{"title":"补充维生素 D 对呼吸道疾病和感染免疫反应的影响:系统回顾与荟萃分析","authors":"Angeline Jeyakumar , Pooja Bhalekar , Pranita Shambharkar","doi":"10.1016/j.hnm.2024.200272","DOIUrl":null,"url":null,"abstract":"<div><h3>Context</h3><p>Vitamin D acts as an immune modulator, by downregulating the production of inflammatory immune markers and upregulating the production of anti-microbial peptides and anti-inflammatory markers. Hence, vitamin D may be useful in improving the immune response against respiratory tract diseases.</p></div><div><h3>Objective</h3><p>A systematic review (following PRISMA guidelines) and meta-analysis were performed to study the effect of vitamin D supplementation on the immune response to respiratory tract diseases irrespective of population type.</p></div><div><h3>Data sources</h3><p>Electronic search engines Pubmed, Pubmed Central, Google Scholar, <span>Clinicaltrials.gov</span><svg><path></path></svg>, Clinical Trial Registry India, ScienceDirect, and Web of Science were searched for relevant articles.</p></div><div><h3>Data extraction</h3><p>Sixteen RCTs were eligible for inclusion. Jadad scale was used to assess the quality of studies. Methods of the selected studies were assessed using the Cochrane Risk of Bias assessment. Using the random-effects model meta-analysis was performed if at least three articles studied similar immune markers. Thus, IL-6, cathelicidin, CRP, TNF alpha, and IFN gamma, were included in the analysis. In all 16 articles were included for qualitative assessment, and 14 articles for meta-analysis.</p></div><div><h3>Data analysis</h3><p>There was a significant decrease in CRP levels after intervention with an overall effect of Z = 3.37 (P < 0.00). The observed increase in IL-10 levels was not significant with an overall effect of Z = 0.84 (p = 0.40). There was no significant decrease in IL6 [Z = 0.59 (P = 0.56)], and interferon-gamma levels [Z = 1.70 (p = 0.09)]. Secondary outcomes including mortality, and length of hospital stay did not show a significant difference in the intervention group.</p></div><div><h3>Conclusion</h3><p>Among the biomarkers studied CRP significantly decreased, with no significant changes in the others. Our findings suggest that vitamin D supplementation modestly affects the immune response. Pooling infectious and non-infectious respiratory diseases could have underestimated our findings. More RCTs are warranted to obtain substantial results.</p></div>","PeriodicalId":36125,"journal":{"name":"Human Nutrition and Metabolism","volume":null,"pages":null},"PeriodicalIF":1.9000,"publicationDate":"2024-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666149724000343/pdfft?md5=c1fd781eb83d577b1c462511d921ef3a&pid=1-s2.0-S2666149724000343-main.pdf","citationCount":"0","resultStr":"{\"title\":\"Effect of vitamin D supplementation on the immune response to respiratory tract infections and inflammatory conditions: A systematic review and meta-analysis\",\"authors\":\"Angeline Jeyakumar , Pooja Bhalekar , Pranita Shambharkar\",\"doi\":\"10.1016/j.hnm.2024.200272\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Context</h3><p>Vitamin D acts as an immune modulator, by downregulating the production of inflammatory immune markers and upregulating the production of anti-microbial peptides and anti-inflammatory markers. Hence, vitamin D may be useful in improving the immune response against respiratory tract diseases.</p></div><div><h3>Objective</h3><p>A systematic review (following PRISMA guidelines) and meta-analysis were performed to study the effect of vitamin D supplementation on the immune response to respiratory tract diseases irrespective of population type.</p></div><div><h3>Data sources</h3><p>Electronic search engines Pubmed, Pubmed Central, Google Scholar, <span>Clinicaltrials.gov</span><svg><path></path></svg>, Clinical Trial Registry India, ScienceDirect, and Web of Science were searched for relevant articles.</p></div><div><h3>Data extraction</h3><p>Sixteen RCTs were eligible for inclusion. Jadad scale was used to assess the quality of studies. Methods of the selected studies were assessed using the Cochrane Risk of Bias assessment. Using the random-effects model meta-analysis was performed if at least three articles studied similar immune markers. Thus, IL-6, cathelicidin, CRP, TNF alpha, and IFN gamma, were included in the analysis. In all 16 articles were included for qualitative assessment, and 14 articles for meta-analysis.