Amirreza AZIMI, Mahsa GHAJARZADEH, Mohammad Ali SAHRAIAN, Mehdi MOHAMMADIFAR, Bita ROOSTAEI, Sara Mohammad Vali SAMANI, Hamid Reza Farhadi SHABESTARI and Sara HANAEI

ABSTRACT

Background: Vitamin D is one of the considerable environmental factors exhibiting immunomodulatory and anti-inflammatory effects.
Objective: To conduct a systematic review and meta-analysis to estimate the effect of vitamin D supplements on IL-10 and INFγ levels in patients with multiple sclerosis.
Methods: We searched PubMed, Scopus, EMBASE, CINAHL, Web of Science, Ovid, The Cochrane Library and gray literature, including references of selected studies, conference abstracts which were published up to May 2019. We included single- or double-blinded RCTs or open-label trials in which one of the main outcomes was INFγ and/ or IL-10 levels after vitamin D supplementation. Only articles that had been published in English were included.
Results: The literature search yielded 369 articles, that were monitored by us. After eliminating duplicates, 128 studies remained; from these, we excluded observational studies, reviews, case reports and non-randomized trials, and 33 studies remained. Finally, only three articles were included. The mean difference for INFγ was 268.4 and 95% CI 200.6-336.1. There was no significant heterogeneity (I2 = 0%, Chi2 = 0.1, p = 0.7). The mean difference for IL-10 was 398.3 and 95% CI -528.05-1324.8). There was significant heterogeneity (I2 = 94%, Chi2 = 31.1 p < 0.001).
Conclusion: The results of this systematic review were not satisfactory. More clinical trials are further needed to evaluate the effects of vitamin D supplements on IL-10 and INFγ levels in patients with multiple sclerosis.
Keywords: multiple sclerosis, systematic review, vitamin D, chemokines

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Amirreza AZIMI, Sara HANAEI, Mohammad Ali SAHRAIAN, Mehdi MOHAMMADIFAR, Sreeram V RAMAGOPALAN and Mahsa GHAJARZADEH

ABSTRACT

Background: Sexual dysfunction (SD) is an important issue for women suffering from multiple sclerosis (MS). There is a discrepancy among the reported prevalence of SD in studies that were conducted in different geographical regions.
Objective: We aimed to conduct this systematic review and meta-analysis to estimate pooled prevalence of SD in women with MS.
Methods: We searched PubMed, Scopus, EMBASE, CINAHL, Web of Science, Ovid, Google Scholar and gray literature, including references of selected studies and conference abstracts that were published up to April 2019. The search strategy included MeSH and text words as (sexual function) OR (sexual dysfunction) AND (Multiple Sclerosis OR Sclerosis, Multiple) OR (Sclerosis, Disseminated) OR (Disseminated Sclerosis) OR (MS) (Multiple Sclerosis) OR (Multiple Sclerosis, Acute Fulminating) AND (Female Sexual Function Index OR FSFI). Two independent researchers independently assessed the articles. Results: The literature search found 168 articles but only nine were considered for the final analysis.
Two studies were from Greece, three from Iran, one from Turkey, one from Poland, one from Germany and one from Italy. In total, 1060 MS cases were analyzed. The prevalence of SD was extremely discrepant, from 27% to 95%, and the pooled estimate was calculated as 55% (95% CI 41%-69%), (I2=96.3%, P<00.1).
Conclusion: Prevalence of SD is discrepant among women with MS in different countries and it should be considered as an important concern.
Keywords: sexual dysfunction, multiple sclerosis, systematic review, prevalence

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