THE ROLE OF VITAMIN D IN PULMONARY SARCOIDOSIS AND INFLAMMATION

Introduction and Objectives Sarcoidosis is a multisystem disease of unknown aetiology characterized by a Th1 granulomatous immune response. Granuloma formation has been linked to a failure of the innate immune system, which could be related to a deficiency in vitamin D. Previous studies have documented low levels of vitamin D in patients with sarcoidosis. We aimed to explore the role of vitamin D in sarcoidosis and its relationship to biomarkers of disease activity and severity. Methods Baseline demography, mode of presentation, Scadding CXR stage and need for treatment was recorded for 184 patients. Additional data including biochemical markers of disease activity and serum vitamin D levels were performed in 66 patients within a 4-week study period. Disease activity was assessed using lymphocyte trend, inflammatory markers, LFT, serum ACE and IgG, physiological and radiological measures as well as the need for treatment. Vitamin D levels were grouped into ‘sufficient’ (>50 nmol/L) and ‘insufficient or deficient’ ( Results Baseline data was similar between the study group and cohort. In this cohort the average age was 57.6 with median length of disease of 4.8 years (2.1–8.0), the treatment rate was 48%. The majority of patients were sufficient in Vitamin D (64%) at time of testing. A positive association between the need for treatment and previously recognised indicators; including lymphocyte trend, higher CXR staging, and mode of presentation was found. Preliminary analysis suggested an inverse correlation between vitamin D and levels of systemic inflammation -CRP (OR 3.61 p-value 0.01) and ESR (OR 9.59 p-value Conclusions The majority of patients were sufficient in Vitamin D. Levels correlated inversely with markers of inflammation but did not appear to be associated with need for treatment or disease severity. This data suggests a link between Vitamin D and systemic inflammation in sarcoidosis and warrants further investigation. Given deficiency may also mimic many symptoms encountered in active sarcoid measurement is useful in robust assessment.