The Paradigm of Autoimmunity: Is Vitamin D the New Player?

Yıl 2016, Cilt: 8 Sayı: 2, 1 - 6, 01.08.2016

Gülbüz Sezgin Eşref M. Özer Oya Uygur Bayramiçli Feride Sinem Akgün Fehime Benli Aksungar Selim Nalbant

Öz

Aim: Vitamin D is necessary for the bone and mineral homeostasis and has also immune regulatory and anti-inflammatory functions. It has been hypothesized that there is a relation between vitamin D deficiency or insufficiency and autoimmune thyroiditis. We aim that to show any relationship between vitamin D deficiency and thyroid autoimmunity. Material and Methods: This prospective study is performed between August 2010 and May 2011 at the Department of Internal Medicine, Endocrinology and Emergency Medicine of Maltepe University, School pof Medicine Hospital. The Ethics Committee of Maltepe University Medical Faculty approved the study.274 patients with Hashimoto’s thyroiditiswere evaluated prospectively for vitamin D, TSH, anti-thyroid peroxidase antibody anti-TPO and anti-thyroglobulin anti-Tg .The correlation between vitamin D and autoimmune parameters is analyzed. Results: According to vitamin D levels there is a statistically significant difference between anti- TPO levels p=0.024; p0.05 . There is also no difference in TSH levels according to vitamin D subgroups p=0.177; p>0.05 . Conclusion: In patients with Hashimoto’s thyroiditis there is a positive correlation between vitamin D level and anti-TPO but not anti-Tg.

Anahtar Kelimeler

nazolabiyal, V-Y ilerletme flebi, ortayüz defekti, ektropiyon

Otoimünite Paradigması: D Vitamini Yeni Oyuncu mu?

Öz

Amaç: Vitamin D, kemik ve mineral homeostazı için gereklidir ve aynı zamanda immunregülatör ve antiinflamatuar fonksiyonları vardır. Vitamin D eksikliği veya yetersizliği ile otoimmün tiroiditler arasında ilişki olduğu hipotezi öne sürülmüştür. Bu çalışmada Vitamin D eksikliği ile tiroid otoimmünitesi arasında ilişki olup olmadığını göstermeyi amaçladık. Materyal- Metod: Çalışmamız Ağustos 2010 ile mayıs 2011 yılları arasında Maltepe Üniversitesi Eğitim ve Araştırma Hastanesi İç Hastalıkları, Endokrinoloji ve Acil servis bölümlerinde prospektif olarak yapılmıştır. Maltepe Üniversitesi Tıp Fakültesi Etik Kurul Komitesinden onay alınmıştır.Hashimoto tiroiditi olan 274 hastada Vitamin D, TSH, anti Tiroid Peroksidaz Antikoru Anti-TPO ve anti Tiroglobulin Anti- Tg seviyeleri ölçülmüştür. Vitamin D ile otoimmün parametreler arasındaki korelasyon incelenmiştir. Bulgular: Vitamin D ile anti-TPO seviyeleri arasında istatistiksel olarak anlamlı bir ilişki vardır p=0.024; p0.05 .D vitamini alt gruplarına gore TSH seviyelerinde de anlamlı bir farklılık yoktur p=0.177; p>0.05 . Sonuç: Hashimoto Tiroiditi olan hastalarda Vitamin D ile anti TPO arasında pozitif korelasyon tespit edilirken anti Tg ile bu korelasyon gözlenmedi.

