Giannetti Arianna, Bernardini Luca, Cangemi Jessica, Gallucci Marcella, Masetti Riccardo, Ricci Giampaolo
Department of Paediatrics, S. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy.
Front Pediatr. 2020 Aug 18;8:447. doi: 10.3389/fped.2020.00447. eCollection 2020.
The prevalence of food allergy is increasing over the last decades. The role of vitamin D in the prevention of food allergy has been largely investigated. Its role on the physiology of calcium and bone is known, but calcitriol (active form of the vitamin D) also influences the epithelial cells, T cells, B cells, macrophages, and dendritic cells. Almost all cells of the adaptive immune system express the vitamin D receptor, making them also capable of being vitamin responsive. Specifically considering the potential role of vitamins in food allergy, vitamin D has been shown to affect several mechanisms that promote immunologic tolerance, including the T regulatory cell function and the induction of tolerogenic dendritic cells. The target of our review is to evaluate the role of vitamin D in the prevention of food allergy in children. There are contradictory data on the relationship among the vitamin D deficiency and the developing of food allergy. Some studies associate lower exposure to sunlight to food allergy; on the other hand, further research has found that higher vitamin D levels could increase the likelihood of allergic sensitization and food allergy. Therefore, there is an urgent need for well-planned randomized controlled trials on vitamin D supplementation, with particular regard to the prevention of food allergy. The role of vitamin D beyond bone and calcium metabolism is not fully understood.
在过去几十年中，食物过敏的患病率一直在上升。维生素D在预防食物过敏方面的作用已得到大量研究。其对钙和骨骼生理的作用是已知的，但骨化三醇（维生素D的活性形式）也会影响上皮细胞、T细胞、B细胞、巨噬细胞和树突状细胞。几乎所有适应性免疫系统的细胞都表达维生素D受体，这使得它们也能够对维生素产生反应。具体考虑到维生素在食物过敏中的潜在作用，维生素D已被证明会影响多种促进免疫耐受的机制，包括调节性T细胞功能和诱导耐受性树突状细胞。我们综述的目的是评估维生素D在预防儿童食物过敏中的作用。关于维生素D缺乏与食物过敏发生之间的关系，存在相互矛盾的数据。一些研究将较少的阳光照射与食物过敏联系起来；另一方面，进一步的研究发现较高的维生素D水平可能会增加过敏致敏和食物过敏的可能性。因此，迫切需要精心设计的关于维生素D补充的随机对照试验，特别是在预防食物过敏方面。维生素D在骨骼和钙代谢之外的作用尚未完全了解。
