Vitamin D: is it important in haematopoietic stem cell transplantation? A review

Abstract

Vitamin D has effects on several body systems, from well-established role in bone metabolism to emerging effects on the immune system. Increasing evidence supports an immunomodulatory effect including inhibition of the pro-inflammatory lymphocyte subsets while enhancing their anti-inflammatory counterpart, in favour of a more tolerogenic status. Vitamin D deficiency is increasingly recognised in association with autoimmune and inflammatory diseases, also with evidence from the field of asthma where vitamin D supplementation may overcome steroid resistance. In the HSCT setting, vitamin D deficiency has been variably associated with increased complications, including graft-versus-host disease (GvHD), with a potential impact on survival outcomes. In this review we provide an overview and critical appraisal of the current literature of the role of vitamin D (and its deficiency) in relation to immunity in both allogeneic and autologous HSCT settings. We conclude that the evidence base is mixed, but a greater understanding of the role of vitamin D in relation to immune reconstitution following HSCT is warranted. Given its potential benefits, its inexpensive cost and favourable side effect profile, consideration of vitamin D levels and its supplementation could be easily incorporated into prospective studies in GvHD, including clinical trials of novel therapeutics, supportive care and biomarkers.

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Acknowledgements

JRS is currently undertaking a fellowship supported by the Anthony Nolan Research Institute.

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JRS lead the writing of the manuscript with support from CA, AM, and JAS.

Correspondence to Jose Ros-Soto.

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This review has been carried out as part of a fellowship supported by the Anthony Nolan Research Institute. JRS is currently undertaking a fellowship supported by the Anthony Nolan Research Institute. The remaining authors declare that they have no conflict of interest.

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