Pediatric Academic Department, University of Rome Tor Vergata, Rome, Italy.
Division of Immunology and Infectious Diseases, University-Hospital Pediatric Department (DPUO), Bambino Gesù Children's Hospital, IRCSS, Rome, Italy.
J Endocrinol Invest. 2021 Jan;44(1):27-35. doi: 10.1007/s40618-020-01327-0. Epub 2020 Jun 15.
Covid-19 is a pandemic of unprecedented proportion, whose understanding and management is still under way. In the emergency setting new or available therapies to contrast the spread of COVID-19 are urgently needed. Elderly males, especially those affected by previous diseases or with comorbidities, are more prone to develop interstitial pneumonia that can deteriorate evolving to ARDS (acute respiratory distress syndrome) that require hospitalization in Intensive Care Units (ICUs). Even children and young patients are not spared by SARS-CoV 2 infection, yet they seem to develop a milder form of disease. In this setting the immunomodulatory role of Vitamin D, should be further investigated.
We reviewed the literature about the immunomodulatory role of Vitamin D collecting data from the databases Medline and Embase.
Vitamin D proved to interact both with the innate immune system, by activating Toll-like receptors (TLRs) or increasing the levels of cathelicidins and β-defensins, and adaptive immune system, by reducing immunoglobulin secretion by plasma cells and pro-inflammatory cytokines production, thus modulating T cells function. Promising results have been extensively described as regards the supplementation of vitamin D in respiratory tract infections, autoimmune diseases and even pulmonary fibrosis.
In this review, we suggest that vitamin D supplementation might play a role in the prevention and/or treatment to SARS-CoV-2 infection disease, by modulating the immune response to the virus both in the adult and pediatric population.
新冠疫情是一场史无前例的大流行,人们对其的理解和管理仍在进行中。在紧急情况下,需要新的或现有的疗法来对抗 COVID-19 的传播。老年男性,特别是那些患有先前疾病或合并症的人,更容易发展为间质性肺炎,这种肺炎可能会恶化,进而发展为需要在重症监护病房(ICU)住院的急性呼吸窘迫综合征(ARDS)。即使是儿童和年轻患者也无法幸免于 SARS-CoV-2 感染,但他们似乎表现出较轻的疾病形式。在这种情况下,应进一步研究维生素 D 的免疫调节作用。
我们回顾了关于维生素 D 的免疫调节作用的文献,从 Medline 和 Embase 数据库中收集数据。
维生素 D 被证明可以与先天免疫系统相互作用,通过激活 Toll 样受体(TLRs)或增加抗菌肽和β-防御素的水平,以及适应性免疫系统,通过减少浆细胞的免疫球蛋白分泌和促炎细胞因子的产生,从而调节 T 细胞的功能。在呼吸道感染、自身免疫性疾病甚至肺纤维化方面,已经广泛描述了维生素 D 补充的有希望的结果。
在这篇综述中,我们认为维生素 D 补充可能在预防和/或治疗 SARS-CoV-2 感染疾病方面发挥作用,通过调节成人和儿童人群对病毒的免疫反应。