Department of Dermatology and Venereology, Medical University of Lodz, Poland.
Lupus. 2012 Apr;21(5):477-84. doi: 10.1177/0961203311427549. Epub 2011 Nov 7.
To identify relationships between vitamin D serum levels and the presence of autoantibodies directed against vitamin D and levels of interleukin(IL)-17 and IL-23 in patients with systemic lupus erythematosus (SLE).
The study included 49 patients with SLE. Serum concentrations of 25(OH)D(3) were measured with electrochemiluminescence immunoassay (ECLIA). Enzyme-linked immunosorbent assays (ELISA) were used to determine antibodies directed against 1,25(OH)(2)D(3) and levels of IL-17 and IL-23 in serum of SLE patients. In evaluation of vitamin D status, the control group consisted of 49 age and gender matched healthy individuals, whereas in assessment of anti-vitamin D antibodies the control group comprised 30 sera from blood donors.
Serum concentration of 25(OH)D(3) in SLE patients during the warm season was 18.47 ± 9.14 ng/ml, which was significantly decreased as compared with that of the control group - 31.27 ± 12.65 ng/ml (p = 0.0005). During the cold season a trend toward lower concentration of 25(OH)D(3) in SLE patients was revealed; however, it did not reach statistical significance (11.71 ± 7.21 ng/ml vs. 16.01 ± 8.46 ng/ml; p = 0.054). Results within the recommended range for vitamin D (30-80 ng/ml; 70-200 nmol/l) were observed only in three patients. The 25(OH)D(3) concentration was decreased in SLE patients with renal disease or leucopenia as compared with the levels in patients who did not have either problem (p = 0.006 and p = 0.047, respectively). The cold season was found to be a risk factor for vitamin D deficiency (<20 ng/ml) (odds ratio = 9.25; p = 0.005). Autoantibodies directed against 1,25(OH)(2)D(3) were detected in three SLE patients. No significant difference in 25(OH)D(3) serum concentrations was found between SLE patients with and without these autoantibodies. No link was shown between the existence of autoantibodies against 1,25(OH)(2)D(3) and clinical or laboratory findings, including IL-17 and IL-23 levels. However, serum concentrations of IL-23 were lower in patients with vitamin D deficiency (p = 0.037).
SLE patients, especially those with leucopenia or renal involvement, are at high risk of vitamin D deficiency and require vitamin D supplementation. Some SLE patient sera contained 1,25(OH)(2)D(3) antibodies, but these antibodies do not appear to affect vitamin D levels.
确定血清维生素 D 水平与针对维生素 D 的自身抗体的存在以及系统性红斑狼疮 (SLE) 患者白细胞介素(IL)-17 和 IL-23 水平之间的关系。
本研究纳入了 49 名 SLE 患者。使用电化学发光免疫分析 (ECLIA) 测定血清 25(OH)D(3)浓度。酶联免疫吸附试验 (ELISA) 用于测定 SLE 患者血清中针对 1,25(OH)(2)D(3)的抗体和 IL-17 和 IL-23 的水平。在评估维生素 D 状态时，对照组由 49 名年龄和性别匹配的健康个体组成，而在评估抗维生素 D 抗体时，对照组由 30 份献血者血清组成。
SLE 患者在温暖季节的血清 25(OH)D(3)浓度为 18.47±9.14ng/ml，明显低于对照组的 31.27±12.65ng/ml（p=0.0005）。在寒冷季节，SLE 患者的 25(OH)D(3)浓度呈下降趋势，但未达到统计学意义（11.71±7.21ng/ml vs. 16.01±8.46ng/ml；p=0.054）。仅在 3 名患者中观察到维生素 D（30-80ng/ml；70-200nmol/l）的推荐范围内的结果。与没有这些问题的患者相比，患有肾脏疾病或白细胞减少症的 SLE 患者的 25(OH)D(3)浓度降低（p=0.006 和 p=0.047）。寒冷季节被发现是维生素 D 缺乏症（<20ng/ml）的危险因素（比值比=9.25；p=0.005）。在 3 名 SLE 患者中检测到针对 1,25(OH)(2)D(3)的自身抗体。未发现自身抗体阳性的 SLE 患者与自身抗体阴性的 SLE 患者的血清 25(OH)D(3)浓度存在显著差异。针对 1,25(OH)(2)D(3)的自身抗体的存在与临床或实验室发现（包括白细胞介素 17 和白细胞介素 23 水平）之间没有关联。然而，维生素 D 缺乏症患者的血清白细胞介素 23 浓度较低（p=0.037）。
SLE 患者，尤其是患有白细胞减少症或肾脏受累的患者，维生素 D 缺乏症的风险较高，需要补充维生素 D。一些 SLE 患者的血清中含有 1,25(OH)(2)D(3)抗体，但这些抗体似乎不会影响维生素 D 水平。
