Perspective: improving vitamin D status in the management of COVID-19
Perspective: improving vitamin D status in the management of COVID-19
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DOI：
10.1038/s41430-020-0661-0
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发表时间：
2020-05-12
影响因子：
4.7
通讯作者：
Montano-Loza, Aldo J.
中科院分区：
文献类型：
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作者：
Ebadi, Maryam;Montano-Loza, Aldo J.
2019 年新型冠状病毒病 (COVID-19) 的爆发是一场全球性的大流行病，对我们的社区产生了不可估量的影响。考虑到 COVID-19 大流行带来的巨大健康和经济负担，任何改善患者病情、加速康复并降低病情恶化和死亡风险的方法都将被认为具有重大的临床和经济重要性。 在 COVID-19 患者中，SARS-CoV-2 病毒与感染患者呼吸道中的血管紧张素转换酶 2 (ACE2) 受体结合，进入宿主细胞 [1]。在疾病的早期阶段，保护性免疫反应负责消除病毒，因此，改善免疫反应的策略非常重要。随着疾病的进展，激活的巨噬细胞和 1 型 T 辅助细胞 (Th1) 免疫细胞释放促炎细胞因子，即白介素 (IL)-1B 和 IL-18，导致肺部炎症和纤维化发生 [2]。老年患者和免疫功能低下的患者面临较高的实质性风险[3]。不幸的是，目前人类对 SARS-CoV-2 免疫反应的知识差距是治疗该疾病的关键障碍；然而，潜在的免疫调节剂可能有助于减轻严重程度并改善结果。维生素 D 是一种分泌类固醇，具有广泛的免疫调节、抗炎、抗纤维化和抗氧化作用。炎症细胞因子[例如IL-1α、IL-1β、肿瘤坏死因子-α]的表达受到维生素D的抑制，其不足与Th1细胞因子的过度表达有关[4]。我们最近发现严重的维生素 D 缺乏 (< 25 nmol/L) 与
A novel coronavirus disease 2019 (COVID-19) outbreak is a global dramatic pandemic that is immeasurably impacting our communities. Considering massive health and economic burden of the COVID-19 pandemic, any means by which to improve the condition of patients to accelerate recovery and to reduce the risk of deterioration and death would be considered of significant clinical and economical importance.In patients with COVID-19, SARS-CoV-2 virus binds to angiotensin converting enzyme 2 (ACE2) receptors in the respiratory tracts of infected patients to enter host cells [1]. At early stages of the disease, protective immune response is responsible for eliminating virus and, therefore, strategies to improve immune responses are of importance. As disease progresses, lung inflammation and fibrosis occur due to the release of pro-inflammatory cytokines, namely interleukin (IL)-1B and IL-18 by activated macrophages and type 1 T helper (Th1) immune cells [2]. Older patients and those that are immunocompromised are at the higher substantial risk [3]. Unfortunately, current knowledge gap on human immune response to SARS-CoV-2 is a critical barrier for treating the disease; however, potential immunomodulators may help alleviate severity and improve outcomes. Vitamin D is a secosteroid that has a wide spectrum of immunomodulatory, antiinflammatory antifibrotic, and antioxidant actions. Expression of inflammatory cytokine [eg, IL-1α, IL-1β, tumor necrosis factor-α] was inhibited by vitamin D and its insufficiency was associated with overexpression of Th1 cytokines [4]. We have recently found that severe vitamin D deficiency (< 25 nmol/L) is associated