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[免疫预防中维生素D状态正常化必要性的理由]

[Justification of the need to normalize vitamin D status for immunoprophylaxis].

作者信息

Tulegenova D E, Ibrayeva L K, Rybalkina D Kh, Minbayeva L S, Bacheva I V

机构信息

Karaganda Medical University, M01K6T3, Karaganda, Republic of Kazakhstan.

出版信息

Vopr Pitan. 2020;89(6):70-81. doi: 10.24411/0042-8833-2020-10080. Epub 2020 Nov 20.

Abstract

Currently, there is an increase in the resistance of microorganisms to the available arsenal of antimicrobial drugs, which makes it necessary to maintain and stimulate the body's own immune-protective properties. The main extraskeletal effect of vitamin D activity is associated with the homeostasis of the immune system. The role of vitamin D in reducing the risk of infection with infectious agents has been studied for a long time. Literature search on the effective use of vitamin D for immunoprophylaxis was carried out in Scopus, Web of Science, PubMed, clinicaltrials.gov databases over the past 10 years for related keywords: vitamin D, immunoprophylaxis. Vitamin D stimulates the synthesis of antimicrobial peptides, cathelicidins and defensins, which exhibit broad-spectrum activity against viruses, bacteria and fungal infections; reduces the concentration of pro-inflammatory cytokines; increases the concentration of anti-inflammatory cytokines. Vitamin D is also involved in cell differentiation, maturation and proliferation of immune cells. The article presents the literature review in order to justify additional intake of vitamin D in case of diagnosis of its deficiency and insufficiency for the purpose of immunoprophylaxis in children and adults, especially in risk groups (elderly age, pregnant women, patients with chronic diseases of respiratory, endocrine and urinary systems, gastrointestinal tract, and infectious diseases). Inclusion of vitamin D in the diet as a dietary supplement, as well as fortification of products with it, can be an effective measure to reduce the risk of both morbidity and mortality, especially during the period of quarantine measures.

摘要

目前,微生物对现有抗菌药物的耐药性正在增加,这使得有必要维持和激发人体自身的免疫保护特性。维生素D活性的主要骨骼外作用与免疫系统的稳态有关。维生素D在降低感染病原体风险方面的作用已经研究了很长时间。在过去10年中,在Scopus、科学网、PubMed、clinicaltrials.gov数据库中使用相关关键词“维生素D”“免疫预防”对维生素D在免疫预防中的有效应用进行了文献检索。维生素D刺激抗菌肽、杀菌肽和防御素的合成,这些物质对病毒、细菌和真菌感染具有广谱活性;降低促炎细胞因子的浓度;增加抗炎细胞因子的浓度。维生素D还参与免疫细胞的分化、成熟和增殖。本文进行文献综述,以论证在诊断维生素D缺乏和不足时额外补充维生素D对于儿童和成人免疫预防的合理性,尤其是在高危人群(老年人、孕妇、患有呼吸、内分泌和泌尿系统、胃肠道及传染病等慢性疾病的患者)中。将维生素D作为膳食补充剂纳入饮食,以及对产品进行强化,可以成为降低发病和死亡风险的有效措施,尤其是在采取隔离措施期间。

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