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Clin Exp Rheumatol. 2011 Nov-Dec;29(6):1024-31. Epub 2011 Dec 22.

Vitamin D levels and potential impact in systemic sclerosis.

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University of Cagliari, A.O.U. of Cagliari, Italy.


Vitamin D is essential not only for calcium and bone metabolism, but it also may exert other biological activities, including immunomodulation through the expression of vitamin D receptor in antigen-presenting cells and activated T cells. Evidence from animal models and human prospective studies of rheumatoid arthritis, multiple sclerosis, type I diabetes, and systemic lupus erythematosus, indeed suggested an important role for vitamin D as a modifiable environmental factor in autoimmune diseases. In systemic sclerosis (SSc), this role has not been completely dissected, although recent studies clearly evidenced a high prevalence of vitamin D deficiency. Moreover, some degree of association between vitamin D deficiency and disease activity or phenotype characteristics has also been observed. Vitamin D deficiency in SSc may be related to several factors: insufficient sun exposure due to disability and skin fibrosis, insufficient intake because of gut involvement and malabsorption. Although it is advisable to regularly check vitamin D status in these patients, there is no consensus about which vitamin D supplementation regimen might be sufficient to modulate immunological homeostasis, and possibly reduce disease activity or severity, thus further prospective studies are needed. Moreover, novel vitamin D analogues with more pronounced immune modulatory effect and lower activity on calcium metabolism are in the pipeline, and might represent a great innovative opportunity for the treatment of vitamin D deficiency in such autoimmune disorders.

[Indexed for MEDLINE]

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