Vitamin D Supplementation in Central Nervous System Demyelinating Disease—Enough Is Enough
The exact cause of multiple sclerosis (MS) remains elusive. Various factors, however, have been identified that increase an individual’s risk of developing this central nervous system (CNS) demyelinating disease and are associated with an acceleration in disease severity. Besides genetic d...
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doaj-6b7547a87c7e46069e983cb5d99fc99b2020-11-24T22:05:49ZengMDPI AGInternational Journal of Molecular Sciences1422-00672019-01-0120121810.3390/ijms20010218ijms20010218Vitamin D Supplementation in Central Nervous System Demyelinating Disease—Enough Is EnoughDarius Häusler0Martin S. Weber1Institute of Neuropathology, University Medical Center, 37099 Göttingen, GermanyInstitute of Neuropathology, University Medical Center, 37099 Göttingen, GermanyThe exact cause of multiple sclerosis (MS) remains elusive. Various factors, however, have been identified that increase an individual’s risk of developing this central nervous system (CNS) demyelinating disease and are associated with an acceleration in disease severity. Besides genetic determinants, environmental factors are now established that influence MS, which is of enormous interest, as some of these contributing factors are relatively easy to change. In this regard, a low vitamin D status is associated with an elevated relapse frequency and worsened disease course in patients with MS. The most important question, however, is whether this association is causal or related. That supplementing vitamin D in MS is of direct therapeutic benefit, is still a matter of debate. In this manuscript, we first review the potentially immune modulating mechanisms of vitamin D, followed by a summary of current and ongoing clinical trials intended to assess whether vitamin D supplementation positively influences the outcome of MS. Furthermore, we provide emerging evidence that excessive vitamin D treatment via the T cell-stimulating effect of secondary hypercalcemia, could have negative effects in CNS demyelinating disease. This jointly merges into the balancing concept of a therapeutic window of vitamin D in MS.http://www.mdpi.com/1422-0067/20/1/218multiple sclerosisvitamin Dvitamin D receptorexperimental autoimmune encephalomyelitisT cellshypercalcemia |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Darius Häusler Martin S. Weber |
spellingShingle |
Darius Häusler Martin S. Weber Vitamin D Supplementation in Central Nervous System Demyelinating Disease—Enough Is Enough International Journal of Molecular Sciences multiple sclerosis vitamin D vitamin D receptor experimental autoimmune encephalomyelitis T cells hypercalcemia |
author_facet |
Darius Häusler Martin S. Weber |
author_sort |
Darius Häusler |
title |
Vitamin D Supplementation in Central Nervous System Demyelinating Disease—Enough Is Enough |
title_short |
Vitamin D Supplementation in Central Nervous System Demyelinating Disease—Enough Is Enough |
title_full |
Vitamin D Supplementation in Central Nervous System Demyelinating Disease—Enough Is Enough |
title_fullStr |
Vitamin D Supplementation in Central Nervous System Demyelinating Disease—Enough Is Enough |
title_full_unstemmed |
Vitamin D Supplementation in Central Nervous System Demyelinating Disease—Enough Is Enough |
title_sort |
vitamin d supplementation in central nervous system demyelinating disease—enough is enough |
publisher |
MDPI AG |
series |
International Journal of Molecular Sciences |
issn |
1422-0067 |
publishDate |
2019-01-01 |
description |
The exact cause of multiple sclerosis (MS) remains elusive. Various factors, however, have been identified that increase an individual’s risk of developing this central nervous system (CNS) demyelinating disease and are associated with an acceleration in disease severity. Besides genetic determinants, environmental factors are now established that influence MS, which is of enormous interest, as some of these contributing factors are relatively easy to change. In this regard, a low vitamin D status is associated with an elevated relapse frequency and worsened disease course in patients with MS. The most important question, however, is whether this association is causal or related. That supplementing vitamin D in MS is of direct therapeutic benefit, is still a matter of debate. In this manuscript, we first review the potentially immune modulating mechanisms of vitamin D, followed by a summary of current and ongoing clinical trials intended to assess whether vitamin D supplementation positively influences the outcome of MS. Furthermore, we provide emerging evidence that excessive vitamin D treatment via the T cell-stimulating effect of secondary hypercalcemia, could have negative effects in CNS demyelinating disease. This jointly merges into the balancing concept of a therapeutic window of vitamin D in MS. |
topic |
multiple sclerosis vitamin D vitamin D receptor experimental autoimmune encephalomyelitis T cells hypercalcemia |
url |
http://www.mdpi.com/1422-0067/20/1/218 |
work_keys_str_mv |
AT dariushausler vitamindsupplementationincentralnervoussystemdemyelinatingdiseaseenoughisenough AT martinsweber vitamindsupplementationincentralnervoussystemdemyelinatingdiseaseenoughisenough |
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