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תא םגו ,ןאכ עיפומש המ תא םג ,אורקלו תוקד 5 תחקל הווש יתעדל
ףרוצמש רמאמה
link-ב
note which was recently published in Annals of Neurology.
Here is the short
post the figure. If anyone wants a copy let me know.
Unfortunatley I cannot
Seasonal Fluctuations of Gadolinium-Enhancing Magnetic
Vitamin D and
Resonance Imaging Lesions in Multiple Sclerosis
Ph.D., Lloyd R. Snowdon, Ph.D. and Reinhold Vieth, Ph.D.
Ashton F. Embry,
Annals of Neurology, 2000, v. 48, p.271-272
showed a striking, near sinusoidal annual variation in
Auer et al1 recently
active magnetic resonance imaging lesions in 53 multiple
the number of
patients. Their results provide solid support for past,
sclerosis (MS)
claims of seasonal fluctuation in MS disease activity.
less-well documented
seasonal fluctuation in lesion activity may provide an
Furthermore, the
identifying environmental factors which are part of MS
important clue for
etiology.
that seasonal changes in the rate of common infections
Auer et al proposed
explain the seasonal fluctuation in lesion activity. They
might partially
factors such as temperature, amount of sunlight and UV
noted that climatic
also be involved1. We suggest that vitamin D supply,
light exposure might
seasonal UV light exposure, is the main environmental
which fluctuates with
Vitamin D and its metabolites have been implicated in MS
factor involved.
experimental and immunological data2. Moreover,
etiology by epidemiological,
D [25(OH)D] also shows a near sinusoidal
circulating 25-hydroxyvitamin
annual fluctuation at higher latitudes3,4.
correspondence between the fluctuations in vitamin
To investigate a possible
activity, we compared published monthly 25(OH)D levels
D intake and lesion
50-80, from southern Germany4 with the data of Auer et
in 415 people, aged
also collected in southern Germany (Figure). Third order
al1 which were
fit both the 25(OH)D and lesion data significantly. When
polynomial curves
are lagged by two months, there is a close correspondence
the 25(OH)D data
curves with high levels of 25(OH)D correlating with low
between the two
activity and vice versa. A two-month lag is within reason
levels of lesion
to reflect the time for a given 25(OH)D level to affect
and is taken
detectable lesion occurrence.
between lesion activity and 25(OH)D level suggests
The inverse correlation
may have a notable immuno-modulating effect on CNS
that vitamin D nutrition
a conclusion also reached through experimental and
inflammation,
The impressive correlation also supports the need
immunological studies2.
trials to test whether improved vitamin D nutrition (not
for proper clinical
1,25(OH)2D) can reduce formation of CNS lesions and
the vitamin D hormone,
of MS. Until definitive results are available,
slow the progression
to ensure their MS patients are receiving a meaningful
clinicians may want
IU/day) throughout the year. Although well above
vitamin D intake (3000-4000
guidelines (200-400 IU), such an intake is physiological
current nutritional
most importantly, provides a desirable target amount of
and safe and
circulating 25(OH)D5.
References
Schumann EM, Kumpfel T et al. Seasonal fluctuations of
1. Auer DP,
magnetic resonance imaging lesions in multiple
gadolinium-enhancing
sclerosis. Ann Neurol 2000;47:276-277
MT and DeLuca HF Vitamin D and multiple sclerosis.
2. Hayes CE, Cantorna
Proc Soc Exp Biol Med 1997; 216:21-27
JD Seasonal variation in vitamin D. Proc Nutr Soc
3. Maxwell
1994;54:533-543
of subclinical vitamin D deficiency in different
4. Scharla SH Prevalence
European countries. Osteoporo Int 1998 Suppl;8:S7-S12
D supplementation, 25-hydroxyvitamin D concentrations,
5. Vieth R Vitamin
and safety.
Am J Clin Nutr 1999; 69:842-856
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