New studies about the benefits of vitamin D for immunity: review, mechanisms and prospects
Part 1: Vitamin D and immune system: Fundamentals of interaction
Vitamin D, long known for its role in maintaining bone health, is becoming more and more recognized as an important regulator of the immune system. The interaction of vitamin D with immunity is a complex and multifaceted process, which includes both innate and adaptive immune reactions. New studies tirelessly shed light on the subtleties of this interaction, revealing its potential in the prevention and treatment of various diseases.
1.1. Vitamin D: Brief review
Vitamin D, or cholecalciferol (vitamin D3) and ergocalciferol (vitamin D2), is a fat -soluble vitamin that is produced in the skin under the influence of ultraviolet radiation (UVB) or enters the body with food and additives. Vitamin D, obtained in any way, passes two stages of hydroxylation: first in the liver, where it turns into 25-hydroxyvitamin D [25(OH)D]also known as calciol, and then in the kidneys, where it is activated up to 1.25 dihydroxyvitamin D [1,25(OH)2D]also known as calcitriol. It is calcitriol that is a biologically active form of vitamin D, which interacts with the vitamin D (VDR) receptor.
1.2. Vitamin D (VDR) receptor: key intermediary
VDR is a nuclear receptor belonging to the super family of steroid hormones receptors. It is present in almost all tissues of the body, including immune cells, such as monocytes, macrophages, dendritic cells, T cells and B cells. The binding of calcitriol with VDR leads to the formation of the VDR-RXR complex (receptor of retinoid X), which is associated with DNA in certain areas of genes called elements of response to vitamin D (VDRE). This binding modulates the transcription of genes, affecting the synthesis of proteins and, therefore, on cell functions.
1.3. Vitamin D and congenital immunity
Congenital immunity is the first line of protection of the body from pathogens. Vitamin D plays an important role in increasing the innate immune response:
- Antimicrobial peptides: Vitamin D induces the expression of antimicrobial peptides, such as Katelicidin (LL-37) and defenses. Katelicidin has a wide range of antimicrobial activity against bacteria, viruses and mushrooms. It damages cell membranes of pathogens and activates immune cells.
- Monocytes and macrophages: Vitamin D affects the differentiation and activation of monocytes and macrophages. It increases their ability to phagocytosis, the destruction of pathogens and the production of cytokines. However, vitamin D can also modulate an inflammatory reaction, preventing excessive activation of macrophages and reducing the production of pro -inflammatory cytokines.
- Dendritic cells (DCS): DCS play a decisive role in the presentation of the antigen of T-cells and initiating an adaptive immune response. Vitamin D affects the ripening and function of DCS, reducing their ability to stimulate T cells and contributing to the development of tolerance.
1.4. Vitamin D and adaptive immunity
Adaptive immunity is a specific immune response that develops in response to the effects of specific antigens. Vitamin D modulates the functions of both T cells and B cells:
- T-cells: Vitamin D affects the differentiation and function of various subpopulations of T cells, including T-highpers (Th) and regulatory T cells (Tregs). It suppresses the development of Th1 and Th17 cells that participate in autoimmune and inflammatory diseases, and contributes to the development of TREGS, which suppress immune reactions and support immune tolerance.
- B cells: Vitamin D inhibits the proliferation and differentiation of B cells into plasma cells, reducing antibodies. This can be useful for autoimmune diseases characterized by excessive development of autoantibodies.
1.5. Genetic factors and vitamin D
Genetic factors can affect vitamin D metabolism and its impact on the immune system. Polymorphisms of genes encoding VDR, enzymes involved in vitamin D metabolism, and components of the immune system can affect susceptibility to infections and autoimmune diseases. For example, certain VDR gene variants are associated with an increased risk of developing multiple sclerosis and other autoimmune diseases.
Part 2: The effect of vitamin D on specific diseases
Numerous studies study the role of vitamin D in the prevention and treatment of various diseases, especially those that are associated with impaired immune system.
2.1. Vitamin D and respiratory infections
Epidemiological data indicates the relationship between vitamin D deficiency and increased susceptibility to respiratory infections such as flu, cold and pneumonia. Clinical studies meta-analyzes showed that vitamin D additives can reduce the risk of respiratory infections, especially in people with vitamin D deficiency. The estimated mechanisms include increased immune response, a decrease in the production of pro-inflammatory cytokines and improving the function of the epithelial barrier of the respiratory tract.
