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维生素 D 补充对克罗恩病患者外周血中辅助性 T 细胞 17/调节性 T 细胞平衡及临床病程的影响。

Effect of Vitamin D Supplementation on Clinical Course and T Helper 17/ T-Regulatory Balance in Peripheral Blood of Patients with Crohn's Disease.

机构信息

Department of Pharmacy, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China.

Department of Gastroenterology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.

出版信息

Turk J Gastroenterol. 2023 May;34(5):463-471. doi: 10.5152/tjg.2023.22496.

Abstract

BACKGROUND

Vitamin D has anti-inflammatory properties and is involved in immune function, making it a potential therapy for Crohn's disease. This study aimed to investigate the effects of vitamin D supplementation on immune function and the clinical efficacy of patients with Crohn's disease.

METHODS

From September 2017 to September 2021, patients with Crohn's disease were recruited and randomly divided into 2 groups: the routine treatment group (n = 52) and the vitamin D supplement group (n = 50). In addition to routine treatment, the vitamin D group received oral calcitriol capsule supplementation, while the routine treatment group did not receive any additional intervention. T helper 17/T-regulatory cell level, inflammatory indicators, and nutritional status were compared between the 2 groups, as well as mucosal healing under endoscopy and the life quality of patients.

RESULTS

C-reactive protein was significantly lower in the vitamin D treatment group compared to the routine treatment group (6.08 ± 2.72 vs. 18.91 ± 2.66, P < .05). Compared to the routine treatment group, the ratio of T helper 17/T-regulatory cells was significantly lower in the vitamin D group (0.26 ± 0.12 vs. 0.55 ± 0.11, P < .05). After vitamin D treatment, both of the average Crohn's disease activity index score (from 319.7 ± 72.7 to 179.6 ± 48.5, P < .05) and simple endoscopic score for Crohn's disease score (from 7.9 ± 2.3 to 3.9 ± 0.6, P < .05) were significantly decreased, while the Inflammatory Bowel Disease Questionnaire score was significantly increased (from 137.8 ± 21.2 to 158.1 ± 25.1, P < .05).

CONCLUSIONS

Vitamin D has the potential to improve the inflammatory status and immune environment of patients with Crohn's disease, which can reduce the level of inflammatory factors and help the recovery of symptoms, thus improving the clinical course and quality of life in Crohn's disease patients.

摘要

背景

维生素 D 具有抗炎特性,并参与免疫功能,因此它可能成为克罗恩病的一种潜在治疗方法。本研究旨在探讨维生素 D 补充对克罗恩病患者免疫功能和临床疗效的影响。

方法

2017 年 9 月至 2021 年 9 月,招募克罗恩病患者并随机分为 2 组:常规治疗组(n=52)和维生素 D 补充组(n=50)。除常规治疗外,维生素 D 组还接受口服钙三醇胶囊补充治疗,而常规治疗组不接受任何额外干预。比较两组患者的 T 辅助 17/T 调节细胞水平、炎症指标和营养状况,比较内镜下黏膜愈合情况和患者生活质量。

结果

与常规治疗组相比,维生素 D 治疗组 C 反应蛋白明显降低(6.08±2.72 比 18.91±2.66,P<.05)。与常规治疗组相比,维生素 D 组 T 辅助 17/T 调节细胞比值明显降低(0.26±0.12 比 0.55±0.11,P<.05)。维生素 D 治疗后,克罗恩病活动指数评分(从 319.7±72.7 降至 179.6±48.5,P<.05)和克罗恩病简单内镜评分(从 7.9±2.3 降至 3.9±0.6,P<.05)均明显下降,而炎症性肠病问卷评分明显升高(从 137.8±21.2 升至 158.1±25.1,P<.05)。

结论

维生素 D 有可能改善克罗恩病患者的炎症状态和免疫环境,降低炎症因子水平,有助于症状缓解,从而改善克罗恩病患者的临床病程和生活质量。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/beb1/10334682/eb0e6bd76371/tjg-34-5-463_f001.jpg

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