Department of Translational Medicine, Università del Piemonte Orientale UPO, Novara; Division of Internal Medicine, Immuno-Rheumatology Unit, CAAD (Center for Translational Research on Autoimmune and Allergic Disease) "Maggiore della Carità" Hospital, Novara; and IRCAD, Interdisciplinary Research Center of Autoimmune Diseases, Novara, Italy.
Rheumatology and Clinical Immunology Unit and Department of Clinical and Experimental Sciences, Spedali Civili and University of Brescia, Italy.
Clin Exp Rheumatol. 2020 Mar-Apr;38(2):343-349. doi: 10.55563/clinexprheumatol/tdf172. Epub 2019 Sep 17.
Vitamin D is a pleiotropic molecule with a well-characterised immunomodulatory activity in vitro; however, its potential clinical application in autoimmune conditions has yet to be clarified. Several authors have investigated the use of vitamin D as a disease-modifying anti-rheumatic drug (DMARD) in rheumatoid arthritis (RA), obtaining divergent conclusions. This systematic review summarises and critically analyses the findings of papers assessing the impact of vitamin D supplementation on pain relief, disease activity, functional status and flare rate. We conclude that the correction of hypovitaminosis D may have a beneficial effect on pain perception; moreover, the achievement of an adequate plasma vitamin D concentration obtained with high-dose regimens might evoke immunomodulatory activities of vitamin D and favourably impact on disease control. Nevertheless, the current evidence is still not strong enough to support the use of cholecalciferol as a DMARD in RA, and further studies are required to clarify this issue.
维生素 D 是一种具有多种生物学功能的分子，在体外具有明确的免疫调节作用；然而，其在自身免疫性疾病中的临床应用尚待阐明。一些作者研究了维生素 D 作为类风湿关节炎 (RA) 中的疾病修饰抗风湿药物 (DMARD) 的用途，得出了不同的结论。本系统综述总结和批判性分析了评估维生素 D 补充对缓解疼痛、疾病活动度、功能状态和发作率影响的研究结果。我们得出结论，纠正维生素 D 缺乏症可能对疼痛感知有有益的影响；此外，通过高剂量方案达到足够的血浆维生素 D 浓度可能会引发维生素 D 的免疫调节作用，并对疾病控制产生有利影响。然而，目前的证据还不够强，不足以支持将胆钙化醇用作 RA 的 DMARD，需要进一步的研究来阐明这个问题。
