Department of Hematology, Iuliu Hatieganu University of Medicine and Pharmacy Cluj and Ion Chiricuta Oncology Institute, Cluj-Napoca, Romania.
Airways Disease Infection Section, National Heart and Lung Institute, Imperial College London, London, UK.
Rev Med Virol. 2017 Jan;27(1). doi: 10.1002/rmv.1909. Epub 2016 Oct 7.
Vitamin D, in addition to its classical functions in bone homeostasis, has a modulatory and regulatory role in multiple processes, including host defense, inflammation, immunity, and epithelial repair. Patients with respiratory disease are frequently deficient in vitamin D, implying that supplementation might provide significant benefit to these patients. Respiratory viral infections are common and are the main trigger of acute exacerbations and hospitalization in children and adults with asthma and other airways diseases. Respiratory monocytes/macrophages and epithelial cells constitutively express the vitamin D receptor. Vitamin D, acting through this receptor, may be important in protection against respiratory infections. Whether the in vitro findings can be translated into a substantial in vivo benefit still remains uncertain. Here we review the in vitro data on the role of vitamin D in antiviral innate immunity, the data concerning the deficient levels of vitamin D in lung diseases, and the in vivo role of supplementation as protection against respiratory viral infections in healthy individuals and in patients with chronic respiratory diseases. Finally, we suggest ways of improving the effectiveness of vitamin D as an adjuvant in the prevention and treatment of acute respiratory infections.
维生素 D 除了在骨骼稳态中的经典功能外，还在多种过程中具有调节和调控作用，包括宿主防御、炎症、免疫和上皮修复。患有呼吸道疾病的患者常常缺乏维生素 D，这意味着补充维生素 D 可能会给这些患者带来显著益处。呼吸道病毒感染很常见，是儿童和成人哮喘和其他气道疾病急性加重和住院的主要诱因。呼吸道单核细胞/巨噬细胞和上皮细胞持续表达维生素 D 受体。维生素 D 通过该受体发挥作用，可能对预防呼吸道感染很重要。体外发现是否可以转化为实质性的体内益处仍不确定。本文综述了维生素 D 在抗病毒先天免疫中的作用的体外数据、肺部疾病中维生素 D 水平不足的数据以及补充剂作为预防和治疗呼吸道病毒感染的健康个体和慢性呼吸道疾病患者的体内作用。最后，我们提出了提高维生素 D 作为急性呼吸道感染辅助治疗的有效性的方法。
