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Vitamin D linked to autoimmune disorders

Posted on: April 12, 2012   by  John Cannell, MD

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There are more than 160 human autoimmune diseases, everything from type one diabetes to Lou Gehrig’s disease. They arise from an improper immune response to substances and tissues normally present in the body. In other words, the body mistakes itself as foreign and attacks its own self. The common treatment of autoimmune diseases today is to suppress the immune system in general with medications.

Recently a Chinese group led by Dr. C Mok and colleagues from Tuen Mun Hospital in Hong Kong studied 290 lupus patients and confirmed previous findings that the lower your vitamin D level, the worse your lupus. The association (remember association is not causation) was quite strong. Dr. Mok also found an amazing 96% of the lupus patients were vitamin D insufficient.

Mok CC, Birmingham DJ, Leung HW, Hebert LA, Song H, Rovin BH. Vitamin D levels in Chinese patients with systemic lupus erythematosus: relationship with disease activity, vascular risk factors and atherosclerosis Rheumatology (Oxford). 2012 Apr;51(4):644-52. Epub 2011 Jun 29.

In an accompanying editorial, Professor Luis Munoz and colleagues from Erlangen University Hospital in Germany supplied a new insight into how vitamin D is involved in autoimmune disorders, and, as far as I am aware, every one of the 160 autoimmune disorders studied so far is somehow involved with vitamin D. What could the connection be, what do 160 autoimmune diseases have in common with vitamin D?

Munoz LE, Schiller M, Zhao Y, Voll RE, Schett G, Herrmann M. Do low vitamin D levels cause problems of waste removal in patients with SLE? Rheumatology (Oxford). 2012 Apr;51(4):585-7. Epub 2011 Oct 27.

Dr. Munoz points out that vitamin D (the repair and maintenance man of the human body) has a “waste removal” function mediated via the immune system. That’s right, vitamin D is also a garbage man for the human body; it stimulates the immune system to come around and collect the debris and detritus of what is left of cells that have gone through the normal process of apoptosis, or cell death.

Evidence that a similar defect links all 160 autoimmune diseases in this garbage man process is not complete but increasingly likely. To quote Professor Munoz, “Considering these robust epidemiological data, one might believe that vitamin D deficiency plays a pivotal role in the multifaceted (cause) of autoimmunity that deserves further scientific research to pinpoint the mechanisms of action of vitamin D in the phagocytosis (eating) and clearance of dying cells.”

5 Responses to Vitamin D linked to autoimmune disorders

  1. Frederica Huxley

    I am fascinated by this article. Am I correct in thinking that when the ‘detritus’ from the apoptosis is cleared by the action of Vitamin D, it is removed from the body via the lymph system?

  2. hlahore@gmail.com

    Yes, vitamin D can prevent a great many auto-immune diseases
    Here are some of the titles of papers at VitaminDWiki

    Solar, vitamin D, and autoimmunity – Dec 2011
    Still unsure of association between vitamin D and asthma and allergies – review April 2012
    Being told you have allergies is associated with less than 10 ng vitamin D – Nov 2011
    Allergic diseases in the elderly – Oct 2011
    Gene, vitamin D, and food allergy – 2011.pdf
    Increase food sensitization by 80 percent if vitamin D deficient with specific genotypes – Aug 2011
    Huge increase in food allergies in Australia may be due to low vitamin D
    Reducing vitamin D reduces cathelicidin which reduces immunity
    Lupus 8X more likely to not even have 20 ng of vitamin D – May 2011
    meta-analysis of autoimmune – 2010.pdf
    3X more allergy to peanuts if child born with low UV – Feb 2011
    More childhood allergies when vitamin D is less than 15 ng – Feb 2011
    Vitamin D may reduce risk of autoimmune disease – systematic review – Oct 2010
    2X more allergies if 11th womb week was in Spring – Vitamin D or pollen Oct 2010
    International patent for sublingual liquid analogue forms of vitamin D – 2007
    Review of vitamin D asthma and allergic diseases – abstract lacks details July 2010
    Vitamin D may be linked to food allergies by intestinal flora – July 2010
    Mechanisms for hypothesis between sunshine and food allergy – July 2010
    Does Vitamin D Intake During Infancy Promote the Development of Atopic Allergy?
    Autoimmunity and vitamin D – several articles April 2010
    hyperlinks to those are available at:
    http://www.vitamindwiki.com/tiki-browse_categories.php?parentId=34&sort_mode=created_desc
    ——————————-
    Some papers on Vitamin D and Lupus
    Lupus increased when whites had low vitamin D (winter) – March 2012
    Vitamin D deficiency and diabetes – rheumatoid arthritis – lupus – Oct 2010
    Immune system and vitamin D patent
    Lupus 8X more likely to not even have 20 ng of vitamin D – May 2011
    Rheumatoid Artiritis Lupus and vitamin D – Review- Nov 2010.pdf
    Vitamin D in Lupus – Oct 2010.PDF
    Lupus in vicious circle with vitamin D – Nov 2010
    Vitamin D deficiency prevalent with Lupus R-Arthritis and Diabetes – Oct 2010
    2000 IU vitamin D for Lupus repletion – Sept 2010
    Taking vitamin D reduced Lupus fatigue– Aug 2010
    Is it time to routinely supplement Lupus patients with vitamin D? – May 2010
    Lupus again found to be related to vitamin D deficiency – should supplementation start? – May 2010
    Vitamin D may not be a good marker of disease activity in Korean patients with systemic lupus
    4X more likely to be vitamin D insufficient Mar 2010
    Vit D and Lupus March 2010 5 pages
    Vit D and autoimmune
    Jan 2010 use PTH to determine 32 ng is minimum; IBD, Diabetes, MS, Lupus, RA
    Review of Vitamin D, immunity and lupus 2010
    Vit D may reduce fatigue in people with Lupus
    Hyperlinks for those are at:
    http://www.vitamindwiki.com/tiki-browse_categories.php?parentId=31&sort_mode=created_desc
    There are many other auto-immune diseases which vitamin D appears to prevent:
    Here are the VitaminDWiki categories – with # of items in each category
    http://www.vitamindwiki.com/tiki-browse_categories.php?parentId=0&deep=off&type=

