维生素D的免疫调节作用在过敏性紫癜中的作用
Journal: Basic Medical Theory Research DOI: 10.32629/bmtr.v8i3.20439
Abstract
过敏性紫癜 (anaphylactoidpurprua）又称亨-舒综合征 (Henoch-SchonleinPurpura,HSP），是一种以自身免疫复合物介导的系统性血管炎。过敏性紫癜的发病率近几年有所上升，并且病情易反复，主要表现为可触性皮肤紫癜、关节肿痛、腹痛及肾脏受累，处于急性期的HSP患儿可能会发生胃肠道出血和肠套叠，不及时发现，会有生命危险；远期预后与肾脏损害程度有关。HSP的发病机制迄今尚未完全清楚，目前大多数学者认为其主要是感染或其他因素，导致机体体液免疫紊乱、细胞免疫失衡、大量炎性因子表达异常、内皮损伤、免疫球蛋白异常沉积有关[1]。维生素D是一种重要的脂溶性维生素，近年来研究发现维生素D除了有调节钙磷代谢功能外，还参与调控机体免疫、炎症、损伤修复，这种免疫调节作用使维生素D与自身免疫性疾病的发生发展产生关联，涉及疾病包括哮喘、炎症性肠病 (IBD) 、呼吸道感染、自身免疫性疾病、糖尿病等[2-4]。
Keywords
维生素D；免疫调节；过敏性紫癜。
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[2] Mirentxu I , Daniela H , Rodrigo N , et al. Immune Response Modulation by Vitamin D: Role in Systemic Lupus Erythematosus[J]. Frontiers in Immunology, 2015, 6:513.
[3] 李金潺,卫丹丹,李小峰,等.维生素D在自身免疫性疾病中的作用[J]. 中国全科医学,2015(18):2184-2187.
[4] Colotta F , Jansson B , Bonelli F . Modulation of inflammatory and immune responses by vitamin D[J]. Journal of Autoimmunity, 2017.
[5] Liu L J , Yu J , Li Y N . Clinical characteristics of Henoch-Schnlein purpura in children[J]. Zhongguo dang dai er ke za zhi = Chinese journal of contemporary pediatrics, 2015, 17(10):1079.
[6] Narchi, H. Risk of long term renal impairment and duration of follow up recommended for Henoch-Schnlein purpura with normal or minimal urinary findings: a systematic review[J]. Archives of Disease in Childhood,2005,90(9):916.
[7] González LM, Janniger C K , Schwartz R A . Pediatric Henoch-Schonlein purpura[J]. International Journal of Dermatology, 2009, 48(11):1157-1165.
[8] Baeke F , Takiishi T , Korf H , et al. Vitamin D: modulator of the immune system[J]. Current Opinion in Pharmacology, 2010, 10(4):482-496.
[9] Dusso A S , Brown A J , Slatopolsky E . Vitamin D[J]. ajp-renal physiology,2005,289(1):F8-28.
[10] Charles H , Antonio F . The Non-Genomic Actions of Vitamin D[J]. Nutrients,2016,8(3):135.
[11] Norman Anthony W,Minireview: vitamin D receptor: new assignments for an already busy receptor[J] .Endocrinology, 2006, 147: 5542-8.
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[13] Kassem S , Yousra S , Abdulla W , et al. Vitamin D, autoimmunity and recurrent pregnancy loss: More than an association[J]. American Journal of Reproductive Immunology, 2018:e12991.
[14] Xavier Guillot and Luca Semerano and Nathalie Saidenberg-Kermanac’h and Géraldine Falgarone and Marie-Christophe Boissier. Vitamin D and inflammation[J]. Joint Bone Spine, 2010.
[15] Dickie L J , Church L D , Coulthard L R , et al. 1,25(OH)2D3 down-regulates intra-cellular Toll-like receptor 9-induced IL-6 production in human monocytes[J]. Rheumatology, 2010, 49(8):1466-1471.
[16] Jung Y O , Cho M L , Lee S Y , et al. Synergism of toll-like receptor 2 (TLR2), TLR4, and TLR6 ligation on the production of tumor necrosis factor (TNF)-α in a spontaneous arthritis animal model of interleukin (IL)-1 receptor antagonist-deficient mice[J]. Immunology Letters, 2009, 123(2):138-143.
