Will there be Enough Evidence to offer Vitamin D Supplementation to Patients with Multiple Sclerosis in 2024?
Author(s):
Hans Klaus Goischke
This narrative overview discusses the scientific findings of the biochemical and metabolic effect of vitamin D on multiple sclerosis up to 2024 with selected targets.
Since the clinical outcome of multiple sclerosis cannot be predicted in individual patients and there may still be a phase of “success and failure”, vitamin D as an add-on therapy could make an early and lasting contribution to the control of dysregulatory inflammatory responses. . As an additional therapy to disease modifying therapies (currently 20 drugs are available, for example ocrelizumab, ofatumumab,ublituximab, rituximab, natalizumab), the B cell kinetics and radiological activity could also be influenced.Some negative vitamin D supplementation studies with zero results could be viewed retrospectively in a more differentiated way through the findings of the three immunologically different phenotypes of multiple sclerosis and with an accentuation of (severe) obesity. This new classification will open up an individualized therapeutic strategy through the targeted immunological effect of 1,25-dihydroxy-vitamin D 3. The relationship between high body mass index and response to vitamin D supplementation and metabolism and the weighting in supplementation studies will become more important in studies.
In an international consensus, daily oral cholecalciferol is preferred due to its safety and minimal need for monitoring in autoimmune diseases. 25-Hydroxyvitamin D3 (25(OH)D in serum is the recognized biomarker for vitamin D status. A connection between vitamin D status and the immune system is recognized. Genetically predicted low levels of 25(OH)D increase the risk of developing multiple sclerosis in adolescence or adulthood.
T he findings of the complex pathobiological mechanisms of vitamin D through the immunomodulatory effects on autoimmune diseases in general and on multiple sclerosis in particular in 2024 justify integrating vitamin D supplementation into the multimodal approach to personalized medicine without the risk of significant side effects.
