维生素D号慢性荨麻疹的研究进展

Correlation between vitamin D and chronic urticaria

慢性荨麻疹患者的平均维生素D与对照组相比明显偏低,且与病情严重程度及病程存在负相关.尽管尚不明确其中的因果关系,两者间的潜在联系可能与维生素D所起的免疫调节作用有关.有研究表明,维生素D可通过结合维生素D受体影响下游信号通路及核内转录水平,从而对肥大细胞、淋巴细胞以及嗜酸性粒细胞等多种免疫细胞的功能产生调节效应.维生素D可抑制肥大细胞释放活性介质,还可影响T淋巴细胞亚群动态平衡和迁移,引起干扰素γ水平下降和白细胞介素10水平升高等变化,可能是维生素D影响荨麻疹发病的重要机制.同时,临床药物试验显示,补充维生素D对慢性荨麻疹的治疗具有潜在的辅助作用.因此,若能继续明确维生素D与慢性荨麻疹发病的因果关系,从细胞及基因层面研究维生素D对肥大细胞等主要效应细胞的具体影响,将有助于为慢性荨麻疹的诊断和治疗找到新的理论依据.

Various studies have demonstrated that the vitamin D level is significantly lower in patients with chronic urticaria than in healthy controls,and is negatively associated with the severity and duration of the disease.Although the causal relationship between vitamin D and chronic urticaria remains unclear,their potential relationship may be associated with immunoregulatory effects of vitamin D.Some researches indicate that vitamin D can regulate the function of immune cells,such as mast cells,lymphocytes and eosinophils,by influencing downstream signaling pathways and nuclear transcription level after binding to its receptor.Vitamin D is able to suppress the release of vasoactive mediators from mast cells,and affect the dynamic balance and migration of T-lymphocyte subsets,followed by the decline of interferon-γ （IFN-γ） level and increase of interleukin-10 （IL-10） level,which may be the important pathogenesis of chronic urticaria.Meanwhile,clinical trials reveal that vitamin D supplementation plays a potential supporting role in the treatment of chronic urticaria.Therefore,clear understanding of the causal relationship between vitamin D and occurrence of chronic urticaria,as well as the specific effect of vitamin D on main effector cells such as mast cells at cellular and genetic levels,will be helpful in finding new theoretical bases for the diagnosis and treatment of chronic urticaria.