Local anti-inflammatory effect of vitamin D in acute and chronic gouty arthritis

Background Vitamin D has immunomodulatory, anti-inflammatory properties and important role in bone metabolism. Effects of vitamin D supplementation in musculoskeletal diseases are well known, but it is unknown if local application of vitamin D can have an anti-inflammatory potential. Aims The aim of this study was to investigate local influence of vitamin D on inflammation, pain, redness and swelling of the affected joint in acute and chronic gouty arthritis. 40 patients with acute gouty arthritis and 40 patients with chronic gouty arthritis were included in study. Methods We did topical application of cholecalciferol in a dose of 180,000 IU daily through seven days on the affected joint for one hour. Local changes of the affected joint such as swelling and redness were observed. Also, serum samples were taken on a 1st, 3rd and 7th day of application in order to measure levels of vitamin D, urates, calcium and C reactive protein. Results We found that local application of vitamin D increased its serum levels in both groups of patients while urates level, swelling, redness and pain was reduced. Effect of vitamin D on pain, redness and inflammation was stronger in a group with acute inflammation. Conclusion Local application of vitamin D may be linked to the reduction of acute and chronic inflammation in gouty arthritis. Relationship between vitamin D and urates in inflammatory process should be investigated further.