High doses of vitamin D3 may help regulate the hyperactive immune response seen in people with multiple sclerosis, results from a pilot study indicate.
Low levels of vitamin D have previously been linked to an increased risk of MS, and patients who have MS and low levels of vitamin D are more likely to experience greater disability and disease activity.
The double-blind, single-center randomized study — conducted by Elias S. Sotirchos, MD, of Johns Hopkins University, and colleagues — included 40 patients with relapsing-remitting MS who were randomized to receive 10 400 IU or 800 IU cholecalciferol daily for 6 months. Evaluations were performed at baseline, 3, and 6 months.
Patients in the high dose group had a larger mean increase in 25-hydroxyvitamin D levels (34.9 ng/mL; 95% confidence interval [CI] 25.0–44.7 ng/mL) compared to the low-dose group (6.9 ng/mL; 95% CI 1.0–13.7 ng/mL). A reduction in the proportion of interleukin-17+CD4+ T cells (P = 5 0.016), CD161+CD4+ T cells (P = 5 0.03), and effector memory CD4+ T cells (P = 5 0.021) with a concomitant increase in the proportion of central memory CD4+ T cells (P = 5 0.018) and naive CD4+ T cells (P = 5 0.04) was observed in the high-dose group, but not the low-dose group. Adverse events, which did not differ between groups, were minor and one relapse occurred in each treatment group.
“We hope that these changes in inflammatory T cell responses translate to a reduced severity of disease,” said study author Peter Calabresi, MD, director of the Johns Hopkins Multiple Sclerosis Center. “Other clinical trials are underway to determine if that is the case.”
The authors note that an optimal level of vitamin D for people with MS has yet to be established; however those in the high-dose group achieved levels within 40 to 60 ng/mL, which has been proposed as a target.
“These results are exciting, as vitamin D has the potential to be an inexpensive, safe and convenient treatment for people with MS,” Dr Calabresi said. “More research is needed to confirm these findings with larger groups of people and to help us understand the mechanisms for these effects, but the results are promising.”