Preventing Vitamin D Deficiency in Pregnancy - Importance for the Mother and Child
Preventing Vitamin D Deficiency in Pregnancy - Importance for the Mother and Child
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DOI：
10.1159/000332072
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发表时间：
2011-01-01
影响因子：
3.9
通讯作者：
Hyppoenen, Elina
中科院分区：
文献类型：
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作者：
Hyppoenen, Elina
母体中激素活性维生素D骨化三醇，1,25(OH)(2)D]的循环浓度在妊娠早期升高，在妊娠晚期增加一倍。骨化三醇的早期升高被认为是母亲维持正常妊娠所需的免疫适应所必需的。这种免疫适应的特点是T辅助型1 （Th1）细胞因子反应的下调和Th2型反应的主导转变。减弱th1介导的免疫应答是骨化三醇对调节性T细胞活性和树突状细胞成熟的影响之一。越来越多的证据表明，补充维生素D可能能够预防子痫前期发生的免疫适应不良和耐受性丧失，从各种类型的观察性研究和临床试验中获得了相关证据。观察性研究也有证据表明，补充维生素D对免疫疾病（如1型糖尿病和过敏性疾病）有潜在的长期规划效应，有证据支持活性维生素D作为一种有效的免疫调节剂的作用。本文强调了活性维生素D对免疫调节的复杂影响，并对免疫疾病的风险具有长期影响。有人建议，在怀孕期间避免维生素D缺乏是至关重要的，虽然越来越多的证据表明进一步增加维生素D的摄入量有重要的好处，但需要进一步的研究来充分确定高剂量的影响。巴塞尔S. Karger股份有限公司版权所有
Circulating maternal concentrations of hormonally active vitamin D calcitriol, 1,25(OH)(2)D] rise early in the first trimester, doubling by the end of the third trimester. The early rise in calcitriol is believed to be necessary for enabling the immunological adaptation by the mother required for the maintenance of a normal pregnancy. This immunological adaptation is characterized by downregulation of the T helper type 1 (Th1) cytokine responses and a shift towards domination by the Th2 type responses. Attenuation of the Th1-mediated immune response is one of the influences of calcitriol on regulatory T cell activity and dendritic cell maturation. There is accumulating evidence that vitamin D supplementation may be able to prevent the immune maladaptation and loss of tolerance that occur in preeclampsia, with evidence for an association obtained from various types of observational studies and clinical trials. There is also evidence from observational studies for potential long-term programming effects of vitamin D supplementation on immunological diseases (such as type 1 diabetes and allergic diseases), with evidence supporting the role of active vitamin D as a potent immunomodulator. This paper highlights the complex effects of active vitamin D on immunomodulation with long-term implications for the risk of immunological diseases. It is suggested that it is essential to avoid vitamin D deficiency during pregnancy, and while accumulating evidence suggests important benefits of further increases in the intake, further research is required to fully establish the influence of high dosages. Copyright (C) 2011 S. Karger AG, Basel