Editors' ChoiceMultiple Sclerosis

Sunshine Vitamin Sheds Light on MS

Science Translational Medicine  06 Jul 2011:
Vol. 3, Issue 90, pp. 90ec102
DOI: 10.1126/scitranslmed.3002828

Abstract

Mother’s advice to get out into the sunshine may be better advice then many realize. Vitamin D, the sunshine vitamin, which is produced in skin exposed to ultraviolet (UVB) light, may have important down-regulatory effects on the inflammatory response in patients.

Multiple sclerosis (MS) is believed to be an autoimmune disease in which the immune system damages the nervous system; thus, immune modulation is an attractive therapeutic goal for MS. In vitro and animal studies show that active vitamin D affects differentiation of immune cells and modulation of immune responses. Now, Kimball et al. study the peripheral blood mononuclear cells (PBMCs) from patients who were enrolled in an open-label, randomized controlled trial for 12 months.

The study by Kimball et al. was undertaken to demonstrate an in vivo mechanism for the clinical effects of vitamin D (cholecalciferol) in MS patients. The clinical results from this trial were previously published and demonstrated that the MS patients in the intervention group had fewer relapses and improved disability at 12 months as compared with controls. Those in the vitamin D group received a high dose of vitamin D, averaging 14,000 IU per day with calcium, whereas controls did not receive supplements. This vitamin D dosing successfully elevated serum vitamin D concentrations from the normal range at baseline to a >50% increase in the intervention group compared with controls. No differences were observed between the T cell proliferative responses of the intervention and control groups at baseline.

After 12 months, the PBMCs proliferative responses to MS disease–associated antigens (including neuronal, milk, and islet antigens) were significantly reduced in the treated group, indicating a role for vitamin D in this immunomodulation. However, markers of generalized inflammation, central nervous system inflammation, and markers of bone formation were not different among groups. Nevertheless, the suppression of T cell reactivity by vitamin D in patients with MS in this exploratory study was impressive and warrants further investigation.

S. Kimball et al., Cholecalciferol plus calcium suppresses abnormal PBMC reactivity in patients with multiple sclerosis. J. Clin. Endocr. Metab. 22 June 2011 (jc.2011-0325). [Abstract]