Objective. To examine the immunologic mechanism by which 1,25-dihydroxyvitamin D3(1,25[OH]2D3) may prevent corticosteroid-induced osteoporosis in patients with early rheumatoid arthritis (RA), with a focus on T cell biology. Methods. Peripheral blood mononuclear cells (PBMCs) and CD4+CD45RO+ (memory) and CD4+CD45RO- (non-memory) T cells separated by fluorescence-activated cell sorting (FACS) from treatment-naive patients with early RA were stimulated with anti-CD3/anti-CD28 in the absence or presence of various concentrations of 1,25(OH)2D3, dexamethasone (DEX), and 1,25(OH)2D3and DEX combined. Levels of T cell cytokines were determined by enzyme-linked immunosorbent assay and flow cytometry. Results. The presence of 1,25(OH)2D3reduced interleukin-17A (IL-17A) and interferon-γ levels and increased IL-4 levels in stimulated PBMCs from treatment-naive patients with early RA. In addition, 1,25(OH)2D3had favorable effects on tumor necrosis factor α (TNFα):IL-4 and IL-17A:IL-4 ratios and prevented the unfavorable effects of DEX on these ratios. Enhanced percentages of IL-17A- and IL-22-expressing CD4+ T cells and IL-17A-expressing memory T cells were observed in PBMCs from treatment-naive patients with early RA as compared with healthy controls. Of note, we found no difference in the percentage of CD45RO+ and CD45RO- cells between these 2 groups. Interestingly, 1,25(OH)2D3, in contrast to DEX, directly modulated human Th17 polarization, accompanied by suppression of IL-17A, IL-17F, TNFα, and IL-22 production by memory T cells sorted by FACS from patients with early RA. Conclusion. These data indicate that 1,25(OH)2D3may contribute its bone-sparing effects in RA patients taking corticosteroids by the modulation of Th17 polarization, inhibition of Th17 cytokines, and stimulation of IL-4.

doi.org/10.1002/art.25043, hdl.handle.net/1765/27627
Arthritis & Rheumatology
Erasmus MC: University Medical Center Rotterdam

Colin, E., Asmawidjaja, P., van Hamburg, J. P., Mus, A., van Driel, M., Hazes, M., … Lubberts, E. (2010). 1,25-Dihydroxyvitamin D3 modulates Th17 polarization and interleukin-22 expression by memory T cells from patients with early rheumatoid arthritis. Arthritis & Rheumatology, 62(1), 132–142. doi:10.1002/art.25043