维生素D缺乏和人类疾病

维生素D在人体健康和疾病中具有重要作用。研究表明全球约50％的人口存在维生素D缺乏风险。引起维生素D缺乏的主要原因是日照不足或通过膳食补充减少。维生素D缺乏对健康的损害不仅表现为佝偻病和骨软化症,还与癌症、心血管病、内分泌系统疾病、自身免疫性疾病、神经系统疾病及结核易患性有关。     

维生素D水平与抗菌肽作用的研究进展

维生素D作为一种免疫调节剂,在抗菌肽的固有免疫调节中发挥重要作用.维生素D可通过Toll样受体识别病原菌,释放抗菌肽,启动固有免疫反应.该文从抗菌肽的功能以及活性维生素D在抗菌肽固有免疫中的作用方面进行综述.     

新生儿维生素D营养健康新概念

近年来关于维生素D对人体健康影响的研究明显升温,除了大家十分熟悉的给婴幼儿补充维生素D可预防佝偻病以外,众多的基础和临床研究证明,维生素D在维持免疫功能、预防糖尿病和癌症等疾病方面有潜在的作用.鉴于目前的研究结果,美国对新生儿补充维生素D的剂量、开始时间等都在进行新的思考.     

维生素D对儿童骨骼外系统的作用

维生素D除了经典的维持骨骼健康的作用外,还对骨骼外系统发挥重要作用。近年来的研究显示,儿童时期的25羟维生素D水平和脑发育、免疫功能、肥胖、代谢综合征、胰岛素抵抗、感染性疾病、过敏、肿瘤以及心血管疾病等有密切关联,而且这方面的研究已经使人们对维生素D缺乏的定义以及维生素D最佳营养状况的认识发生了改变。鉴于维生素D在儿童健康方面的重要作用,更多的户外活动和维生素D补充是必要的。     

维生素D与水通道蛋白的研究进展

维生素D是一种脂溶性类固醇激素,通过与维生素D受体(vitamin D receptor,VDR)结合构成1,25 (OH)2D3/VDR信号通路参与调节机体钙磷代谢、糖代谢、脂代谢、水代谢等多种生物功能的调节.水通道蛋白是一类相对分子质量较小的疏水跨膜蛋白,在特殊的组织或细胞中如肾小管、内分泌腺、红细胞等细胞膜上特异表达,参与体内水平衡及代谢的调节.维生素D可以通过抑制肾素-血管紧张素系统在糖尿病肾病等疾病中起积极的作用,而水通道蛋白作为评价肾脏疾病进展及肾脏功能的新指标逐渐走进人们的视线,有研究证实维生素D在参与调节水通道蛋白的表达,维生素D和水通道在肾脏损伤及慢性肾脏疾病发挥着重要作用.     

维生素D在克罗恩病中的作用机制及外源性补充作用北大核心CSCD

维生素D不仅可调节钙磷代谢,还具有免疫调节的作用。克罗恩病(Crohn's disease,CD)患者普遍缺乏维生素D。研究表明维生素D与CD等自身免疫性疾病有关,通过调节肠道免疫、修复肠黏膜屏障、抑制肠纤维化、增强对英夫利西单抗的应答、调节肠道菌群等途径改善CD患者的病情,促进患者的康复。外源性维生素D补充在提高血清维生素D水平的同时可以诱导疾病的缓解。但目前仅有少数随机双盲、安慰剂对照试验研究维生素D在CD中的治疗效果,有关维生素D最佳的补充形式、具体的补充剂量及需要维持的最佳血清浓度尚未明确。该文主要讨论维生素D在CD的作用机制及外源性维生素D补充对CD的有益作用。     

25(OH)D免疫功能的研究进展

维生素D不仅具有调节体内钙磷代谢的作用,在体内免疫调节也发挥着重要的作用,与自身免疫性疾病、感染性疾病的发生、发展及干预、转归有密切关系.文章就维生素D与免疫的相关关系及研究进展做一综述.     

