Inflammation and vitamin D: the infection connection

• Published in: Inflammation research Vol. 63; no. 10; pp. 803 - 819
• Main Authors: Mangin, Meg, Sinha, Rebecca, Fincher, Kelly
• Format: Journal Article
• Language: English
• Published: Basel Springer Basel 01.10.2014
• Subjects: Allergology; Angiotensin II Type 1 Receptor Blockers - therapeutic use; Animals; Autoimmune Diseases - blood; Autoimmune Diseases - etiology; Autoimmune Diseases - immunology; Bacterial Infections - blood; Bacterial Infections - complications; Bacterial Infections - drug therapy; Bacterial Infections - immunology; Biomedical and Life Sciences; Biomedicine; Dermatology; Humans; Imidazoles - therapeutic use; Immunology; Inflammation - blood; Inflammation - drug therapy; Inflammation - immunology; Neurology; Pharmacology/Toxicology; Receptors, Calcitriol - immunology; Review; Rheumatology; Tetrazoles - therapeutic use; Vitamin D - blood; Vitamin D - immunology; Vitamin D - metabolism; Vitamin D Deficiency - blood; Vitamin D Deficiency - diagnosis; Vitamin D Deficiency - drug therapy; Vitamin D Deficiency - etiology; Vitamin D Deficiency - immunology; Infection; Inflammation; Vitamin D; Immunotherapy
• ISSN: 1023-3830; 1420-908X; 1420-908X
• DOI: 10.1007/s00011-014-0755-z

Introduction Inflammation is believed to be a contributing factor to many chronic diseases. The influence of vitamin D deficiency on inflammation is being explored but studies have not demonstrated a causative effect. Methods Low serum 25(OH)D is also found in healthy persons exposed to adequate sunlight. Despite increased vitamin D supplementation inflammatory diseases are increasing. The current method of determining vitamin D status may be at fault. The level of 25(OH)D does not always reflect the level of 1,25(OH)2D. Assessment of both metabolites often reveals elevated 1,25(OH)2D, indicating abnormal vitamin D endocrine function. Findings This article reviews vitamin D's influence on the immune system, examines the myths regarding vitamin D photosynthesis, discusses ways to accurately assess vitamin D status, describes the risks of supplementation, explains the effect of persistent infection on vitamin D metabolism and presents a novel immunotherapy which provides evidence of an infection connection to inflammation. Conclusion Some authorities now believe that low 25(OH)D is a consequence of chronic inflammation rather than the cause. Research points to a bacterial etiology pathogenesis for an inflammatory disease process which results in high 1,25(OH)2D and low 25(OH)D. Immunotherapy, directed at eradicating persistent intracellular pathogens, corrects dysregulated vitamin D metabolism and resolves inflammatory symptoms.