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维生素 D 补充剂对桥本甲状腺炎女性 CD4 T 细胞亚群频率的影响:一项双盲安慰剂对照研究。

Effects of vitamin D supplements on frequency of CD4 T-cell subsets in women with Hashimoto's thyroiditis: a double-blind placebo-controlled study.

机构信息

Department of Immunology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran.

Department of Immunology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.

出版信息

Eur J Clin Nutr. 2019 Sep;73(9):1236-1243. doi: 10.1038/s41430-019-0395-z. Epub 2019 Jan 29.

Abstract

BACKGROUND

Vitamin D is a modulator of immune functions. Investigations on the mechanisms of vitamin D action and pathogenesis of Hashimoto's thyroiditis (HT) have revealed that vitamin D can reduce damages to thyroid cells caused by autoreactive immune cells.

METHODS

Totally, 48 female patients with HT disease were introduced to the study by endocrinologists. Patients were divided into two major groups of 24 individuals and treated weekly with 50,000 IU of cholecalciferol (vitamin D group) or placebo (placebo group) using oral administration for 3 months. Eventually, 17 of the 24 patients in each group finished the study. Before and after supplementation, frequencies of Th1, Th17, Th2 and Tr1 cells and mean fluorescent intensity (MFI) of the associated cytokines, including IFN-γ, IL-17, IL-4 and IL-10, were assessed using flow cytometry. Furthermore, gene expression of IL-10 was assessed using real-time PCR.

RESULTS

Results of this study showed that cholecalciferol supplementation caused a significant decrease in Th17/Tr1 ratio. The proportion and MFI of Th1, Th2, Tr1 and Th17 cells included no significant changes in vitamin D group, compared to those in placebo group. Expression rate and MFI of IL-10 increased in both groups. This increase was higher in vitamin D group than placebo group with no significance.

CONCLUSIONS

In this novel preliminary clinical trial study, supplementation with cholecalciferol in HT patients for 3 months changed the balance of CD4 T-cell subsets to improve the disease control. However, further studies are necessary to investigate effects of vitamin D on immune functions in HT patients.

摘要

背景

维生素 D 是免疫功能的调节剂。对维生素 D 作用机制和桥本甲状腺炎(HT)发病机制的研究表明,维生素 D 可减少自身反应性免疫细胞对甲状腺细胞的损伤。

方法

内分泌学家共纳入 48 例女性 HT 患者。患者分为两组,每组 24 例,分别给予每周 50000IU 胆钙化醇(维生素 D 组)或安慰剂(安慰剂组)口服治疗 3 个月。最终,每组各有 17 例患者完成研究。在补充前后,采用流式细胞术评估 Th1、Th17、Th2 和 Tr1 细胞的频率以及相关细胞因子 IFN-γ、IL-17、IL-4 和 IL-10 的平均荧光强度(MFI)。此外,采用实时 PCR 评估 IL-10 的基因表达。

结果

本研究结果表明,胆钙化醇补充可显著降低 Th17/Tr1 比值。与安慰剂组相比,维生素 D 组 Th1、Th2、Tr1 和 Th17 细胞的比例和 MFI 无明显变化。两组 IL-10 的表达率和 MFI 均增加,维生素 D 组增加高于安慰剂组,但无统计学意义。

结论

在这项新的初步临床试验中,HT 患者补充胆钙化醇 3 个月可改变 CD4 T 细胞亚群的平衡,从而改善疾病控制。然而,需要进一步研究来探讨维生素 D 对 HT 患者免疫功能的影响。

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