RESEARCH - The immunoregulatory role of vitamins A, D and E in patients with primary Sjögren’s syndrome

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Rheumatology Advance Access published online on November 27, 2009

Rheumatology, doi:10.1093/rheumatology/kep374

The immunoregulatory role of vitamins A, D and E in patients with

primary Sjögren’s syndrome

Szodoray1,2, Ildiko F. Horvath1, Gabor Papp1, Sandor Barath1,

Edit Gyimesi1, Laszlo Csathy3, Janos Kappelmayer3, Sandor Sipka1, Asim

K. Duttaroy4, Britt Nakken2 and Margit Zeher1

13rd Department of Medicine, Division of Clinical Immunology, Medical

and Health Science Centre, University of Debrecen, Debrecen, Hungary,

2Immunobiological Laboratory, Institute for Basic Medical Sciences,

University of Oslo, Oslo, Norway, 3Department of Clinical Biochemistry

and Molecular Pathology, Medical and Health Science Centre, University

of Debrecen, Debrecen, Hungary and 4Department of Nutrition, Institute

for Basic Medical Sciences, University of Oslo, Oslo, Norway.

Abstract

Objective. The aim of the present study was to investigate the

immunomodulating role of fat-soluble vitamins in 25 patients with

primary SS (pSS) and 15 healthy individuals.

Methods. Plasma levels of vitamins A, D and E were determined by HPLC.

Peripheral NK, NK T cells, T-cell subsets, B cells, IL-10 producing

Tr1 cells, CD4+CD25+ Treg cells and Th17 were determined by flow

cytometry. Various Th1- and Th2-soluble cytokines were assessed by

ELISA, whereas intracytoplasmic cytokines (IFN-, IL-4, -10 and -17)

were measured by flow cytometry. Correlation was assessed between

vitamin levels and immunological and clinical parameters.

Results. Vitamin A levels did not differ between patients and

controls, yet in patients with extraglandular manifestations (EGMs) a

significant decrease in vitamin A levels was apparent compared with

pSS patients without EGMs (P = 0.005). Vitamin E levels were increased

in patients compared with controls (P = 0.004), whereas vitamin D

levels were similar in pSS and control subjects. In patients, vitamin

A showed a positive correlation with both NK cell (P = 0.038) and Th17

cell (P = 0.025), and a negative correlation with Schirmer’s test

values (P = 0.035). Positive correlation was found between vitamin E

and NK cells (P = 0.043), Th1 cells (P = 0.049) and the Th1/Th2 ratio

(P = 0.043). In the control group, we found correlation between

vitamin E and serum IL-10 levels (P = 0.003).

Conclusions. Our data suggest that fat-soluble vitamins may be

important in immunoregulatory processes in patients with pSS.

http://rheumatology.oxfordjournals.org/cgi/content/abstract/kep374v1?papetoc

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