vitamin d intake and its protective role in multiple sclerosis: the checkmate to survivin?

vitamin d has long been speculated to reduce the risk of multiple sclerosis (ms). however, its role in development and modulating the course of ms has yet to be clarified. to date, there is no scientific evidence for the use of vitamin d as monotherapy for ms in clinical practice and perplexities still exist on potential disadvantages of vitamin d intake. we hypothesize that vitamin d may be effective against ms inhibiting survivin gene expression and thereby affecting the development and progression of the disease. however, decreased levels of survivin may lead to worse outcomes during the acute phase of cardiovascular conditions such as ami and stroke taking into account the highest-risk status of patients with ms. thus, vitamin d should be administered to patients with ms after excluding potential associated risk factors for cvd and defining threshold vitamin d levels above which supplementations might negatively influence recovery from ami and stroke.