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Multiple sclerosis and vitamin D: an update

European Journal of Clinical Nutrition volume 58, pages 1095–1109 (2004)Cite this article

Abstract

MS is a chronic, immune-mediated inflammatory and neurodegenerative disease of the central nervous system (CNS), with an etiology that is not yet fully understood. The prevalence of MS is highest where environmental supplies of vitamin D are lowest. It is well recognized that the active hormonal form of vitamin D, 1,25-dihydroxyvitamin D (1,25-(OH)2D), is a natural immunoregulator with anti-inflammatory action. The mechanism by which vitamin D nutrition is thought to influence MS involves paracrine or autocrine metabolism of 25OHD by cells expressing the enzyme 1α-OHase in peripheral tissues involved in immune and neural function. Administration of the active metabolite 1,25-(OH)2D in mice and rats with experimental allergic encephalomyelitis (EAE, an animal model of MS) not only prevented, but also reduced disease activity. 1,25-(OH)2D alters dendritic cell and T-cell function and regulates macrophages in EAE. Interestingly, 1,25-(OH)2D is thought to be operating on CNS constituent cells as well.

Vitamin D deficiency is caused by insufficient sunlight exposure or low dietary vitamin D3 intake. Subtle defects in vitamin D metabolism, including genetic polymorphisms related to vitamin D, might possibly be involved as well. Optimal 25OHD serum concentrations, throughout the year, may be beneficial for patients with MS, both to obtain immune-mediated suppression of disease activity, and also to decrease disease-related complications, including increased bone resorption, fractures, and muscle weakness.

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Acknowledgements

The authors thank Jolijn Kragt, Arie van Nieuw Amerongen, Michael Eddleston, Pat Lee and I-Jin Chew for reading and commenting on draft versions and Adriana Dusso for always answering vitamin D queries.

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Authors and Affiliations

  1. Department of Molecular Cell Biology and Immunology, VU Medical Center, Amsterdam, The Netherlands

    B M VanAmerongen & C D Dijkstra

  2. Department of Endocrinology, VU Medical Center, Amsterdam, The Netherlands

    P Lips

  3. Department of Neurology, VU Medical Center, Amsterdam, The Netherlands

    C H Polman

  4. Department of Dental Basic Sciences (ACTA), VU Medical Center, Amsterdam, The Netherlands

    B M VanAmerongen

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  1. B M VanAmerongen
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  2. C D Dijkstra
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  3. P Lips
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Contributions

Guarantor: CD Dijkstra.

Contributors: BV initiated this study together with CD. The paper was written by BV and CD with contribution from PL. CD contributed her expertise on MS, EAE, the immune system and gene polymorphism. PL contributed his expertise on vitamin D deficiency and consequences for bone loss, fractures and therapeutic implications. CP contributed his clinical expertise on patients with MS. All authors read and contributed to the manuscript.

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Correspondence to B M VanAmerongen.

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VanAmerongen, B., Dijkstra, C., Lips, P. et al. Multiple sclerosis and vitamin D: an update. Eur J Clin Nutr 58, 1095–1109 (2004). https://doi.org/10.1038/sj.ejcn.1601952

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  • DOI: https://doi.org/10.1038/sj.ejcn.1601952

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