Autoimmune disorders associated with low vitamin D during pregnancy – Nov 2019

Immunomodulatory Effects of Vitamin D in Pregnancy and Beyond.

Front Immunol. 2019 Nov 22;10:2739. doi: 10.3389/fimmu.2019.02739
Cyprian F1, Lefkou E2, Varoudi K2, Girardi G1.

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OAPS = Obstretic antiphospholipid syndrome - see description at the bottom of this page

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In addition to its role in calcium homeostasis and bone formation, a modulatory role of the active form of vitamin D on cells of the immune system, particularly T lymphocytes, has been described. The effects of vitamin D on the production and action of several cytokines has been intensively investigated in recent years. In this connection, deficiency of vitamin D has been associated with several autoimmune diseases, including
(rheumatoid arthritis (RA),

• systemic lupus erythematosus (SLE),
• antiphospholipid syndrome (APS),
• Hashimoto Thyroiditis (HT), and
• multiple sclerosis (MS).

In a successful pregnancy, the maternal immune response needs to adapt to accommodate the semiallogeneic fetus. Disturbances in maternal tolerance are implicated in infertility and pregnancy complications such as

• miscarriages (RM) and
• preeclampsia (PE).

It is well-known that a subset of T lymphocytes, regulatory T cells (Tregs) exhibit potent suppressive activity, and have a crucial role in curtailing the destructive response of the immune system during pregnancy, and preventing autoimmune diseases. Interestingly, vitamin D deficiency is common in pregnant women, despite the widespread use of prenatal vitamins, and adverse pregnancy outcomes such as RM, PE, intrauterine growth restriction have been linked to hypovitaminosis D during pregnancy. Research has shown that autoimmune diseases have a significant prevalence within the female population, and women with autoimmune disorders are at higher risk for adverse pregnancy outcomes. Provocatively, dysregulation of T cells plays a crucial role in the pathogenesis of autoimmunity, and adverse pregnancy outcomes where these pathologies are also associated with vitamin D deficiency. This article reviews the immunomodulatory role of vitamin D in autoimmune diseases and pregnancy. In particular, we will describe the role of vitamin D from conception until delivery, including the health of the offspring. This review highlights an observational study where hypovitaminosis D was correlated with decreased fertility, increased disease activity, placental insufficiency, and preeclampsia in women with APS.

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OAPS = Obstretic antiphospholipid syndrome
Antiphospholipid syndrome (APS) is an autoimmune disorder. Signs and symptoms vary, but may include blood clots, miscarriage, rash, chronic headaches, dementia, and seizures.1 APS occurs when your body's immune system makes antibodies that attack phospholipids