The Role of Vitamin D Deficiency in the Pathogenesis and Course of Selected Autoimmune and Immune - Mediated Diseases
DOI:
https://doi.org/10.12775/QS.2026.73.75365Keywords
Vitamin d deficiency, autoimmunity, immune-mediated diseases, multiple sclerosis, rheumatoid arthritis, inflammatory bowel diseases, Crohn's disease, ulcerative colitis, vitamin d, 25-hydroxyvitamin D, autoimmune thyroid diseaseAbstract
Introduction: Vitamin D has immunomodulatory effects, which may be relevant in autoimmune and immune-mediated diseases.
Aim: The aim of this study was to present current data on the role of vitamin D deficiency in the pathogenesis and course of selected diseases.
Methods: A narrative literature review was conducted, including mainly publications from 2018–2026 concerning multiple sclerosis, rheumatoid arthritis, autoimmune thyroid diseases, and inflammatory bowel diseases.
Results: Vitamin D deficiency is frequently observed in the analyzed diseases. Mechanistic data indicate its influence on dendritic cells, T and B lymphocytes, and the regulation of the inflammatory response. However, the results of supplementation studies remain heterogeneous; some studies have shown improvement in selected laboratory or radiological parameters or disease activity indices.
Conclusions: Available data do not allow vitamin D deficiency to be unequivocally considered a causal factor, nor supplementation to be regarded as a specific immunomodulatory treatment. Correction of confirmed deficiency remains justified, while the effect of supplementation on the long-term course of these diseases requires further research.
References
1. Martens, P. J., Gysemans, C., Verstuyf, A., & Mathieu, C. (2020). Vitamin D's effect on immune function. Nutrients, 12(5), 1248. https://doi.org/10.3390/nu12051248
2. Gallo, D., Baci, D., Kustrimovic, N., et al. (2023). How does vitamin D affect immune cells crosstalk in autoimmune diseases? International Journal of Molecular Sciences, 24(5), 4689. https://doi.org/10.3390/ijms24054689
3. Meza-Meza, M. R., Ruiz-Ballesteros, A. I., & de la Cruz-Mosso, U. (2022). Functional effects of vitamin D: From nutrient to immunomodulator. Critical Reviews in Food Science and Nutrition,62(11), 3042–3062. https://doi.org/10.1080/10408398.2020.1862753
4. Brown, G., Marchwicka, A., & Marcinkowska, E. (2024). Vitamin D and immune system. Advances in Food and Nutrition Research, 109, 1–41. https://doi.org/10.1016/bs.afnr.2023.12.00
5. Giustina, A., Bilezikian, J. P., Adler, R. A., Banfi, G., Bikle, D. D., Binkley, N., Bollerslev, J., Bouillon, R., Brandi, M. L., Casanueva, F. F., di Somma, C., Erfurth, E. M., Fuleihan, G. E.-H., Fassio, A., Giustina, G., Marcocci, C., Messina, C., Napoli, N., Procopio, M., ... Cianferotti, L. (2024). Consensus statement on vitamin D status assessment and supplementation: Whys, whens, and hows. Endocrine Reviews, 45(5), 625–654. https://doi.org/10.1210/endrev/bnae009
6. Cui, A., Zhang, T., Xiao, P., Fan, Z., Wang, H., & Zhuang, Y. (2023). Global and regional prevalence of vitamin D deficiency in population-based studies from 2000 to 2022: A pooled analysis of 7.9 million participants. Frontiers in Nutrition, 10, 1070808. https://doi.org/10.3389/fnut.2023.1070808
7. Fletcher, J., Bishop, E. L., Harrison, S. R., Swift, A., Cooper, S. C., Dimeloe, S. K., Raza, K., & Hewison, M. (2022). Autoimmune disease and interconnections with vitamin D. Endocrine connections, 11(3), e210554. https://doi.org/10.1530/EC-21-0554
