# Vitamin D and Fish Oil for Autoimmune Disease and Inflammation

> **NIH NIH R01** · BRIGHAM AND WOMEN'S HOSPITAL · 2021 · $613,498

## Abstract

ABSTRACT
 Autoimmune diseases affect ~ 5% of the U.S. population and carry a high burden of morbidity, health care
costs, disability, and premature mortality. In the first cycle of this award, we leveraged an innovative nationwide
NIH-funded double-blind, placebo-controlled randomized trial, VITAL, to test the effects of vitamin D (vitamin
D3 [cholecalciferol]) and marine omega-3 fatty acid (eicosapentaenoic acid [EPA] + docosahexaenoic acid
[DHA]) supplements upon the risk of incident autoimmune disease and changes in biomarkers of systemic
inflammation. Data from laboratory studies, observational epidemiologic research, and small prevention trials
strongly suggest that these nutritional agents have anti-inflammatory and immunomodulating benefits. Popular
enthusiasm for vitamin D and fish oil supplements underscores the urgent need for rigorous testing. We have
recruited, randomized, and are following 25,874 VITAL participants, men aged ≥50 and women aged ≥55
nationwide, including 20% African Americans. Following a 3 month run-in, eligible participants were randomly
assigned to one of four treatment groups: vitamin D3 (2000 IU/d) and fish oil (EPA+DHA, 1 g/d); vitamin D3 and
fish oil placebo; placebo vitamin D3 and fish oil; and placebo vitamin D3 and placebo fish oil. At yearly intervals,
all participants receive a new pill supply, are asked about compliance and side effects, and report incident
autoimmune diseases. A physician endpoints committee has confirmed 444 incident autoimmune disease
cases by medical record review to date. In a randomly selected subcohort of 1634 VITAL participants, blood
samples have been assayed for changes in C-reactive peptide, interleukin-6, and tumor necrosis factor-
receptor 2 in all four trial arms. With this renewal grant, we will complete the 5 pre-specified years and a 2 year
observational extension, critically important given the long latency of autoimmune disease onset. Continued
follow-up will improve statistical power for detecting preventive effects on autoimmune disease incidence, and
will enable investigations of effects over time and effect modification by baseline factors and biomarkers. We
hypothesize that there will be a delayed reduction in autoimmune disease, and that the largest preventive
effects will be among those with high systemic inflammation, including the obese and those with elevated
baseline biomarkers of inflammation. In this renewal, we also will test for changes in “Specialized Pro-
Resolving Mediators” (SPM), novel omega-3 fatty acid-dependent lipids responsible for inflammation
resolution. We will employ cutting-edge quantitative liquid chromatography-tandem mass spectroscopy to
extend understanding of the biological mechanisms by which omega-3 fatty acids influence inflammation
resolution and potentially autoimmune disease pathogenesis. Given the ongoing NIH-funded VITAL trial
infrastructure, our strong multidisciplinary research team, and success with prior large mail-based tri...

## Key facts

- **NIH application ID:** 10172848
- **Project number:** 5R01AR059086-09
- **Recipient organization:** BRIGHAM AND WOMEN'S HOSPITAL
- **Principal Investigator:** Karen H Costenbader
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $613,498
- **Award type:** 5
- **Project period:** 2010-05-07 → 2024-04-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10172848

## Citation

> US National Institutes of Health, RePORTER application 10172848, Vitamin D and Fish Oil for Autoimmune Disease and Inflammation (5R01AR059086-09). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10172848. Licensed CC0.

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