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补充维生素D后桥本甲状腺炎女性患者CD4 T细胞细胞因子谱的变化:一项双盲、随机临床试验

Alterations in CD4 T Cell Cytokines Profile in Female Patients with Hashimoto's Thyroiditis Following Vitamin D Supplementation: A Double-blind, Randomized Clinical Trial.

作者信息

Chahardoli Reza, Robat-Jazi Behrouz, Azizi Fereidoun, Amouzegar Atieh, Khalili Davood, Zadeh-Vakili Azita, Mansouri Fatemeh, Saboor-Yaraghi Ali Akbar

机构信息

School of Advanced Technologies in Medicine, Shaheed Beheshti University of Medical Sciences, Tehran, Iran.

Department of Immunology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.

出版信息

Endocr Metab Immune Disord Drug Targets. 2024;24(12):1454-1463. doi: 10.2174/0118715303273297231226153751.

Abstract

BACKGROUND

Hashimoto's thyroiditis (HT) is an autoimmune disease characterized by the destruction of thyroid cells through immune processes involving T helper (Th)1 cytokines. This clinical trial investigates the impact of vitamin D supplementation on serum cytokine levels and gene expression in CD4+ T cells from HT patients, aiming to understand its effects on Th-1, Th-2, Th-17, and regulatory T (Treg) cell-associated factors.

METHODS

Female patients were randomly assigned in a double-blind design to either a vitamin D-supplemented group, which received cholecalciferol (1, 25(OH)D) at a dose of 50,000 IU, or the placebo group, which received a weekly placebo for a duration of three months. Serum cytokine levels were assessed using enzyme-linked immunosorbent assay (ELISA), while genes' expression levels were measured using real-time PCR.

RESULTS

Serum 25-hydroxyvitamin D and levels exhibited a significant increase following vitamin D supplementation, in comparison to the placebo group. Additionally, the vitamin D supplementation resulted in a significant elevation of serum calcium (Ca) levels compared to baseline. In the vitamin D group, there was a significant decrease in both serum levels and expression of the interleukin (IL)-17 gene when compared to baseline, although no statistical difference was observed between the placebo and vitamin D groups. The gene expression of transforming growth factor-beta (TGFβ) was significantly increased in the vitamin D group compared to baseline, with no significant difference between the two study groups. Vitamin D treatment had no effect on serum levels of interferon-gamma (IFNϒ) and IL-4. While the gene expression of IL-4 in the vitamin D group did not exhibit a statistically significant increase, the level of GATA3 transcription factor increased significantly when compared to the placebo group. The expression of IFNϒ and transcription factors, T-bet, RORc, and forkhead box protein 3 (FOXP3) in genes did not show significant changes following vitamin D supplementation.

CONCLUSION

The findings suggest that vitamin D supplementation may hold potential benefits for autoimmune diseases, such as HT. However, further longitudinal clinical trials are necessary to gain a more comprehensive understanding of the specific effects of vitamin D on HT.

摘要

背景

桥本甲状腺炎(HT)是一种自身免疫性疾病,其特征是通过涉及辅助性T(Th)1细胞因子的免疫过程破坏甲状腺细胞。本临床试验研究补充维生素D对HT患者血清细胞因子水平和CD4+T细胞基因表达的影响,旨在了解其对Th-1、Th-2、Th-17和调节性T(Treg)细胞相关因子的作用。

方法

女性患者采用双盲设计随机分为两组,一组为补充维生素D组,接受剂量为50,000 IU的胆钙化醇(1,25(OH)D),另一组为安慰剂组,接受每周一次的安慰剂,持续三个月。采用酶联免疫吸附测定(ELISA)评估血清细胞因子水平,采用实时PCR测定基因表达水平。

结果

与安慰剂组相比,补充维生素D后血清25-羟基维生素D水平显著升高。此外,与基线相比,补充维生素D导致血清钙(Ca)水平显著升高。在维生素D组中,与基线相比,血清白细胞介素(IL)-17水平和基因表达均显著降低,尽管安慰剂组和维生素D组之间未观察到统计学差异。与基线相比,维生素D组中转化生长因子-β(TGFβ)的基因表达显著增加,两个研究组之间无显著差异。维生素D治疗对血清干扰素-γ(IFNϒ)和IL-4水平无影响。虽然维生素D组中IL-4的基因表达未显示出统计学上的显著增加,但与安慰剂组相比,GATA3转录因子水平显著增加。补充维生素D后,IFNϒ和基因中的转录因子T-bet、RORc和叉头框蛋白3(FOXP3)的表达未显示出显著变化。

结论

研究结果表明,补充维生素D可能对HT等自身免疫性疾病具有潜在益处。然而,需要进一步的纵向临床试验以更全面地了解维生素D对HT的具体作用。

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