8. Martínez-Lapiscina, E. H., Mahatanan, R., Lee, C. H., Charoenpong, P., & Hong, J. P. (2020).Associations of serum 25(OH) vitamin D levels with clinical and radiological outcomes in multiple sclerosis: A systematic review and meta-analysis. Journal of the Neurological Sciences, 411,116668. https://doi.org/10.1016/j.jns.2020.116668
9. Clasen, J. L., Cole, R., Aune, D., Sellon, E., & Heath, A. K. (2023). Vitamin D status and risk of rheumatoid arthritis: systematic review and meta-analysis. BMC rheumatology, 7(1), 3. https://doi.org/10.1186/s41927-023-00325-y
10. Islam, M. A., Khandker, S. S., Alam, S. S., Kotyla, P., & Hassan, R. (2019). Vitamin D status in patients with systemic lupus erythematosus (SLE): A systematic review and meta-analysis. Autoimmunity Reviews, 18(11), 102392. https://doi.org/10.1016/j.autrev.2019.102392
11. Gubatan, J., Chou, N. D., Nielsen, O. H., & Moss, A. C. (2019). Systematic review with metaanalysis: Association of vitamin D status with clinical outcomes in adult patients with inflammatory bowel disease. Alimentary Pharmacology & Therapeutics, 50(11–12), 1146–1158. https://doi.org/10.1111/apt.15506
12. Hahn, J., Cook, N. R., Alexander, E. K., et al. (2022). Vitamin D and marine omega 3 fatty acid supplementation and incident autoimmune disease: VITAL randomized controlled trial. BMJ, 376,e066452. https://doi.org/10.1136/bmj-2021-066452
13. Nguyen, M., Bryant, K., & O'Neill, S. (2018). Vitamin D in SLE: A role in pathogenesis and fatigue? A review of the literature. Lupus, 27(13), 2003–2011. https://doi.org/10.1177/0961203318796293
14. Carlberg, C. (2019). Vitamin D signaling in the context of innate immunity: Focus on human monocytes. Frontiers in Immunology, 10, 2211. https://doi.org/10.3389/fimmu.2019.02211
15. Hafkamp, F. M. J., Taanman-Kueter, E. W. M., van Capel, T. M. M., Kormelink, T. G., & de Jong, E. C. (2022). Vitamin D3 Priming of Dendritic Cells Shifts Human Neutrophil-Dependent Th17 Cell Development to Regulatory T Cells. Frontiers in immunology, 13, 872665. https://doi.org/10.3389/fimmu.2022.872665
16. Nagy, N. A., Lozano Vigario, F., Sparrius, R., van Capel, T. M. M., van Ree, R., Tas, S. W., de Vries, I. J. M., Geijtenbeek, T. B. H., Slütter, B., de Jong, E. C., & DC4Balance consortium (2023). Liposomes loaded with vitamin D3 induce regulatory circuits in human dendritic cells. Frontiers in immunology, 14, 1137538. https://doi.org/10.3389/fimmu.2023.113753
17. Ghaseminejad-Raeini, A., Ghaderi, A., Sharafi, A., Nematollahi-Sani, B., Moossavi, M., Derakhshani, A., & Sarab, G. A. (2023). Immunomodulatory actions of vitamin D in various immune-related disorders: a comprehensive review. Frontiers in immunology, 14, 950465. https://doi.org/10.3389/fimmu.2023.950465
18. Giordano, A., Clarelli, F., Pignolet, B., Mascia, E., Sorosina, M., Misra, K., Ferrè, L., Bucciarelli, F., Manouchehrinia, A., Moiola, L., Martinelli, V., Rocca, M. A., Liblau, R., Filippi, M., & Esposito, F. (2025). Vitamin D affects the risk of disease activity in multiple sclerosis. Journal of neurology, neurosurgery, and psychiatry, 96(2), 170–176. https://doi.org/10.1136/jnnp-2024-334062
19. Thouvenot, E., Laplaud, D., Lebrun-Frenay, C., Derache, N., Le Page, E., Maillart, E., Froment-Tilikete, C., Castelnovo, G., Casez, O., Coustans, M., Guennoc, A. M., Heinzlef, O., Magy, L., Nifle, C., Ayrignac, X., Fromont, A., Gaillard, N., Caucheteux, N., Patry, I., De Sèze, J., … D-Lay MS Investigators (2025). High-Dose Vitamin D in Clinically Isolated Syndrome Typical of Multiple Sclerosis: The D-Lay MS Randomized Clinical Trial. JAMA, 333(16), 1413–1422. https://doi.org/10.1001/jama.2025.1604