维生素D与癫疒间的相关性研究进展

维生素D除参与调节体内钙磷代谢外,其缺乏与全身和神经系统的多种疾病的发病密切相关,如多发性硬化、阿尔茨海默症、帕金森病和脑血管疾病等。近年来研究发现维生素D可能在癫疒间的发病机制中起着重要作用,并可能具有一定的抗惊厥作用。该文对维生素D在癫疒间中的作用,血清维生素D水平及其受体基因的多态性与癫疒间的关系进行了综述,也总结了抗癫疒间药和维生素D之间的相互作用。     

维生素D与过敏性疾病相关性的研究进展

过敏性疾病的患病率在全世界呈上升趋势.流行病学调查结果显示西方发达国家维生素D制剂的使用与过敏性疾病发病率同步增加,早期补充维生素D可能增加患过敏性疾病的风险.近期研究发现维生素D缺乏的地区过敏性疾病发病率也较高,多数学者认为维生素D缺乏与过敏性疾病流行相关.研究发现维生素D参与过敏性疾病的免疫反应,如抑制Th1细胞、树突细胞发育及Th2细胞分化,参与维持肠黏膜上皮细胞屏障完整性,但无证据表明维生素D过量或缺乏可导致过敏性疾病的发生.

Abstract：

The prevalence of allergy diseases is increasing globally. Epidemiological surveies showed that the increased allergy prevalence rates followed the time trend of rickets prophylaxis in western countries. and vitamin D supplement increased the risk of allergy in early stage.Currently,most of investigators think that vltamin D deficiency may be one of the risk factors for allergy diseases.Laboratory investigations showed that vitamin D inhibited Th1、dendritic cell(DC)and Th2 cell proliferating,and keeped on epithelial suIfaces barrier tunction.However,no study has found generating of allergy disease is associated with vitamin D deftciency or excess.     

维生素D与川崎病的关系及作用机制研究进展

维生素D是重要的类固醇激素,具有广泛的生物学效应,是心血管疾病及其他多种疾病的保护因素。目前川崎病（KD）的病因及发病机制尚不清楚,但近年来的研究发现,维生素D血清水平不足或缺乏与KD存在相关性。维生素D不足或缺乏可能通过影响炎性反应、脂肪细胞因子、内皮功能、血小板功能及DNA甲基化等途径影响KD,增加其冠脉损伤发生的风险。该综述就维生素D与KD的关系及其可能存在的多种作用机制的研究进展进行阐述。     

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??Vitamin D may play an important role in extraskeletal system beyond its traditional effect on the skeleton. Emerging evidence supports an association between 25-hydroxyvitamin D3 ??25??OH??D3?? levels and brain development??immune function??obesity??metabolic syndrome??insulin resistance??infection??allergy??cancers??and cardiovascular diseases in pediatric and adolescent populations. Mary studies have influenced the definition of vitamin D deficiency and what level of vitamin D should be regarded as optimal. Given the important role of vitamin D in childhood health??more time spent in outdoor activity and vitamin D supplementation may be necessary for optimal health in infants??children??and adolescents.     

Use of Vitamin D in Various Disorders

Approximately 1 billion people worldwide have been identified as vitamin D deficient in the 21st century, and the number is on the rise; non-classical actions of vitamin D were initially recognized around 30 y ago when receptors for vitamin D were detected in neoplastic cells lines. The aim of this review is to provide a brief overview of the non-classical actions of vitamin D. Reports describing the associations of non skeletal actions of vitamin D, especially pertaining to the immune system, inflammatory disorders, cancers and cardiovascular disease have been summarized in this paper. Reports support a role for the active form of vitamin D in mediating normal function of both the innate and adaptive immune systems. Studies also suggest a link between vitamin D deficiency and autoimmune diseases, such as rheumatoid arthritis, systemic sclerosis, systemic lupus erythematosus and type 1diabetes. There is believed to be an inverse association between serum 25-hydroxyvitamin D concentrations and the incidence of colorectal cancer, sporadic colorectal adenoma and breast cancer. Vitamin D deficiency has been linked with various cardiovascular diseases such as hypertension, myocardial infarction, and stroke. Several epidemiological and genetic studies suggest a strong association between vitamin D and non skeletal acute and chronic disorders. However, currently, robust clinical data are still lacking to support raising intake requirements and target vitamin D plasma levels. Nonetheless, the high prevalence of vitamin D deficiency is alarming and requires implementation of clear supplementation guidelines.     

