维生素 D、ACE2 和蛋白酶（如 TMPRSS2 和 Furin）在 SARS-CoV-2 发病机制和 COVID-19 严重程度中的作用。
Role of Vitamin D, ACE2 and the Proteases as TMPRSS2 and Furin on SARS-CoV-2 Pathogenesis and COVID-19 Severity.
机构信息
Department of Medical CBRN Defence, University of Health Sciences, Etlik, Ankara, Turkey.
Molecular Application and Research Unit of R and D Laboratory, University of Health Sciences, Etlik, Ankara, Turkey.
出版信息
Arch Med Res. 2023 Apr;54(3):223-230. doi: 10.1016/j.arcmed.2023.02.002. Epub 2023 Feb 14.
BACKGROUND
COVID-19, the 21 century pandemic disease caused by SARS-CoV-2, has shown a wide clinical spectrum ranging from asymptomatic to deadly serious pneumonia.
OBJECTIVE
In our study, the relationship between the pathogenesis and clinical severity of COVID-19 and vitamin D, ACE2, Furin and TMPRSS2 was investigated.
METHODS
Serum 25(OH)D, 1,25(OH)D and ACE2 protein were measured in 85 COVID-19 cases, divided into 5 groups, according to disease severity, from asymptomatic to severe and including a healthy control group. Expression levels of ACE2, VDR, TMPRSS2 and Furin mRNAs in PBMC were also measured. The relationship of the parameters within each group, the severity of the disease and the effect on the patients' fate were investigated.
RESULTS
Statistically significant differences were found between the severity of COVID-19 and all study parameters, except for serum 25(OH)D. A strong negative correlation was found between serum ACE2 protein, 1,25(OH)D, and ACE2 mRNA, and disease severity, length of hospital stay and death/survival rate. Vitamin D deficiency increased the death risk by 5.6-fold (95% CI 0.75-41.47), and the levels of 1,25(OH)D lower than 1 ng/mL increased the risk of death by 3.8-fold (95% CI 1.07-13.30).
CONCLUSION
This study suggests that vitamin D supplementation could be beneficial in the treatment and/or prevention of COVID-19.
背景
由 SARS-CoV-2 引起的 21 世纪大流行病 COVID-19，表现出从无症状到致命性严重肺炎的广泛临床谱。
目的
在我们的研究中，我们研究了 COVID-19 的发病机制和临床严重程度与维生素 D、ACE2、Furin 和 TMPRSS2 之间的关系。
方法
在 85 例 COVID-19 患者中，根据疾病严重程度（从无症状到严重）将其分为 5 组，并与健康对照组进行比较，测量血清 25(OH)D、1,25(OH)D 和 ACE2 蛋白。还测量了 PBMC 中 ACE2、VDR、TMPRSS2 和 Furin mRNA 的表达水平。研究了组内各参数之间的关系、疾病严重程度以及对患者预后的影响。
结果
除了血清 25(OH)D 之外，COVID-19 的严重程度与所有研究参数之间存在统计学显著差异。血清 ACE2 蛋白、1,25(OH)D 和 ACE2 mRNA 与疾病严重程度、住院时间和死亡/生存率呈强负相关。维生素 D 缺乏使死亡风险增加 5.6 倍（95%CI 0.75-41.47），1,25(OH)D 水平低于 1ng/mL 使死亡风险增加 3.8 倍（95%CI 1.07-13.30）。
结论
本研究表明，维生素 D 补充可能有益于 COVID-19 的治疗和/或预防。
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