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Review

Vitamin D as an Immune Modulator in Systemic Lupus Erythematosus: A Narrative Review

by
Oana Raluca Predescu
1,
Florentin Ananu Vreju
2,
Stefan Cristian Dinescu
2,
Cristina Elena Bita
2,
Anca Emanuela Musetescu
2,
Alesandra Florescu
2,* and
Paulina Lucia Ciurea
2
1
Doctoral School, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
2
Department of Rheumatology, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
*
Author to whom correspondence should be addressed.
Life 2025, 15(10), 1580; https://doi.org/10.3390/life15101580
Submission received: 9 September 2025 / Revised: 3 October 2025 / Accepted: 8 October 2025 / Published: 10 October 2025
(This article belongs to the Section Medical Research)

Abstract

Systemic lupus erythematosus (SLE) is a multisystem autoimmune disease in which environmental factors modulate genetically determined immune dysregulation. Vitamin D has emerged as a plausible modifier of disease expression because its active metabolite signals through the vitamin D receptor on innate and adaptive immune cells and influences antigen presentation, cytokine balance, and lymphocyte differentiation. This narrative review synthesizes current evidence on vitamin D status and supplementation in SLE with attention to organ-specific domains. Observational studies consistently report high rates of hypovitaminosis D in SLE and associations with less favorable clinical profiles, including higher global and renal disease activity, adverse cardiometabolic features, greater infection vulnerability, and neuropsychiatric manifestations. Preclinical models demonstrate neuroprotective and barrier-stabilizing actions of vitamin D analogs, supporting biological plausibility. Interventional trials indicate that supplementation safely corrects deficiency and shows signals of benefit for selected outcomes (e.g., modest activity reductions or fatigue in specific contexts), although effects on interferon signatures, complement, and autoantibodies are heterogeneous and often limited. Overall, current evidence supports optimization of vitamin D status as a low-risk adjunct in comprehensive SLE care while highlighting the need for adequately powered, organ-focused randomized trials using standardized measurements and prespecified endpoints to define causality, therapeutic targets, and long-term safety.
Keywords: systemic lupus erythematosus; vitamin D; disease activity; lupus nephritis; neurolupus; cardiovascular risk systemic lupus erythematosus; vitamin D; disease activity; lupus nephritis; neurolupus; cardiovascular risk

Share and Cite

MDPI and ACS Style

Predescu, O.R.; Vreju, F.A.; Dinescu, S.C.; Bita, C.E.; Musetescu, A.E.; Florescu, A.; Ciurea, P.L. Vitamin D as an Immune Modulator in Systemic Lupus Erythematosus: A Narrative Review. Life 2025, 15, 1580. https://doi.org/10.3390/life15101580

AMA Style

Predescu OR, Vreju FA, Dinescu SC, Bita CE, Musetescu AE, Florescu A, Ciurea PL. Vitamin D as an Immune Modulator in Systemic Lupus Erythematosus: A Narrative Review. Life. 2025; 15(10):1580. https://doi.org/10.3390/life15101580

Chicago/Turabian Style

Predescu, Oana Raluca, Florentin Ananu Vreju, Stefan Cristian Dinescu, Cristina Elena Bita, Anca Emanuela Musetescu, Alesandra Florescu, and Paulina Lucia Ciurea. 2025. "Vitamin D as an Immune Modulator in Systemic Lupus Erythematosus: A Narrative Review" Life 15, no. 10: 1580. https://doi.org/10.3390/life15101580

APA Style

Predescu, O. R., Vreju, F. A., Dinescu, S. C., Bita, C. E., Musetescu, A. E., Florescu, A., & Ciurea, P. L. (2025). Vitamin D as an Immune Modulator in Systemic Lupus Erythematosus: A Narrative Review. Life, 15(10), 1580. https://doi.org/10.3390/life15101580

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