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Confirmation of association between Multiple Sclerosis, CYP27B1 & Vitamin D

Sunday, July 25th, 2010 | Tags: , , , , , , , , , , , , , , , , , , , , ,
Posted in External News Articles, Uncategorized

Confirmation of association between multiple sclerosis, CYP27B1 and vitamin D

Multiple sclerosis, MS (OMIM No. 126200), is a complex inflammatory disease that is characterized by lesions in the central nervous system.

Both genes and other environmental factors influence disease susceptibility. One of the environmental factors that has been implicated in MS and autoimmune disease, such as type 1 diabetes, is vitamin D deficiency, in which patients have lower levels of 25-hydroxyvitamin D3 (25-OHD3) in blood than do controls.

Previtamin D3 is produced in the skin, and turned into 25-OHD3 in the liver. In the kidney, skin and immune cells, 25-OHD3 is turned into bioactive 1,25(OH)2D3 by the enzyme coded by CYP27B1 (cytochrome P450 family 27 subfamily B peptide 1) on chromosome 12q13.1–3. 1,25(OH)2D3 binds to the vitamin D receptor, expressed in T cells and antigen-presenting cells. 1,25(OH)2D3 has a suppressive role in the adaptive immune system, decreasing T-cell and dendritic cell maturation, proliferation and differentiation, shifting the balance between T-helper 1 (Th1) and Th2 cells in favor of Th2 cells and increasing the suppressive function of regulatory T cells. Rs703842 in the 12q13–14 region was associated with MS in a recent study by the Australian and New Zealand Multiple Sclerosis Genetics Consortium (ANZgene).

We show associations with three SNPs in this region in our Swedish materials (2158 cases, 1759 controls) rs4646536, rs10877012 and rs10877015 (P=0.01, 0.01 and 3.5 × 10−3, respectively). We imputed rs703842 SNP and performed a joint analysis with the ANZgene results, reaching a significant association for rs703842 (P=5.1 × 10−11; odds ratio 0.83; 95% confidence interval 0.79–0.88).

Owing to its close association with 25-OHD3, our results lend further support to the role of vitamin D in MS pathology.

  1. 1Neuroimmunology Unit, Department of Clinical Neuroscience, Center for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden
  2. 2Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
  3. 3Department of Clinical Neuroscience, Center for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden

Correspondence: E Sundqvist, Neuroimmunology Unit, Department of Clinical Neuroscience, Center for Molecular Medicine L8:04, Karolinska Institutet, Stockholm 17176, Sweden. Tel: +46 85 177 6258; Fax: +46 85 177 6248; E-mail: Emilie.Sundqvist@ki.se

Received 4 December 2009; Revised 19 March 2010; Accepted 4 June 2010; Published online 21 July 2010.

http://www.nature.com/ejhg/journal/vaop/ncurrent/abs/ejhg2010113a.html

Multiple sclerosis and vitamin D: a review and recommendations.

Sunday, July 25th, 2010 | Tags: , , , , , , , ,
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Multiple sclerosis and vitamin D: a review and recommendations.

Solomon AJ, Whitham RH.

Department of Neurology, Oregon Health & Science University, 3181 Southwest Sam Jackson Park Road, CR 120, Portland, OR 97239, USA. solomoan@ohsu.edu

A relationship between vitamin D and several diseases, including multiple sclerosis (MS), has recently received interest in the scientific community. Vitamin D appears to have important actions beyond endocrine function, particularly for the immune system. Risk of development of MS, as well as disease severity, has been associated with vitamin D in a variety of studies. There remains a need for prospective studies to further establish this relationship. Given the current evidence of the potential benefits of vitamin D, it appears to be reasonable and safe to consider vitamin D supplementation at dosing adequate to achieve normal levels in patients with MS and clinically isolated syndrome.

source : http://www.ncbi.nlm.nih.gov/pubmed/20556546

Lighting the way to better health: vitamin D

Thursday, July 22nd, 2010 | Tags: , , , , , , , ,
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Lighting the way to better health: vitamin D

17th July 2010

The Lancet

The public health message is compellingly simple: avoid the sun to prevent melanoma and other forms of skin cancer. Unfortunately, exposure to sunlight is the mainstay of vitamin D synthesis, and vitamin D deficiency causes rickets and osteomalacia, contributes to osteoporosis, and has been associated with many other disorders, including diabetes, cancer, and cardiovascular disease.

