Papel da vitamina D no lúpus eritematoso sistêmico
Palavras-chave:
Lúpus eritematoso sistêmico, Sistema imune, Vitamina DResumo
Além do papel na homeostase do cálcio, acredita-se que a forma ativa da vitamina D apresente efeitos imunomoduladores, suprimindo ou ativando o sistema imune. Estudos recentes têm relacionado a deficiência ou a insuficiência de vitamina D a várias doenças autoimunes, como lúpus eritematoso sistêmico, artrite reumatoide, diabetes Mellitus tipo 1 e esclerose múltipla. Dessa forma, o presente trabalho buscou descrever o metabolismo da vitamina D e suas funções, enfatizando sua ação no sistema imune bem como a participação no lúpus eritematoso sistêmico. Todas as evidências encontradas estão voltadas para a relação entre baixos níveis de vitamina D e manifestações clínicas do lúpus eritematoso sistêmico, porém ainda não está definido se a suplementação ou recuperação desses níveis possa influir na atividade da doença. Dessa forma, há necessidade de mais estudos para avaliar os possíveis benefícios terapêuticos da suplementação de vitamina D no lúpus eritematoso sistêmico.
Referências
Bouillon R, Carmeliet G, Verlinden L, van Etten E, Verstuyf A, Luderer HF, et al. Vitamin D and human health: lessons from vitamin D receptor null mice. Endocr Rev. 2008; 29(6):726-76.
Jones BJ, Twomey PJ. Issues with vitamin D in routine clinical practice. Rheumatol. 2008; 47(9): 1267-68.
Lemire JM, Ince A, Takashima M. 1,25-Dihydroxyvitamin D3 attenuates the expression of experimental murine lupus of MRL/1 mice. Autoimmunity. 1992; 12(2):143-8.
Holick MF. Vitamin D: importance in the prevention of cancers, type 1 diabetes, heart disease and osteoporosis. Am J Clin Nutr. 2004; 79(3):362-71.
Orbach H, Zandman-Goddard G, Amital H, Barak V, Szekanecz Z, Szucs G, et al. Novel biomarkers in autoimmune diseases: prolactin, ferritin, vitamin D, and TPA levels in autoimmune diseases. Ann N Y Acad Sci. 2007; 1109:385-400.
Lima I, Néri F, Santiago MB. Dosagem sérica de adenosina deaminase em lúpus eritematoso sistêmico: ausência de associação com atividade de doença. Rev Bras Reumatol. 2005; 45(5):273-9.
Kamen DL, Aranow C. The link between vitamin D deficiency and systemic lupus erythematosus. Curr Rheumatol Rep. 2008; 10(4):273-80.
Arnson Y, Amital H, Shoenfeld Y. Vitamin D and autoimmunity: new etiological and therapeutic considerations. Ann Rheum Dis. 2007; 66(9): 1137-42.
Holick MF. Sunlight and vitamin D for bone health and prevention of autoimmune diseases, cancers, and cardiovascular disease. Am J Clin Nutr. 2004; 80(6 Suppl):1678S-88S.
Bringhurst FR, Demay MB, Kronenberg HM. Hormones and disorders of mineral metabolism. In: Kronenberg HM, Melmed S, Polonsky KS, Larsen PR, editors. Williams textbook of endocrinology. Philadelphia: Elsevier; 2008. v.11.
Leventis P, Patel S. Clinical aspects of vitamin D in the management of rheumatoid arthritis. Rheumatol. 2008; 47(11):1617-21.
Bandeira F, Griz L, Dreyer P, Eufrazino C, Bandeira C, Freese E. Vitamin D deficiency: a global perspective. Arq Bras Endocrinol Metabol. 2006; 50(4):640-6.
National Academy of Sciences. Recommended Dietary Allowances [Internet]. Washington (DC): NAS; 1989 [cited 2010 Dec 15]. Avalilable from: <http://www.nap.edu/catalog.php?record_id=1349>.
Institute of Medicine. Dietary reference intake for calcium, phosphorus, magnesium, vitamin d and fluoride [Internet]. Washington (DC): IOM; 1997 [cited 2011 May 1]. Available from: <http://www.nap.edu/catalog.php?record_id=5776>.
Pittard WB, Geddes KM, Hulsey TC, Hollis BW. How much vitamin D for neonates? Am J Dis Child. 1991; 145(10):1147-9.
Datta S, Alfaham M, Davies DP, Dunstan F, Woodhead S, Evans J, et al. Vitamin D deficiencyin pregnant women from a non-European ethnic minority population: an international study. Br J Obstet Gyneaecol. 2002; 109(8):905-8.
Institute of Medicine. Dietary reference intakes for calcium and vitamin D [Internet]. Washington (DC): IOM; 2010 [cited 2011 May 10]. Available from: <http://www.iom.edu/Reports/2010/DietaryReference-Intakes-for-Calcium-and-VitaminD.aspx>.
