Sharjah Institute of Medical Research, University of Sharjah, Sharjah, United Arab Emirates.
Pharmacy Department, Dubai Health Authority, Dubai, United Arab Emirates.
Life Sci. 2022 Oct 15;307:120909. doi: 10.1016/j.lfs.2022.120909. Epub 2022 Aug 24.
The ability of vitamin D (VitD) to modulate immune responses in the clinical setting of COVID-19 infection is not well investigated. This study aimed to evaluate the ability of VitD to attenuate inflammatory responses in patients with severe COVID-19.
Blood samples and nasopharyngeal swabs were obtained from patients with severe COVID-19 who had been treated (20 patients), or not (25 patients), with VitD, during their stay in the intensive care unit. Western blotting was used to evaluate the expressions of STAT3, JNK and AKT signaling pathways and ELISA was used to measure levels of IL-6, IL-17, and IL-1β in blood of these patients.
Reduced levels of STAT3, JNK and AKT pathways and lower levels of proinflammatory cytokines such as IL-6, IL-17, and IL-1β were observed in VitD treated patients (50,000 IU of cholecalciferol weekly for 3 weeks), and in vitro following treatment of poly I:C stimulated PBMCs with VitD (50 nM of calcitriol). Moreover, lower circulatory levels of these proinflammatory cytokines following treatment with VitD were associated with lower serum levels of COVID-19-related severity markers such as D-dimer and C-reactive proteins (P < 0.001) which in overall resulted in shorter length of ICU stay for VitD treated compared to untreated patients (18 days for VitD treated vs. 28 days for VitD untreated; P = 0.01).
This study reveals that VitD plays immunomodulatory role during COVID-19 infection, which further emphasizes the importance of maintaining a normal level of this vitamin for the prevention of hyperinflammatory conditions associated with COVID-19.
维生素 D（VitD）在 COVID-19 感染的临床环境中调节免疫反应的能力尚未得到充分研究。本研究旨在评估 VitD 减轻重症 COVID-19 患者炎症反应的能力。
从重症 COVID-19 患者的血液样本和鼻咽拭子中获得，这些患者在重症监护病房住院期间接受了 VitD 治疗（20 例）或未接受 VitD 治疗（25 例）。使用 Western blot 评估 STAT3、JNK 和 AKT 信号通路的表达，使用 ELISA 测量这些患者血液中 IL-6、IL-17 和 IL-1β 的水平。
在接受 VitD 治疗的患者（每周给予 50,000 IU 胆钙化醇 3 周）和体外使用 VitD（50 nM 骨化三醇）处理 Poly I:C 刺激的 PBMCs 后，观察到 STAT3、JNK 和 AKT 通路的水平降低，以及促炎细胞因子如 IL-6、IL-17 和 IL-1β 的水平降低。此外，VitD 治疗后这些促炎细胞因子的循环水平降低与 COVID-19 相关严重程度标志物如 D-二聚体和 C 反应蛋白的血清水平降低相关（P<0.001），这总体上导致 VitD 治疗组患者与未治疗组患者相比 ICU 住院时间更短（VitD 治疗组为 18 天，VitD 未治疗组为 28 天；P=0.01）。
本研究揭示了 VitD 在 COVID-19 感染期间发挥免疫调节作用，这进一步强调了维持这种维生素正常水平对于预防与 COVID-19 相关的过度炎症状态的重要性。
