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SARS-CoV-2 诱导的维生素 D 缺乏和心理压力:自身免疫性疾病发病的表现。

SARS-CoV-2 induced vitamin D deficiency and psychological stress: a manifestation of autoimmune disease onset.

机构信息

Immunology & Allergy, American International University, Al-Jahra, Saad Al Abdullah, Kuwait.

Department of Chemical & Medical Engineering, Al-Sabah Hospital, Industrial Shuwaikh, Kuwait.

出版信息

Front Immunol. 2024 Oct 2;15:1434486. doi: 10.3389/fimmu.2024.1434486. eCollection 2024.

Abstract

INTRODUCTION

The global SARS-CoV-2 pandemic significantly altered lifestyles, access to healthcare, and social interactions, introducing unprecedented physical and psychological stress all over the world. This study explores the relationship between psychological stress, vitamin D (Vit-D) levels, and autoimmune connective tissue diseases, including systemic lupus erythematosus, systemic sclerosis, polymyositis, dermatomyositis, and rheumatoid arthritis.

METHODS

The analysis was based on over one million patient data points derived from anti-nuclear antibody (ANA) testing conducted both before and during the COVID-19 pandemic 2017-2021. In a subset of patients, longitudinal data were collected bi-yearly to yearly over 5-8 years using the same three-month criteria. The dataset was analyzed using GraphPad Prism9 using paired t-tests or ordinary one-way ANOVA with a significance threshold of p < 0.05 to ensure robust correlations between the variables.

RESULTS

Data indicated that Vit-D levels peaked between 2017 and 2019 before declining, while ANA data demonstrated a rise in autoimmune connective tissue disease cases during the pandemic, reaching a peak in 2021. A clear correlation was observed, with autoimmune disease incidence increasing as Vit-D levels decreased. In-depth case analysis revealed that declining Vit-D levels preceded higher ANA titers and increased autoimmune disease severity, whereas improvements in Vit-D levels were associated with reduced ANA titers and less severe disease manifestations.

CONCLUSIONS

The findings suggest that maintaining mental health and ensuring adequate Vit-D supplementation could be essential strategies for mitigating autoimmune disease risks and maintaining immune stability, particularly in pandemic scenarios. Clinically, these results underscore the need for early interventions targeting both psychological well-being and Vit-D levels to reduce the burden of autoimmune diseases.

摘要

简介

全球范围内的 SARS-CoV-2 大流行极大地改变了人们的生活方式、获得医疗保健的途径和社交互动,在全球范围内带来了前所未有的身体和心理压力。本研究探讨了心理压力、维生素 D(Vit-D)水平与自身免疫性结缔组织疾病之间的关系,包括系统性红斑狼疮、系统性硬化症、多发性肌炎、皮肌炎和类风湿关节炎。

方法

该分析基于超过一百万名患者的数据点,这些数据点源自 2017-2021 年期间进行的抗核抗体(ANA)检测。在患者的一个子集中,使用相同的三个月标准,每年或每两年收集长达 5-8 年的纵向数据。使用 GraphPad Prism9 分析数据集,使用配对 t 检验或普通单因素方差分析,显著性阈值为 p < 0.05,以确保变量之间存在稳健的相关性。

结果

数据表明,Vit-D 水平在 2017 年至 2019 年期间达到峰值,然后下降,而 ANA 数据显示,在大流行期间,自身免疫性结缔组织疾病病例增加,在 2021 年达到峰值。观察到明确的相关性,自身免疫性疾病发病率随着 Vit-D 水平的降低而增加。深入的案例分析表明,Vit-D 水平的下降先于更高的 ANA 滴度和增加的自身免疫性疾病严重程度,而 Vit-D 水平的改善与较低的 ANA 滴度和较轻的疾病表现相关。

结论

研究结果表明,保持心理健康和确保充足的 Vit-D 补充可能是减轻自身免疫性疾病风险和维持免疫稳定性的重要策略,特别是在大流行情况下。在临床上,这些结果强调了需要早期干预心理幸福感和 Vit-D 水平,以降低自身免疫性疾病的负担。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ef7b/11479920/3968cabb478f/fimmu-15-1434486-g001.jpg

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