2. The term vitamin D generally refers to two very similar
molecules, vitamin D2 (Ergocalciferol) and Vitamin D3
(Cholecalciferol), which is created by skin cells in
response to ultra-violet B light1.
Multiple Sclerosis: Disease of immune system, which
normally protect our body, instead attacks the covering
(myelin sheath) surrounding the nerve in our body and
spinal cord2.
9. Active Vit. D→IL-10 cells↑(Anti-inflammative)
↓
↓IL–6
↓IL–17
↓
↑(CD4 + CD25)
↓
Stabilizes the immunity4.
10. Environmental link
Genetic link
Environmental link:
Several studies suggests that maintaining
adequate level of vitamin D may have protective
effect and lower risk of MS6.
MS more common in areas farther away from the
equator where there is less sunshine, which
suggest that there is a relationship between
vitamin D and the risk of developing MS. E.g. UK,
Scotland etc6.
11. Recent research suggests that the lack of vitamin D in
early childhood or before birth might increase the risk of
developing MS later in life6.
Very large dose may cause toxicity6.
Studies have found that more people with MS would be
expected are born in May than in November6.
12. Genetic link:
The demonstration that rare variants in CYP27B1, which
encodes the enzyme that converts vitamin D to its active
form, are strongly associated with MS risk supports a
casual role of vitamin D deficiency as a risk factor for
MS.
The study found that an important gene implicated in
susceptibility to MS, the variant gene HLA-DRB1*1501,
can be switched on by vitamin D in laboratory
experiments6.
13. Randomized controlled trials (RCT) are
considered to produce the most reliable scientific
data. RCT have been needed to confirm the
association between vitamin D and MS suggested
by these previous studies and to determine if
vitamin D supplementation may help patient with
MS7.
The study was also designed so that the authors
and patients were both “blinded” to which patients
were in the high dose vitamin D7.
14. In the journal of clinical investigation,
researchers led by Magdalena Huber at the
university of Marburg in Germany use a
mouse model of MS to determined the role of
Tc 17 cells.
They found that Tc17 cells help Th17
immune cells to invade CNS by secreting the
protein IL-17.
Without Tc17 cells,the Th17 cells did not
accumulate in the CNS, preventing
development of MS.
15. With supplementation, the median vitamin D level
in the low dose group rose from 22ng/dl to 28ng/dl
at the end of study7.
The median vitamin D level in the high dose group
rose from 24ng/ml to 48ng/ml7.
While the high dose group did reach higher level
of vitamin D, there seemed to be no advantages
from high dose vitamin D supplementation in
patients with MS compared to supplementation for
adequate vitamin D levels7.
16. These studies did not find that high vitamin levels were
more protective for patients with MS than adequate
level7.
More research is needed to determine the best level of
vitamin D for patients with MS. Several additional studies
are underway now. While we wait for these results,
research so far suggest that it may be beneficial for
patients with MS with vitamin D insufficiency to take
vitamin D supplementation for a goal level of greater
than 30ng/ml7.
17. 1.Food standers agency.
Eat well, be well-Vitamin D[ cited 2010 16 Feb]
Available from: www.eatwell.gov.uk
2.www.mayoclinic.org/multiple-sclerosis
3.Test Book of Biochemistry U.Satyanarayana
U.Chakrapani
4.American Journal of Clinical Nutrition 1992,
5.Hypponen E, Power C.
American Journal of Clinical Nutrition 2007,
6.www.mstrust.org.uk
7.American Academy of Neurology
8.Ramagopalan SV et al,Expression of the MS-associated MHC
class ii Allele HLA_DRB1*1501 is regulated by vitamin D.
