147P London, UK
Pharmacology 2016

 

 

Vitamin D and immunomodulation in rheumatoid arthritis

I. Buondonno1, G. Rovera2, F. Sassi1, M. Rigoni1, R. Pellerito2, G. Isaia1, P. D\'Amelio1. 1Department of Medical Science, Gerontology and Bone Metabolic Disease Section, University of Torino, Torino, ITALY, 2Rheumatology Unit, Ospedale Mauriziano, Torino, ITALY.

Introduction: The aim of this study was to evaluate differences in T helper (Th) cell sub-types and osteoclast (OCs) precursors in peripheral blood between patients affected by early rheumatoid arthritis (eRA) and healthy controls. The effect of administration of cholecalcipherol on clinical and laboratory parameters was subsequently evaluated.

Methods: Thirty six eRA patients and 31 age-matched controls were enrolled and compared for levels of 25OH vitamin D, Th, OCs precursors including both classical and non-classical and pro-inflammatory cytokines at baseline. In the second phase of the study, eRA were randomly assigned to standard treatment with methotrexate (MTX) and glucocorticoids (GC) with or without cholecalcipherol (300,000 IU) and followed for 3 mo nths .

Results: In eRA, 25OH vitamin D levels were significantly lower, although still within the normal range. Levels of Th1 and Th17 cells were increased in eRA as well as non-classical OCs precursors. Levels of TNFα, TGFβ1, RANKL, IL-23 and IL-6 were increased in eRA. Non-classical OCs, IL-23 and IL-6 correlated with disease severity and activity. Standard treatment with MTX and GC ameliorated clinical symptoms and reduced IL-23, whereas it did not affect Th sub-sets nor OCs precursors. After 3 months, the combined use of cholecalcipherol significantly ameliorated the effect of treatment on general health.

Quadratic
Variable mean F p
Treatment Th1 10.332 2.395 0.132
Th17 0.737 1.023 0.320
Non classical OCs 0.045 1.816 0.188
OCs 0,081 2.05 0.162
Treatment+ Th1 4.263 0.988 0.328
Cholecalcipherol Th17 2.116 2.938 0.097
Non classical OCs 0.028 1.123 0.298
OCs 0.019 0.483 0.492

Conclusion: In eRA, a significant imbalance in Th sub-types accompanied by increased levels of non-classical OCs precursors and pro-inflammatory cytokines was observed. A single dose of cholecalcipherol (300,000 IU) combined with standard treatment significantly ameliorates patients general health, even in the absence of hypovitaminosis D.