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维生素 D 在人类免疫缺陷病毒感染中的作用:对免疫和疾病的影响。

Vitamin D in Human Immunodeficiency Virus Infection: Influence on Immunity and Disease.

机构信息

Unidad de Infección Viral e Inmunidad, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Majadahonda, Spain.

出版信息

Front Immunol. 2018 Mar 12;9:458. doi: 10.3389/fimmu.2018.00458. eCollection 2018.

Abstract

People living with human immunodeficiency virus (HIV) infection typically have hypovitaminosis D, which is linked to a large number of pathologies, including immune disorders and infectious diseases. Vitamin D (VitD) is a key regulator of host defense against infections by activating genes and pathways that enhance innate and adaptive immunity. VitD mediates its biological effects by binding to the Vitamin D receptor (VDR), and activating and regulating multiple cellular pathways. Single nucleotide polymorphisms in genes from those pathways have been associated with protection from HIV-1 infection. High levels of VitD and VDR expression are also associated with natural resistance to HIV-1 infection. Conversely, VitD deficiency is linked to more inflammation and immune activation, low peripheral blood CD4+ T-cells, faster progression of HIV disease, and shorter survival time in HIV-infected patients. VitD supplementation and restoration to normal values in HIV-infected patients may improve immunologic recovery during combination antiretroviral therapy, reduce levels of inflammation and immune activation, and increase immunity against pathogens. Additionally, VitD may protect against the development of immune reconstitution inflammatory syndrome events, pulmonary tuberculosis, and mortality among HIV-infected patients. In summary, this review suggests that VitD deficiency may contribute to the pathogenesis of HIV infection. Also, VitD supplementation seems to reverse some alterations of the immune system, supporting the use of VitD supplementation as prophylaxis, especially in individuals with more severe VitD deficiency.

摘要

人类免疫缺陷病毒(HIV)感染者通常患有维生素 D 缺乏症,这与许多病理学有关,包括免疫紊乱和传染病。维生素 D(VitD)是宿主防御感染的关键调节剂,通过激活增强先天和适应性免疫的基因和途径来实现。VitD 通过与维生素 D 受体(VDR)结合来介导其生物学效应,并激活和调节多种细胞途径。来自这些途径的基因中的单核苷酸多态性与 HIV-1 感染的保护有关。高水平的 VitD 和 VDR 表达也与对 HIV-1 感染的天然抵抗力有关。相反,VitD 缺乏与更多的炎症和免疫激活、外周血 CD4+T 细胞减少、HIV 疾病进展更快以及 HIV 感染患者的生存时间缩短有关。HIV 感染者 VitD 补充和恢复正常水平可能会改善联合抗逆转录病毒治疗期间的免疫恢复、降低炎症和免疫激活水平,并增强对病原体的免疫力。此外,VitD 可能有助于预防免疫重建炎症综合征事件、肺结核和 HIV 感染患者的死亡。总之,本综述表明 VitD 缺乏可能导致 HIV 感染的发病机制。此外,VitD 补充似乎可以逆转免疫系统的一些改变,支持将 VitD 补充作为预防措施,特别是在 VitD 缺乏更严重的个体中。

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