Kamen Diane, Aranow Cynthia
Medical University of South Carolina, USA.
Curr Opin Rheumatol. 2008 Sep;20(5):532-7. doi: 10.1097/BOR.0b013e32830a991b.
There is growing interest in the contribution of vitamin D deficiency to autoimmunity. It is therefore timely to review the immunologic actions of vitamin D and the evidence linking vitamin D deficiency to autoimmune disease in animal models and to systemic lupus erythematosus in epidemiologic studies.
A number of recent studies have highlighted the association between systemic lupus erythematosus and vitamin D deficiency. Vitamin D deficiency skews the immunologic response towards loss of tolerance. Adding vitamin D in vitro reverses immunologic abnormalities characteristic of systemic lupus erythematosus.
Multiple systemic lupus erythematosus cohorts have low vitamin D levels. The physiologic and clinical consequences of vitamin D deficiency in systemic lupus erythematosus are not entirely known. Prospective studies of vitamin D in systemic lupus erythematosus are limited, but most cross-sectional studies show an inverse relationship between levels of vitamin D and disease activity. This suggests that repletion of vitamin D may have benefits beyond bone health for patients with systemic lupus erythematosus.
维生素 D 缺乏对自身免疫的影响日益受到关注。因此,适时回顾维生素 D 的免疫作用以及在动物模型中维生素 D 缺乏与自身免疫性疾病的关联证据,以及在流行病学研究中与系统性红斑狼疮的关联证据。
近期多项研究强调了系统性红斑狼疮与维生素 D 缺乏之间的关联。维生素 D 缺乏会使免疫反应偏向于失去耐受性。在体外添加维生素 D 可逆转系统性红斑狼疮的特征性免疫异常。
多个系统性红斑狼疮队列的维生素 D 水平较低。维生素 D 缺乏在系统性红斑狼疮中的生理和临床后果尚不完全清楚。关于系统性红斑狼疮中维生素 D 的前瞻性研究有限,但大多数横断面研究表明维生素 D 水平与疾病活动呈负相关。这表明补充维生素 D 可能对系统性红斑狼疮患者除骨骼健康外还有益处。