Maria G. Lazzaroni MD, Cecilia Nalli MD and Angela Tincani MD
Narin N. Carmel MD, Pnina Rotman-Pikielny MD, Alexey Lavrov MD and Yair Levy MD
Background: Vitamin D is a pivotal factor in calcium homeostasis and exerts immunomodulatory effects. Hypovitamin D has been demonstrated in systemic sclerosis (SSc) patients and may be related to more severe disease of longer duration and with extensive skin involvement.
Objectives: To seek anti-vitamin D antibodies in SSc patients, as found by previous research in patients with systemic lupus erythematosus (SLE).
Methods: The study included 54 SSc patients and 41 volunteers. Immunoglobulin (Ig) G and IgM autoantibody levels against 25(OH)D and 1,25(OH)D were obtained from patients and controls and compared. SSc patients were assessed for autoantibody profile and disease severity.
Results: Vitamin D antibodies were present in 87% of SSc patients and 42% of controls. Higher levels of anti-25(OH)D IgM antibodies were detected in SSc patients compared to controls (0.48 ± 0.22 vs. 0.29 ± 0.29, respectively, P = 0.002); however, IgG levels were lower in the SSc patients. No such discriminative effect was found regarding anti-1,25(OH)D antibodies between SSc and controls. No correlation was found between vitamin D antibodies and other autoantibodies, disease severity, or target organ damage.
Conclusions: To the best of our knowledge, this is the first study of these novel anti-vitamin D antibodies in SSc patients and the first time a correlation between IgM 25(OH) vitamin D antibodies and scleroderma has been identified. Further research on the pathophysiological significance and therapeutic potential of vitamin D is required.
Eleonora Ballanti MD, Maria Sole Chimenti MD PhD and Roberto Perricone MD
Systemic vasculitides are a group of uncommon diseases characterized by blood vessel inflammation. The complement system is involved in the pathogenesis and clinical manifestations of several autoimmune diseases, including systemic vasculitides. This enzymatic system is a component of the innate immune system. Its main function was initially believed to be limited to the recognition and elimination of pathogens, but research in recent years has demonstrated the important role that complement proteins play in modulating adaptive immunity and in bridging innate and adaptive responses. Its activation is also critical for the development of T cell immunity and natural antibodies as well as for the regulation of autoreactive B cells. In systemic vasculitides, particularly small-medium vessel vasculitides, the complement system has been shown to contribute to the development of inflammatory damage. In view of these crucial functions, the complement system represents an attractive therapeutic target for a wide range of diseases, including vasculitic disorders.
Albert Selva-O’Callaghan MD PhD and Ricard Cervera MD PhD FRCP
Attila Kovacs MD PhD, Adelina G. Siminischi MD, Beáta Baksay MD, Andras Gall MD, Maria Takacs MD and Zoltan Szekanecz MD PhD
Adam Austin MD, Angela Tincani MD, Shaye Kivity MD, María-Teresa Arango MSc and Yehuda Shoenfeld MD FRCP MaACR
Nurit Katz-Agranov MD, Amir Tanay MD, Daniel Bachar MD and Gisele Zandman-Goddard MD
Itzhak Sharabi MD, Amir Tanay MD and Gisele Zandman-Goddard MD
Abdulla Watad MD, Alessandra Soriano MD, Hananya Vaknine MD, Yehuda Shoenfeld MD FRCP MaACR and Howard Amital MD MHA