Anahtar Kelimeler

Vitamin D, Tiroid otoimmünitesi, Anti-Tg, Anti-TPO

Kaynakça

• 1. Arnson Y, Amital H, Shoenfeld Y. Vitamin D and autoimmunity: new etiological and therapeutic considerations. Ann Rheum Dis 2007; 66: 1137–1142.
• 2. Jameson JL, Weetman AP. Tiroidbezihastalıkları. In: Braunwald E, Fauci AS, Kasper DL, Hauser SL, Longo DL, Jameson JL, editors. Ceviri editoru: Sağlıker Y. Harrison Ic Hastalıkları Prensipleri (15. Ed.). Istanbul: Nobel Matbaacılık; 2004. S.2060-2075. (in Turkish).
• 3. Kayaalp O, Rasyonel tedavi yönünden tıbbi farmakoloji. Feryal Matbaacılık 2002 (in Turkish).
• 4. Bhalla AK, Amento EP, Clemens TL. Specific high-affinity receptors for 1,25- dihydroxyvitaminD3 in human peripheral blood mononuclear cells: presence in monocytes and induction in T lymphocytes following activation. J Clin Endocrinol Metab 1983; 57:1308-1310
• 5. Provvedini DM, Tsoukas CD, Deftos LJ. 1,25DihydroxyvitaminD3 receptors in human leukocytes. Science 1983; 221:1181- 1183.
• 6. Turken O. et al, Breast cancer in association with thyroid disorders. Breast Cancer Res 2003, 5:R110-R113.
• 7. Hollick MF. Sunlightand vitamin D for bone health and prevention of autoimmune diseases, cancer and cardiovascular disease. Am J ClinNutr 2004; 80 (6 suppl): S1678- 88.
• 8. Wang TJ, Pencina MJ, Booth SL, et al. Vitamin D deficiency and risk of cardiovascular disease. Circulation 2008;117:503-511.
• 9. Merlino LA, Curtis J, MikulsTR, et al. Vitamin D intake is inversely associated with rheumatoid arthritis: results from the lIowaWomen’s Health Study. Arthritis Rheum 2004; 50: 72- 77
• 10. Cantorna MT. Vitamin D and its role in immunology: multipl sclerosis, and inflammatory bowel disease. Prog Biophys Mol Biol 2006; 92: 60- 4
• 11. Hypponen E, Laara E, Reunanen A,et all. Intake of vitamin D and risk of type 1 diabetes: a birth-cohort study.Lancet 2001; 358: 1500– 1503
• 12. Huisman AM, White KP, Algra A, et al. Vitamin D levels in women with systemic lupus erythematosus and fibromyalgia. J Rheumatol 2001; 28: 2535–2539
• 13. Elias E. Mazokopakis, Dimitrios A.et al. Hashimoto’s autoimmune thyroiditis and vitamin D deficiency. Hellenic Journal of Nuclear Medicine 2014;17(1): 37-40
• 14. Tamer G and Mesci B. Role of vitamin D in the immune system. Turkish Journal of Endocrinology and Metabolism 2013, 17 5–7 (doi:10.4274/ Tjem.1938)
• 15. Tamer G, Arik S, Tamer I, et al. Relative vitamin D insufficiency in Hashimoto’s thyroiditis. Thyroid 2011;21(8) :891-896.
• 16. Shapira Y, Agmon-Levin N, Shoenfeld Y. Geoepidemiology of autoimmune diseases. Autoimmunity 2010;8:468-476
• 17. CanarisGJ, Manowitz NR, Mayor G, et al. The Colorado thyroid disease prevalence study. ArchInternMed 2000;160:526-534
• 18. Hekimsoy Z, Dinç G, Kafesçiler S, et al. Vitamin D status among adults in Aegean region of Turkey. BMC Public Health 2010;10:782
• 19. Chistiakov DA. Immunogenetics of Hashimoto’s thyroiditis. J Autoimmune Dis 2005; 2: 1
• 20. Fournier C, Gepner P, Sadouk M. Invivo beneficial effects of cyclosporine A and 1,25-dihydroxyvitaminD3 on the induction of experimental autoimmune thyroiditis. ClinImmunoImmunopathol 1990; 54: 53- 63
• 21. Hahn HJ, Kuttler B, Mathieu C. 1,25- DihydroxyvitaminD3 reduced MHC antigen expression on pancreatic beta-cell in vitro. Transplant Proc 1997; 26: 2156- 7.
• 22. İlicin G, Unal S, Biberoğlu K, et al, İcHastalıklarıcilt 22. Baskı Ankara: GunesKitapevi ISBN 975- 8531- 78- 6. S: 2217- 2219
• 23. Holick MF. Vitamin D Status: Measurement, interpretation, and clinical application. Ann Epidemiol 2009;19(2):73-78
• 24. Kivity S, Agmon-Levin N, Zisappl M, et al. Vitamin D and autoimmune thyroid diseases. Cell MolImmunol 2011;8:243-247
• 25. Dong Yeob Shin, Kwang Joon Kim, Daham Kim, et al. Low Serum Vitamin D Is Associated with Anti-Thyroid Peroxidase Antibody in Autoimmune Thyroiditis. Yonsei Med J. 2014;55(2):476-481
• 26. Yao Jin, Chen Xi, Jiang Qin, et al. Vitamin D and Age-Related Macular Degeneration. Handbook of Nutrition, Diet and the Eye 2014, Pages 339–348.
• 27. Ann M. Campagna, Ann M. Settgast, Patricia F. Walker, et al. Effect of Country of Origin, Age, and Body Mass Index on Prevalence of Vitamin D Deficiency in a US Immigrant and Refugee Population. Mayo Clinic Proceedings Volume 88, Issue 1, January 2013, 31–37
• 28. Amal Mohammed HuseinMacka wy, Bushra Mohammed Al-ayed, Bashayer Mater Al-rashidi. Vitamin D deficiency and its association with thyroid disease. International Journal of Health Science. Int J Health Sci (Qassim). 2013; 7(3): 267–275.