Vitamin D Resistance in Autoimmunity

A forum to discuss the Coimbra Protocol which uses high-dose vitamin D3 to treat multiple sclerosis.
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Petr75
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Vitamin D Resistance in Autoimmunity

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2021 Apr 7
Praxis Dr. Beatrix Schweiger, Bensheim, Germany
Vitamin D Resistance as a Possible Cause of Autoimmune Diseases: A Hypothesis Confirmed by a Therapeutic High-Dose Vitamin D Protocol
https://pubmed.ncbi.nlm.nih.gov/33897704/

Abstract

Vitamin D3 (cholecalciferol) is a secosteroid and prohormone which is metabolized in various tissues to the biologically most active vitamin D hormone 1,25(OH)2D3 (calcitriol). 1,25(OH)2D3 has multiple pleiotropic effects, particularly within the immune system, and is increasingly utilized not only within prophylaxis, but also within therapy of various diseases. In this context, the latest research has revealed clinical benefits of high dose vitamin D3 therapy in autoimmune diseases. The necessity of high doses of vitamin D3 for treatment success can be explained by the concept of an acquired form of vitamin D resistance. Its etiology is based on the one hand on polymorphisms within genes affecting the vitamin D system, causing susceptibility towards developing low vitamin D responsiveness and autoimmune diseases; on the other hand it is based on a blockade of vitamin D receptor signaling, e.g. through pathogen infections. In this paper, we review observational and mechanistic evidence for the acquired vitamin D resistance hypothesis. We particularly focus on its clinical confirmation from our experience of treating multiple sclerosis patients with the so-called Coimbra protocol, in which daily doses up to 1000 I.U. vitamin D3 per kg body weight can be administered safely. Parathyroid hormone levels in serum thereby provide the key information for finding the right dose. We argue that acquired vitamin D resistance provides a plausible pathomechanism for the development of autoimmune diseases, which could be treated using high-dose vitamin D3 therapy.

full https://www.frontiersin.org/articles/10 ... 55739/full
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Petr75
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Re: Vitamin D Resistance in Autoimmunity

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2021 Apr 9
Internal Medicine, Jinnah Sindh Medical University, Karachi, PAK
Association Between Serum Vitamin D Levels and Frequency of Relapses in Patients With Multiple Sclerosis
https://pubmed.ncbi.nlm.nih.gov/33987049/

Abstract

Introduction Multiple sclerosis (MS) is an immune-mediated inflammatory disease of the central nervous system affecting the myelin sheath of neurons with a wide range of symptoms. Among various risk factors studied that can increase the relapse, vitamin D is also a potential risk factor. In this study, we will determine the association between vitamin D status and frequency of relapses in patients with MS. Material and methods Seventy-four (74) patients with a confirmed diagnosis of MS, with more than one (01) relapse per year, for a minimum of two years, were included in the case group. Seventy-four (74) participants with a confirmed diagnosis of MS with one (01) or no relapse per year, for a minimum of two years, were included in the control group. After informed consent, the patient blood was drawn via phlebotomy and was sent to the lab for vitamin D levels. Results The mean serum vitamin D level was significantly lower in case group compared to control group (18.21 ± 4.21 ng/mL vs. 29.21 ± 5.72 ng/mL; p-value: < 0.0001). The number of participants with vitamin D level less than 30 ng/mL were significantly higher in patients with case group compared to control group (78.37% vs. 50.0%; p-value: 0.0003) Conclusion In this study, patients with more relapses per year had low level of serum vitamin D. There is emerging strong evidence that vitamin D plays an important role in the pathogenesis, progression, and disease burden of autoimmune disease, including MS.
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Re: Vitamin D Resistance in Autoimmunity

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2021 Sep 16
Department of Neurology, Medical University, Lublin, Poland
Correlation between vitamin D and alterations in MRI among patients with multiple sclerosis
https://pubmed.ncbi.nlm.nih.gov/34558256/

Abstract

Introduction: Multiple sclerosis (MS) is a disease of unknown etiology. Diagnosis of MS is primarily based on detection of myelin damage by magnetic resonance imaging (MRI) and classification of demyelination according to the McDonald Criteria. Cholecalciferol (vitamin D3) has been shown to affect the onset and progression of MS via its immunomodulating properties. The role of vitamin D in MS pathogenesis and treatment deserves further investigation, as there is sufficient evidence to suggest a correlation between vitamin D blood level and brain MRI lesion load.

State of knowledge: Elevated blood vitamin D concentration is linked with demyelination, as determined by T2-weighted and gadolinium-enhanced MRI. Blood vitamin D blood levels are affected by sun exposure, among other factors; however, there is no evident connection between abnormalities in myelination and seasonality. Vitamin D supplementation among MS patients has been associated with a lower probability of new lesions and loss of existing lesion volume, as observed seen in T1-weighted MRI scans (p=0.03). An increase in TGF-beta levels was noted among patients using vitamin D supplementation, which may suggest a mechanism by which cholecalciferol may improve MS prognosis. Patients with clinically isolated syndrome (CIS) exhibited an inverse correlation between vitamin D concentration and risk of new lesions as seen in T2-weighted MRI scans. Moreover, vitamin D intake among these patients lowered the risk of progression to clinically definite multiple sclerosis (CDMS). Daily intake of vitamin D during fingolimod treatment correlated strongly with lower numbers of new lesions. High dose vitamin D supplementation during interferon beta-1a treatment was linked to lower mean percentage of lesions compared with volume pre-treatment seen by T2-weighted MRI.

Results: Recent findings advocate for the monitoring of vitamin D blood levels in MS patients. Vitamin D supplementation should be considered in both MS patients and patients with CIS, where other signs of disease may be delayed. Moreover, vitamin D supplementation appears to lower the likelihood of new demyelination changes apparent in MRI examinations.
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