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The importance of vitamin D to the immune system and the overall
chronic vitamin D deficiency in the world population at large has been  a
"hot" topic of research in recent years and months.  In particular, 
celiac disease patients are even more susceptable to vitamin D
deficiency due to malabsorption of the fat soluble vitamin.  Low sun 
exposure and vitamin D deficiency have been linked to MS.  Below are  some
abstracts of recent studies.

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J Neurosci Res. 2007 Aug 15;85(11):2480-90.
1,25-dihydroxyvitamin D(3) reverses experimental autoimmune
encephalomyelitis by inhibiting chemokine synthesis and monocyte
trafficking.
Pedersen LB, Nashold FE, Spach KM, Hayes CE.
Department of Biochemistry, College of Agricultural and Life Sciences, 
University of Wisconsin-Madison, Madison, Wisconsin.

Multiple sclerosis (MS) is a complex neurodegenerative disease whose 
pathogenesis involves genetic and environmental risk factors leading  to
an aberrant, neuroantigen-specific, CD4(+) T cell-mediated
autoimmune response. In support of the hypothesis that vitamin D(3)  may
reduce MS risk and severity, we found that vitamin D(3) and 1,25-
dihydroxyvitamin D(3) (1,25-(OH)(2)D(3)) inhibited induction of
experimental autoimmune encephalomyelitis (EAE), an MS model. To
investigate how 1,25-(OH)(2)D(3) could carry out anti-inflammatory 
functions, we administered 1,25-(OH)(2)D(3) or a placebo to mice with 
EAE, and subsequently analyzed clinical disease, chemokines, inducible 
nitric oxide synthase (iNOS), and recruitment of dye-labeled
monocytes. The 1,25-(OH)(2)D(3) treatment significantly reduced
clinical EAE severity within 3 days. Sharp declines in chemokines, 
inducible iNOS, and CD11b(+) monocyte recruitment into the central 
nervous system (CNS) preceded this clinical disease abatement in the 
1,25-(OH)(2)D(3)-treated animals. The 1,25-(OH)(2)D(3) did not directly 
and rapidly inhibit chemokine synthesis in vivo or in vitro. Rather, the 
1,25-(OH)(2)D(3) rapidly stimulated activated CD4(+) T cell apoptosis in 
the CNS and spleen. Collectively, these results support a model
wherein inflammation stimulates a natural anti-inflammatory feedback 
loop. The activated inflammatory cells produce 1,25-(OH)(2)D(3), and  this
hormone subsequently enhances the apoptotic death of
inflammatory CD4(+) T cells, removing the driving force for continued 
inflammation. In this way, the sunlight-derived hormone could reduce  the
risk of chronic CNS inflammation and autoimmune-mediated
neurodegenerative disease. (c) 2007 Wiley-Liss, Inc.

PMID: 17600374 [PubMed - in process]

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J Neurol Neurosurg Psychiatry. 2007 Jun 19; [Epub ahead of print]
A longitudinal study of serum 25-hydroxyvitamin D and intact PTH
levels indicate the importance of vitamin D and calcium homeostasis 
regulation in multiple sclerosis.
Soilu-Hanninen M, Laaksonen M, Laitinen I, Eralinna JP, Lilius EM, 
Mononen I.
University of Turku, Finland.

BACKGROUND: Past sun exposure and vitamin D3 supplementation
have been associated with a reduced risk of multiple sclerosis (MS). 
There are no previous longitudinal studies of vitamin D in MS.
OBJECTIVES: To compare regulation of vitamin D and calcium
homeostasis between MS patients and healthy controls. To study
correlation of parameters of vitamin D metabolism with MS activity. 
METHODS: We measured 25-hydroxyvitamin D, intact PTH, calcium,
phosphate, magnesium, chloride, alkaline phosphatase, albumin and  TSH in
serum every three months and at the time of relapses during  one year in
23 MS patients and in 23 healthy controls. MRI BOD and T2  activity was
assessed every 6 months. RESULTS: Vitamin D deficiency  [S-25(OH)D </= 37
nmol/L] was common affecting half of the patients  and controls at some
time of the year. Seasonal variation of 25(OH)D  was similar in the
patients and in the controls, but the 25(OH)D serum  levels were lower and
the iPTH serum levels were higher during MS  relapses than in remission.
All 21 relapses during the study occurred at  serum iPTH > 20 ng/L (2.2
pmol/L), whereas 38% of patients in
remission had iPTH </= 20 ng/L. MS patients had a relative
hypocalcaemia and a blunted PTH response in the winter. There was  no
correlation between serum 25(OH)D and MRI parameters.
CONCLUSIONS: The endocrine circuitry regulating serum calcium may  be
altered in MS. There is an inverse relationship between serum
vitamin D level and MS clinical activity. The role of vitamin D in MS must

be explored further.

