Alfacalcidol treatment restores derailed immune-regulation in patients with undifferentiated connective tissue disease

Eva Zold, Peter Szodoray, Britt Nakken, Sandor Barath, Janos Kappelmayer, Laszlo Csathy, Agota Hajas, Sandor Sipka, Edit Gyimesi, Janos Gaal, Zsolt Barta, Judit Hallay, Gyula Szegedi, Edit Bodolay

Research output: Review article

37 Citations (Scopus)


Vitamin D deficiency may contribute to pathological changes in the number and function of CD4+ T helper cell subsets (CD4+Th1, CD4+Th17, CD4+CD25brightFoxp3-natural regulatory T cells-nTreg) in patients with undifferentiated connective tissue disease (UCTD). The aim of the present study was to evaluate, whether alfacalcidol could restore immune-regulatory changes in patients with UCTD. We assessed the optimal dose of alfacalcidol that could normalize the elevated levels of IFN-γ expressed by the CD4+Th1 cells and the IL-17 expressed by Th17 cells. Furthermore alfacalcidol decreased the Th1 and Th17 related cytokine levels, repaired the nTreg/Th7 balance, and restored the functional activity of nTreg cells. Twenty one UCTD patients with Vitamin D deficiency (<30ng/ml) were administered with three different daily doses of alfacalcidol. Seven patients were supplemented with 0.5μ g/day, 7 patients with 1.0μg/day, and 7 patients with 1.5μg/day alfacalcidol treatment during 5weeks. Our results indicated that 1.0μg/day alfacalcidol during 5weeks was the optimal therapeutic regime to increase the vitamin D levels, repair the nTreg/Th17 balance and raise the capacity of nTreg cells to suppress the proliferation of autologous CD4+CD25μ cells. 1.5μg daily dose alfacalcidol was not more effective than the 1.0μg/day treatment. In this study we described that vitamin D deficiency can contribute to the complex immune-regulatory abnormalities in patients with UCTD and vitamin D substitution therapy can improve the fine balance of pro- and anti-inflammatory processes in the disease.

Original languageEnglish
Pages (from-to)155-162
Number of pages8
JournalAutoimmunity Reviews
Issue number3
Publication statusPublished - jan. 1 2011


ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology

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