Azimi Amirreza, Ghajarzadeh Mahsa, Sahraian Mohammad Ali, Mohammadifar Mehdi, Roostaei Bita, Samani Sara Mohammad Vali, Shabestari Hamid Reza Farhadi, Hanaei Sara
Multiple Sclerosis Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran.
Universal Council of Epidemiology (UCE), Universal Scientific Education and Research Network (USERN), TUMS, Tehran, Iran.
Maedica (Bucur). 2019 Dec;14(4):413-417. doi: 10.26574/maedica.2019.14.4.413.
Vitamin D is one of the considerable environmental factors exhibiting immunomodulatory and anti-inflammatory effects. To conduct a systematic review and meta-analysis to estimate the effect of vitamin D supplements on IL-10 and INFγ levels in patients with multiple sclerosis. We searched PubMed, Scopus, EMBASE, CINAHL, Web of Science, Ovid, The Cochrane Library and gray literature, including references of selected studies, conference abstracts which were published up to May 2019. We included single- or double-blinded RCTs or open-label trials in which one of the main outcomes was INFγ and/ or IL-10 levels after vitamin D supplementation. Only articles that had been published in English were included. The literature search yielded 369 articles, that were monitored by us. After eliminating duplicates, 128 studies remained; from these, we excluded observational studies, reviews, case reports and non-randomized trials, and 33 studies remained. Finally, only three articles were included. The mean difference for INFγ was 268.4 and 95 % CI 200.6-336.1. There was no significant heterogeneity (I ² = 0 %, Chi ² = 0.1, p = 0.7). The mean difference for IL-10 was 398.3 and 95% CI -528.05-1324.8). There was significant heterogeneity (I2 = 94 %, Chi2 = 31.1 p < 0.001). The results of this systematic review were not satisfactory. More clinical trials are further needed to evaluate the effects of vitamin D supplements on IL-10 and INFγ levels in patients with multiple sclerosis.
维生素D是具有免疫调节和抗炎作用的重要环境因素之一。进行一项系统评价和荟萃分析，以评估维生素D补充剂对多发性硬化症患者白细胞介素-10（IL-10）和干扰素γ（INFγ）水平的影响。我们检索了PubMed、Scopus、EMBASE、CINAHL、Web of Science、Ovid、Cochrane图书馆以及灰色文献，包括所选研究的参考文献、截至2019年5月发表的会议摘要。我们纳入了单盲或双盲随机对照试验（RCT）或开放标签试验，其中主要结局之一是补充维生素D后的INFγ和/或IL-10水平。仅纳入以英文发表的文章。文献检索共获得369篇文章，由我们进行监测。去除重复项后，剩余128项研究；从中我们排除了观察性研究、综述、病例报告和非随机试验，剩余33项研究。最后，仅纳入3篇文章。INFγ的平均差值为268.4，95%置信区间为200.6 - 336.1。无显著异质性（I² = 0%，χ² = 0.1，p = 0.7）。IL-10的平均差值为398.3，95%置信区间为 -528.05 - 1324.8）。存在显著异质性（I² = 94%，χ² = 31.1，p < 0.001）。该系统评价的结果并不理想。进一步需要更多的临床试验来评估维生素D补充剂对多发性硬化症患者IL-10和INFγ水平的影响。
