An update on vitamin D and human immunity – Oct 2011

Martin Hewison mhewison@mednet.ucla.edu
DOI: 10.1111/j.1365-2265.2011.04261.x
Clinical Endocrinology
Accepted Article (Accepted, unedited articles published online for future issues)
Keywords: vitamin D;CYP27B1;vitamin D receptor;toll-like receptor;monocyte;neutrophil;T-cell;cathelicidin;tuberculosis

In the last five years there has been a remarkable change in our understanding of the health benefits of vitamin D. The classical actions of vitamin D as a determinant of mineral metabolism and rachitic bone disease have been expanded to include a broader role in skeletal homeostasis and prevalent bone disorders such as osteoporosis. However, it is the non-skeletal functions of vitamin D that have attracted most attention. Although, pluripotent responses to vitamin D have been recognized for many years, our new perspective on non-classical vitamin D function stems from two more recent concepts. The first is that impaired, vitamin D status is common to many populations across the globe. This has prompted studies to explore the health impact of sub-optimal circulating levels of vitamin D, with association studies linking vitamin D ‘insufficiency’ to several chronic health problems including autoimmune and cardiovascular disease, hypertension and common cancers. In support of a broader role for vitamin D in human health, studies in vitro and using animal models have highlighted immunomodulatory and anti-cancer effects of vitamin D that appear to depend on localized activation of vitamin D.

The conclusion from these reports is that many non-classical actions of vitamin D are independent of conventional vitamin D endocrinology and are therefore more sensitive to variations in vitamin D status.

The current review summarizes these developments, with specific reference to the newly-identified effects of vitamin D on the immune system, but also highlights the challenges in translating these observations to clinical practice.

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