Diseases

vitamin D3 in patients with rheumatoid arthritis

 The standard of therapy for RA is triple disease-modifying anti-rheumatic drug (DMARD) therapy along with anti-inflammatory therapy using non-steroidal anti-inflammatory drugs (NSAIDs). The use of immunological DMARTD agents like infliximab, etanercept and rituximab are also combined with methotrexate. This all generates sometimes troublesome side effetcs.  No other pain reduction treatments are available so far.

1,25 dihydroxy vitamin D3 has been found to have a role in the suppression of autoimmunity and a role in chronic neuropathic pain. The autors add to this general fact:

The amelioration of autoimmune disease seems to be by the inhibition of T helper-1 (Th1) cells. Th1 cells secrete interferon- γ (IFN-γ), interleukin-2 (IL-2) and tumor necrosis factor alpha (TNF-α). In autoimmune diseases, like RA, Th1 cells are directed against self-antigens.

1,25-dihydroxy vitamin D3 decreases the production of IFN-γ, IL-2 and IL-5 in Th-1 cells and inhibits Th-1 proliferation. 1,25-dihydroxy vitamin D3 increases the production of IL-4 by Th-2 cells, which results in an immumos-upressive action.

Murine models have shown that experimental arthritis can be prevented by administration of 1,25 dihydroxy vitamin D3.

Supplementation of 1,25 dihydroxy vitamin D3 has been shown to be protective against RA in Caucasian women. An uncontrolled study on patients with active RA showed a significant decrease in the disease activity scores (DAS) on addition of alpha calcidol to patients with rheumatoid arthritis being treated with methrotrexate alone or in combination with steroids.