Thursday, 14 April 2016

Vitamin D affects B cell function


Background:While vitamin D is increasingly recognized as a potential immune regulator of MSdisease activity, its impact on B lymphocytes, however, remains ill-defined.
Methods:We assessed the impact of vitamin D on B-cell proliferation and cytokine secretion ex vivo and screened for effects of hypovitaminosis D and vitamin D supplementation on the compartmentalized distribution of B-cell subtypes in peripheral blood and cerebrospinal fluid (CSF) from patients with relapsing remitting MS (n = 95) and various neurologic and healthy controls (n = 57).
Results: B cells from MS patients with 25(OH)D serum levels < 20 ng/ml, displayed enhanced immunoreactivity ex vivo as a consequence of more vigorous responses of CD27+memory phenotypes. Immune responses decreased when B cells from either source were co-cultured in the presence of vitamin D or when retesting B cells from MS patients after prolonged supplementation with vitamin D. Hypovitaminosis D was detectable in the serum of 40/95 MS patients, correlated with decreased vitamin D concentrations in CSF and with higher disease activity, and was paralleled by intrathecal accumulation of CD27+ B-cell subtypes and plasma cells.
Conclusion:B-cell immunoreactivity is attenuated by vitamin D. Our finding that vitamin D deficiency affects the intrathecal compartment and coincides with increased frequencies of effector B-cell subtypes in the CSF suggests that hypovitaminosis D might contribute to augmenting disease activity in the target organ and supports a potential benefit of vitamin D supplementation in MS.


As MS becomes a B cell disease, why not see what everything does on B cell function. This study looks at vitamin D and B cell function and  if you have low vitamin D levels in the blood these are low in the brain and you have more B cell activity.

This study suggests that vitamin D plays a role in regulating humoral immunity and suggest a scenario in which low 25(OH)D levels in peripheral blood and CSF act together to facilitate the intrathecal accumulation of blood-derived, antigen-experienced, post-switched memory B cells. Once they have entered the CSF, their proliferative potency is enhanced and their subsequent differentiation into antibody-secreting effector cells promoted. As a consequence, hypovitaminosis D might contribute to augmenting MS disease activity in the target organ thus supporting a potential benefit of vitamin D supplementation in MS.

24 comments:

  1. It's about time this was recognised more widely and GPs given the green light to prescribe to all their MS patients.

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  2. I agree with Anon@9:15. A lot of MS patients I know don't take vitamin d because their neurologists don't prescribe them. We also need a standard for the type of vitamin d...should we take d2 or d3? I am currently taking 50000 IU of d3. But I need to get it from a compounding pharmacy. My regular pharmacy only gives out d2 in such high doses. From what I have read d3 supplements are more effective.

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    1. Vitamin d3 is what mammals make in their skin when exposed to UVB, vitamin d2 is what fungi produce when exposed to UV. They are chemically different. Humans can use either to control blood calcium levels but it is unknown if they are interchangeable for other uses in the body. If you are taking 50,000IU a week, then you could take 5,000IU or 10,000IU a day and get the same effect and 5,000IU and 10,000IU D3 are readily available from places like Amazon. Vitamin d3 as a supplement is very cheap.

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    2. Yes. Vitamin D3 supplements are very cheap. That is why it is not prescribed often. There is no money to be made from it!

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  3. Got to agree, vitD suplementation is not a common prescription, so we end up doing this for ourselves... im taking 10.000 iu a day, till im on the higher normal level, then ill continue with 5.000 a day. I read we have to be careful about kidney stones, is there any other important side effect that we have to be aware of?

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    1. The kidney stones link, at none toxic doses, has been disproved. Toxicity can occur with massive doses (>40,000IU a day for months or single doses of millions of IU). Some people suffer indigestion but this is probably the oil in the capsule so try a different make. If it takes 10,000IU a day to reach the correct level it takes 10,000IU a day to maintain it as consumption increases with supply. There is a lot of poor information published on vitamin d so read carefully.

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  4. As far as I know the form of vitamin D that acts directly on the immune system is Cholecalciferol (vitamin D3).

    What I've read about hypercalcemia and on kidney stone associated with iso VD is connected to a very rich calcium intake, low intake of water and doses higher than 20,000 IU / day without the accompaniment of a restricted diet of foods containing calcium...

    In addition to DMT (Copaxone) I take 10.400 iu of VD3 every day, exactly, since I discovered the disease for 02 years and while actually MS seems to be "quiet" ...

