Značaj uloge vitamina D kod obolelih od multiple skleroze

  • Suncica Stankov

Sažetak


Etiologija multiple skleroze je i dalje najvećim delom nepoznata, ali brojni dokazi ukazuju da postoji interakcija između genetskih i faktora spoljašnje sredine koji utiču na  povećanje rizika za nastanak multiple skleroze. Faktori spoljašnje sredine za koje se smatra da učestvuju u patogenezi multiple skleroze uključuju Epstein-Barr virusnu infekciju, deficijenciju vitamina D i B12, kao i pušenje cigareta. Iako tačna etiologija multiple skleroze nije još uvek determinisana, mnogi patofiziološki, eksperimentalni, epidemiološki, imunološki i biološki dokazi ukazuju na značaj uloge hipovitaminoze D kao jednog od najvažnijih spoljašnjih faktora u etiologiji multiple skleroze. Prevalencija multiple skleroze je veoma visoka u područjima sa niskim unosom D vitamina, a imunološke studije ukazuju da vitamin D ima modulirajući potencijal u odnosu na imuni sistem i značajnu ulogu u regulaciji homeostaze T limfocita.  Pored dobro poznate osnovne uloge D vitamina u metabolizmu kostiju i homeostazi kalcijuma, vitamin D pokazuje i imunomodulatornu, anti-inflamatornu i potencijalnu neuroprotektivnu funkciju, što ukazuje na povoljno terapijsko dejstvo vitamina D u autoimunim bolestima kao što je multipla skleroza. Posebnu pažnju privlače savremena istraživanja koja ukazuju da lečenje deficijencije vitamina D može umanjiti invaliditet uzrokovan multiplom sklerozom. Prevencija bolesti i unapređenje zdravstvenog stanja obolelih od multiple skleroze mogući su kroz otkrivanje deficijencije vitamina D, njenu korekciju i adekvatnu upotrebu suplemenata, što značajno može uticati na poboljšanje kvaliteta života i zdravstvenog statusa osoba obolelih od multiple skleroze.

Reference

Bendik I, Friedel A, Roos F.F, Weber P, Eggersdorfer M. Vitamin D: a critical and essential micronutrient for human health. Front Physiol. 2014; 5: 248.

Landel V, Annweilerb C, Milleta P, Morelloa M, Féron F. Vitamin D, Cognition and Alzheimer’s Disease: The Therapeutic Benefit is in the D-Tails. Journal of Alzheimer’s Disease 2016;53:419–444.

Wang H, Chen W, Li D, Yin X, Zhang X, Olsen N, Zheng S. G, Vitamin D and Chronic Diseases. Aging and disease 2017; 3:346-53.

Schwalfenberg G. Not enough vitamin D. Can Fam Physician 2007;53:841-854.

Ghasemi N, Razavi S, Nikzad E. Multiple Sclerosis: Pathogenesis, Symptoms, Diagnoses and Cell-Based Therapy. Cell Journal(Yakhteh) 2017;1:1-10.

Bikle D.D. Vitamin D Metabolism, Mechanism of Action, and Clinical Applications. Chem Biol. 2014;21:319–329.

Nair R, Maseeh A. Vitamin D: The “sunshine” vitamin. J Pharmacol Pharmacother. 2012; 3:118–126.

van der Schaft J, Koek H.L, Dijkstra E, Verhaar H.J.J, van der Schouw Y.T, Emmelot-Vonk M.H. The association between vitamin D and cognition: A systematic review. Ageing Research Reviews 2013,12:1013-23.

Mulcahy K.B, Trigoboff E, Opler L, Lee Demler T. Physician Prescribing Practices of Vitamin D in a Psychiatric Hospital. Innov Clin Neurosci. 2016;13:21–27.

Darwish H, Haddad R, Osman S, et al. Effect of Vitamin D Replacement on Cognition in Multiple Sclerosis Patients. Scientific Reports 2017;7:45926. doi:10.1038/srep45926.

Dörr J, Döring A, Paul F. Can we prevent or treat multiple sclerosis by individualised vitamin D suplly? The EPMA Journal 2013;4:4.

Didonna A, Oksenberg J.R. Genetic determinants of risk and progression in multiple sclerosis. Clin Chim Acta. 2015;449:16–22.

Ashtari F, Ajalli M, Shaygannejad V, Akbari M, Hovsepian S. The relation between Vitamin D status with fatigue and depressive symptoms of multiple sclerosis. J Res Med Sci. 2013;18:193–197.

Bazelier M.T, van Staa T, Uitdehaag B.MJ, Cooper C, Leufkens H.GM, Vestergaard P, Bentzen J, de Vries F. The Risk of Fracture in Patients With Multiple Sclerosis: The UK General Practice Research Database. Journal of Bone and Mineral Research 2011; 9:2271–2279.

