2011_ASM_12_vitamin_D_lupus | American Colle...


Press Release
CHICAGO - The first study to report the effects vitamin D has on the immune system of people with
lupus was reported this week a the American College of Rheumatology Annual Scientific Meeting in
Systemic lupus erythematosus, also called SLE or lupus, is a chronic inflammatory disease that can
affect the skin, joints, kidneys, lungs, nervous system, and/or other organs of the body. The most
common symptoms include skin rashes and arthritis, often accompanied by fatigue and fever. Lupus
occurs mostly in women, typically developing in individuals in their twenties and thirties - prime childbearing age.
There is a connection between lupus and the disturbance of regulatory T cells (which play an
important role in maintaining a healthy immune system), T helper lymphocytes (white blood cells
that assist other white blood cells in the immune system), and B cells (which make antibodies that
fight off attacks on the immune system). Vitamin D has been shown to affect the numbers and
function of many of these immune cells. Because of this connection, researchers — led by Benjamin
Terrier, MD; Patrice Cacoub, MD, PhD; and Nathalie Costedoat-Chalumeau, MD,PhD; from the
Internal Medicine Department of the Pitié-Salpétrií¨re Hospital in Paris, France — studied 24 people
with lupus to determine their vitamin D status and to determine whether vitamin D supplementation
would be well tolerated and potentially beneficial to their immune systems. Only patients with no or
mild lupus activity were included in this study.
All of the participants in the study were taking a stable dose of prednisone and/or
immunosuppressive drugs. Each participant with vitamin D deficiency received vitamin D
supplementation (100,000 IU of cholecalciferol) each week for four weeks followed by the same
amount each month for six months. Researchers evaluated each participant at the beginning of the
study, at two months, and again at six months to see how well they were tolerating the
supplementation and how it was affecting their immune systems. Researchers also analyzed the
blood lymphocytes of each participant at the three time-points to monitor the evolution of regulatory
T cells, T helper lymphocytes and B cells under vitamin D therapy.
Among the 24 patients in the study, 20 (who were around the age of 30) had low levels of vitamin D
and received supplementation. The researchers noted the supplementation was safe, and the
participants did not develop too much calcium in their blood or calcium deposits (such as kidney
Serum 25(OH)D levels dramatically increased with vitamin D supplementation - reaching normal
values at two months and six months. The clinical activity of lupus did not change significantly, and
none of the patients showed a flare of the disease or required an increase in corticosteroids or
immunosuppressive drugs. However, the levels of anti-DNA antibodies, which are abnormal and
pathogenic antibodies produced by B cells, decreased at two months and six months.
The number of regulatory T cells increased with vitamin D supplementation at both two and six
months, with a similar trend for both naí¯ve and activated memory regulatory T cells, which
represent two subsets of regulatory T cells. This increase of regulatory T cells was also associated
with an increased expression of molecules associated with their suppressive function (i.e., GITR and

