PMID- 23483715
OWN - NLM
STAT- PubMed-not-MEDLINE
DCOM- 20130314
LR  - 20240322
IS  - 1756-2856 (Print)
IS  - 1756-2864 (Electronic)
IS  - 1756-2856 (Linking)
VI  - 6
IP  - 2
DP  - 2013 Mar
TI  - Contribution of vitamin D insufficiency to the pathogenesis of multiple 
      sclerosis.
PG  - 81-116
LID - 10.1177/1756285612473513 [doi]
AB  - The contribution of vitamin D insufficiency to the pathogenesis of multiple 
      sclerosis (MS) is reviewed. Among the multiple recently discovered actions of 
      vitamin D, an immunomodulatory role has been documented in experimental 
      autoimmune encephalomyelitis and in humans. This action in the peripheral immune 
      system is currently the main known mechanism through which vitamin D might 
      influence MS, but other types of actions could be involved within the central 
      nervous system. Furthermore, vitamin D insufficiency is widespread in temperate 
      countries and in patients with MS at the earliest stages of the disease, 
      suggesting that the deleterious effects related to vitamin D insufficiency may be 
      exerted in these patients. In fact, many genetic and environmental risk factors 
      appear to interact and contribute to MS. In genetics, several human leukocyte 
      antigen (HLA) alleles (more particularly HLA-DRB1*1501) could favour the disease 
      whereas some others could be protective. Some of the genes involved in vitamin D 
      metabolism (e.g. CYP27B1) also play a significant role. Furthermore, three 
      environmental risk factors have been identified: past Epstein-Barr virus 
      infection, vitamin D insufficiency and cigarette smoking. Interactions between 
      genetic and environmental risk or protective factors may occur during the 
      mother's pregnancy and could continue during childhood and adolescence and until 
      the disease is triggered in adulthood, therefore possibly modulating the MS risk 
      throughout the first decades of life. Furthermore, some clinical findings already 
      strongly suggest that vitamin D status influences the relapse rate and 
      radiological lesions in patients with MS, although the results of adequately 
      powered randomized clinical trials using vitamin D supplementation have not yet 
      been reported. While awaiting these incontrovertible results, which might be long 
      in coming, patients with MS who are currently in vitamin D insufficiency should 
      be supplemented, at least for their general health status, using moderate doses 
      of the vitamin.
FAU - Pierrot-Deseilligny, Charles
AU  - Pierrot-Deseilligny C
AD  - Service de Neurologie 1, Hopital de la Salpetriere, Assistance Publique-Hopitaux 
      de Paris, Universite Pierre et Marie Curie (Paris VI), Paris, France.
FAU - Souberbielle, Jean-Claude
AU  - Souberbielle JC
LA  - eng
PT  - Journal Article
PL  - England
TA  - Ther Adv Neurol Disord
JT  - Therapeutic advances in neurological disorders
JID - 101480242
PMC - PMC3582312
OTO - NOTNLM
OT  - Epstein-Barr virus
OT  - genetics
OT  - multiple sclerosis
OT  - smoking
OT  - vitamin D
COIS- Conflict of interest statement: The authors declare that there is no conflict of 
      interest.
EDAT- 2013/03/14 06:00
MHDA- 2013/03/14 06:01
PMCR- 2013/03/01
CRDT- 2013/03/14 06:00
PHST- 2013/03/14 06:00 [entrez]
PHST- 2013/03/14 06:00 [pubmed]
PHST- 2013/03/14 06:01 [medline]
PHST- 2013/03/01 00:00 [pmc-release]
AID - 10.1177_1756285612473513 [pii]
AID - 10.1177/1756285612473513 [doi]
PST - ppublish
SO  - Ther Adv Neurol Disord. 2013 Mar;6(2):81-116. doi: 10.1177/1756285612473513.