| Vitamin D: an instrumental factor in the anti-phospholipid syndrome by inhibition of tissue factor expression. | |
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MedLine Citation:
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PMID: 20980705 Owner: NLM Status: In-Process |
Abstract/OtherAbstract:
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BACKGROUND AND AIMS: Antiphospholipid syndrome (APS) is a systemic autoimmune disease characterised by thrombosis, obstetric complications and the presence of anti-phospholipid antibodies such as anti-β2GPI-Abs. These antibodies may set off the coagulation cascade via several mechanisms, including the induction of tissue factor (TF) expression. Vitamin D has recently emerged as an immunomodulator that might exert an anti-thrombotic effect. Therefore, we studied serum vitamin D levels in a cohort of APS patients, as well as the effect of vitamin D in an in vitro model of APS-mediated thrombosis. METHODS: Serum vitamin D levels were measured in 179 European APS patients and 141 healthy controls using the LIAISON chemiluminescent immunoassay, and the levels were evaluated in conjunction with a wide spectrum of clinical manifestations. In an vitro model, anti-β2GPI antibodies were purified from four patients with APS to evaluate the expression of TF in activated starved human umbilical vein endothelial cells. The effect of vitamin D (1,25-dihydroxyvitamin D, 10 nm) on anti-β2GPI-Abs mediated TF expression was analysed by immunoblot. RESULTS: Vitamin D deficiency (serum level ≤15 ng/ml) was documented in 49.5% of our APS patients versus 30% of controls (p<0.001) and was significantly correlated with thrombosis (58% vs 42%; p<0.05), neurological and ophthalmic manifestations, pulmonary hypertension, livedo reticularis and skin ulcerations. In vitro vitamin D inhibited the expression of TF induced by anti-β2GPI-antibodies. CONCLUSIONS: Vitamin D deficiency is common among APS patients and is associated with clinically defined thrombotic events. Vitamin D inhibits anti-β2GPI-mediated TF expression in vitro. Thus, vitamin D deficiency might be associated with decreased inhibition of TF expression and increased coagulation in APS. Evaluation of vitamin D status and vitamin D supplementation in APS patients should be considered. |
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Authors:
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N Agmon-Levin; M Blank; G Zandman-Goddard; H Orbach; P L Meroni; A Tincani; A Doria; R Cervera; W Miesbach; L Stojanovich; V Barak; B S Porat-Katz; H Amital; Y Shoenfeld |
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Publication Detail:
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Type: Journal Article Date: 2010-10-27 |
Journal Detail:
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Title: Annals of the rheumatic diseases Volume: 70 ISSN: 1468-2060 ISO Abbreviation: Ann. Rheum. Dis. Publication Date: 2011 Jan |
Date Detail:
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Created Date: 2010-12-17 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0372355 Medline TA: Ann Rheum Dis Country: England |
Other Details:
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Languages: eng Pagination: 145-50 Citation Subset: IM |
Affiliation:
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The Zabludowicz Center for Autoimmune Diseases and Department of Medicine B, Sheba Medical Center, Tel Hashomer, Israel. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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