Abstract
Vitamin D is responsible for regulation of calcium and phosphate metabolism and maintaining a healthy mineralized skeleton. It is also known as an immunomodulatory hormone. Experimental studies have shown that 1,25-dihydroxyvitamin D, the active form of vitamin D, exerts immunologic activities on multiple components of the innate and adaptive immune system as well as endothelial membrane stability. Association between low levels of serum 25-hydroxyvitamin D and increased risk of developing several immune-related diseases and disorders, including psoriasis, type 1 diabetes, multiple sclerosis, rheumatoid arthritis, tuberculosis, sepsis, respiratory infection, and COVID-19, has been observed. Accordingly, a number of clinical trials aiming to determine the efficacy of administration of vitamin D and its metabolites for treatment of these diseases have been conducted with variable outcomes. Interestingly, recent evidence suggests that some individuals might benefit from vitamin D more or less than others as high inter-individual difference in broad gene expression in human peripheral blood mononuclear cells in response to vitamin D supplementation has been observed. Although it is still debatable what level of serum 25-hydroxyvitamin D is optimal, it is advisable to increase vitamin D intake and have sensible sunlight exposure to maintain serum 25-hydroxyvitamin D at least 30 ng/mL (75 nmol/L), and preferably at 40–60 ng/mL (100–150 nmol/L) to achieve the optimal overall health benefits of vitamin D.
Highlights
Vitamin D is classically known to regulate calcium and phosphate metabolism
The purpose of the present review is to provide a high-level summary of the biologic effects of vitamin D on the immune system and the relationship between vitamin D and several types of immune-related diseases and conditions
The prevalence of multiple sclerosis (MS) is higher in countries with higher latitudes where people are more susceptible to vitamin D deficiency similar to what has been observed in type 1 diabetes [105]
Summary
Vitamin D is classically known to regulate calcium and phosphate metabolism It plays an essential role in maintaining healthy mineralized skeleton, and is an immunomodulatory hormone [1,2]. Both the vitamin D receptor (VDR) and metabolizing enzymes are expressed by various types of immune cells including lymphocytes, monocytes, macrophages, and dendritic cells [3,4]. D or its metabolites leads to changes in the occurrence and progression of various immune-related diseases [1,5] This supports the clinical and epidemiological data that link vitamin D with the incidence and severity of many disorders such as psoriasis, multiple sclerosis, rheumatoid arthritis, type 1 diabetes, and infectious diseases [2] (Figure 1).
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