系统性红斑狼疮患者补充维生素D：与疾病活动度、疲劳及干扰素特征基因表达的关系
Vitamin D supplementation in systemic lupus erythematosus: relationship to disease activity, fatigue and the interferon signature gene expression.
作者信息
Magro Rosalie, Saliba Christian, Camilleri Liberato, Scerri Christian, Borg Andrew A
机构信息
Rheumatology Department, Mater Dei Hospital, Tal-Qroqq, Msida, MSD, 2090, Malta.
Faculty of Medicine and Surgery, University of Malta, Msida, Malta.
出版信息
BMC Rheumatol. 2021 Dec 3;5(1):53. doi: 10.1186/s41927-021-00223-1.
BACKGROUND
In addition to the well-known role of vitamin D in calcium homeostasis and bone metabolism, vitamin D is important in the modulation of the immune system and inflammatory processes. Vitamin D deficiency is common in patients with systemic lupus erythematosus (SLE), possibly as a result of sun avoidance. The aim of this prospective open-label study was to assess the effect of the treatment of vitamin D deficiency and insufficiency in SLE patients, particularly with regards to disease activity, fatigue and interferon signature gene expression.
METHODS
31 SLE patients, 13 with vitamin D deficiency and 18 with vitamin D insufficiency were treated with vitamin D3. They were supplemented with vitamin D3 8000 IU daily for 8 weeks if they were vitamin D deficient, or 8000 IU daily for 4 weeks if they were insufficient. This was followed by 2000 IU daily maintenance. They were assessed at baseline, after 6 and 12 months by means of an interview, filling in questionnaires and blood tests. The expression of 12 interferon signature genes in RNA extracted from whole blood was measured by using QuantiGene Plex technology.
RESULTS
An improvement in disease activity measured by systemic lupus erythematosus disease activity index-2K (SLEDAI-2K; p = 0.028) and fatigue measured by fatigue severity scale (FSS; p = 0.071) at 12 months were noted. A significant decrease in anti-double stranded deoxyribonucleic acid (dsDNA) titre (p = 0.045) was also noted. The mean interferon signature gene expression score decreased from baseline to 6 months, however statistical significance was not achieved (p = 0.165).
CONCLUSIONS
Improved disease activity and fatigue have been noted when Vitamin D has been supplemented in vitamin D deficient/insufficient SLE patients. One possible mechanism could be the suppression of the interferon signature gene expression.
TRIAL REGISTRATION
The study was registered with the ISRCTN registry on 12/04/2021 (Trial ID: ISRCTN59058825).
背景
除了维生素D在钙稳态和骨代谢中广为人知的作用外，维生素D在调节免疫系统和炎症过程中也很重要。维生素D缺乏在系统性红斑狼疮（SLE）患者中很常见，可能是由于避免日晒所致。这项前瞻性开放标签研究的目的是评估治疗SLE患者维生素D缺乏和不足的效果，特别是在疾病活动、疲劳和干扰素特征基因表达方面。
方法
31例SLE患者，13例维生素D缺乏，18例维生素D不足，接受维生素D3治疗。如果他们维生素D缺乏，则每天补充8000国际单位维生素D3，持续8周；如果不足，则每天补充8000国际单位，持续4周。之后每天维持2000国际单位。在基线、6个月和12个月时，通过访谈、填写问卷和血液检查对他们进行评估。使用QuantiGene Plex技术测量从全血中提取的RNA中12种干扰素特征基因的表达。
结果
在12个月时，观察到系统性红斑狼疮疾病活动指数-2K（SLEDAI-2K；p = 0.028）测量的疾病活动有所改善，疲劳严重程度量表（FSS；p = 0.071）测量的疲劳也有所改善。抗双链脱氧核糖核酸（dsDNA）滴度也显著降低（p = 0.045）。从基线到6个月，平均干扰素特征基因表达评分下降，但未达到统计学显著性（p = 0.165）。
结论
在维生素D缺乏/不足的SLE患者中补充维生素D后，疾病活动和疲劳得到改善。一种可能的机制可能是干扰素特征基因表达受到抑制。
试验注册
该研究于2021年4月12日在ISRCTN注册中心注册（试验编号：ISRCTN59058825）。
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