Regulation of Immune Function by Vitamin D and Its Use in Diseases of Immunity

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Key points

  • Vitamin D deficiency, owing to low dietary intake or low sunlight exposure, is an environmental risk factor for autoimmune and infectious diseases.

  • The bioactive form of vitamin D has a wide variety of immunomodulatory effects in innate and adaptive immune cells.

  • Vitamin D enhances the antimicrobial activity in macrophages relevant for defense against infectious diseases.

  • The role of vitamin D supplementation in a situation of vitamin D sufficiency remains unclear.

  • Beneficial effects on disease

Metabolism and mode of action of 1,25(OH)2D3 in a nutshell

Vitamin D, or cholecalciferol, is a secosteroidal prohormone that can be obtained from diet (eg, fatty fish, cod liver oil, egg yolk, and fortified dairy products); however, its main source is endogenous production in the skin through ultraviolet B (UV-B)–mediated photosynthesis. The form produced in animals and humans is vitamin D3, whereas fungi and some plants produce vitamin D2. In the present work, the focus is on vitamin D3.

Vitamin D requires 2 sequential hydroxylation steps to become the

Vitamin D as a modulator of the immune system

The widespread expression of the nuclear receptor VDR and vitamin D–metabolizing enzymes in practically all cells of the innate and adaptive immune system, such as macrophages, dendritic cells (DCs) and activated B and T cells, indicate an important immunomodulatory role for 1,25(OH)2D3.9, 15, 16 Through local production of 1,25(OH)2D3, these cells are able to obtain supraphysiologic doses of the bioactive metabolite, which are necessary for subsequent immune modulation. Herein, we discuss the

Vitamin D and diseases of immunity

Inflammation is a common factor in many chronic disorders, and concern has been raised about the impact of vitamin D deficiency on several inflammatory immune processes. There is a clear link between infections, inflammation, and autoimmunity. In addition to genetic factors, environmental triggers (more specifically viruses, bacteria, and other infectious pathogens) are thought to play a key role in the development and progression of autoimmune diseases. Genetic studies show an association

Summary

In general, vitamin D deficiency is associated with an increased risk for various autoimmune and infectious diseases. However, whether this is a cause or a consequence, or just an association, is not yet clear. Although in vitro studies show that vitamin D and its metabolites play a crucial role in the modulation of phenotype and function of immune cells and animal studies provide substantial evidence for a therapeutic effect in autoimmunity and infection, human data for the potential clinical

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    Disclosure Statement: The authors have nothing to disclose.

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