Department of Hepatobiliary Surgery and Organ Transplant, The First Hospital of China Medical University, Shenyang, Liaoning 110001, P.R. China.
Department of Obstetrics, The First Hospital of China Medical University, Shenyang, Liaoning 110001, P.R. China.
Mol Med Rep. 2021 May;23(5). doi: 10.3892/mmr.2021.12021. Epub 2021 Mar 24.
Recurrent pregnancy loss (RPL) is usually characterized as ≥3 miscarriages before 20 weeks of gestation. Patients with RPL may have autoimmune abnormalities or alloimmune problems. Vitamin D has a major function on the mechanism of immunomodulation at the maternal‑fetal interface. However, whether vitamin D can be used as an effective method to treat patients with RPL requires investigation. It has been reported that vitamin D could prevent the occurrence of antiphospholipid syndrome (APS) by reducing the expression levels of anti‑β2 glycoprotein and tissue factor in RPL cases with APS. In addition, there is an opposite relationship between vitamin D and thyroid peroxidase antibody levels in autoimmune thyroid disease cases with RPL. Vitamin D changes the ratio of T helper (Th) 1/Th2 and regulatory T cell/Th17 to a certain extent, as well as affects the activity of natural killer cells and the production of cytokines to reduce the incidence of RPL. The objective of the current review was to address the research progress of vitamin D in RPL in recent years, which could facilitate the use of vitamin D treatment to enhance the pregnancy outcome of RPL. Collectively, it was suggested that vitamin D may be used as an important and effective immunotherapeutic agent for patients with RPL.
复发性流产（RPL）通常定义为妊娠 20 周前发生≥3 次自然流产。RPL 患者可能存在自身免疫异常或同种免疫问题。维生素 D 在母体-胎儿界面的免疫调节机制中具有重要功能。然而，维生素 D 是否可作为治疗 RPL 患者的有效方法仍需进一步研究。有报道称，维生素 D 通过降低 RPL 合并抗磷脂综合征（APS）患者抗β2 糖蛋白和组织因子的表达水平，可预防 APS 的发生。此外，在 RPL 合并自身免疫性甲状腺疾病的患者中，维生素 D 与甲状腺过氧化物酶抗体水平呈负相关。维生素 D 在一定程度上改变辅助性 T 细胞（Th）1/Th2 和调节性 T 细胞/Th17 的比例，并影响自然杀伤细胞的活性和细胞因子的产生，从而降低 RPL 的发生率。本综述旨在探讨近年来维生素 D 在 RPL 中的研究进展，为维生素 D 治疗 RPL 以改善妊娠结局提供依据。综上所述，维生素 D 可能成为 RPL 患者一种重要且有效的免疫治疗药物。
