Do Vitamin D Levels Affect Antibody Titers Produced in Response to HPV Vaccine?
Antibody Titers Produced in Response
Authors: Zimmerman RK1, Lin CJ, Raviotta JM, Nowalk MP.
In addition to its well-known effects on bone metabolism, vitamin D is an immunomodulating hormone. Serum vitamin D levels in males 18-25 years were measured at baseline, and HPV antibody titers were measured one month following the third quadrivalent HPV vaccine dose. Vitamin D levels were >30 ng/ml (normal) in 60 males and <30 ng/ml (low) in 113 males. Reverse cumulative distribution curves and scatter plots showed higher antibody titers with low vitamin D for all vaccine strains (P<0.05). In linear regression analyses, antibody titers for all HPV strains were significantly higher among those with lower vitamin D levels and among younger participants (P<0.05). These relationships add to the body of knowledge of the complex role of vitamin D in immunoregulation.
Vitamin D has multiple immunologic effects beyond its well-known role in bone metabolism. For instance, vitamin D insufficiency has been linked to inflammatory diseases, such as multiple sclerosis and inflammatory bowel disease.1 In multiple sclerosis (MS), low vitamin D levels are associated with increases in MS activity and in the number of gadolinium-enhancing lesions.2
Research on vitamin D and immunological response to vaccination shows mixed results. Studies of children and adolescents, and of adults >50 y of age have found no association between vitamin D deficiency and response to influenza vaccine.3,4 In patients with chronic kidney disease, vitamin D deficiency is associated with a poor response to hepatitis B immunization.5 Vitamin D supplementation resulted in higher antibody titers after tetanus toxoid boosters.6 A systematic review of vitamin D for the treatment of infectious diseases was inconclusive but stressed the need for further research on the topic.7This study, conducted in the context of a trial of different HPV vaccine schedules in college-aged males, sought to determine the association between pre-vaccination serum vitamin D levels and post HPV vaccination antibody titers.