补充维生素D能否改善复发缓解型多发性硬化症患者的炎症？

Can Vitamin D Supplementation Improve Inflammation in Relapsing-Remitting Multiple Sclerosis Patients?

作者信息

Lis Martyna, Niedziela Natalia, Adamczyk-Zostawa Jowita, Wierzbicki Krzysztof, Czuba Zenon, Zalejska-Fiolka Jolanta, Bartman Wojciech, Świętek Agata, Adamczyk-Sowa Monika

机构信息

Department of Neurology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, 40-055 Katowice, Poland.

Department of Ophthalmology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, 40-055 Katowice, Poland.

出版信息

Biomedicines. 2024 Jul 17;12(7):1580. doi: 10.3390/biomedicines12071580.

DOI:10.3390/biomedicines12071580

PMID:39062153

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11274703/

Abstract

(1) Background: Studies indicate that vitamin D (VitD) may reduce inflammation in multiple sclerosis (MS). The aim of the study was to assess the effect of supplementation with different doses of VitD on inflammation in relapsing-remitting MS (RRMS) patients. (2) Methods: The effect of 6-month supplementation with different doses of oral VitD (2000 IU/day) in a high-dose group (HD, = 23) and a low-dose group (15,960 IU/month) (LD, = 29) on selected markers of inflammation was assessed in 52 RRMS patients. (3) Results: Females constituted the majority of participants (63.46%). The median age [years] was 39.5 [34.5-49.8] and 47 [40.0-55.0] in the HD and LD groups, respectively. Significant differences were observed in age ( = 0.028), body weight ( = 0.014) and height ( = 0.001) between the study groups. Considering the BMI, statistically significant differences were not found ( = 0.496). The median 25(OH)D concentration [ng/mL] increased from 23.023 [15.578-25.76] in the HD group and 28.318 [20.644-32.232] in the LD group to 29.819 [24.937-38.064] and 30.837 [25.382-36.789], respectively ( < 0.01), and the increase was significantly higher in the HD group ( = 0.01). Hypovitaminosis D was found in most patients (71.2%) initially, and serum VitD levels were still <30.0 ng/mL in 46.2% of the participants at the follow-up. A significant increase in the levels of IL-4, IL-6, IL-17A, IL-22, IL-23 and TNF -α [pg/mL] and a decrease in IL-10 levels were reported during the study ( < 0.01). A significant positive correlation was observed between 25(OH)D serum levels and sCD40L (R = 0.33; < 0.05) and TNF-α (R = 0.28; < 0.05), and a significant negative correlation was reported between 25(OH)D and IL-23 (R = -0.32; < 0.01) at the beginning of the study. (4) Conclusions: In RRMS patients, the doses of VitD were probably too low to induce beneficial effects on inflammation. Further studies are warranted to determine the effect of VitD supplementation on inflammatory markers in MS patients.

摘要

（1）背景：研究表明，维生素D（VitD）可能减轻多发性硬化症（MS）中的炎症。本研究的目的是评估补充不同剂量的VitD对复发缓解型MS（RRMS）患者炎症的影响。（2）方法：在52例RRMS患者中，评估高剂量组（HD，n = 23）每日口服2000 IU VitD和低剂量组（LD，n = 29）每月口服15960 IU VitD，为期6个月的补充对选定炎症标志物的影响。（3）结果：女性占参与者的大多数（63.46%）。HD组和LD组的年龄中位数[岁]分别为39.5[34.5 - 49.8]和47[40.0 - 55.0]。研究组之间在年龄（P = 0.028）、体重（P = 0.014）和身高（P = 0.001）方面观察到显著差异。考虑到BMI，未发现统计学上的显著差异（P = 0.496）。HD组的25（OH）D浓度中位数[ng/mL]从23.023[15.578 - 25.76]增加到29.819[24.937 - 38.064]，LD组从28.318[20.644 - 32.232]增加到30.837[25.382 - 36.789]（P < 0.01），且HD组的增加显著更高（P = 0.01）。最初大多数患者（71.2%）存在维生素D缺乏，随访时46.2%的参与者血清VitD水平仍<30.0 ng/mL。研究期间报告IL - 4、IL - 6、IL - 17A、IL - 22、IL - 23和TNF -α水平[pg/mL]显著增加，IL - 10水平降低（P < 0.01）。研究开始时，观察到25（OH）D血清水平与sCD40L（R = 0.33；P < 0.05）和TNF -α（R = 0.28；P < 0.05）之间存在显著正相关，25（OH）D与IL - 23之间存在显著负相关（R = -0.32；P < 0.01）。（4）结论：在RRMS患者中，VitD剂量可能过低，无法对炎症产生有益影响。有必要进一步研究以确定补充VitD对MS患者炎症标志物的影响。