Ultraviolet B radiation produces 90% of vitamin D in human beings; only a very small proportion can be obtained through diet. However, at high latitudes, levels of sunlight in winter are often so low that vitamin D insufficiency is common. Avoidance of the sun’s rays by covering up or use of sunscreen can compound this problem, and is thought to have contributed to a recent increase in metabolic bone disease. Cancer Research UK recognises the need to balance skin cancer prevention with generation of adequate vitamin D, but specified that “the skin efficiently produces vitamin D at levels of sun exposure below those that cause sunburn…when it comes to sun exposure, little and often is best”. Australia’s SunSmart guidelines underwent a revision to reflect this balance in 2006—07.

A major concern is that people might seek prolonged sun exposure without protection to boost vitamin D synthesis. Indeed, the American Academy of Dermatology argues that the risks of sun exposure outweigh the benefits, advocating instead for dietary supplementation as a safe source of vitamin D. A report published in the British Journal of Nutrition emphasises that in the UK, a unified approach to vitamin D supplementation is needed to address deficiency in pregnant women and avoid life-threatening complications for their babies.

Despite the simmering debate about sun exposure surrounding vitamin D, the SUNLIGHT consortium’s genome-wide association study, published in The Lancet today, should add to our understanding of the genetic basis of interindividual variability in the synthesis of vitamin D. These findings could eventually help to identify who is most at risk of vitamin D insufficiency and related diseases. Until such potential applications come to the fore, the message about sun exposure has to be sensibly moderate. Enjoy the summer sun, with caution.

Source : The lancet

http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(10)61094-X/fulltext?elsca1=TL-160710&elsca2=email&elsca3=segment

Scottish Vitamin D Summit Captures International Attention

Wednesday, July 21st, 2010 | Tags: , , , , , , , , , , , , , , , , , , , , , , , , ,
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Scottish Vitamin D Summit Captures International Attention

For immediate release : July 21st 2010

Shine on Scotland campaigners and the MS Society Scotland held productive talks with the Scottish Government yesterday as planning continues for the Scottish Summit on Vitamin D and MS which will take place in Glasgow in September.

Cabinet Secretary for Health and Wellbeing Nicola Sturgeon will open the event at which international researchers and scientists will be present to discuss the latest research on vitamin D and the implications for public health policy in Scotland.

In recent weeks more researchers from as far afield as Australia have confirmed their attendance at the summit.  International media organisations have also expressed an interest in the event which looks set to be high profile.

Looking ahead to September, Ryan McLaughlin said:

“It’s incredibly exciting that it’s now so close.  A lot of work has gone into the campaign and hopefully this summit will make a real difference.  The Scottish Government and Parliament have been very supportive of the campaign and it’s great to have reached this stage”.

Craig Wilkie, Head of Policy and Communications at MS Society Scotland also attended the meeting at St Andrews House:

“The Summit is a great opportunity to bring internationally renowned researchers to Scotland to discuss a hugely important public health issue.  The focus will be a practical one in terms of public health policy and we have the chance to learn lessons from other countries and make a significant contribution to the health of the nation”.

More than half the world’s population gets insufficient vitamin D, says UCR biochemist

Sunday, July 18th, 2010 | Tags: , , , , , , , , , , ,
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Contact: Iqbal Pittalwala
iqbal@ucr.edu
951-827-6050
University of California – Riverside

RIVERSIDE, Calif. – Vitamin D surfaces as a news topic every few months. How much daily vitamin D should a person get? Is it possible to have too much of it? Is exposure to the sun, which is the body’s natural way of producing vitamin D, the best option? Or do supplements suffice?

In the July 2010 issue of Endocrine Today, a monthly newspaper published by SLACK, Inc., to disseminate information about diabetes and endocrine disorders, Anthony Norman, a distinguished professor emeritus of biochemistry and biomedical sciences and an international expert on vitamin D, notes that half the people in North America and Western Europe get insufficient amounts of vitamin D.

Anthony Norman is a distinguished professor of biochemistry and biomedical sciences (emeritus) at UC Riverside, and an international expert on vitamin D.

Anthony Norman is a distinguished professor of biochemistry and biomedical sciences (emeritus) at UC Riverside, and an international expert on vitamin D.

“Elsewhere, it is worse,” he says, “given that two-thirds of the people are vitamin D-insufficient or deficient. It is clear that merely eating vitamin D-rich foods is not adequate to solve the problem for most adults.”

Currently, the recommended daily intake of vitamin D is 200 international units (IU) for people up to 50 years old; 400 IU for people 51 to 70 years old; and 600 IU for people over 70 years old.

