Li Qing, Chan Hung
Dermatology Hospital, Southern Medical University, Guangzhou, China.
Department of Dermatology, University of California San Diego, San Diego, La Jolla, CA, USA.
Mol Med. 2025 Jul 18;31(1):259. doi: 10.1186/s10020-025-01311-5.
Growing evidence demonstrates that the immunoregulatory properties of vitamin D are primarily mediated by its active hormonal form, 1,25-dihydroxyvitamin D3 (calcitriol). This secosteroid modulates immune homeostasis through three principal mechanisms: (1) strengthening antimicrobial defense via innate immune potentiation, (2) downregulating pathological inflammatory cascades, and (3) fine-tuning adaptive immunity through lymphocyte differentiation control. Clinically, serum concentrations of the inactive precursor, 25-hydroxyvitamin D3 (25(OH)D3), exhibit an inverse correlation with systemic immune activation and the prevalence/severity of dermatological conditions, including atopic dermatitis, psoriasis, and systemic sclerosis. Suboptimal 25(OH)D3 levels are thus recognized as a modifiable risk factor for such disorders, with vitamin D3 supplementation demonstrating therapeutic potential in improving clinical outcomes. Furthermore, prolonged vitamin D3 supplementation may reduce disease incidence across a spectrum of dermatopathologies. This review synthesizes contemporary mechanistic and clinical insights into vitamin D's immunoregulatory role in cutaneous diseases. To optimize therapeutic efficacy, future clinical trials should incorporate analysis of vitamin D receptor (VDR) polymorphisms as a predictive biomarker in vitamin D3 intervention strategies.
越来越多的证据表明，维生素D的免疫调节特性主要由其活性激素形式1,25-二羟基维生素D3（骨化三醇）介导。这种类固醇通过三种主要机制调节免疫稳态：（1）通过增强先天免疫来加强抗菌防御，（2）下调病理性炎症级联反应，以及（3）通过控制淋巴细胞分化来微调适应性免疫。临床上，非活性前体25-羟基维生素D3（25(OH)D3）的血清浓度与全身免疫激活以及皮肤病（包括特应性皮炎、银屑病和系统性硬化症）的患病率/严重程度呈负相关。因此，25(OH)D3水平不足被认为是这些疾病的一个可改变的风险因素，补充维生素D3在改善临床结果方面显示出治疗潜力。此外，长期补充维生素D3可能会降低一系列皮肤病的发病率。本综述综合了当代关于维生素D在皮肤疾病中免疫调节作用的机制和临床见解。为了优化治疗效果，未来的临床试验应将维生素D受体（VDR）多态性分析作为维生素D3干预策略中的预测生物标志物纳入其中。