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Its mission is to advance rheumatology. The end points were tolerance. Finally. researchers observed a decrease in memory B cells (which produce antibodies) at two months and in activated CD8+ T cells (which may contribute to the disease process in lupus) at six months.rheumatology.. followed by 100 000 UI per month for 6 months. Paris. visit www. Patients with hypovitaminosis D (< 30 ng/mL) and stable dosage of prednisone and/or immunosuppressant agents received vitamin D supplementation: 100 000 UI of cholecalciferol per week for 4 weeks. Immunotherapy. France) David Klatzmann (Laboratory I3 Immunology. Editor’s Notes: Benjamin Terrier. A decrease in T helper lymphocytes.. France) Kubéraka Mariampillai (Pitié-Salpétrií¨re Hospital. The ACR/ARHP Annual Scientific Meeting is the premier meeting in rheumatology. November 6 in Hall F2. with an increase of regulatory T cells and a decrease of memory B cells and effector T cells. previously shown to be increased in lupus. Paris. November 8 in the on-site press conference room. France) Michelle Rosenzwajg (Laboratory I3 Immunology. Terrier will be available for media questions and briefing at 8:30 am on Tuesday. these findings need to be confirmed in large randomized controlled trials. INSERM U959. Paris. Taken together. Paris.. Follow the meeting on Twitter by using the official hashtag: #ACR2011. LAP).org/education. INSERM U959. UMR CNRS 7211.11:00 am on Sunday. Paris. Immunomodulatory effects of vitamin D were recently described in vitro. Paris 6. “However. 2 of 3 03/07/15 16:38 . France) David Saadoun (Department of Internal Medicine and Laboratory I3 Immunology. Terrier. we measured vitamin D level in SLE patients (according to the revised ACR criteria). Paris.org/about/newsroom/2. Immunopathology. Suresnes. “This preliminary study provides encouraging results and suggests the beneficial role of vitamin D supplementation in patients with SLE. France. UMR CNRS 7211. notably the expansion of Tregs able to suppress inflammatory responses and the decrease of Th17 cells. Immunotherapy. Paris. France) Background/Purpose: Systemic lupus erythematosus (SLE) is associated with perturbations in regulatory T cells (Tregs). Groupe Hospitalier Pitié-Salpetrií¨re. Immunotherapy.” The American College of Rheumatology is an international professional medical society that represents more than 8. UMR CNRS 7211. T helper lymphocytes producing interleukin (IL)-17 (Th17 cells) and B cells. France) Yoland Schoindre (Foch Hospital. France) Guillaume Geri (CHU Pitié-Salpíªtrií¨re. W 175C. Université Pierre et Marie Curie. Paris. Method: In this monocenter prospective study.2011_ASM_12_vitamin_D_lupus | American Colle. Dr.000 rheumatologists and rheumatology health professionals around the world. was noted after two months of vitamin D supplementation. https://www. For more information about the meeting. Immunopathology. INSERM U959.rheumatology. To evaluate tolerance and immunologic and clinical effects of vitamin D supplementation in SLE. France) Nathalie Costedoat-Chalumeau (CHU Pitié-Salpíªtrií¨re. immunologic effects and clinical efficacy. MD.” explains Dr. will present this research during the ACR Annual Scientific Meeting at the McCormick Place Convention Center from 9:00 . discover the ACR’s Simple Tasks campaign. Learn more about living well with rheumatic disease as well as rheumatologists and the role they play in health care. these results provide evidence of normalization of abnormal lymphocyte numbers in these patients. which highlights how rheumatic diseases strike women disproportionately and in the prime of their lives. Presentation Number: 577 RESTORATION OF REGULATORY T CELLS-TH17 CELLS BALANCE IN SYSTEMIC LUPUS ERYTHEMATOSUS THROUGH VITAMIN D SUPPLEMENTATION Benjamin Terrier (Pitié-Salpíªtrií¨re Hospital. France) Patrice Cacoub (CHU Pitié-Salpíªtrií¨re. Objective. Paris. Paris. Patients were screened at day 0 (D0) and at month 2 (M2) and 6 (M6) after the beginning of vitamin D supplementation.. Immunopathology. Also. France) Jean-Charles Piette (CHU Pitié-Salpíªtrií¨re.

None.4±14. N.001) at M6.8 at M6 (p=0.3% at M2 and 4. Anti-DNA levels decreased from 177±63 at D0 to 124±67 at M2 (p<0. Serum 25(OH)D levels dramatically increased from 18.6±1. None.01.65. The percentage of Tregs (CD4+CD25hiCD127-FoxP3+) increased under vitamin D supplementation (3.05) and 103±36 UI/mL at M6 (p<0. Klatzmann. None. respectively) and HLA-DR+ CD8+ T cells (46.6% at M2 and 27.12 and p<0.81. respectively) and Th1 cells (16. M. None. None. K. Treatment was safe with no hypercalcemia or lithiasis.. Conclusion: This is the first study to report the immunologic effects of vitamin D supplementation in vivo during SLE.2011_ASM_12_vitamin_D_lupus | American Colle.5 at M2 (p=0. This study suggests the beneficial role of vitamin D in SLE which needs to be confirmed in randomized controlled trials.rheumatology.6±14.6±2.2% at D0 to 4. C.1% at M2 and 13. age 31±8 years) had low vitamin D levels and received vitamin D supplementation. p<0.9±6. respectively)..01 and p=0.5±10. Schoindre.1 ng/mL (p<0. Previous | Index | Next Media Contact Suzanne Forte/Erin Latimer Office-(404) 633-3777 Newsroom . Y. None. We also observed a decrease in class-switched memory B cells (28.7±12.3% at M6.9±2. Disease activity assessed by the SLEDAI was 2. Vitamin D modulates the Tregs-Th17 balance by increasing Tregs and decreasing the Th17 cells.3±1. Disclosure: B.5 at D0. GITR and LAP).7% at D0 to 11.5% at D0 to 24.1 (p<0.8±16. p<0. Piette.6% at M6.2% at M6.05. p=0.67) and 1. p<0.0% at D0 to 40.05 and p=0. P. and decreases Th1 cells and memory B cells. Result: Among 24 patients.16).6±0. A decrease in Th17 (2.0±5. Geri. Costedoat-Chalumeau.(312) 808-2104 2011 Press Releases Previous | Index | Next 3 of 3 03/07/15 16:38 . Saadoun.org/about/newsroom/2. This was associated with an increased expression of molecules associated with suppression of Tregs (i. 20 (20 women.001.6±6.001) at M2 and 41. G. Cacoub. None.e. Terrier. Rosenzwajg.5% at M6. J. None. https://www. D. D.9% at M2 and 2.5±1. respectively) with a similar trend between naí¯ve and activated memory Tregs.01 and p<0. 2. None.. Mariampillai.01).1±18.0±1.4% at M6.1% at D0 to 1.9±1.7±6.. None.0±1. p<0.1±14.0±15.7 at D0 to 51. respectively) was observed mainly after 2 months of vitamin D supplementation.001 and p<0.8% at M2 and 36.