2.2. Vitamin D and Covid-19
Covid-19 pandemia attracted special attention to the role of vitamin D in an immune response to the SARS-COV-2 virus. Some studies have shown that vitamin D deficiency is associated with an increased risk of infection Covid-19, a more severe course of the disease and increased mortality. However, the results of the studies are contradictory, and it is necessary to conduct larger and well-planned clinical studies to determine whether the additives of vitamin D can really prevent or treat Covid-19. The alleged mechanisms include the increase in the congenital immune response against the virus, a decrease in the production of pro-inflammatory cytokines and the prevention of a “cytokine storm”, which is a serious complication of the COVID-19.
2.3. Vitamin D and autoimmune diseases
Vitamin D plays an important role in the modulation of the immune system and maintaining immune tolerance, which makes it potentially useful for autoimmune diseases, such as multiple sclerosis, rheumatoid arthritis, systemic lupus erythematosus and inflammatory diseases of the intestine.
- Scattered sclerosis (RS): Epidemiological data indicates the relationship between the low level of vitamin D and the increased risk of RS development. Clinical studies have shown that vitamin D additives can reduce the frequency of exacerbations and the progression of the disease in patients with RS.
- Rheumatoid arthritis (RA): Some studies have shown that vitamin D deficiency is associated with an increased risk for the development of RA and a greater severity of the disease. Vitamin D additives can reduce inflammation and improve clinical symptoms in patients with RA.
- System red lupus (SLE): Patients with SLE often observe vitamin D deficiency. Studies have shown that vitamin D additives can reduce the activity of the disease and improve the quality of life in patients with SLE.
- Inflammatory diseases of the intestine (BCC): Vitamin D deficiency is common in patients with BCC, such as Crohn’s disease and ulcerative colitis. Studies have shown that vitamin D additives can reduce inflammation and improve the symptoms in patients with BCC.
2.4. Vitamin D and cancer
Some studies have shown that vitamin D can play a role in cancer prevention. Vitamin D can inhibit the growth of cancer cells, induce apoptosis (programmed cell death) and suppress angiogenesis (the formation of new blood vessels that feed the tumor). Epidemiological data indicate the relationship between a higher level of vitamin D and a reduced risk of developing certain types of cancer, such as colon cancer, breast cancer and prostate cancer. However, further research is necessary to confirm these results and determine the optimal dose of vitamin D for cancer prevention.
2.5. Vitamin D and other diseases
Vitamin D can also play a role in the prevention and treatment of other diseases, such as:
- Cardiovascular diseases: Vitamin D deficiency is associated with an increased risk of developing cardiovascular diseases, such as hypertension, coronary heart disease and stroke.
- Type 2 diabetes: Vitamin D can improve insulin sensitivity and reduce the risk of type 2 diabetes.
- Osteoporosis: Vitamin D is necessary for absorption of calcium and maintaining bone health. Vitamin D deficiency can lead to osteoporosis and increased risk of fractures.
- Depression: Some studies have shown that vitamin D deficiency is associated with an increased risk of depression.
Part 3: Vitamin D level assessment and additive recommendations
It is important to regularly assess the level of vitamin D in the body and take appropriate measures to maintain its optimal level.
3.1. Vitamin D level assessment
The most accurate way to assess the level of vitamin D is to measure the concentration of 25 (OH) D in blood serum. Level 25 (OH) D reflects vitamin D reserves in the body and its availability for transformation into an active form. The optimal level 25 (OH) D is 30-50 ng/ml (75-125 nmol/l). The level below 20 ng/ml (50 nmol/l) is considered a deficiency of vitamin D, and the level of 20 to 30 ng/ml (50-75 nmol/l) is insufficient.
3.2. Causes of vitamin D deficiency
Vitamin D deficiency can be caused by various factors, including:
- Insufficient stay in the sun: The main source of vitamin D is its production in the skin under the influence of UVB radiation. Insufficient stay in the sun, especially in the winter months and in people with dark skin, can lead to a deficiency of vitamin D.
- Insufficient consumption of vitamin D with food: Vitamin D is contained in a small number of products such as fatty fish (salmon, tuna, mackerel), egg yolks and enriched products (milk, yogurt, grain). Insufficient consumption of these products can lead to vitamin D.
