Hart Prue H, Lucas Robyn M, Booth David R, Carroll William M, Nolan David, Cole Judith M, Jones Anderson P, Kermode Allan G
Telethon Kids Institute, University of Western Australia , Perth, WA , Australia.
Telethon Kids Institute, University of Western Australia, Perth, WA, Australia; National Centre for Epidemiology and Public Health, Research School of Population Health, Australian National University, Canberra, ACT, Australia.
Front Immunol. 2017 Jan 24;8:3. doi: 10.3389/fimmu.2017.00003. eCollection 2017.
Low vitamin D and insufficient sun exposure are additive independent risk factors for the development of multiple sclerosis (MS). The usual measure of vitamin D status, serum 25-hydroxy vitamin D [25(OH)D], is also a marker of recent exposure to the UVB rays of sunshine. The main evidence for a protective effect for MS development of higher 25(OH)D comes from observational studies, but this study design cannot separate out whether 25(OH)D is acting as a marker of vitamin D status, sun exposure, or both. In light of a lack of definitive outcomes in MS patients after trials of vitamin D supplementation and the ability of narrowband UVB to induce vitamin D, as well as other immune-regulatory molecules in skin, the Phototherapy for Clinically Isolated Syndrome (PhoCIS) trial was established to investigate the benefits of narrowband UVB, in addition to supplemented vitamin D, on MS development in individuals with Clinically Isolated Syndrome. We propose that the PhoCIS trial provides a fresh approach to re-defining the reported associations of 25(OH)D levels with MS development and progression.
维生素D水平低和阳光照射不足是多发性硬化症（MS）发病的独立相加风险因素。维生素D状态的常用指标血清25-羟基维生素D [25(OH)D]，也是近期阳光中紫外线B（UVB）照射的一个标志物。较高的25(OH)D对MS发病具有保护作用的主要证据来自观察性研究，但这种研究设计无法区分25(OH)D是作为维生素D状态的标志物、阳光照射的标志物，还是两者兼而有之。鉴于补充维生素D试验后MS患者缺乏明确的结果，以及窄谱UVB能够诱导皮肤中维生素D以及其他免疫调节分子，开展了临床孤立综合征光疗（PhoCIS）试验，以研究除补充维生素D外，窄谱UVB对临床孤立综合征患者MS发病的益处。我们认为，PhoCIS试验为重新定义所报道的25(OH)D水平与MS发病及进展之间的关联提供了一种新方法。
