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维生素 D 的免疫作用及其与自身免疫的关系。

Immunological effects of vitamin D and their relations to autoimmunity.

机构信息

Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, OH, 44195, USA.

Department of Inflammation and Immunity, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, 44106, USA.

出版信息

J Autoimmun. 2019 Jun;100:7-16. doi: 10.1016/j.jaut.2019.03.002. Epub 2019 Mar 8.

Abstract

Vitamin D deficiency is an established risk factor for many autoimmune diseases and the anti-inflammatory properties of vitamin D underscore its potential therapeutic value for these diseases. However, results of vitamin D3 supplementation clinical trials have been varied. To understand the clinical heterogeneity, we reviewed the pre-clinical data on vitamin D activity in four common autoimmune diseases: multiple sclerosis (MS), rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), and inflammatory bowel disease (IBD), in which patients are commonly maintained on oral vitamin D3 supplementation. In contrast, many pre-clinical studies utilize other methods of manipulation (i.e. genetic, injection). Given the many actions of vitamin D3 and data supporting a vitamin D-independent role of the Vitamin D receptor (VDR), a more detailed mechanistic understanding of vitamin D3 activity is needed to properly translate pre-clinical findings into the clinic. Therefore, we assessed studies based on route of vitamin D3 administration, and identified where discrepancies in results exist and where more research is needed to establish the benefit of vitamin D supplementation.

摘要

维生素 D 缺乏是许多自身免疫性疾病的既定危险因素,而维生素 D 的抗炎特性突出了其在这些疾病中的潜在治疗价值。然而,维生素 D3 补充临床试验的结果各不相同。为了了解临床异质性,我们回顾了四种常见自身免疫性疾病(多发性硬化症、类风湿关节炎、系统性红斑狼疮和炎症性肠病)中维生素 D 活性的临床前数据,这些疾病中患者通常接受口服维生素 D3 补充。相比之下,许多临床前研究采用了其他操纵方法(如遗传、注射)。鉴于维生素 D3 的多种作用以及支持维生素 D 受体(VDR)非依赖作用的数据,需要更详细的机制理解来将临床前发现正确转化为临床应用。因此,我们根据维生素 D3 的给药途径评估了研究,并确定了结果存在差异的地方,以及需要更多研究来确定维生素 D 补充的益处的地方。

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