Department of Medical Oncology, Our Lady of Lourdes Hospital, Drogheda, Ireland.
Department of Genetics, University of Cambridge, Cambridge, United Kingdom.
Front Endocrinol (Lausanne). 2021 Mar 31;12:644298. doi: 10.3389/fendo.2021.644298. eCollection 2021.
Vitamin D is a potent steroid hormone that induces widespread changes in gene expression and controls key biological pathways. Here we review pathophysiology of vitamin D with particular reference to COVID-19 and pancreatic cancer. Utility as a therapeutic agent is limited by hypercalcemic effects and attempts to circumvent this problem have used vitamin D superagonists, with increased efficacy and reduced calcemic effect. A further caveat is that vitamin D mediates multiple diverse effects. Some of these (anti-fibrosis) are likely beneficial in patients with COVID-19 and pancreatic cancer, whereas others (reduced immunity), may be beneficial through attenuation of the cytokine storm in patients with advanced COVID-19, but detrimental in pancreatic cancer. Vitamin D superagonists represent an untapped resource for development of effective therapeutic agents. However, to be successful this approach will require agonists with high cell-tissue specificity.
维生素 D 是一种强效甾体激素，可诱导广泛的基因表达变化，并控制关键的生物途径。在这里，我们特别参考了 COVID-19 和胰腺癌来回顾维生素 D 的病理生理学。作为治疗剂的用途受到高钙血症效应的限制，为了规避这个问题，人们使用了维生素 D 超强激动剂，它们具有更高的疗效和更低的钙效应。另一个需要注意的是，维生素 D 介导多种不同的作用。其中一些（抗纤维化）可能对 COVID-19 和胰腺癌患者有益，而另一些（降低免疫力）可能通过减轻晚期 COVID-19 患者的细胞因子风暴有益，但对胰腺癌患者则有害。维生素 D 超强激动剂是开发有效治疗剂的未开发资源。然而，要取得成功，这种方法需要具有高细胞组织特异性的激动剂。