PMID: 17578859 [PubMed - as supplied by publisher]

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J Neurol. 2007 May;254(5):581-90. Epub 2007 Apr 11.
Vitamin D levels in people with multiple sclerosis and community
controls in Tasmania, Australia.
van der Mei IA, Ponsonby AL, Dwyer T, Blizzard L, Taylor BV, Kilpatrick 
T, Butzkueven H, McMichael AJ.
Menzies Research Institute, Private Bag 23, Hobart, Tasmania, 7001, 
Australia, [log in to unmask]

BACKGROUND : Adequate 25(OH)D levels are required to prevent
adverse effects on bone health. Population-based data on factors
associated with 25(OH)D levels of people with MS have been lacking. 
Objectives To examine the prevalence and determinants of vitamin D 
insufficiency in a population-based sample of MS cases and controls,  and
to compare 25(OH)D status between MS cases and controls,
taking into account case disability. METHODS : We conducted a
population based case-control study in Tasmania, Australia (latitude 41-
43 degrees S) on 136 prevalent cases with MS confirmed by magnetic 
resonance imaging and 272 community controls, matched on sex and
year of birth. Measurements included serum 25(OH)D, sun exposure,  skin
type, dietary vitamin D intake and disability including EDSS.  RESULTS : A
high prevalence of vitamin D insufficiency was found in MS  cases and
controls. Among MS cases, increasing disability was strongly  associated
with lower levels of 25(OH)D and with reduced sun
exposure. Cases with higher disability (EDSS > 3) were more likely to 
have vitamin D insufficiency than controls (OR = 3.07 (1.37, 6.90) for 25
(OH)D </= 40 nmol/l), but cases with low disability were not (OR = 0.87 
(0.41, 1.86)). CONCLUSION : The strong associations between
disability, sun exposure and vitamin D status indicate that reduced 
exposure to the sun, related to higher disability, may contribute to the 
high prevalence of vitamin D insufficiency found in this population- based
MS case sample. Active detection of vitamin D insufficiency  among people
with MS and intervention to restore vitamin D status to  adequate levels
should be considered as part of the clinical
management of MS.

PMID: 17426912 [PubMed - in process]

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 Neurology. 2007 Jul 24;69(4):381-8.
Childhood sun exposure influences risk of multiple sclerosis in
monozygotic twins.
Islam T, Gauderman WJ, Cozen W, Mack TM.
Department of Preventive Medicine, University of Southern California,  Los
Angeles, CA, USA.

OBJECTIVE: To address the role of childhood sun exposure on the risk  of
multiple sclerosis (MS) after controlling for genetic susceptibility, we 
investigated the association between sun exposure and MS comparing 
disease-discordant monozygotic (MZ) twins. METHOD: Twins with MS
were sought by yearly newspaper advertisements throughout North
America from 1980 to 1992. Diagnosis was verified by updated medical 
documentation through 2005. This analysis was restricted to 79
disease- and exposure-discordant monozygotic twin pairs who had
ranked themselves before 1993 in relation to each of nine childhood  sun
exposure activities. A sun exposure index (SI) was defined as the  sum of
those exposures for which one twin ranked higher than his or  her co-twin.
The SI difference within each twin pair was calculated by  subtracting the
SI value of the affected twin from the SI value of the  unaffected twin
(range -9 to +9). The results were then analyzed using  conditional
logistic models. Result: Each of the nine sun exposure- related activities
during childhood seemed to convey a strong
protection against MS within MZ twin pairs. Depending on the activity, 
the odds ratio (OR) ranged from 0.25 to 0.57. For example, the risk of 
subsequent MS was substantially lower (OR 0.40, 95% CI 0.19 to 0.83)  for
the twin who spent more time suntanning in comparison with the  co-twin.
For each unit increase in SI, the relative risk of MS decreased  by 25%.
CONCLUSION: Early sun avoidance seems to precede the
diagnosis of multiple sclerosis (MS). This protective effect is
independent of genetic susceptibility to MS.

PMID: 17646631 [PubMed - in process]

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