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  5. Why do people keep thinking they have to get their Vit D via a doctor's prescription? The correct Vit D (D3) is readily available from health stores, supermarkets, pharmacies etc, and there are plenty of good suppliers of reliable quality Vit D3 online as well.

    There is so much information from reliable sources (including this blog and the conventional MS Society websites, not to mention the Vit D Council) on Vit D and MS that even if "Gold Standard" studies and trials are lacking in this area it is pretty b... clear that for PwMS taking Vit D is a sensible thing to do. It's not sensible to go completely overboard (e.g. decide to take up the Coimbra protocol without medical supervision), but 5,000 IU per day is fine, and some people need to take more, and some a bit less. There is also pretty sound information around indicating that PwMS should aim to keep their Vit D levels at around 150 nmol/L (60 ng/ml).

    Like anyone who has a chronic health condition, a PwMS needs to take some responsibility for their own health as their MS isn't going to just "go away" - no matter how much any of us might all want it to. Sitting back and remaining ignorant with so much information now available only a few mouse clicks away is just an excuse for remaining a doormat.

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    1. You're right, of course, but I prefer it prescribed. It's not the cost, it's the fact that it's now on my medical records and seen as part of the whole treatment package. Plus, it can be monitored and I am in a better position to ask for a re-test of levels at any stage.

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  6. Heartening. Instead of just blowing away B-cells with DMTs - actually looking at the components of what might be going biologically wrong on a smaller scale.

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  7. It is worth reminding people that 2 studies have shown that the RDA for vitamin d was calculated incorrectly. This is not a disputable error in interpretation, it is a statistical error. Instead of considering the variation in 25(OH)D with vitamin d supplementation from a number of trials, they looked at the distribution of the mean values. This is a shocking error but not as shocking as their failure to admit they made it.

    Nutrients. 2014 Oct; 6(10): 4472–4475. Published online 2014 Oct 20. doi: 10.3390/nu6104472, A Statistical Error in the Estimation of the Recommended Dietary Allowance for Vitamin D Paul J. Veugelers and John Paul Ekwaru

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  8. I am curious about one thing. When MS was considered a T cell disease, then were there any studies done on how Vit D affects T cells?

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    1. MS is a T cell disease. Yes they have done the VD T cell stuff

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    2. MS is not just a T cell disease?

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    3. No, there are other players but T cells are important.

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    4. I think the bard said it best. "All MS is a stage and B&T cells are merely players...."

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  9. One concern I have... Vitamin D is certainly important. But to what extent may it be a case of "seek and ye shall find"? Might a crucial role not be found for many vitamins/minerals if there was enough investigative drive, research interest? I worry about a touch of hype to the exclusion of other things.

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    1. Take vit D and be cured....alleluia!

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    2. The interest in vitamin d came from the epidemiology of MS vs latitude, and when it was realised that vitamin d was an important part of the immune system (and did not just control calcium), which showed in Sarcoidosis and some Lymphomas. These links are not seen in other vitamins. There is no evidence vitamin d alone will cure pre existing MS. However, your parents/you having sufficient vitamin d may reduce the risk of you getting MS in the first place.

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    3. But vD has only been studied to the extent it has because of the obvious relationship to sun exposure / latitude. Many other vitamins / minerals simply haven't been studied. Many of them won't be so important. One or two may be. We just don't know, because the money isn't there to do endless research without the initial basis that vD had in providing some possible explanation for the geographical spread of MS. I'm not saying that vD isn't worth taking as a supplement, but it shouldn't be considered enough - a good all round diet with _no_ deficiencies is the aim, in my opinion.

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    4. As far as I know, and Prof. G. commented on this Canadian study, were found four genes pointed to inadequate absorption of Vitamin D3 by sunlight and food. If so it is, and you're one of the "lucky" to have such genes, you need to supplement D3 anyway already q the body will have difficulty such...

      http://www.medicaldaily.com/genetic-vitamin-d-deficiency-may-increase-risk-multiple-sclerosis-could-trip-beach-349826

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  10. I wish these studies wouldn't state what doseage the participants were taking of D3 -- and also what the serum levels of those who responded were -- so we have an idea of what serum level we need to have as a target level.

    My MS doctor said that 70 was an idea level but I'd like to have confirmation of that.

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    1. Anon at 3.20am - did your doctor mean 70 nmol/L or 70 ng/ml? There is a big difference - 70 nmol/L is 28 ng/ml and both of these are not that much over the "grey zone" for borderline deficiency according to the levels used in many countries. Quite a number of clinicians believe that PwMS should aim for maintaining their D3 levels at around 150nmol/L or 60ng/ml.

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