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Vitamin D deficiency, owing to low dietary intake or low sunlight exposure, is an environmental risk factor for autoimmune and infectious diseases.
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The bioactive form of vitamin D has a wide variety of immunomodulatory effects in innate and adaptive immune cells.
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Vitamin D enhances the antimicrobial activity in macrophages relevant for defense against infectious diseases.
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The role of vitamin D supplementation in a situation of vitamin D sufficiency remains unclear.
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Beneficial effects on disease
Endocrinology and Metabolism Clinics of North America
Regulation of Immune Function by Vitamin D and Its Use in Diseases of Immunity
Section snippets
Key points
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.