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Open Access Highly Accessed Review

Can we prevent or treat multiple sclerosis by individualised vitamin D supply?

Jan Dörr12*, Andrea Döring123 and Friedemann Paul12

Author Affiliations

1 NeuroCure Clinical Research Center, Charité - Universitätsmedizin Berlin, Charitéplatz 1, Berlin, 10117, Germany

2 Clinical and Experimental Research Center for Multiple Sclerosis, Charité - Universitätsmedizin Berlin, Berlin, Germany

3 Current address: Department of Neurology, DIAKO, Flensburg, Germany

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EPMA Journal 2013, 4:4  doi:10.1186/1878-5085-4-4

Published: 29 January 2013

Abstract

Apart from its principal role in bone metabolism and calcium homeostasis, vitamin D has been attributed additional effects including an immunomodulatory, anti-inflammatory, and possibly even neuroprotective capacity which implicates a possible role of vitamin D in autoimmune diseases like multiple sclerosis (MS). Indeed, several lines of evidence including epidemiologic, preclinical, and clinical data suggest that reduced vitamin D levels and/or dysregulation of vitamin D homeostasis is a risk factor for the development of multiple sclerosis on the one hand, and that vitamin D serum levels are inversely associated with disease activity and progression on the other hand. However, these data are not undisputable, and many questions regarding the preventive and therapeutic capacity of vitamin D in multiple sclerosis remain to be answered. In particular, available clinical data derived from interventional trials using vitamin D supplementation as a therapeutic approach in MS are inconclusive and partly contradictory. In this review, we summarise and critically evaluate the existing data on the possible link between vitamin D and multiple sclerosis in light of the crucial question whether optimization of vitamin D status may impact the risk and/or the course of multiple sclerosis.

Keywords:
Multiple sclerosis; Vitamin D; Cholecalciferol; Prevention; Therapy; Risk factor; Supplementation; Personalised medicine; Targeted prevention; Tailored therapy