Vitamin D: Role in pathogenesis of multiple sclerosis

Background: Epidemiological data support a potential relationship between vitamin D deficiency and an increased risk of developing multiple sclerosis (MS). In vitro studies have expanded the potential role of vitamin D and its receptor beyond calcium modulation, regulation, and maintenance of bone mineralization to include immune modulation. Review Summary: Whether vitamin D's immunomodulatory effects can be translated into clinical benefits in MS patients is still a matter of debate. A review of biochemistry of vitamin D and its synthesized derivatives is discussed in the context of treating vitamin D deficiency. Animal studies, which have led to some human studies, are also discussed. Future studies are pending and will likely yield conclusive results as to the benefit and possible synergistic effects of vitamin D with other disease-modifying therapies of MS. Conclusion: Further prospective studies are needed to identify vitamin D levels during the various phases of MS, including relapses, remissions, and progression, and to determine whether correcting vitamin D during any or all of these phases may affect the incidence or even the course of the disease.