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维生素D与类风湿关节炎:一个仍未解开的谜团。

Vitamin D and rheumatoid arthritis: an ongoing mystery.

作者信息

Bragazzi Nicola L, Watad Abdulla, Neumann Shana G, Simon Michael, Brown Stav B, Abu Much Arsalan, Harari Adam, Tiosano Shmuel, Amital Howard, Shoenfeld Yehuda

机构信息

aSchool of Public Health, Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy bDepartment of Medicine B cZabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel Hashomer dSackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

出版信息

Curr Opin Rheumatol. 2017 Jul;29(4):378-388. doi: 10.1097/BOR.0000000000000397.

Abstract

PURPOSE OF REVIEW

In recent years, there has been a growing interest in the value of vitamin D and its effects on autoimmunity. The aim of this review is to summarize the current knowledge on the association between vitamin D and rheumatoid arthritis (RA) in terms of prevalence, disease activity, clinical expression, serology and gene polymorphisms of vitamin D receptors.

RECENT FINDINGS

Studies have shown contrasting findings concerning the association between vitamin D levels and RA. Vitamin D seems to have immunomodulatory properties. Therefore, low vitamin D levels could contribute to increased immune activation. However, the potential role of vitamin D supplementation in preventing RA manifestation and its beneficial role as a component of RA treatment remain controversial. The relationship between RA susceptibility and vitamin D polymorphisms is also unclear.

SUMMARY

Despite advancements synthesized by some recent meta-analyses, the relationship between vitamin D and RA requires further evaluation. Further research is needed to confirm the relationship between RA susceptibility and vitamin D polymorphisms and to determine whether vitamin D plays a role in preventing the manifestation of RA. Finally, additional studies are required to determine the impact and optimal amount of vitamin D supplementation in the treatment of RA patients.

摘要

综述目的

近年来,人们对维生素D的价值及其对自身免疫的影响越来越感兴趣。本综述的目的是总结目前关于维生素D与类风湿关节炎(RA)之间关联的知识,包括患病率、疾病活动度、临床表现、血清学以及维生素D受体的基因多态性。

最新发现

关于维生素D水平与RA之间的关联,研究结果存在差异。维生素D似乎具有免疫调节特性。因此,低维生素D水平可能导致免疫激活增加。然而,补充维生素D在预防RA发生中的潜在作用及其作为RA治疗组成部分的有益作用仍存在争议。RA易感性与维生素D多态性之间的关系也不明确。

总结

尽管最近一些荟萃分析取得了进展,但维生素D与RA之间的关系仍需进一步评估。需要进一步研究来证实RA易感性与维生素D多态性之间的关系,并确定维生素D是否在预防RA发生中起作用。最后,还需要更多研究来确定补充维生素D对RA患者治疗的影响及最佳剂量。

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