- Diseases that violate vitamin D absorption: Some diseases, such as Crohn’s disease, celiac disease and cystic fibrosis, may disrupt vitamin D absorption in the intestines.
- Liver and kidney diseases: Diseases of the liver and kidneys can disrupt the transformation of vitamin D into its active form.
- Obesity: Vitamin D is a fat -soluble vitamin, and in people with obesity it can be deposited in adipose tissue, reducing its accessibility for the body.
- Some drugs: Some drugs, such as glucocorticoids, antifungal drugs and HIV medicines, can reduce vitamin D.
3.3. Recommendations for vitamin D additives
Recommendations for the dosage of vitamin D vary depending on the age, state of health and level of vitamin D in the body. As a rule, adults are recommended to take 600-800 IU vitamin D per day. People with vitamin D deficiency may require a higher dose that the doctor must prescribe. The upper limit of vitamin D consumption is 4000 IU per day for adults.
3.4. Vitamin D safety
Vitamin D is usually considered safe when receiving in recommended doses. However, taking high doses of vitamin D can lead to hypercalcemia (an increased level of calcium in the blood), which can cause nausea, vomiting, weakness and damage to the kidneys. It is important to consult a doctor before taking vitamin D additives, especially if you have any diseases or you take any medication.
Part 4: new areas of research
Studies in the field of vitamin D and immunity continue to develop actively, opening new prospects for the prevention and treatment of various diseases.
4.1. Individualized approach to the dosage of vitamin D
More and more attention is paid to the development of an individualized approach to the dosage of vitamin D, taking into account the genetic factors, lifestyle and health status of each person. For example, people with certain genetic variants of the VDR gene may require a higher dose of vitamin D to achieve the optimal level in the blood.
4.2. The effect of vitamin D on the intestinal microbia
New studies study the effect of vitamin D on the intestinal microbia, a set of microorganisms that live in the intestines. The intestinal microbia plays an important role in the regulation of the immune system, and vitamin D can affect its composition and function. Changes in the intestinal microbioma caused by vitamin D can affect the immune response and susceptibility to various diseases.
4.3. Vitamin D and cancer immunotherapy
Studies study the potential role of vitamin D in increasing the effectiveness of cancer immunotherapy. Immunotherapy is a type of cancer treatment that stimulates the patient’s immune system to fight cancer cells. Vitamin D can enhance the antitumor immune response and increase the effectiveness of immunotherapy.
4.4. Vitamin D and age -related changes in immunity
With age, the immune system undergoes changes known as immunostering, which leads to a decrease in the immune response and increased susceptibility to infections. Studies study the role of vitamin D in mitigating the effects of immunostation and maintaining the health of the immune system in the elderly.
4.5. Vitamin D and pregnancy
Vitamin D plays an important role in the development of the fetal immune system. Vitamin D deficiency during pregnancy can negatively affect the immune development of the child and increase the risk of developing allergic diseases such as asthma and eczema. Recommendations for taking vitamin D during pregnancy can be higher than for other adults.
Part 5: Key conclusions and future directions
Studies of vitamin D and its influence on the immune system continue to expand, providing valuable information about its role in maintaining health and preventing diseases. Although many results are promising, it is important to note that additional studies are needed in order to fully understand the complex mechanisms of the interaction of vitamin D with the immune system and develop optimal strategies for its use in clinical practice. Key areas for future research include:
- Larger and well -planned clinical research: Larger and well -planned clinical studies are needed using standardized protocols and clear end points for assessing the effectiveness of vitamin D in the prevention and treatment of various diseases.
- Studying the mechanisms of action of vitamin D: A deeper study of the mechanisms is necessary, through which vitamin D affects the immune system at the molecular and cellular level.
- Development of individualized strategies for using vitamin D: It is necessary to develop individualized strategies for using vitamin D, taking into account the genetic factors, lifestyle and health status of each person.
- Assessment of the effect of vitamin D on the intestinal microbia: It is necessary to study in more detail the effect of vitamin D on the intestinal microbia and its role in the regulation of the immune system.
- Studying the interaction of vitamin D with other nutrients: It is necessary to study the interaction of vitamin D with other nutrients, such as vitamin K2 and magnesium, which also play an important role in bone health and immune system.
Continuing to explore the complex relationships between vitamin D and the immune system, we can discover new opportunities to improve the health and well -being of people around the world.
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