The second committee meeting was held August 4-5, 2009 in Washington, DC and included an Information-Gathering Workshop on August 4, 2009. The agenda for this workshop is below, along with the PowerPoint presentations that were used by the speakers during the workshop.
Please note, online presentations from this meeting are subject to copyright protection. Permission from the speaker is required prior to any copying, reproducing, or rebroadcasting any portion of the speaker's presentations. Additional copyright and legal policies of The National Academies can be read in the National Academies Legal Statement.
Vitamin D may suppress infections which lead to development of Multiple Sclerosis
Steven R Brenner, None (16 August 2007)
J Neurol Neurosurg Psychiatry 2008
I read the article with reference to the inverse relationship between multiple sclerosis clinical activity and deficiency of vitamin D by Soilu-Hannienen (1) with interest, and was considering what mechanism could be in play to cause such a relationship.
25-hydroxylated metabolites of vitamin D act as intracellular regulators of the synthesis and action of defensin (2) molecules against bacterial antigens, defensin being an endogenously synthesized antimicrobial substance (2).
Human cathelicidin antimicrobial peptide gene is a target of vitamin D receptor and is strongly up-regulated by 1,25-dihydroxyvitamin D3, indicating vitamin D receptor and the 1,25-dihydroxyvitaminD3 regulate primate innate immunity (3)
Association between serum 25-hydroxyvitamin D and depressive symptoms in Japanese: analysis by survey season
A Nanri, T Mizoue, Y Matsushita, K Poudel-Tandukar, M Sato, M Ohta, N Mishima
European Journal of Clinical Nutrition (19 August 2009) doi:10.1038/ejcn.2009.96 Short Communication
Vitamin D A Key Player In Overall Health Of Several Body Organs, Says Biochemist
In a paper published in the August issue of the American Journal of Clinical Nutrition, Norman identifies vitamin D's potential for contributions to good health in the adaptive and innate immune systems, the secretion and regulation of insulin by the pancreas, the heart and blood pressure regulation, muscle strength and brain activity. In addition, access to adequate amounts of vitamin D is believed to be beneficial towards reducing the risk of cancer.
Norman also lists 36 organ tissues in the body whose cells respond biologically to vitamin D. The list includes bone marrow, breast, colon, intestine, kidney, lung, prostate, retina, skin, stomach and the uterus.
Serum 25-hydroxyvitamin D and colon cancer: eight-year prospective study.
Garland CF, Comstock GW, Garland FC, Helsing KJ, Shaw EK, Gorham ED.
Lancet. 1989 Nov 18;2(8673):1176-8.
PMID: 2572900
Blood samples taken in 1974 in Washington County, Maryland, from 25 620 volunteers were used to investigate the relation of serum 25-hydroxyvitamin D (25-OHD) with subsequent risk of getting colon cancer. 34 cases of colon cancer diagnosed between August, 1975, and January, 1983, were matched to 67 controls by age, race, sex, and month blood was taken. Risk of colon cancer was reduced by 75% in the third quintile (27-32 ng/ml) and by 80% in the fourth quintile (33-41 ng/ml) of serum 25-OHD. Risk of getting colon cancer decreased three-fold in people with a serum 25-OHD concentration of 20 ng/ml or more. The results are consistent with a protective effect of serum 25-OHD on colon cancer.
Prospective study of predictors of vitamin D status and survival in patients with colorectal cancer
K Ng, B M Wolpin, J A Meyerhardt, K Wu, A T Chan, B W Hollis, E L Giovannucci, M J Stampfer, W C Willett and C S Fuchs
Br J Cancer 101: 916-923; advance online publication, August 18, 2009; doi:10.1038/sj.bjc.6605262
"Dr. Jodie Burton is the acting principal investigator (PI) of the dose-escalation trial of oral vitamin D3 with calcium supplementation in patients with multiple sclerosis with Dr. O'Connor. She started the trial as his fellow, while doing an additional 2 years of training in MS specifically after she received her neurology certification. She completed her fellowship training in 2007. Now she is staff doing clinical research and continuing with the vitamin D trial. As of August 2009, she will be Assistant Professor in Neurology in the Department of Clinical Neuroscience in Calgary and at the University of Calgary. She will be part of the MS team there with Dr. Luanne Metz and the MS group.
Please scroll down for an abstract of the trial:
A Phase I/II dose-escalation trial of oral vitamin D3 with calcium supplementation in patients with multiple sclerosis."
Conclusions:
High-dose VD3 (~10 000 IU/day, possibly higher) in MS is safe and tolerable, with evidence of clinical improvement."
25-Hydroxyvitamin D and functional outcomes in adolescents.
Lamberg-Allardt CJ, Viljakainen HT.
Am J Clin Nutr. 2008 Aug;88(2):534S-536S. Review.
PMID: 18689396
CONCLUSIONS
Cross-sectional studies have shown a relation among serum 25(OH)D concentration, serum PTH concentration, and BMD in adolescents. Long-term randomized controlled intervention studies have shown that vitamin D3 supplementation has a positive effect on BMD in adolescence; some of these studies found an effect with doses as small as 5 µg (200 IU) to 10 µg (400 IU) per day, or without supplemental calcium.
