Vitamin D and Environmental Factors in Multiple Sclerosis: A Review

Multiple sclerosis (MS) is an autoimmune illness with an uncertain etiology and a low treatment efficacy, resulting in a large social cost. Given that the myelin destruction model, clinical manifestations, and therapeutic response potential in MS are all linked, it's only natural that we look into the various factors (genetic, hormonal, and environmental) that play a role in the autoimmune process in order to better control the immune system's dysregulation. Results from epidemiological and clini¬cal studies clearly suggest that changes in vitamin D serum concentrations are correlated with the magnitude of the risk of developing MS, the phases of relapse and remittance and with gender differences in vitamin D metabolism. Vitamin D concentration in serum should be between 50 and 80 nmol/l to ensure appropriate calcium metabolism. The optimal vitamin D blood concentration required to control the aberrant immune response in MS patients, a subgroup of MS patients appropriate for vitamin D treatment, and the application of vitamin D in an optimally effective and safe dosage are all reviewed. The MS prevalence rate in Bulgaria has increased two-fold in 17 years, although this is a rather small time to presume that the population's gene pool has changed. As a result, more research into possible interactions between various environmental factors and their function in illness development is justified and required.