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维生素 D 补充治疗糖尿病足溃疡:当前视角。

Vitamin D Supplementation in Diabetic Foot Ulcers: A Current Perspective.

机构信息

Department of Pharmacy Practice, Manipal College of Pharmaceutical Sciences, Manipal Academy of Higher Education, Manipal, Karnataka-576104, India.

Manipal Center for Infectious Diseases, Prasanna School of Public Health, Manipal Academy of Higher Education, Manipal, Karnataka-576104, India.

出版信息

Curr Diabetes Rev. 2021;17(4):512-521. doi: 10.2174/1573399816999201012195735.

Abstract

INTRODUCTION

Diabetic foot ulcer (DFU) is a major complication of diabetes mellitus, as it can physically and emotionally impact the person. Its management can be challenging and expensive, depending on the severity of the wound and the presence of infection.

BACKGROUND

The fat-soluble molecule, vitamin D, has gained great importance ever since its pleiotropism has been recognized. Its efficacy could be attributed to the presence of vitamin D receptors in most of the body tissues. Vitamin D plays a significant role in cell proliferation, differentiation, and immune modulation. It modulates the T and B cells resulting in the suppression of the immunoglobulins, autoimmunity, and inflammation.

METHODS

We performed a literature search with the objective to highlight the role of vitamin D in peripheral vascular disease and peripheral neuropathy, which are the major risk factors for DFU, as well as evidences of its role in wound healing and management of DFU.

RESULTS

Preclinical and clinical studies have shown that vitamin D influences multiple phases of wound healing and thereby accelerates the process. It modulates various cells involved in proliferation and remodelling phases. Vitamin D also enhances the expression of antimicrobial peptides that help to eliminate the microbes, as well as suppress the proinflammatory responses while enhancing the anti-inflammatory responses.

CONCLUSION

This review concludes vitamin D to have a protective role in the immune and vascular system, improve glycaemic outcomes, and wound healing. Therefore, vitamin D could be a preferred adjuvant in the management of DFU.

摘要

简介

糖尿病足溃疡(DFU)是糖尿病的主要并发症,因为它会对患者的身体和心理造成影响。其治疗可能具有挑战性且费用高昂,具体取决于伤口的严重程度和感染情况。

背景

脂溶性分子维生素 D 自从其多效性被认识以来,就变得非常重要。它的功效可以归因于其在大多数身体组织中都存在维生素 D 受体。维生素 D 在细胞增殖、分化和免疫调节中发挥着重要作用。它调节 T 和 B 细胞,从而抑制免疫球蛋白、自身免疫和炎症。

方法

我们进行了文献检索,目的是强调维生素 D 在周围血管疾病和周围神经病变中的作用,这是 DFU 的主要危险因素,以及其在伤口愈合和 DFU 管理中的作用的证据。

结果

临床前和临床研究表明,维生素 D 影响伤口愈合的多个阶段,从而加速愈合过程。它调节参与增殖和重塑阶段的各种细胞。维生素 D 还增强了抗菌肽的表达,有助于消除微生物,并抑制促炎反应,同时增强抗炎反应。

结论

本综述得出结论,维生素 D 在免疫系统和血管系统中具有保护作用,可改善血糖控制结果并促进伤口愈合。因此,维生素 D 可能是 DFU 管理的首选辅助药物。

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