“There is a wide consensus among scientists that the relative daily intake of vitamin D should be increased to 2,000 to 4,000 IU for most adults,” Norman says. “A 2000 IU daily intake can be achieved by a combination of sunshine, food, supplements, and possibly even limited tanning exposure.”

While there is now abundant data on vitamin D and its benefits, Norman believes there is room for more study.

“The benefits of more research on the topic justifies why this field of research deserves additional governmental funding,” he says. “Already, several studies have reported substantial reductions in incidence of breast cancer, colon cancer and type 1 diabetes in association with adequate intake of vitamin D, the positive effect generally occurring within five years of initiation of adequate vitamin D intake.”

Because vitamin D is found in very few foods naturally (e.g. fish, eggs and cod liver oil) other foods such as milk, orange juice, some yogurts and some breakfast foods are fortified with it. The fortification levels aim at about 400 IU per day.

Norman, who holds the title of Presidential Chair in Biochemistry-Emeritus, has been researching vitamin D for nearly 50 years. In 1967, his laboratory discovered that the vitamin is converted into a steroid hormone by the body. Two years later, his laboratory discovered the vitamin D receptor (or VDR), an essential receptor for the steroid hormone form of vitamin D that is present in more than 37 target organs of the body that respond biologically to the vitamin.

“There is now irrevocable evidence that receptors in the immune, pancreas, heart-cardiovascular, muscle and brain systems in the body generate biological responses to the steroid hormone form of vitamin D,” he says.


Hypovitaminosis D – one of the MS risk factors?

Thursday, July 15th, 2010 | Tags: , , , ,
Posted in Uncategorized

The role of hypovitaminosis D as a possible risk factor for multiple sclerosis is reviewed.

First, it is emphasized that hypovitaminosis D could be only one of the risk factors for multiple sclerosis and that numerous other environmental and genetic risk factors appear to interact and combine to trigger the disease.

Secondly, the classical physiological notions about vitamin D have recently been challenged and the main new findings are summarized.
This vitamin could have an important immunological role involving a number of organs and pathologies, including autoimmune diseases and multiple sclerosis. Furthermore, human requirements for this vitamin are much higher than previously thought, and in medium- or high-latitude countries, they might not be met in the majority of the general population due to a lack of sunshine and an increasingly urbanized lifestyle. Thereafter, the different types of studies that have helped to implicate hypovitaminosis D as a risk factor for multiple sclerosis are reviewed.

In experimental autoimmune encephalomyelitis, vitamin D has been shown to play a significant immunological role.

Diverse epidemiological studies suggest that a direct chain of causality exists in the general population between latitude, exposure to the sun, vitamin D status and the risk of multiple sclerosis. New epidemiological analyses from France support the existence of this chain of links.

Recently reported immunological findings in patients with multiple sclerosis have consistently shown that vitamin D significantly influences regulatory T lymphocyte cells, whose role is well known in the pathogenesis of the disease.

Lastly, in a number of studies on serum levels of vitamin D in multiple sclerosis, an insufficiency was observed in the great majority of patients, including at the earliest stages of the disease.
The questionable specificity and significance of such results is detailed here.

Based on a final global analysis of the cumulative significance of these different types of findings, it would appear likely that hypovitaminosis D is one of the risk factors for multiple sclerosis.

Charles Pierrot-Deseilligny1 and Jean-Claude Souberbielle2

1 Service de Neurologie 1, Hoˆ pital de la Salpeˆ trie` re, Assistance Publique Hoˆ pitaux de Paris, Universite´ Pierre et Marie Curie (Paris VI), Paris, France
2 Service d’explorations fonctionnelles, Hoˆ pital Necker-Enfants-Malades, Assistance Publique Hoˆ pitaux de Paris, Universite´ Rene´ Descartes (Paris V),
Paris, France

Source: Brain © The Author (2010). Published by Oxford University Press on behalf of the Guarantors of Brain.(12/07/10)

A dose of Midday sun can be good for you: Advice U-turn after years of telling us to cover up

Wednesday, July 7th, 2010 | Tags: , , , , , , ,
Posted in Uncategorized

According to the old song, only mad dogs and Englishmen go out in the midday sun.

Yet the latest thinking is that maybe everyone should give it a try.

After years of urging us to cover up, a leading charity is expected to recommend short spells exposed to the sun at its highest.

