Fatima Mahejabeen, Lamis Aselah, Siddiqui Shiza W, Ashok Tejaswini, Patni Nassar, Fadiora Olatunji E
Internal Medicine, Deccan College of Medical Sciences, Hyderabad, IND.
Research, Dubai Medical College, Dubai, ARE.
Cureus. 2022 Jun 22;14(6):e26186. doi: 10.7759/cureus.26186. eCollection 2022 Jun.
Multiple sclerosis (MS) is an immune-mediated demyelinating disease of the nervous system with incredibly intricate etiopathogenesis involving numerous genetic, epigenetic, and environmental risk factors. Major environmental risk factors include ultraviolet (UV) radiation, vitamin D, Epstein-Barr virus (EBV) infection, smoking, and high body mass index (BMI). Vitamin D, in particular, can be viewed as one piece of this puzzle, with various tabs and pockets, occupying a sequential site. In this article, we have briefly discussed the neuroimmunology of MS and the role of vitamin D in regulating immune responses. Various observational studies and clinical trials were reviewed and discussed according to stages of disease activity and course of the disease. The data reviewed in this article implied that serum vitamin D levels greatly influence the risk of developing MS and disease activity. Long-term follow-up studies indicated that low serum vitamin D levels correlate with worse disability outcomes. Since clinical trials did not provide significant evidence, the role of vitamin D in controlling disease activity remains unresolved. Larger clinical trials are needed to support the findings of observational studies and provide significant evidence in favour of vitamin D.
多发性硬化症（MS）是一种免疫介导的神经系统脱髓鞘疾病，其发病机制极其复杂，涉及众多遗传、表观遗传和环境风险因素。主要的环境风险因素包括紫外线（UV）辐射、维生素D、爱泼斯坦-巴尔病毒（EBV）感染、吸烟和高体重指数（BMI）。特别是维生素D，可以被视为这个拼图中的一块，有各种标签和口袋，占据着一个连续的位置。在本文中，我们简要讨论了MS的神经免疫学以及维生素D在调节免疫反应中的作用。根据疾病活动阶段和病程对各种观察性研究和临床试验进行了综述和讨论。本文综述的数据表明，血清维生素D水平极大地影响患MS的风险和疾病活动。长期随访研究表明，低血清维生素D水平与更差的残疾结局相关。由于临床试验没有提供显著证据，维生素D在控制疾病活动中的作用仍未得到解决。需要更大规模的临床试验来支持观察性研究的结果，并提供支持维生素D的显著证据。
