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Author response to Drs. Golan & Miller

  • Elias S. Sotirchos, Johns Hopkins University School of Medicineess@jhmi.edu
  • P Bhargava, Baltimore, MD; PA Calabresi, Baltimore, MD
Submitted May 11, 2016

We thank Drs. Golan and Miller for the comments on our article reporting that high-dose cholecalciferol supplementation (10,400 IU/day) decreases the proportion of circulating IL17+CD4+T cells, with no effect noted in the low-dose group (800 IU/day). [1] A similar effect was observed on CD161+CD4+T cells; CD161 is considered a membrane marker of IL-17-producing cells. [2] We did not observe any significant changes in serum cytokine levels, including IL-17.

Serum cytokine levels are known to vary significantly throughout the day due to numerous exogenous factors and are also sensitive to changes related to sample collection, processing, and storage. [3] These methodologic issues likely explain the discrepant results observed between studies examining the effect of vitamin D supplementation on serum IL-17 levels. [1,4-6]

1. Sotirchos ES, Bhargava P, Eckstein C, et al. Safety and immunologic effects of high- vs low-dose cholecalciferol in multiple sclerosis. Neurology 2016;86:382-390.

2. Cosmi L, De Palma R, Santarlasci V, et al. Human interleukin 17-producing cells originate from a CD161+CD4+ T cell precursor. J Exp Med 2008;205:1903-1916.

3. Zhou X, Fragala MS, McElhaney JE, Kuchel GA. Conceptual and methodological issues relevant to cytokine and inflammatory marker measurements in clinical research. Curr Opin Clin Nutr Metab Care 2010;13:541-547.

4. Golan D, Halhal B, Glass-Marmor L, et al. Vitamin D supplementation for patients with multiple sclerosis treated with interferon-beta: a randomized controlled trial assessing the effect on flu-like symptoms and immunomodulatory properties. BMC Neurol 2013;13:60.

5. Aivo J, Hanninen A, Ilonen J, Soilu-Hanninen M. Vitamin D3 administration to MS patients leads to increased serum levels of latency activated peptide (LAP) of TGF-beta. J Neuroimmunol 2015;280:12-15.

6. Toghianifar N, Ashtari F, Zarkesh-Esfahani SH, Mansourian M. Effect of high dose vitamin D intake on interleukin-17 levels in multiple sclerosis: a randomized, double-blind, placebo-controlled clinical trial. J Neuroimmunol;285:125-128.

For disclosures, please contact the editorial office at journal@neurology.org.

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