  3. Bradley Susan

    I have adequate vitamin D levels as per Grassroots data and have had for a couple of years. However last year I had a major flare up of guttate psoriasis – I had recently stopped taking simvastatin. I went back on the simvastatin and the psoriasis went into remission. So for me at least vitamin D is not the sole answer.

  4. SteveB

    Dr. Cannell,
    I appreciate your site and this post.

    I believe, however, that there is another “biochemical mechanism” which better explains the process by which Vitamin D performs its auto-immune disease prevention function. Let me explain.

    There is an inflammatory pathway called the “5-Lipoxygenase Inflammatory Pathway.” There are hundreds, if not over a thousand, scientific studies with abstracts that can be found via google scholar.

    “5-LO” is both like and unlike D3. It’s like D3 in that it is implicated in most, if not all, the auto-immune diseases.

    It’s unlike D3 in that, it is among, if not the, primary culprits driving auto-immune diseases.

    The Life Extension Foundation says that… “It may surprise you that of the ten leading causes of death in this country—including heart disease, cancer, and diabetes—seven are linked to a single enzyme in your body.”

    http://www.lef.org/magazine/mag2011/ss2011_Neutralize-a-Lethal-Enzyme_01.htm

    I have made a list of the diseases in which 5-LO is implicated. That’s here…

    https://www.facebook.com/note.php?note_id=163618093676419

    Now, the question is, of course, what does this have to do with Vitamin D3? Well, check out this study. I put it to you that the best explanation for why Vitamin D3 so profoundly and positively impacts auto-immune diseases is because of its regulation of 5-Lipoxygenase…

    From the study below… “Remarkably, the VDRE at position +42,000 [on the 5-LO gene] is one of the strongest known VDREs of the human genome.”
    ———————-
    Functional characterization of vitamin D responding regions in the human 5-Lipoxygenase gene
    http://www.ncbi.nlm.nih.gov/pubmed/17500032
    Abstract
    5-lipoxygenase (5-LO) is the key enzyme in the biosynthesis of proinflammatory leukotrienes. The 5-LO gene is a primary target of 1alpha,25-dihydroxyvitamin D(3) (1alpha,25(OH)(2)D(3)) and its expression is prominently increased during myeloid cell differentiation. Since no functional vitamin D response element (VDRE) has been reported for this gene so far, we performed in silico screening of the whole 5-LO gene area (84 kb, including 10 kb promoter region) and identified 22 putative VDREs. Both gelshift and reporter gene assays identified four of these candidates as functional VDREs. Their approximate positions are -2,250 (promoter), +21,400 (intron 2), +42,000 (intron 4) and +50,600 (intron 5) in relation to the transcription start site (TSS). Remarkably, the VDRE at position +42,000 is one of the strongest known VDREs of the human genome. Chromatin immunoprecipitation (ChIP) assays demonstrated simultaneous association of vitamin D receptor (VDR), retinoid X receptor (RXR) and RNA polymerase II (Pol II) to the 5-LO gene regions containing two of these four putative VDREs. This indicates DNA looping of the TSS to even very distant gene regions. In summary, we suggest that the upregulation of the primary 1alpha,25(OH)(2)D(3) target 5-LO is mediated in vivo by a prominent VDRE in intron 4.

    Thanks for all you do.

    Steve

  5. SteveB

    Here are some of the questions I have asked myself when thinking about Vitamin D3 and the “mechanism” by which it prevents auto-immune diseases and whether or not that mechanism is 5-Lipoxygenase Inflammation regulation.

    Q: What is the substance, if not 5-LO, that is implicated in virtually all auto-immune diseases, with a certain and specific relationship to D3, documented in health science?

    A: I don’t know of any.

    Q: What other substances, like Vitamin D3, have been shown to be beneficial to prevention of many, if not most or all, auto-immune disorders?

    A: Well, Omega 3 Fatty Acids also, right?
    http://www.jacn.org/content/21/6/495.short

    But Omega 3 Fatty Acids inhibit 5-Lipoxygenase.
    http://www.ncbi.nlm.nih.gov/pubmed/8719931

    —————————

    Talking points….

    1 – I’ve spent a lot of hours looking at these questions. I have never found a substance that helped in prevention of an auto-immune disorder that wasn’t also a 5-Lipoxygenase inhibitor. If there is one, point me to it.

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