El Manar University, Tunis, Tunisia.
Clin Exp Rheumatol. 2010 Jul-Aug;28(4 Suppl 60):S50-7. Epub 2010 Sep 24.
There is little knowledge about clinical and immunological variables associated with vitamin D insufficiency in inflammatory diseases. We sought to investigate disease variables associated with vitamin D levels in patients with Behçet's disease (BD) and its interaction with inflammatory responses.
One hundred and sixty BD patients (102 patients in active stage) were enrolled in a study assessing the relationship between serum vitamin D concentrations and disease activity. As control diseases we studied 22 Rheumatoid arthritis (RA) and 30 multiple sclerosis (MS) patients. Serum concentrations of vitamin D were assayed with a radioimmunoassay kit. To assess the correlation between inflammatory mediators, immune cell expression and vitamin D, 20 active BD patients and 18 healthy controls were investigated: T-cell subsets and Treg cells were quantified by flow cytometry. Th1/Th2 ratio and Th17 were studied by intracytoplasmic cytokines expression (IFN-γ, IL-4, IL-10 and IL-17).
Decreased levels of vitamin D were observed in active BD patients compared to patients in the inactive stage and to healthy controls (p=0.0246; p=0.0001). A low significant difference was observed between inactive BD and healthy controls (p=0.004). Active BD expressed higher vitamin D levels than RA (p=0.007) and MS (p=0.044) patients (p=0.0238). In active BD, vitamin D levels were correlated with CRP and ESR. Serum levels of vitamin D correlated positively with the number of Treg cells (r=0.640; p=0.0024). The IFN-γ/IL-4 ratio (Th1/Th2) was inversely correlated with serum 25(OH)D levels (r=-0.599; p=0.0053).
Active BD was associated with lower serum Vitamin D levels. Our results showed that low levels of vitamin D were associated with a decrease in Treg cells and a skewing of the Th1/Th2 balance towards Th1. These findings suggest that vitamin D is an important promoter of T cell regulation in vivo in BD patients. As suggested in other inflammatory/autoimmune diseases, vitamin D may modulate inflammatory mediators.
关于炎症性疾病中维生素 D 不足相关的临床和免疫学变量，我们知之甚少。我们试图研究与 Behçet 病（BD）患者维生素 D 水平相关的疾病变量及其与炎症反应的相互作用。
本研究纳入 160 例 BD 患者（102 例处于活动期），评估血清维生素 D 浓度与疾病活动度之间的关系。作为对照疾病，我们研究了 22 例类风湿关节炎（RA）和 30 例多发性硬化症（MS）患者。采用放射免疫分析法检测血清维生素 D 浓度。为了评估炎症介质、免疫细胞表达与维生素 D 之间的相关性，我们对 20 例活动期 BD 患者和 18 例健康对照者进行了研究：通过流式细胞术定量检测 T 细胞亚群和 Treg 细胞。通过细胞内细胞因子表达（IFN-γ、IL-4、IL-10 和 IL-17）研究 Th1/Th2 比值和 Th17。
与活动期 BD 患者、缓解期 BD 患者和健康对照者相比，活动期 BD 患者的维生素 D 水平降低（p=0.0246；p=0.0001）。缓解期 BD 患者与健康对照者之间存在显著差异（p=0.004）。与 RA（p=0.007）和 MS（p=0.044）患者相比，活动期 BD 患者的维生素 D 水平更高（p=0.0238）。在活动期 BD 中，维生素 D 水平与 CRP 和 ESR 相关。血清维生素 D 水平与 Treg 细胞数量呈正相关（r=0.640；p=0.0024）。IFN-γ/IL-4 比值（Th1/Th2）与血清 25（OH）D 水平呈负相关（r=-0.599；p=0.0053）。
活动期 BD 与血清维生素 D 水平降低相关。我们的研究结果表明，低水平的维生素 D 与 Treg 细胞减少和 Th1/Th2 平衡向 Th1 倾斜有关。这些发现表明，维生素 D 是 BD 患者体内 T 细胞调节的重要促进剂。与其他炎症/自身免疫性疾病一样，维生素 D 可能调节炎症介质。
