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Sarcoidosis & Vitamin D

Sarcoidosis & Vitamin D. Lindsey Janeiro. Vitamin D. Fat-soluble vitamin Hormone Sources: Dietary Supplements, Synthesized from the sun. Vitamin D Functions. Regulating blood calcium levels Maintaining bone health Assisting in cell differentiation Regulation of immune response.

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Sarcoidosis & Vitamin D

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  1. Sarcoidosis & Vitamin D Lindsey Janeiro

  2. Vitamin D • Fat-soluble vitamin • Hormone • Sources: • Dietary • Supplements, • Synthesized from the sun Thompson JL, Manore MM, Vaughan LA. The Science of Nutrition. Second Edition. San Francisco, CA: Pearson Higher Ed.; 2011.

  3. Vitamin D Functions • Regulating blood calcium levels • Maintaining bone health • Assisting in cell differentiation • Regulation of immune response Thompson JL, Manore MM, Vaughan LA. The Science of Nutrition. Second Edition. San Francisco, CA: Pearson Higher Ed.; 2011. Hewison M. Vitamin D and the immune system: New perspectives on an old theme. Endocrinology & Metabolism Clinics of North America. 2010; 39(2): 365-379.

  4. Sarcoidosis • Chronic systemic inflammatory disease • Granulomas • Tiny clusters of immune cells (macrophages) • Typically affects: • Lungs, lymphatic system, eyes, skin, joints, heart, liver, and brain • Exact genetic causation unclear • Potential infectious, environmental, & genetic factors Kavathia D, Buckley JD, Rao D, Rybicki B, Burke R. Elevated 1,25-dihydroxyvitamin D levels are associated with protracted treatment in sarcoidosis. Respiratory Medicine. 2010; 104: 564-570. Maver A, Medica I, Salobir B, Tercelj M, Peterlin B. Lack of association of immune-response-gene polymorphisms with susceptibility to sarcoidosis in Slovenian patients. Genetic and Molecular Research. 2010; 9(1): 58-68. Rosenbaum JT, Pasadhika S, Crouser ED, et al. Hypothesis: Sarcidosis is a STAT1-mediated disease. Clinical Immunology. 2009; 132: 174-183.

  5. Sarcoidosis • Symptoms are usually non-specific complaints: • Fatigue • Depression • “Asthma symptoms” (wheezing, coughing) • Muscle pain • Weakness • Arthritis • Reduced work capacity • Hypercalcemia Kavathia D, Buckley JD, Rao D, Rybicki B, Burke R. Elevated 1,25-dihydroxyvitamin D levels are associated with protracted treatment in sarcoidosis. Respiratory Medicine. 2010; 104: 564-570. Hinz A, Fleischer M, Brähler E, Wirtz H, Bosse-Henck A. Fatigue in patients with sarcoidosis, compared to the general population. General Hospital Psychiatry. 2011; 33: 462-468.

  6. Correlation between Vitamin D and Sarcoidosis • Elevated 1,25-dihydroxyvitamin D3 • Increased 1α-hydroxylase activity • Kidneys • Macrophages • Excess calcitriol and calcium don’t lead to the shutdown of 1α-hydroxylase in macrophages • Hypercalcemia Hewison M. Vitamin D and the immune system: New perspectives on an old theme. Endocrinology & Metabolism Clinics of North America. 2010; 39(2): 365-379. Borges MC, Martini LA, Rogero MM. Current perspectives on vitamin D, immune system, and chronic diseases. Nutrition. 2011; 27: 399-404.

  7. The Metabolism of Vitamin D in a Normal Renal Cell Compared to a Macrophage Cell in Sarcoidosis Patients Ackermann D. Hypercalcemia in sarcoidosis – case report, prevalence, pathophysiology, and therapeutic options. TherUmsch. 2007; 64(5): 281-286. Hewison M. Vitamin D and the immune system: New perspectives on an old theme. Endocrinology & Metabolism Clinics of North America. 2010; 39(2): 365-379. Conrado T, Miranda-Filho DB, Bandeira F. Vitamin D deficiency in HIV-infected individuals: One more risk factor for bone loss and cardiovascular disease. ArquivosBrasileiros de Endocrinologia & Metabologia. 2002; 54 (2). http://dx.doi.org/10.1590/S0004-27302010000200006

  8. References • 1.) Thompson JL, Manore MM, Vaughan LA. The Science of Nutrition. Second Edition. San Francisco, CA: Pearson Higher Ed.; 2011. • 2.) Erdal BS, Clymer BD, Yildiz VO, Julian MW, Crouser ED. Unexpectedly high prevalence of sarcoidosis in a representative U.S. metropolitan population. Respiratory Medicine. 2012; xx: 1-7 (article in press, available online 3/12/2012) • 3.) Kavathia D, Buckley JD, Rao D, Rybicki B, Burke R. Elevated 1,25-dihydroxyvitamin D levels are associated with protracted treatment in sarcoidosis. Respiratory Medicine. 2010; 104: 564-570. • 4.) Ackermann D. Hypercalcemia in sarcoidosis – case report, prevalence, pathophysiology, and therapeutic options. TherUmsch. 2007; 64(5): 281-286. • 5.) Hewison M. Vitamin D and the immune system: New perspectives on an old theme. Endocrinology & Metabolism Clinics of North America. 2010; 39(2): 365-379. • 6.) Rosenbaum JT, Pasadhika S, Crouser ED, et al. Hypothesis: Sarcidosis is a STAT1-mediated disease. Clinical Immunology. 2009; 132: 174-183. • 7.) Hinz A, Fleischer M, Brähler E, Wirtz H, Bosse-Henck A. Fatigue in patients with sarcoidosis, compared to the general population. General Hospital Psychiatry. 2011; 33: 462-468. • 8.) Maver A, Medica I, Salobir B, Tercelj M, Peterlin B. Lack of association of immune-response-gene polymorphisms with susceptibility to sarcoidosis in Slovenian patients. Genetic and Molecular Research. 2010; 9(1): 58-68. • 9.) Borges MC, Martini LA, Rogero MM. Current perspectives on vitamin D, immune system, and chronic diseases. Nutrition. 2011; 27: 399-404. • 10.) Conrado T, Miranda-Filho DB, Bandeira F. Vitamin D deficiency in HIV-infected individuals: One more risk factor for bone loss and cardiovascular disease. ArquivosBrasileiros de Endocrinologia & Metabologia. 2002; 54 (2). http://dx.doi.org/10.1590/S0004-27302010000200006

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