Restoration of regulatory and effector T cell balance and B cell homeostasis in systemic lupus erythematosus patients through vitamin D supplementation Report as inadecuate

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Arthritis Research and Therapy

, 14:R221

First Online: 17 October 2012Received: 10 March 2012Revised: 10 July 2012Accepted: 05 September 2012


IntroductionSystemic lupus erythematosus SLE is a T and B cell-dependent autoimmune disease characterized by the appearance of autoantibodies, a global regulatory T cells Tregs depletion and an increase in Th17 cells. Recent studies have shown the multifaceted immunomodulatory effects of vitamin D, notably the expansion of Tregs and the decrease of Th1 and Th17 cells. A significant correlation between higher disease activity and lower serum 25-hydroxyvitamin D levels 25OHD was also shown.

MethodsIn this prospective study, we evaluated the safety and the immunological effects of vitamin D supplementation 100 000 IU of cholecalciferol per week for 4 weeks, followed by 100 000 IU of cholecalciferol per month for 6 months. in 20 SLE patients with hypovitaminosis D.

ResultsSerum 25OHD levels dramatically increased under vitamin D supplementation from 18.7±6.7 at day 0 to 51.4±14.1 p<0.001 at 2 months and 41.5±10.1 ng-mL p<0.001 at 6 months. Vitamin D was well tolerated and induced a preferential increase of naïve CD4 T cells, an increase of regulatory T cells and a decrease of effector Th1 and Th17 cells. Vitamin D also induced a decrease of memory B cells and anti-DNA antibodies. No modification of the prednisone dosage or initiation of new immunosuppressant agents was needed in all patients. We did not observe SLE flare during the 6 months follow-up period.

ConclusionsThis preliminary study suggests the beneficial role of vitamin D in SLE patients and needs to be confirmed in randomized controlled trials.


CDKN1Acyclin-dependent kinase inhibitor 1A

ECDPhycoerythrin-Texas Red

ELISAenzyme-linked immunosorbent assay

FITCfluorescein isothiocyanate

FoxP3forkhead box P3

GSEAgene set enrichment analysis

ICAindependent component analysis



25OHD25-hydroxyvitamin D

PBMCperipheral blood mononuclear cell

PCy7Phycoerythrin-Cyanin 7


PMAphorbol myristate acetate

SELENA-SLEDAISafety of Estrogens in Lupus Erythematosus National Assessment-Systemic Lupus Erythematosus Disease Activity Index

SLEsystemic lupus erythematosus

Th17T helper lymphocytes producing IL-17

Tregsregulatory T cells.

Electronic supplementary materialThe online version of this article doi:10.1186-ar4060 contains supplementary material, which is available to authorized users.

and Nathalie Costedoat-Chalumeau contributed equally to this work.

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Author: Benjamin Terrier - Nicolas Derian - Yoland Schoindre - Wahiba Chaara - Guillaume Geri - Noël Zahr - Kubéraka Mariampillai


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