Huang W-J, Chen W-W, Zhang X. Multiple sclerosis: Pathology, diagnosis and treatments (Review). Experimental and therapeutic medicine 2017;13:3163-3166.

Zuvich RL, McCauley JL, Pericak-Vance MA, Haines JL. Genetics and Pathogenesis of Multiple Sclerosis. Semin Immunol. 2009;21:328–333.

Libbey J.E, Cusick M.F, Fujinami R.S. Role of Pathogens in Multiple Sclerosis. Int Rev Immunol. 2014;33:266–283.

Namjooyan F, Ghanavati R, Majdinasab N, Jokari S, Janbozorgi M. Uses of Complementary and Alternative Medicine in Multiple Sclerosis. J Tradit Complement Med. 2014;4:145–152.

Shaygannejad V, Golabchi K, Haghighi S, Dehghan H, Moshayedi A. A Comparative Study of 25 (OH) Vitamin D Serum Levels in Patients with Multiple Sclerosis and Control Group in Isfahan, Iran. Int J Prev Med. 2010;1:195–201.

Nessler S, Brück W. Advances in multiple sclerosis research in 2009. J Neurol 2010; 257:1590–1593.

Döring A, Paul F, Dörr J. Vitamin D und Multiple Sklerose. Nervenarzt 2013;84:173–189.

Kampman M.T, Wilsgaard T, Mellgren S.I. Outdoor activities and diet in childhood and adolescence relate to MS risk above the Arctic Circle. J Neurol 2007;254:471–477.

Islam T, Gauderman WJ, Cozen W, Mack TM. Childhod sun exposure influences risk of multiple sclerosis in monozygotic twins. Neurology 2007; 69:381-8.

Dalmay F, Bhalla D, Nicoletti A, Cabrera-Gomez IA, Cabre P, Ruiz F, Druet-Cabanac M, Dumas M, Preux PM. Multiple sclerosis and solar exposure before the age of 15 years: case-control study in Cuba, Martinique and Sicily. Mult Scler 2010;16:899-908.

Mc Dowell TY, Amr S, Culpepper WJ, Langenberg P, Royal W, Bever C, Bradham DD. Sun exposure, vitamin D and age at disease onset in relapsing multiple sclerosis. Neuroepidemiology 2001;36:39-45.

Harandi A.A, Harandi A. A, Pakdaman H, Sahraian M.A. Vitamin D and multiple sclerosis. Iran J Neurol 2014;13:1-6.

Kfoczyńska M, Kucharska A, Sińska B. Rola witaminy D w stwardnieniu rozsianym. Postepy Hig Med Dosw 2015;69:440-446.

Pludowski P et all. Vitamin D effects on musculoskeletal health, immunity, autoimmunity, cardiovascular disease, cancer, fertility, pregnancy, dementia and mortality-A review of recent evidence. Autoimmunity reviews 2013;12:976-89.

Ascherio A, Munger KL. Environmental risk factors for multiple sclerosis. Part I: The role of infection. Ann Neurol 2007;61:288-299.

Stein MS, Liu Y, Gray OM, Baker JE, Kolbe SC, Ditchfield MR, Egan GF, Mitchell PJ, Harrison LC, Butzkueven H, et al. A randomized trial of high-dose vitamin D2 in relapsing-remitting multiple sclerosis. Neurology 2011;77:1611-18.

Mosayebi G, Ghazavi A, Ghasami K, Jand Y, Kokhaei P. Therapeutic effect of vitamin D3 in multiple sclerosis patients. Immunol Invest 2011;40:627-639.

Shaygannejad V, Janghorbani M, Ashtari F, Dehghan H. Effects of Adjunct Low-Dose Vitamin D on Relapsing-Remitting Multiple Sclerosis Progression: Preliminary Findings of a Randomized Placebo-Controlled Trial. Multiple Sclerosis International. 2012;2012:452541. doi:10.1155/2012/452541.

Soilu-Hänninen M, Åivo J, Lindström B-M, Elovaara I, Sumelahti ML, Färkkilä M, Tienari P, Atula S, Sarasoja T, Herrala L, et al. A randomised, double blind, placebo controlled trial with vitamin D3 as an add on treatment to interferon β-1b in patients with multiple sclerosis. J Neurol Neurosurg Psychiatry 2012; 83:565-571.

Yadav V, Shinto L, Bourdette D. Complementary and alternative medicine for the treatment of multiple sclerosis. Expert Rev Clin Immunol. 2010;6:381–395.

Shahbeigi S, Pakdaman H, Fereshtehnejad S-M, Nikravesh E, Mirabi N, Jalilzadeh G. Vitamin D3 Concentration Correlates with the Severity of Multiple Sclerosis. Int J Prev Med. 2013;4:585–591.

Pierrot-Deseilligny C. Clinical implications of a possible role of vitamin D in multiple sclerosis. J Neurol 2009;256:1468–79.

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2018/07/17
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