Kondo Yasuteru
Yasuteru Kondo, Department of Hepatology, Sendai Kousei Hospital, Aoba, Sendai City 980, Miyagi, Japan.
World J Gastroenterol. 2017 Feb 28;23(8):1325-1327. doi: 10.3748/wjg.v23.i8.1325.
It has been reported that the serum level of vitamin D3 (VitD3) could affect the natural course of chronic hepatitis C (CH-C) and the response to treatment with pegylated interferon (Peg-IFN) and ribavirin. Although several mechanisms for the favorable effects of VitD3 supplementation were reported, the total effect of VitD3 supplementation remains unclear. Previously, we reported that supplementation with 1(OH)VitD3 could enhance the Th1 response inducing not only a favorable immune response for viral eradication but also HCC control. Recently, the main treatment of CH-C should be direct acting antivirals (DAAs) without Peg-IFN. Peg-IFN is a strong immune-modulator. Therefore, an immunological analysis should be carried out to understand the effect of VitD3 after treatment of DAAs without Peg-IFN. The induction of a favorable immune response by adding VitD3 might be able to suppress the hepatocarcinogenesis after achieving SVR, especially in children and elderly patients with severe fibrosis lacking sufficient amounts of VitD3.
据报道，血清维生素D3（VitD3）水平可能会影响慢性丙型肝炎（CH-C）的自然病程以及聚乙二醇干扰素（Peg-IFN）和利巴韦林治疗的反应。尽管报道了补充VitD3产生有利作用的几种机制，但补充VitD3的总体效果仍不清楚。此前，我们报道补充1（OH）VitD3可增强Th1反应，不仅诱导有利于病毒清除的免疫反应，还能控制肝癌。最近，CH-C的主要治疗方法应是使用不含Peg-IFN的直接抗病毒药物（DAA）。Peg-IFN是一种强效免疫调节剂。因此，应该进行免疫学分析，以了解在不使用Peg-IFN的DAA治疗后VitD3的作用。添加VitD3诱导有利的免疫反应可能能够在实现持续病毒学应答（SVR）后抑制肝癌发生，尤其是在缺乏足够量VitD3的重度纤维化儿童和老年患者中。
