Clinic of Pulmonology, Clinical Center Serbia, Belgrade, Serbia.
Curr Opin Pulm Med. 2011 Sep;17(5):297-302. doi: 10.1097/MCP.0b013e328348b3cb.
Calcium metabolism impairments have long been recognized as a complication of sarcoidosis. For more than six decades physicians and investigators have been trying to elucidate this severe problem; nevertheless it seems puzzlingly new for both readers and researchers.
This review highlights the problems of calcium metabolism in sarcoidosis in relation to vitamin D synthesis, which is definitely altered by granulomatous inflammation. Increasing evidence suggests that vitamin D is an immunomodulating hormone that inhibits both antigen presentation by cells of the innate immune system, and the cytokine release and proliferation of Th1 cells. As calcium homeostasis is primary controlled by levels of vitamin D, parathyroid hormone (PTH) and calcitonin, this literature review emphasizes the role of general immunomodulating properties of vitamin D and the correlation with calcium metabolism impairments, with the special accent on already known interactions with sarcoidosis.
Granuloma formation has been related to a failure of the innate immune system. One of the possible explanations is a vitamin D deficiency. The evidence-based findings on calcium metabolism impairments and the interactions with vitamin D might help both clinicians and researchers in developing new strategies.
钙代谢紊乱一直被认为是肉样瘤病的一种并发症。六十多年来，医生和研究人员一直在努力阐明这一严重问题；然而，对于读者和研究人员来说，这似乎仍然是一个令人困惑的新问题。
本综述强调了钙代谢紊乱与维生素 D 合成的关系，而维生素 D 的合成肯定会受到肉芽肿性炎症的影响。越来越多的证据表明，维生素 D 是一种免疫调节激素，它可以抑制固有免疫系统细胞的抗原呈递，以及 Th1 细胞的细胞因子释放和增殖。由于钙稳态主要由维生素 D、甲状旁腺激素 (PTH) 和降钙素的水平控制，因此这篇文献综述强调了维生素 D 的一般免疫调节特性及其与钙代谢紊乱的相关性，特别强调了其与肉样瘤病的已知相互作用。
肉芽肿的形成与固有免疫系统的失败有关。一种可能的解释是维生素 D 缺乏。基于证据的钙代谢紊乱发现以及与维生素 D 的相互作用可能有助于临床医生和研究人员制定新的策略。
