Corresponding intensity profiles (bottom) of ` Ca2+ transients before and after the application ofnifedipine.
The link between vitamin D and systemic lupus erythematosus (SLE) was first described in 1995 [1]. The discovery of vitamin D MedChemExpress GKT137831 receptor expression by cells of the immune system has spurred more research on the immunomodulatory properties of vitamin D over the past decade. Both the innate and adaptive immune systems have a wide array of cells such as macrophages, dendritic cells, T cells, and B cells which express vitamin D receptors that may respond to the biologically active form of vitamin D (1,25dihydroxyvitamin D) [2]. Several studies across the globe have reported that vitamin D deficiency is more prevalent among SLE patients than the general population [3]. A possible explanation for this is the sun avoidance by SLE patients, which is an established trigger of lupus flares. To date, there are over a hundred studies on SLE and vitamin D. The investigators of these studies have tried to establish the prevalence of vitamin D deficiency and its significance in various clinical aspects such as disease activity, disease damage and laboratory parameters. A question which is yet to be answered is whether or not vitamin D deficiency truly alters the course and prognosis of SLE. The answer to this question has important clinical implications, as it may offer potential therapeuticpossibilities with vitamin D supplementation. Therefore, the aim of this systematic review is to summarise and evaluate the evidence from published literature focusing on the clinical significance of vitamin D in SLE.Methodology Search StrategyWe used the terms “lupus”, “systemic lupus erythematosus”, “SLE”, “vitamin D” and `SLE and vitamin D” to search the following databases: MEDLINE, Scopus, Web of Knowledge and CINAHL. Furthermore, the references of all retrieved articles were reviewed for relevant citations.Inclusion CriteriaAll adult human cohort and case-control studies written in English, which investigated the role and effects of vitamin D in SLE published between the years 2000 and 2012 were included.Exclusion CriteriaStudies in other languages apart from English, case reports, case series, animal studies letters to the editor and review articles wereVitamin D in SLEexcluded. Regarding the justification for excluding paediatric studies; apart from the age factor, paediatric SLE runs a more aggressive clinical course than adult SLE with higher rates of organ GKT137831 site involvement and the disease tends to be more severe at presentation [4,5]. Besides, studies on vitamin D receptor gene polymorphisms were not selected. Most of the aforementioned studies lacked emphasis on and were not powered to investigate the correlation between measured vitamin D levels (25[OH]D) and its clinical significance [6,7,8]. Stringent selection criteria were applied in order to achieve a high level of homogeneity in the studies included in this systematic review.Screening of Articles for EligibilityRetrieved articles were screened for eligibility based on titles and abstracts and were subsequently classified as `include’, `possible’ and `exclude’ categories. The `include’ and `possible’ categories comprised studies reporting (1) measured vitamin D levels and/or vitamin D supplementation, and (2) disease activity, disease damage, laboratory parameters and/or organ involvement in SLE. In the `possible’ category, there were uncertainties concerning the study design, sample popu.Corresponding intensity profiles (bottom) of ` Ca2+ transients before and after the application ofnifedipine.
The link between vitamin D and systemic lupus erythematosus (SLE) was first described in 1995 [1]. The discovery of vitamin D receptor expression by cells of the immune system has spurred more research on the immunomodulatory properties of vitamin D over the past decade. Both the innate and adaptive immune systems have a wide array of cells such as macrophages, dendritic cells, T cells, and B cells which express vitamin D receptors that may respond to the biologically active form of vitamin D (1,25dihydroxyvitamin D) [2]. Several studies across the globe have reported that vitamin D deficiency is more prevalent among SLE patients than the general population [3]. A possible explanation for this is the sun avoidance by SLE patients, which is an established trigger of lupus flares. To date, there are over a hundred studies on SLE and vitamin D. The investigators of these studies have tried to establish the prevalence of vitamin D deficiency and its significance in various clinical aspects such as disease activity, disease damage and laboratory parameters. A question which is yet to be answered is whether or not vitamin D deficiency truly alters the course and prognosis of SLE. The answer to this question has important clinical implications, as it may offer potential therapeuticpossibilities with vitamin D supplementation. Therefore, the aim of this systematic review is to summarise and evaluate the evidence from published literature focusing on the clinical significance of vitamin D in SLE.Methodology Search StrategyWe used the terms “lupus”, “systemic lupus erythematosus”, “SLE”, “vitamin D” and `SLE and vitamin D” to search the following databases: MEDLINE, Scopus, Web of Knowledge and CINAHL. Furthermore, the references of all retrieved articles were reviewed for relevant citations.Inclusion CriteriaAll adult human cohort and case-control studies written in English, which investigated the role and effects of vitamin D in SLE published between the years 2000 and 2012 were included.Exclusion CriteriaStudies in other languages apart from English, case reports, case series, animal studies letters to the editor and review articles wereVitamin D in SLEexcluded. Regarding the justification for excluding paediatric studies; apart from the age factor, paediatric SLE runs a more aggressive clinical course than adult SLE with higher rates of organ involvement and the disease tends to be more severe at presentation [4,5]. Besides, studies on vitamin D receptor gene polymorphisms were not selected. Most of the aforementioned studies lacked emphasis on and were not powered to investigate the correlation between measured vitamin D levels (25[OH]D) and its clinical significance [6,7,8]. Stringent selection criteria were applied in order to achieve a high level of homogeneity in the studies included in this systematic review.Screening of Articles for EligibilityRetrieved articles were screened for eligibility based on titles and abstracts and were subsequently classified as `include’, `possible’ and `exclude’ categories. The `include’ and `possible’ categories comprised studies reporting (1) measured vitamin D levels and/or vitamin D supplementation, and (2) disease activity, disease damage, laboratory parameters and/or organ involvement in SLE. In the `possible’ category, there were uncertainties concerning the study design, sample popu.