Vieth R. Vitamin D supplementation, 25-hydroxyvitamin D concentrations, and safety. Am J Clin Nutr. 1999; 69(5):842-56.
Dawson-Hughes B, Heaney RP, Holick MF, Lips P, Meunier PJ, Vieth R. Estimates of optimal vitamin D status. Osteoporos Int. 2005; 16(7):713-6.
Chesney RW. Vitamin D and the magic mountain: the anti-infectious role of the vitamin. J Pediatr. 2010; 156(5):698-703 .
Holick MF. Vitamin D status: measurement, interpretation, and clinical application. Ann Epidemiol. 2009; 19(2):73-8.
Devlin TM. Princípios de nutrição II: micronutrientes. In: Stephen GC, editor. Manual de bioquímica com correlações clínicas. São Paulo: Edgard Blücher Ltda; 2003. v.5.
Bhalla AK, Amento EP, Clemens TL, Holick MF, Krane SM. Specific high-affinity receptors for 1,25-dihydroxyvitamin D3 in human peripheral blood mononuclear cells: presence in monocytes and induction in T lymphocytes following activation. J Clin Endocrinol Metab. 1983; 57(6): 1308-10.
Provvedini DM, Tsoukas CD, Deftos LJ, Manolagas SC. 1,25-dihydroxyvitamin D3 receptors in human leukocytes. Science. 1983; 221(4616):1181-3.
Adorini L, Penna G. Control of autoimmune diseases by the vitamin D endocrine system. Nat Clin Pract Rheumatol. 2008; 4(8):404-12.
Maskin M. La vitamina D, el sistema inmune y lãs enfermedades de la piel. Educ Med. 2009; 15(6): 401-09.
Szodoray P, Nakken B, Gaal J, Jonsson R, Szegedi A, Zold E, et al. The complex role of vitamin D in autoimmune diseases. Scand J Immunol. 2008; 68(3):261-9.
D’Cruz DP, Khamashta MA, Hughes GR. Systemic Lupus Erythematosus. Lancet. 2007; 369(9561): 587-96.
Pons-Estel GJ, Alarcon GS, Scofield L, Reinlib L, Cooper GS. Understanding the epidemiology and progression of systemic lupus erythematosus. Semin Arthritis Rheum. 2010; 39(4):257-68.
Cutolo M, Otsa K. Review: vitamin D, immunity and lupus. Lupus. 2008; 17(1):6-10.
Ruiz-Irastorza G, Egurbide MV, Olivares N, Martinez-Berriotxoa A, Aguirre C. Vitamin D deficiency in systemic lupus erythematosus: prevalence, predictors and clinical consequences. Rheumatol. 2008; 47(6):920-3;
Borba VZ, Vieira JG, Kasamatsu T, Radominski SC, Sato EI, Lazaretti-Castro M. Vitamin D deficiency in patients with active systemic lupus erythematosus. Osteoporos Int. 2009; 20(3):427-33.
Kamen DL, Cooper GS, Bouali H, Shaftman SR, Hollis BW, Gilkeson GS. Vitamin D deficiency in systemic lupus erythematosus. Autoimmun Rev. 2006; 5(2):114-7.
Carvalho JF, Blank M, Kiss E, Tarr T, Amital H, Shoenfeld Y. Antivitamin D in SLE: preliminary results. Ann N Y Acad Sci. 2007; 1109:550-7.
Kim HA, Sung JM, Jeon JY, Yoon JM, Suh CH. Vitamin D may not be a good marker of disease activity in Korean patients with systemic lupus erythematosus. Rheumatol Int. 2011; 31(9): 1189-94.
Souto M, Coelho A, Guo C, Mendonça L, Argolo S, Papi J, et al. Vitamin D insufficiency in Brazilian patients with SLE: prevalence, associated factors, and relationship with activity. Lupus. 2011; 20(10): 1019-26.
Fragoso TS, Dantas AT, Marques CDL, Rocha Junior LF, Melo JHL, Costa AJG, et al. Níveis séricos de 25-HydroxivitaminaD3 e a sua associação com parâmetros clínicos e laboratoriais em pacientes com lúpus eritematoso sistêmico. Rev Bras Reumatol. 2012; 52(1)60-5.
Clinical Trials Studies. Vitamin D3 in systemic lupus erythematosus [Internet]. 2011 [cited 2011 May 10]. Available from: <http://clinicaltrials.gov/ct2/show/NCT00710021>.
Downloads
Publicado
Como Citar
Edição
Seção
Licença
Copyright (c) 2023 Thaisa de Mattos TEIXEIRA, Célia Lopes da COSTA
Este trabalho está licenciado sob uma licença Creative Commons Attribution 4.0 International License.
