Spector Stephen A
University of California San Diego, San Diego, CA, USA.
Top Antivir Med. 2011 Feb-Mar;19(1):6-10.
Vitamin D is important for cell growth, immunity, and metabolism. Deficiency has classically been associated with rickets and decreased bone density and more recently with increased risk and severity of autoimmune diseases, cancers, myocardial infarction, diabetes, and infectious diseases. How vitamin D can affect these diverse conditions is the subject of much research. The active form of vitamin D (vitamin D3) has been implicated recently in an intracellular process known as autophagy. In addition to its role in maintaining cellular homeostasis during conditions of stress, autophagy plays an important role in the control of many intracellular microorganisms including Mycobacterium tuberculosis. Recent work has identified that HIV-1 reduces autophagy during permissive infection and that agents that induce autophagy, including vitamin D3, can inhibit HIV-1 replication. These findings help provide a biological explanation for the increased risk of more rapid disease progression observed in HIV-infected persons with low levels of vitamin D or with genetic variants within the vitamin D receptor that alter binding to vitamin D. Controlled trials are needed to determine the potential for therapeutic benefit of vitamin D supplementation in HIV disease. This article summarizes a presentation by Stephen A. Spector, MD, at the IAS-USA continuing medical education program held in Chicago in April 2010.
维生素D对细胞生长、免疫和新陈代谢至关重要。传统上，维生素D缺乏与佝偻病和骨密度降低有关，最近又与自身免疫性疾病、癌症、心肌梗死、糖尿病和传染病的风险及严重程度增加有关。维生素D如何影响这些不同病症是众多研究的主题。维生素D的活性形式（维生素D3）最近被认为与一种名为自噬的细胞内过程有关。除了在应激条件下维持细胞稳态方面的作用外，自噬在控制包括结核分枝杆菌在内的许多细胞内微生物方面也发挥着重要作用。最近的研究发现，HIV-1在允许性感染期间会减少自噬，而诱导自噬的物质，包括维生素D3，可以抑制HIV-1复制。这些发现有助于为维生素D水平低或维生素D受体存在改变与维生素D结合的基因变异的HIV感染者中观察到的疾病进展加快风险增加提供生物学解释。需要进行对照试验来确定补充维生素D对HIV疾病的潜在治疗益处。本文总结了医学博士斯蒂芬·A·斯佩克特在2010年4月于芝加哥举行的IAS-USA继续医学教育项目上的一次演讲。
