Vitamin D Level in Iranian Patients with Neuromyelitis Optica

Document Type : Original Article (s)

Authors

1 Professor, Department of Pathology, School of Medicine AND Infectious Disease and Tropical Medicine Research Center, Isfahan University of Medical Sciences, Isfahan, Iran

2 General Practitioner, Neuroscience Research Center, Isfahan University of Medical Sciences, Isfahan, Ira

3 Professor, Department of Neurology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

4 Assistant Professor, Department of Pathology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

5 Assistant Professor, Department of Epidemiology and Biostatistics, School of Health, North Khorasan University of Medical Sciences, Bojnurd, Iran

6 Student of Medicine, Research Committee, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

Abstract

Background: Neuromyelitis optica is one of the inflammatory diseases of the central nervous system (CNS) that causes demyelination and axonal injury, especially in optic nerve and spinal cord. Considering the immunoregulatory function of vitamin D, deficiency of this vitamin may play a role in the pathogenesis as well as the severity of neuromylitis optica. The aim of this study was to compare the serum level of vitamin D in patients with neuromylitis optica and control group, and to investigate the relationship between the level of this vitamin and disability and number of attacks during the year in these patients.Methods: In this cross-sectional study, 40 patients with neuromylitis optica and 40 healthy individuals as a control group participated. Serum level of 25 (OH) vitamin D was measured using high-performance liquid chromatography (HLPC) method and compared. Clinical parameters such as Expanded Disability Status Scale (EDSS) and Annualized Relapse Rate (ARR) were also evaluated in patients.Findings: The median of serum levels of vitamin D was higher in patients (46.2 ng/ml) than in controls (29.65 ng/ml) (P < 0.001). The prevalence of Vitamin D insufficiency in the control group (52.5%) was higher than this prevalence in patients (5.0%). Moreover, there was no significant relationship between serum vitamin D levels with body mass index (BMI), EDSS, and ARR in patients.Conclusion: According to our findings, there was no significant association between vitamin D deficiency and neuromylitis optica disease.

Keywords

References

  1. Jarius S, Ruprecht K, Wildemann B, Kuempfel T, Ringelstein M, Geis C, et al. Contrasting disease patterns in seropositive and seronegative neuromyelitis optica: A multicentre study of 175 patients. J Neuroinflammation 2012; 9: 14.
  2. Pandit L, Asgari N, Apiwattanakul M, Palace J, Paul F, Leite MI, et al. Demographic and clinical features of neuromyelitis optica: A review. Mult Scler 2015; 21(7): 845-53.
  3. Levin MH, Bennett JL, Verkman AS. Optic neuritis in neuromyelitis optica. Prog Retin Eye Res 2013; 36: 159-71.
  4. Lennon VA, Wingerchuk DM, Kryzer TJ, Pittock SJ, Lucchinetti CF, Fujihara K, et al. A serum autoantibody marker of neuromyelitis optica: Distinction from multiple sclerosis. Lancet 2004; 364(9451): 2106-12.
  5. Chen S, Sims GP, Chen XX, Gu YY, Chen S, Lipsky PE. Modulatory effects of 1,25-dihydroxyvitamin D3 on human B cell differentiation. J Immunol 2007; 179(3): 1634-47.
  6. Baeke F, Takiishi T, Korf H, Gysemans C, Mathieu C. Vitamin D: Modulator of the immune system. Curr Opin Pharmacol 2010; 10(4): 482-96.
  7. Boonstra A, Barrat FJ, Crain C, Heath VL, Savelkoul HF, O'Garra A. 1alpha,25-Dihydroxyvitamin d3 has a direct effect on naive CD4(+) T cells to enhance the development of Th2 cells. J Immunol 2001; 167(9): 4974-80.
  8. Dankers W, Colin EM, van Hamburg JP, Lubberts E. Vitamin D in autoimmunity: Molecular mechanisms and therapeutic potential. Front Immunol 2016; 7: 697.
  9. Koduah P, Paul F, Dorr JM. Vitamin D in the prevention, prediction and treatment of neurodegenerative and neuroinflammatory diseases. EPMA J 2017; 8(4): 313-25.
  10. Mealy MA, Newsome S, Greenberg BM, Wingerchuk D, Calabresi P, Levy M. Low serum vitamin D levels and recurrent inflammatory spinal cord disease. Arch Neurol 2012; 69(3): 352-6.
  11. Chanson JB, Zephir H, Collongues N, Outteryck O, Blanc F, Fleury M, et al. Evaluation of health-related quality of life, fatigue and depression in neuromyelitis optica. Eur J Neurol 2011; 18(6): 836-41.
  12. Akaishi T, Takahashi T, Misu T, Abe M, Ishii T, Fujimori J, et al. Progressive patterns of neurological disability in multiple sclerosis and neuromyelitis optica spectrum disorders. Sci Rep 2020; 10(1): 13890.
  13. Wingerchuk DM, Banwell B, Bennett JL, Cabre P, Carroll W, Chitnis T, et al. International consensus diagnostic criteria for neuromyelitis optica spectrum disorders. Neurology 2015; 85(2): 177-89.
  14. Kurtzke JF. Rating neurologic impairment in multiple sclerosis: An expanded disability status scale (EDSS). Neurology 1983; 33(11): 1444-52.
  15. Min JH, Waters P, Vincent A, Cho HJ, Joo BE, Woo SY, et al. Low levels of vitamin D in neuromyelitis optica spectrum disorder: association with disease disability. PLoS One 2014; 9(9): e107274.
  16. Tabrizi R, Moosazadeh M, Akbari M, Dabbaghmanesh MH, Mohamadkhani M, Asemi Z, et al. High prevalence of vitamin d deficiency among Iranian population: A systematic review and meta-analysis. Iran J Med Sci 2018; 43(2): 125-39.
  17. Karimi-Hasanabad S, Rafraf M, Asghari-Jafarabadi M. Prevalence of vitamin D deficiency and its relationship with body mass index and waist circumference in female adolescents 17-14 years, Boukan. Iran J Diabetes Lipid Disord 2014; 14(1): 55-62. [In Persian].
  18. Tangpricha V, Pearce EN, Chen TC, Holick MF. Vitamin D insufficiency among free-living healthy young adults. Am J Med 2002; 112(8): 659-62.
  19. Jitprapaikulsan J, Siritho S, Prayoonwiwat N. Vitamin D level status in Thai neuromyelitis optica patients. J Neuroimmunol 2016; 295-296: 75-8.
  20. Shan Y, Tan S, Zhang L, Huang J, Sun X, Wang Y, et al. Serum 25-hydroxyvitamin D3 is associated with disease status in patients with neuromyelitis optica spectrum disorders in south China. J Neuroimmunol 2016; 299: 118-23.
  21. Albert PJ, Proal AD, Marshall TG. Vitamin D: The alternative hypothesis. Autoimmun Rev 2009; 8(8): 639-44.

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History

  • Receive Date: 20 April 2021
  • Revise Date: 07 May 2024
  • Accept Date: 06 April 2022

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