Institute of Clinical Physiology, National Research Council, 56124 Pisa, Italy.
Nutrients. 2024 Jun 4;16(11):1762. doi: 10.3390/nu16111762.
Autoimmune thyroid diseases (AITD) are among the most frequent autoimmune disorders, with a multifactorial etiology in which both genetic and environmental determinants are probably involved. Celiac disease (CeD) also represents a public concern, given its increasing prevalence due to the recent improvement of screening programs, leading to the detection of silent subtypes. The two conditions may be closely associated due to common risk factors, including genetic setting, changes in the composition and diversity of the gut microbiota, and deficiency of nutrients like vitamin D. This comprehensive review discussed the current evidence on the pivotal role of vitamin D in modulating both gut microbiota dysbiosis and immune system dysfunction, shedding light on the possible relevance of an adequate intake of this nutrient in the primary prevention of AITD and CeD. While future technology-based strategies for proper vitamin D supplementation could be attractive in the context of personalized medicine, several issues remain to be defined, including standardized assays for vitamin D determination, timely recommendations on vitamin D intake for immune system functioning, and longitudinal studies and randomized controlled trials to definitely establish a causal relationship between serum vitamin D levels and the onset of AITD and CeD.
自身免疫性甲状腺疾病（AITD）是最常见的自身免疫性疾病之一，其病因具有多因素性，遗传和环境决定因素都可能参与其中。由于最近筛查计划的改进导致无症状亚型的检出率增加，乳糜泻（CeD）也成为了公众关注的问题。由于共同的危险因素，包括遗传背景、肠道微生物群落组成和多样性的变化以及维生素 D 等营养素的缺乏，这两种疾病可能密切相关。这篇综合综述讨论了维生素 D 在调节肠道微生物群落失调和免疫系统功能障碍方面的关键作用的现有证据，阐明了在 AITD 和 CeD 的一级预防中摄入足够的这种营养素的可能相关性。虽然基于未来技术的适当维生素 D 补充策略在个性化医疗方面可能具有吸引力，但仍有几个问题需要确定，包括用于维生素 D 测定的标准化检测、关于维生素 D 摄入以维持免疫系统功能的及时建议，以及纵向研究和随机对照试验，以明确确定血清维生素 D 水平与 AITD 和 CeD 发病之间的因果关系。