The advice, from Cancer Research UK, reflects concern that current sunbathing recommendations are unnecessarily restrictive and are leading to low levels of vitamin D.

Although the vitamin is found in some foods, most of that found in the body comes from sunlight exposure, and most of us just don’t have enough of it.

In England, half of the population is low in the ’sunshine vitamin’ when winter ends, while in Scotland the proportion is two thirds.

As part of its remit to prevent skin cancer, the charity advises trying to stay out of the sun when it is at its peak and cover the skin with clothing and generous amounts of sunscreen.

But a confidential statement being prepared by the charity acknowledges that the evidence about the benefits of vitamin D is growing.

The vitamin is vital for calcium absorption and bone health, and could help ward off Alzheimer’s.

Recent research has shown that vitamin D supplements are as good as some drugs at keeping prostate cancer under control – and it is said that taking supplements in pregnancy and childhood could wipe out 80 per cent of cases of multiple sclerosis.

Read more:

IOF releases new position statement on Vitamin D for older adults

Monday, July 5th, 2010 | Tags: , , ,
Posted in Uncategorized

IOF has released a new position statement on Vitamin D for older adults which makes important recommendations for vitamin D nutrition from an evidence-based perspective.

Vitamin D is important for bone and muscle development, function and preservation. For this reason it is a vital component in the maintenance of bone strength and in the prevention of falls and osteoporotic fractures.

The objective of this statement, published in the leading bone journal, Osteoporosis International (OI DOI 10 1007/s00198-010-1285-3), was to use and examine all available evidence to support new recommendations for optimal vitamin D status.

The best available clinical indicator of vitamin D status is serum 25OHD and vitamin D intake and effective sun exposure are the major determinants of this level. Serum 25OHD levels decline with ageing but the response to vitamin D3 supplementation is not affected by age or by usual calcium dietary intake.

Preventing vitamin D deficiency has a major impact on falls and osteoporotic fractures. Vitamin D deficiency is associated with decreased muscle strength in older men and women and supplementation improves lower limb strength and reduces risk of falling. Vitamin D affects fracture risk through its effect on bone metabolism and on falls risk.

Key recommendations:

  • The estimated average vitamin D requirement of older adults to reach a serum 25OHD level of 75 nmol/l (30ng/ml) is 20 to 25 µg/day (800 to 1000 IU/day).
  • Intakes may need to increase to as much as 50 µg(2000IU) per day in individuals who are obese, have osteoporosis, limited sun exposure (e.g. housebound or institutionalised), or have malabsorption.
  • For high risk individuals it is recommended to measure serum 25OHD levels and treat if deficient.

The lead author of the statement, Professor Bess Dawson-Hughes of Tufts University, US, stated that, “Global vitamin D status shows widespread insufficiency and deficiency. This high prevalence of suboptimal levels raises the possibility that many falls and fractures can be prevented with vitamin D supplementation. This is a relatively easy public health measure that could have significant positive effects on the incidence of osteoporotic fractures.”

Oliver Gillie: Time to abandon this outdated view on staying out of the sun

Monday, July 5th, 2010 | Tags: , , , , , , , , , , , , , ,
Posted in Uncategorized

Monday, 5 July 2010

Lack of sunshine and the vitamin that it makes in our skin is probably the most serious single cause of disease in the UK today.

Vitamin D deficiency is well known as the classic cause of rickets and serious bone diseases, but in the last 10 years it has also been identified as a major risk factor for diabetes, heart disease, arthritis, infections, some cancers and other ills.

The cost of all this disease to the UK has been put at an astounding £27bn annually, which compares with only £5bn for the cost of disease caused by smoking.

Small amounts of vitamin D can be obtained from food but you can’t obtain more than about 10 per cent of the optimal amount this way unless you eat oily fish – skin and all – three times a day.

We depend on the sun for our vitamin D. Since our weather is so unreliable, British people suffer more than almost any other from vitamin D deficiency.

Many years of bad advice has also been a factor.

The British Isles are located far north so the winter sun is not strong enough to make any vitamin D. The prevailing westerly wind bringing cloud in from the Atlantic is also against us. The Scots are worst off because there is nothing to the west to protect them. Their vitamin D levels are lower and they have the highest incidence of multiple sclerosis in the world.

Scientists studying MS now believe that it may be prevented if women take vitamin D in pregnancy and children take regular supplements. Another devastating disease, diabetes type 1 – affecting mostly children who must inject themselves with insulin – could be prevented by the same vitamin D supplements.

