2011 Jun 22.

Cholecalciferol plus calcium suppresses abnormal PBMC reactivity in patients with multiple sclerosis.

Author information

  • 1Departments of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada. samantha.kimball@utoronto.ca

Abstract

CONTEXT:

The active metabolite of vitamin D, 1,25-dihydroxyvitamin D [1,25(OH)(2)D], is a potent modulator of immune cells in vitro.

OBJECTIVE:

Our objective was to determine whether the sun-dependent nutrient, cholecalciferol, can alter disease-associated cellular immune abnormalities in patients with multiple sclerosis (MS).

DESIGN:

This was an open-label, 12-month, randomized controlled trial.

SETTING:

Patients with MS were recruited from the MS Clinic at St. Michael's Hospital, Toronto.

PATIENTS:

Forty-nine patients were matched (for age, sex, disease duration, disease-modifying drug, and disability) and enrolled (treated n = 25; control n = 24). Four patients were lost to follow-up (n = 2 from each group).

INTERVENTION:

Treated patients received increasing doses of cholecalciferol (4,000-40,000 IU/d) plus calcium (1200 mg/d), followed by equilibration to a moderate, physiological intake (10,000 IU/d). Control patients did not receive supplements.

MAIN OUTCOME MEASURES:

At enrollment and at 12 months, peripheral blood mononuclear cell (PBMC) proliferative responses to disease-associated, MS-relevant, and control antigens were measured, along with selected serum biochemical markers.

RESULTS:

At 12 months, mean serum 25-hydroxyvitamin D [25(OH)D] concentrations were 83 ± 35 nmol/liter and 179 ± 76 nmol/liter in control and treated participants, respectively (paired t, P < 0.001). Serum 1,25(OH)(2)D did not differ between baseline and 1 yr. In treated patients, 12-month PBMC proliferative responses to neuron antigens myelin basic protein and exon-2 were suppressed (P = 0.002). In controls, there were no significant changes in disease-associated PBMC responsiveness. There were no significant differences between groups in levels of selected biomarkers.

INTERPRETATION:

MS-associated, abnormal T cell reactivities were suppressed in vivo by cholecalciferol at serum 25(OH)D concentrations higher than 100 nmol/liter.

PMID:
21697250
[PubMed - indexed for MEDLINE]
PMCID:
PMC3417163
Free PMC Article

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