Role of Vitamin D on Endothelial Function and Erythropoiesis: Implications for Sickle Cell

Abstract

Endothelial dysfunction and chronic anaemia are key features of sickle cell disease (SCD), which significantly increases the risk of vaso-occlusive crises, pulmonary hypertension and stroke in affected individuals. Evidence indicates that vitamin D (VD), known for bone health, is linked to better endothelial function by increasing nitric oxide (NO) bioavailability, and promoting antioxidant and anti-inflammatory activities. It also regulates erythropoiesis by enhancing and prolonging red blood cell production and lifespan. VD deficiency is common in individuals affected by SCD, intensifying the already poor cardiovascular health. Up to date, only one study have investigated the effect of VD supplementation, and endothelial function outcome measures in SCD. The potential benefits of maintaining adequate circulating VD concentration in improving endothelial dysfunction and chronic anaemia would be of immense significance to affected individuals living in sub-Saharan Africa, who bear the greatest burden of the disease, with a substantial impact on morbidity and mortality. There is a lack of clinical data investigating the effect of VD on erythropoiesis in SCD. Therefore, this review aims to examine the current evidence regarding the influence of VD on both endothelial function and erythropoiesis and the clinical implications of enhancing endothelial function and erythropoiesis through VD supplementation in this at-risk group. A thorough search of databases, including PubMed, MEDLINE, and Google Scholar, was performed to gather relevant articles exploring the interplay between VD, endothelial function and erythropoiesis in SCD. Robust clinical evidence is warranted to show the impact of VD supplementation on improving endothelial function and erythropoiesis in SCD.