25-hydroxyvitamin D levels inversely associate with risk for developing coronary artery calcification.
de Boer IH, Kestenbaum B, Shoben AB, Michos ED, Sarnak MJ, Siscovick DS.
J Am Soc Nephrol. 2009 Aug;20(8):1805-12. Epub 2009 May 14.
PMID: 19443637
doi: 10.1681/ASN.2008111157
"In conclusion, lower 25-hydroxyvitamin D concentrations associate with increased risk for incident CAC. Accelerated development of atherosclerosis may underlie, in part, the increased cardiovascular risk associated with vitamin D deficiency."
nfluence of season and latitude on the cutaneous synthesis of vitamin D3: exposure to winter sunlight in Boston and Edmonton will not promote vitamin D3 synthesis in human skin.
Webb AR, Kline L, Holick MF.
J Clin Endocrinol Metab. 1988 Aug;67(2):373-8.
PMID: 2839537
doi:10.1210/jcem-67-2-373
These results quantify the dramatic influence of changes in solar UVB radiation on cutaneous vitamin D3 synthesis and indicate the latitudinal increase in the length of the "vitamin D winter" during which dietary supplementation of the vitamin may be advisable.
Vitamin D status is positively correlated with regulatory T cell function in patients with multiple sclerosis.\nSmolders J, Thewissen M, Peelen E, Menheere P, Cohen Tervaert JW, Damoiseaux J, Hupperts R.\nPLoS One. 2009 Aug 13;4(8):e6635.\nPMID: 19675671
Prevalence and Associations of 25-Hydroxyvitamin D Deficiency in US Children: NHANES 2001-2004.
Kumar J, Muntner P, Kaskel FJ, Hailpern SM, Melamed ML.
Pediatrics. 2009 Aug 3. [Epub ahead of print]
PMID: 19661054
CONCLUSIONS: 25(OH)D deficiency is common in the general US pediatric population and is associated with adverse cardiovascular risks.
1,25(OH)2 vitamin d inhibits foam cell formation and suppresses macrophage cholesterol uptake in patients with type 2 diabetes mellitus.
Oh J, Weng S, Felton SK, Bhandare S, Riek A, Butler B, Proctor BM, Petty M, Chen Z, Schechtman KB, Bernal-Mizrachi L, Bernal-Mizrachi C.
Circulation. 2009 Aug 25;120(8):687-98. Epub 2009 Aug 10.
PMID: 19667238
doi: 10.1161/CIRCULATIONAHA.109.856070
Conclusion- These results identify reduced vitamin D receptor signaling as a potential mechanism underlying increased foam cell formation and accelerated cardiovascular disease in diabetic subjects.
Environmental risk factors for autism: Do they help cause de novo genetic mutations that contribute to the disorder?
Kinney DK, Barch DH, Chayka B, Napoleon S, Munir KM.
Med Hypotheses. 2009 Aug 20. [Epub ahead of print]
PMID: 19699591
ScienceDaily (Aug. 25, 2009) - Low levels of vitamin D are known to nearly double the risk of cardiovascular disease in patients with diabetes, and researchers at Washington University School of Medicine in St. Louis now think they know why.
They have found that diabetics deficient in vitamin D can't process cholesterol normally, so it builds up in their blood vessels, increasing the risk of heart attack and stroke. The new research has identified a mechanism linking low vitamin D levels to heart disease risk and may lead to ways to fix the problem, simply by increasing levels of vitamin D.
Measurement of vitamin D levels in inflammatory bowel disease patients reveals a subset of Crohn's disease patients with elevated 1,25-dihydroxyvitamin D and low bone mineral density.
Abreu MT, Kantorovich V, Vasiliauskas EA, Gruntmanis U, Matuk R, Daigle K, Chen S, Zehnder D, Lin YC, Yang H, Hewison M, Adams JS.
Gut. 2004 Aug;53(8):1129-36.
PMID: 15247180
doi: 10.1136/gut.2003.036657.
Conclusions: These data demonstrate that elevated 1,25(OH)2D is more common in CD than previously appreciated and is independently associated with low bone mineral density. The source of the active vitamin D may be the inflamed intestine. Treatment of the underlying inflammation may improve metabolic bone disease in this subgroup of patients.
Vitamin D, nervous system and aging.
Tuohimaa P, Keisala T, Minasyan A, Cachat J, Kalueff A.
Psychoneuroendocrinology. 2009 Aug 4. [Epub ahead of print]
PMID: 19660871
Explaining multiple sclerosis prevalence by ultraviolet exposure: a geospatial analysis.
Beretich B, Beretich T.
Mult Scler. 2009 Aug;15(8):891-8.
PMID: 19667017
DOI: 10.1177/1352458509105579
Conclusion
This analysis suggests a strong association between UV radiation and MS distribution, and an increase in risk for MS in those areas with a low UVI.