Why we should offer routine vitamin D supplementation in pregnancy and childhood to prevent multiple sclerosis
Why we should offer routine vitamin D supplementation in pregnancy and childhood to prevent multiple sclerosis
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DOI：
10.1016/j.mehy.2004.06.022
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发表时间：
2005-01-01
影响因子：
4.7
通讯作者：
Chaudhuri, A
中科院分区：
文献类型：
--
作者：
Chaudhuri, A
多发性硬化症（MS）是一种中枢神经系统脱髓鞘疾病，慢性病程，使年轻人致残。这种疾病在距离赤道最远的地理区域更为普遍。没有任何形式的治疗是已知的有效预防MS或其致残并发症。一些流行病学研究表明，在生命早期暴露于阳光下具有保护作用，最近的一项纵向研究证实，维生素D补充剂可降低女性MS的终生患病率。关于维生素D对发育中的大脑的作用知之甚少，但实验数据表明，大脑白色物质是维生素D反应性的，大脑和脊髓中的少突胶质细胞表达维生素D受体。提示在脑发育过程中，维生素D水平可能影响少突胶质细胞的分化和轴突粘附，维生素D的相对依赖性可能增加少突胶质细胞的凋亡。迁移对MS易感性的年龄效应可以通过维生素D对大脑发育的作用来解释。在多发性硬化症高发地区，在生命早期补充维生素D可以降低多发性硬化症的发病率。此外，像叶酸一样，在怀孕期间也应该常规推荐补充维生素D。通过改变一个重要的环境因素（阳光照射和维生素D水平）来预防MS提供了一种实用且具有成本效益的方法，可以减轻后代的疾病负担。(C)2004爱思唯尔有限公司保留所有权利。
Multiple sclerosis (MS) is a demyelinating disease of the central nervous system that runs a chronic course and disables young people. The disease is more prevalent in the geographic areas that are farthest from the equator. No form of treatment is known to be effective in preventing MS or its disabling complications. A number of epidemiological studies have shown a protective effect of exposure to sunlight during early life and a recent longitudinal study confirmed that vitamin D supplementation reduced life-time prevalence of MS in women. Very Little is known regarding the role of vitamin D on the developing brain but experimental data suggest that cerebral white matter is vitamin D responsive and oligodendrocytes in the brain and spinal cord and express vitamin D receptors. It is possible that differentiation and axonal adhesion of oligodendrocytes are influenced by vitamin D level during brain development and a relative tack of vitamin D may increase oligodendroglial apoptosis. The age effect of migration on susceptibility to develop MS could be explained by a role of vitamin D on brain development. In areas of high MS prevalence, dietary supplementation of vitamin D in early life may reduce the incidence of MS. In addition, like folic acid, vitamin D supplementation should also be routinely recommended in pregnancy. Prevention of MS by modifying an important environmental factor (sunlight exposure and vitamin D Level) offers a practical and cost-effective way to reduce the burden of the disease in the future generations. (C) 2004 Elsevier Ltd. All rights reserved.