Indeed it is possible that these two diseases could now be eradicated if Government had the will.

However a recommendation that pregnant women take vitamin D has been ignored over many years by obstetricians.

Standard advice is that babies are not given vitamin D until they are six months old. Nobody any longer remembers the reason for this, which is implemented nowhere else.

Everybody thinks that breast milk is a complete food – and so it might be if mothers sunbathed as often as they can. As it is, breast milk in the UK is deficient in vitamin D while artificial milk is supplemented.

This need not be a problem if mothers give vitamin D drops to their babies. Melanoma, the worst form of skin cancer, has dramatically increased during some 20 years of advice to avoid the sun and use suncream. This is quite possibly because the advice has been wrong. Suncream blocks the action of UVB (shortwave ultraviolet radiation from the sun) – so blocking synthesis of vitamin D with loss of protection against cancer – while UVA (longwave radiation), which seems to carry the main risk of melanoma, is not blocked by many creams.

We could do much, much more. The Irish Republic has already fortified semi-skimmed milk with vitamin D, Finland has fortified milk and Israel is making milk fortification mandatory. Jordan is bringing in fortification of bread.

The UK the Food Standards Agency has hummed and hawed. The United States has had fortification for 80 years. What are the English and Scots waiting for?

The one simple action open to us all is to sunbathe, carefully without burning. The sun is natural, free, and safe if you are sensible. It’s also good to take a vitamin D supplement of at least 1000 to 2000 IUs [international units of measurement] per day.

The author is a health writer and vitamin D campaigner.

http://www.independent.co.uk/opinion/commentators/oliver-gillie-time-to-abandon-this-outdated-view-on-staying-out-of-the-sun-2018389.html

Pregnant women ‘must take vitamin D supplements’

Sunday, July 4th, 2010 | Tags: , , , , , ,
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By Caroline Parkinson
Health reporter, BBC News

Pregnant women in the UK should be told to routinely take vitamin D supplements, researchers say.

The team at University College London Institute of Child Health says official bodies currently offer conflicting advice.

Writing in the British Journal of Nutrition, they say there is a “strong case” for a daily dose of vitamin D in pregnancy.

But one leading expert said more evidence was needed.

The Department of Health advises pregnant women to ensure they receive a certain level of vitamin D – 10 micrograms per day. The researchers say this in effect endorses use of supplements, because diet and the sun provide too little.

But the National Institute of health and Clinical Excellence (NICE) said in its guidance that it did not support supplements.

It has instead said that women should simply “be informed” about the importance of having adequate vitamin D levels during their pregnancy and while breastfeeding – adding that some women may choose to do this via supplements.

Additionally, pregnant women on low incomes are entitled to a range of nutrients – including vitamin D – as part of the Healthy Start Scheme.

‘Unacceptably high’

The paper said the UK was the only one of 31 countries examined which did not recommend that women of reproductive age took a vitamin D supplement, and that it also fails to endorse a daily supplement for expectant mothers.

Dr Elina Hypponen, co-author of the paper, said: “The incidence of vitamin D deficiency in pregnant women in Britain is unacceptably high, especially during winter and spring.

“This is compounded by a lack of exposure to sunlight and the limitations of an average diet to meet the optimal need.

“In the most severe cases, maternal vitamin D deficiency can be life threatening to a newborn.

“We believe that the routine provision of a daily supplement throughout pregnancy would significantly decrease the number of mothers who are clearly vitamin D deficient, reducing related serious risks to their babies.”

Dr Hypponen said past evidence showed a proactive approach to supplements coincided with a much lower incidence of deficiency linked diseases such as infantile hypocalcaemia [also known as William's syndrome, which affects development], and rickets [which weakens bones].

One in four

The authors say women from some ethnic minorities are recognised to be at greater risk because their darker skin means they do not absorb as much sunlight.

But they add that the problem is also common among white women, even when they live in southern England.

Women are more likely to be vitamin D deficient than men, and a previous study found one in four pregnant mothers has been found to be vitamin D deficient during winter and spring

The Royal College of Obstetricians and Gynaecologists recommends only women at risk of vitamin D deficiency should take a supplement.

Patrick O’Brien, a spokesman for the college, said: “There is gradually accumulating evidence that universal vitamin D supplementation in the UK might be beneficial for the whole population.

“But more research is needed on the balance of risks and benefits in women at low risk of vitamin D deficiency, and on the correct dosage to use.”

http://news.bbc.co.uk/1/hi/health/10486310.stm

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