</p></div><div><h3>Data analysis</h3><p>There was a significant decrease in CRP levels after intervention with an overall effect of Z = 3.37 (P < 0.00). The observed increase in IL-10 levels was not significant with an overall effect of Z = 0.84 (p = 0.40). There was no significant decrease in IL6 [Z = 0.59 (P = 0.56)], and interferon-gamma levels [Z = 1.70 (p = 0.09)]. Secondary outcomes including mortality, and length of hospital stay did not show a significant difference in the intervention group.</p></div><div><h3>Conclusion</h3><p>Among the biomarkers studied CRP significantly decreased, with no significant changes in the others. Our findings suggest that vitamin D supplementation modestly affects the immune response. Pooling infectious and non-infectious respiratory diseases could have underestimated our findings. More RCTs are warranted to obtain substantial results.</p></div>\",\"PeriodicalId\":36125,\"journal\":{\"name\":\"Human Nutrition and Metabolism\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":1.9000,\"publicationDate\":\"2024-05-22\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.sciencedirect.com/science/article/pii/S2666149724000343/pdfft?md5=c1fd781eb83d577b1c462511d921ef3a&pid=1-s2.0-S2666149724000343-main.pdf\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Human Nutrition and Metabolism\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S2666149724000343\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"ENDOCRINOLOGY & METABOLISM\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Human Nutrition and Metabolism","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2666149724000343","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"ENDOCRINOLOGY & METABOLISM","Score":null,"Total":0}
引用次数: 0
摘要
背景维生素 D 是一种免疫调节剂,它能下调炎性免疫标记物的产生,上调抗微生物肽和抗炎标记物的产生。数据来源通过电子搜索引擎 Pubmed、Pubmed Central、Google Scholar、Clinicaltrials.gov、Clinical Trial Registry India、ScienceDirect 和 Web of Science 搜索相关文章。采用 Jadad 量表评估研究质量。采用 Cochrane 偏倚风险评估法对所选研究的方法进行评估。如果至少有三篇文章研究了类似的免疫标记物,则采用随机效应模型进行荟萃分析。因此,IL-6、cathelicidin、CRP、TNF alpha 和 IFN gamma 均被纳入分析范围。数据分析干预后 CRP 水平显著下降,总体效应为 Z = 3.37(P < 0.00)。观察到的 IL-10 水平升高不明显,总效应为 Z = 0.84(P = 0.40)。IL6 [Z = 0.59 (P = 0.56)]和γ干扰素水平[Z = 1.70 (P = 0.09)]没有明显下降。结论在所研究的生物标志物中,CRP 明显下降,其他生物标志物无明显变化。我们的研究结果表明,补充维生素 D 对免疫反应的影响不大。如果将感染性和非感染性呼吸道疾病的患者集中在一起,可能会低估我们的研究结果。要获得实质性结果,还需要进行更多的研究性试验。
Effect of vitamin D supplementation on the immune response to respiratory tract infections and inflammatory conditions: A systematic review and meta-analysis
Context
Vitamin D acts as an immune modulator, by downregulating the production of inflammatory immune markers and upregulating the production of anti-microbial peptides and anti-inflammatory markers. Hence, vitamin D may be useful in improving the immune response against respiratory tract diseases.
Objective
A systematic review (following PRISMA guidelines) and meta-analysis were performed to study the effect of vitamin D supplementation on the immune response to respiratory tract diseases irrespective of population type.
Data sources
Electronic search engines Pubmed, Pubmed Central, Google Scholar, Clinicaltrials.gov, Clinical Trial Registry India, ScienceDirect, and Web of Science were searched for relevant articles.
Data extraction
Sixteen RCTs were eligible for inclusion. Jadad scale was used to assess the quality of studies. Methods of the selected studies were assessed using the Cochrane Risk of Bias assessment. Using the random-effects model meta-analysis was performed if at least three articles studied similar immune markers. Thus, IL-6, cathelicidin, CRP, TNF alpha, and IFN gamma, were included in the analysis. In all 16 articles were included for qualitative assessment, and 14 articles for meta-analysis.
Data analysis
There was a significant decrease in CRP levels after intervention with an overall effect of Z = 3.37 (P < 0.00). The observed increase in IL-10 levels was not significant with an overall effect of Z = 0.84 (p = 0.40). There was no significant decrease in IL6 [Z = 0.59 (P = 0.56)], and interferon-gamma levels [Z = 1.70 (p = 0.09)]. Secondary outcomes including mortality, and length of hospital stay did not show a significant difference in the intervention group.
Conclusion
Among the biomarkers studied CRP significantly decreased, with no significant changes in the others. Our findings suggest that vitamin D supplementation modestly affects the immune response. Pooling infectious and non-infectious respiratory diseases could have underestimated our findings. More RCTs are warranted to obtain substantial results.