维生素D免疫调节的研究进展

The research progress of vitamin D on immunity

维生素D是人体生命中不可缺少的营养素,由于免疫细胞同样表达1α-羟化酶和维生素D受体(vitamin D receptor,VDR),所以维生素D是一种重要的免疫调节剂,它可以调节固有免疫和适应性免疫。维生素D通过与维生素D受体结合,激活和调节多种细胞通路来发挥其生物学效应。尤其是免疫细胞(抗原递呈细胞、B细胞、T细胞)能够表达1α-羟化酶从而合成维生素D的活性代谢物,更进一步证明了维生素D的免疫调节特性。维生素D缺乏会导致诸如自身免疫性疾病等异常反应。一些观察研究表明补充维生素D有利于降低疾病的严重程度。但是,用于预防或治疗自身免疫性疾病所需补充的血浆25-羟维生素D浓度标准仍有争议。本文将对维生素D免疫调节研究进展以及维生素D在自身免疫性内分泌疾病(自身免疫性甲状腺疾病、1型糖尿病、Addison’s病)发病机制中的作用进行综述。

Vitamin D is an essential nutrient for human life,the 1α-hydroxylase and the vitamin D receptor are also expressed in cells of the immune system,indicating that vitamin D has immunomodulatory properties.It can regulate both innate and adaptive immunity.Vitamin D mediates its biological effects by binding to the vitamin D receptor,and activating and regulating multiple cellular pathways.In particular,cells of the immune system(antigen presenting cells,B cells and T cells),due to the expression of 1α-hydroxylase(CYP27 B1),are able to synthesize the active metabolite of vitamin D,which shows more immunomodulatory properties.Thus,it is possible that vitamin D insufficiency or deficiency may unsettle the normal immune response,predisposing to the development of the autoimmune diseases.Several observational studies have suggested beneficial effects of vitamin D supplementation in reducing the severity of disease activity.However,the optimal plasma 25-hydroxyvitamin D concentration that is necessary to prevent or treat autoimmune diseases is still under debate.This review presents the recent research progress on the immunoregulatory effect of vitamin D and summarize the evidence regarding the role of vitamin D in the pathogenesis of autoimmune endocrine diseases,including autoimmune thyroid disease,type 1 diabetes mellitus and Addison’s disease.