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维生素D缺乏与类风湿关节炎:流行病学、免疫学、临床及治疗方面

Vitamin D Deficiency and Rheumatoid Arthritis: Epidemiological, Immunological, Clinical and Therapeutic Aspects.

作者信息

Heidari Behzad, Hajian-Tilaki Karimollah, Babaei Mansour

机构信息

Mobility Impairment Research Center; Babol University of Medical Sciences, Babol, Islamic Republic of Iran.

Clinical Research Development Unit of Rouhani Hospital; Babol University of Medical Sciences, Babol, Islamic Republic of Iran.

出版信息

Mediterr J Rheumatol. 2019 Jun 29;30(2):94-102. doi: 10.31138/mjr.30.2.94. eCollection 2019 Jun.

Abstract

BACKGROUND/AIM: Vitamin D displays an immunologic effect which can modulate function of Th17-related cytokines and thereby prevent perpetuation of inflammation in chronic disorders like rheumatoid arthritis (RA). This review aims to conduct a literature review to provide a summary of recent studies addressing the relationship between vitamin D deficiency and RA based on epidemiological, immunological and therapeutic aspects.

METHODS

PubMed, Scopus and Google scholar were searched for relevant papers published between 2000-2018.

RESULTS

Low intake of vitamin D increases the risk of incident RA, and vitamin D deficiency has been shown to be inversely associated with RA activity in most of these studies. However, characteristics of RA and serum vitamin D status differ across the studies. The results of studies on the effect of supplemental vitamin D in RA vary, from no efficacy to significant improvement in disease activity, as well as quality of life. This should be attributed to variations in dosage of vitamin D, duration of treatment, baseline serum vitamin D in RA patients and characteristics of RA across diverse studies.

CONCLUSION

Current data indicate a therapeutic potential for vitamin D in RA. However, further studies are needed to identify an optimal and effective dosage, duration of treatment and patients who will get the best benefit from the treatment.

摘要

背景/目的:维生素D具有免疫调节作用,可调节与Th17相关的细胞因子功能,从而预防类风湿性关节炎(RA)等慢性疾病中炎症的持续存在。本综述旨在进行文献回顾,从流行病学、免疫学和治疗学方面总结近期关于维生素D缺乏与RA关系的研究。

方法

检索PubMed、Scopus和谷歌学术,查找2000年至2018年间发表的相关论文。

结果

维生素D摄入量低会增加患RA的风险,在大多数此类研究中,维生素D缺乏与RA活动呈负相关。然而,各项研究中RA的特征和血清维生素D水平有所不同。关于补充维生素D对RA疗效的研究结果各不相同,从无效到疾病活动及生活质量显著改善均有。这应归因于不同研究中维生素D的剂量、治疗持续时间、RA患者的基线血清维生素D水平以及RA的特征存在差异。

结论

目前的数据表明维生素D在RA治疗中具有潜在作用。然而,需要进一步研究以确定最佳有效剂量、治疗持续时间以及能从治疗中获益最大的患者。

相似文献

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Vitamin D Deficiency and Rheumatoid Arthritis.维生素D缺乏与类风湿关节炎
Clin Rev Allergy Immunol. 2017 Jun;52(3):373-388. doi: 10.1007/s12016-016-8577-0.

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本文引用的文献

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Modulation of inflammatory and immune responses by vitamin D.维生素 D 对炎症和免疫反应的调节作用。
J Autoimmun. 2017 Dec;85:78-97. doi: 10.1016/j.jaut.2017.07.007. Epub 2017 Jul 18.
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