20. Hupperts, R., Smolders, J., Vieth, R., Holmøy, T., Marhardt, K., Schluep, M., Killestein, J., Barkhof, F., Beelke, M., Grimaldi, L. M. E., & SOLAR Study Group (2019). Randomized trial of daily high-dose vitamin D3 in patients with RRMS receiving subcutaneous interferon β-1a. Neurology, 93(20), e1906–e1916. https://doi.org/10.1212/WNL.0000000000008445
21. Cassard, S. D., Fitzgerald, K. C., Qian, P., Emrich, S. A., Azevedo, C. J., Goodman, A. D., Sugar, E. A., Pelletier, D., Waubant, E., & Mowry, E. M. (2023). High-dose vitamin D3 supplementation in relapsing-remitting multiple sclerosis: a randomised clinical trial. EClinicalMedicine, 59, 101957. https://doi.org/10.1016/j.eclinm.2023.101957
22. Al-Saoodi, H., Kolahdooz, F., Andersen, J. R., & Jalili, M. (2024). Effect of vitamin D on inflammatory and clinical outcomes in patients with rheumatoid arthritis: a systematic review and dose-response meta-analysis of randomized controlled trials. Nutrition reviews, 82(5), 600–611. https://doi.org/10.1093/nutrit/nuad083
23. Ranjbar, M., Rahimlou, M., Fallah, M., Djafarian, K., & Mohammadi, H. (2025). Effects of vitamin D supplementation in patients with rheumatoid arthritis: A systematic review and meta-analysis. Heliyon, 11(3), e42463. https://doi.org/10.1016/j.heliyon.2025.e42463
24. Durá-Travé, T., & Gallinas-Victoriano, F. (2024). Autoimmune Thyroiditis and Vitamin D. International journal of molecular sciences, 25(6), 3154. https://doi.org/10.3390/ijms25063154
25. Tang, J., Shan, S., Li, F., & Yun, P. (2023). Effects of vitamin D supplementation on autoantibodies and thyroid function in patients with Hashimoto's thyroiditis: A systematic review and meta-analysis. Medicine, 102(52), e36759. https://doi.org/10.1097/MD.0000000000036759
26. Grove-Laugesen, D., Ebbehoj, E., Watt, T., Riis, A. L., Østergård, T., Bruun, B. J., Juel Christiansen, J., Hansen, K. W., & Rejnmark, L. (2023). Effect of Vitamin D Supplementation on Graves' Disease: The DAGMAR Trial. Thyroid : official journal of the American Thyroid Association, 33(9), 1110–1118. https://doi.org/10.1089/thy.2023.0111
27. Vernia, F., Valvano, M., Longo, S., Cesaro, N., Viscido, A., & Latella, G. (2022). Vitamin D in Inflammatory Bowel Diseases. Mechanisms of Action and Therapeutic Implications. Nutrients, 14(2), 269. https://doi.org/10.3390/nu14020269
28. Valvano, M., Magistroni, M., Cesaro, N., Carlino, G., Monaco, S., Fabiani, S., Vinci, A., Vernia, F., Viscido, A., & Latella, G. (2024). Effectiveness of Vitamin D Supplementation on Disease Course in Inflammatory Bowel Disease Patients: Systematic Review With Meta-Analysis. Inflammatory bowel diseases, 30(2), 281–291. https://doi.org/10.1093/ibd/izac253
29. Ramezani, R., Ghorbaninejad, P., Eslahi, M., Sheikhi, L., Abbasi, F., Hasanzadeh, M., Mohammadpour, S., & Milajerdi, A. (2024). Effects of Vitamin D Supplementation on Serum 25-Hydroxy Cholecalciferol in Inflammatory Bowel Diseases: A Meta-Analysis of Randomized Clinical Trials. International journal of preventive medicine, 15, 65. https://doi.org/10.4103/ijpvm.ijpvm_133_23
30. Sninsky, J. A., Sansgiry, S., Taylor, T., Perrin, M., Kanwal, F., & Hou, J. K. (2026). The Real-World Impact of Vitamin D Supplementation on Inflammatory Bowel Disease Clinical Outcomes. Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association, 24(6), 1666–1674.e2. https://doi.org/10.1016/j.cgh.2025.07.013
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Copyright (c) 2026 Magdalena Maria Iwaszko, Marcelina Skajewska, Wojciech Ziębka , Szymon Bojanowski, Aleksandra Wojtera
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