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Vitamin D Supplementation in Central Nervous System Demyelinating Disease—Enough Is Enough

1
Institute of Neuropathology, University Medical Center, 37099 Göttingen, Germany
2
Department of Neurology, University Medical Center, 37099 Göttingen, Germany
*
Author to whom correspondence should be addressed.
Int. J. Mol. Sci. 2019, 20(1), 218; https://doi.org/10.3390/ijms20010218
Received: 28 September 2018 / Revised: 24 December 2018 / Accepted: 24 December 2018 / Published: 8 January 2019
(This article belongs to the Special Issue New Molecular Mechanisms in Multiple Sclerosis)
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Abstract

The exact cause of multiple sclerosis (MS) remains elusive. Various factors, however, have been identified that increase an individual’s risk of developing this central nervous system (CNS) demyelinating disease and are associated with an acceleration in disease severity. Besides genetic determinants, environmental factors are now established that influence MS, which is of enormous interest, as some of these contributing factors are relatively easy to change. In this regard, a low vitamin D status is associated with an elevated relapse frequency and worsened disease course in patients with MS. The most important question, however, is whether this association is causal or related. That supplementing vitamin D in MS is of direct therapeutic benefit, is still a matter of debate. In this manuscript, we first review the potentially immune modulating mechanisms of vitamin D, followed by a summary of current and ongoing clinical trials intended to assess whether vitamin D supplementation positively influences the outcome of MS. Furthermore, we provide emerging evidence that excessive vitamin D treatment via the T cell-stimulating effect of secondary hypercalcemia, could have negative effects in CNS demyelinating disease. This jointly merges into the balancing concept of a therapeutic window of vitamin D in MS. View Full-Text
Keywords: multiple sclerosis; vitamin D; vitamin D receptor; experimental autoimmune encephalomyelitis; T cells; hypercalcemia multiple sclerosis; vitamin D; vitamin D receptor; experimental autoimmune encephalomyelitis; T cells; hypercalcemia
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Häusler, D.; Weber, M.S. Vitamin D Supplementation in Central Nervous System Demyelinating Disease—Enough Is Enough. Int. J. Mol. Sci. 2019, 20, 218.

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