Vitamin D Homeostasis in Sarcoidosis



Status:Not yet recruiting
Conditions:Food Studies, Endocrine
Therapuetic Areas:Endocrinology, Pharmacology / Toxicology
Healthy:No
Age Range:21 - Any
Updated:2/17/2019
Start Date:July 1, 2019
End Date:December 30, 2023
Contact:Connie Hsia, MD
Email:Connie.Hsia@utsouthwestern.edu
Phone:2146483426

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This study evaluates the relationship between vitamin-D status and severity of sarcoidosis,
and the effects of vitamin-D repletion in vitamin-D insufficient patients with sarcoidosis.
Half the patients with sarcoidosis who are vitamin-D insufficient will receive standard
vitamin-D supplementation via standard regimen while the other half will receive a placebo.
Sarcoidosis patients who are vitamin-D sufficient will also act as controls.

Sarcoidosis is a multi-system inflammatory disease characterized by T-helper lymphocyte
hyperactivity leading to granulomatous inflammation. The granuloma cells autonomously convert
25-hydroxy-vitamin-D (25OHD) to the active metabolite 1,25-dihydroxy-vitamin-D (1,25OH2D)
independent of normal feedback control but dependent on substrate (25OHD) concentration.

Circulating 1,25OH2D exerts both anti-inflammatory and mineral metabolic actions. Deficiency
of 25OHD limits substrate-dependent 1,25OH2D synthesis, diminishes anti-antigenic innate
immunity and augments pro-inflammatory adaptive immunity. Thus, low vitamin-D stores could
aggravate sarcoid inflammation while repletion of vitamin-D stores could mitigate
inflammation in sarcoidosis.

Inclusion Criteria:

- Stable medical condition defined as no hospitalization or emergency room visit in the
previous 3 months

- No evidence of active pulmonary or systemic infection

- No other active inflammatory disease,

- No active malignancy.

- Normal serum ionized calcium level

Exclusion Criteria:

- Hospitalization or emergency room visit in the previous 3 months

- Evidence of active pulmonary or systemic infection

- Evidence of active other inflammatory disease

- Evidence of active malignancy

- Elevated serum ionized calcium level
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