维生素D与孤独症谱系障碍的关系

孤独症谱系障碍（ASD）是一种复杂的与多个遗传和环境危险因素有关的神经发育障碍。过去几年遗传和环境因素间相互作用已成为研究的热点。最近提出了维生素D缺乏可能是ASD的一个环境危险因素。维生素D在维持大脑内稳态、促进胚胎和神经发育、免疫调节（包括大脑自身的免疫系统）、抗氧化、抗凋亡、影响神经分化及基因调控方面都有独特的作用。多项研究表明ASD患儿血清中维生素D浓度相比健康儿童存在显著降低。因此,母孕期和儿童早期缺乏维生素D可能是引起ASD的环境危险因素之一。     

Vitamin D insufficiency in a boy with obsessive–compulsive disorder

Vitamin D deficiency not only causes low bone mass but also may lead to neuropsychiatric disorders. In the present case, vitamin D supplementation reduced obsessive–compulsive disorder (OCD) symptoms associated with streptococcal infection in a 7‐year‐old boy. Sudden onset of symptoms, including excessive hand washing and fear of touching anything, had occurred 1 month before presentation. Although there are few studies on a possible causal relationship between vitamin D and neuropsychiatric disorders, the present report; together with previous data, suggest an etiological role of vitamin D‐related immune processes.     

Correlation between the cord vitamin D levels and regulatory T cells in newborn infants

Vitamin D is important for calcium homeostasis, muscle, and bone health. It has also immunomodulatory capacities in vivo and in vitro. Regulatory T cells (Treg) have been found to suppress a number of T cell-mediated immune disorders, including allergic responses and autoimmune diseases. This study aimed to investigate the correlation between 25-hydroxyvitamin D (25(OH)D) levels and the regulatory T cells in cord blood. The study group is comprised of 101 full-term newborn infants. Umbilical cord 25(OH)D levels and number and percentage of T lymphocyte, T helper, and Treg cells were measured. Infants were grouped according to 25-hydroxyvitamin D levels (25(OH)D <12 ng/ml and 25(OH)D >12 ng/ml) (converting factor of 25OHD level into SI unit, 2.6). Severe vitamin D deficiency (25(OH)D <12 ng/ml) was observed in 32% of the infants. There was no significant correlation between 25-hydroxyvitamin D levels and T cell number and percentages. There were also no significant differences in white blood cell, total lymphocyte count, T helper, and Treg cell percentage and number between groups. These results suggest that the serum level of 25-hydroxyvitamin D is not crucially involved in the correlation between vitamin D status and T cell regulation in cord blood.     

维生素D3与支气管哮喘

支气管哮喘在世界各国都有逐年上升的趋势,大量研究显示其发生与免疫调节有密切关系,而维生素D3在支气管哮喘有其特定免疫调节机制,可通过调节细胞因子、调节性T细胞、基质金属蛋白酶-9等对支气管哮喘起到一定作用.维生素D3对支气管哮喘免疫调节可为临床有效治疗哮喘提供一定的理论依据,并最终为支气管哮喘患儿提供新的免疫治疗方法.     

维生素D调控钙离子结合蛋白机制的研究进展

CaBP-9k和CaBP-28k是一类具有维生素D依赖性的钙结合蛋白,在钙离子的主动转运过程中发挥着重要作用.研究表明维生素D能够上调机体钙离子结合蛋白的表达含量,从而促进机体对钙离子的吸收.维生素D和钙结合蛋白的缺乏可以导致机体钙稳态的失调,出现低钙血症、佝偻病、骨质疏松等病变.该文对钙结合蛋白的结构、在机体的分布、受维生素D调控的机制等研究进展作一综述,以期为预防和治疗骨发育异常提供新思路.