[17] Chang H , Zhang Q Y , Lin Y , et al. Correlation of TLR2 and TLR4 expressions in peripheral blood mononuclear cells to Th1- and Th2-type immune responses in children with henoch-schönlein purpura[J]. International Journal of Clinical & Experimental Medicine, 2015, 8(8):13532.
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[19] 张爱飞,冯正平.维生素D免疫调节的研究进展[J].中国骨质疏松杂志,2019,25(4):564-569.
[20] Gregori S , Casorati M , Amuchastegui S , et al. Regulatory T cells induced by 1 alpha,25-dihydroxyvitamin D3 and mycophenolate mofetil treatment mediate transplantation tolerance[J]. Journal of Immunology, 2001, 167(4):1945-53.
[21] 陈燕媚,周继昌.维生素D对免疫系统作用机制的研究进展[J].营养学报,2020,42(03):301-307.
[22] 冯小倩,田秀英,罗亚瑞.过敏性紫癜与T淋巴细胞亚群及效应细胞因子的关系[J/OL].重庆医学:1-9[2020-10-11].http://kns.cnki.net/kcms/detail/50.1097.R.20200930.1958.016.html.
[23] 尹薇,陈晶.儿童过敏性紫癜免疫机制研究[J].中华实用儿科临床杂志,2017,032(021):1604-1607.
[24] Chen O , Zhu X B , Ren H , et al. The imbalance of Th17/Treg in Chinese children with Henoch-Schonlein purpura.[J]. International Immunopharmacology,2013,16(1):67-71.
[25] 王烨,梁庆红,张莹,等. CD4+T淋巴细胞亚群在儿童过敏性紫癜病理机制中的调控作用[J]. 中华实用儿科临床杂志, 2015(30):1614-1618.
[26] 黄丹琳,许自川,党西强,等. 儿童紫癜性肾炎肾组织Th1/Th2比值与肾脏微血管损伤的关系[J]. 中国当代儿科杂志, 2011(04):273-277.
[27] Cosmi Lorenzo,Liotta Francesco,Maggi Enrico et al. Th17 and non-classic Th1 cells in chronic inflammatory disorders: two sides of the same coin.[J] .Int Arch Allergy Immunol, 2014, 164: 171-7.
[28] 王强,史洋溢,曹玫,等. Th17细胞/Treg细胞失衡在儿童过敏性紫癜发病机制中的作用[J]. 中国实验血液学杂志, 2015(05):1391-1396.
[29] 邵晓珊,江超,李宇红,等.儿童紫癜性肾炎 CD4+CD25+调节性 T 细胞的功能研究[J].中华儿科杂志,2014,52(7):516-520.
[30] 李海园,刘志伟.维生素D的免疫调节作用与儿童疾病[J].临床儿科杂志,2012,30(8):792-794.
[31] Fawaz L, Mrad MF, Kazan JM, Sayegh S, Akika R, Khoury SJ. Comparative effect of 25(OH)D3 and 1,25(OH)2D3 on Th17 cell differentiation. Clin Immunol. 2016 May;166-167:59-71.
[32] Wen Hong-Yan,Luo Jing,Li Xiao-Feng et al. 1,25-Dihydroxyvitamin D modulates T cell differentiation and impacts on the production of cytokines from Chinese Han patients with early rheumatoid arthritis[J] .Immunol Res, 2019, 67: 48-57.
[33] 李琳,秦晨光,张么成,等.滤泡辅助性T细胞在系统性红斑狼疮发病机制中的研究进展[J].华南国防医学杂志,2018,032(009):664-668.
[34] Xiaochuan W , Haixia C . The Pathogenesis and Treatment of Pediatric Henoch-Schnlein Purpura Nephritis[J]. Journal of Pediatric Pharmacy, 2012.
[35] Sheng,Chen,Gary P,Sims,Xiao Xiang,Chen,Yue Ying,Gu,Shunle,Chen,Peter E,Lipsky.Modulatory effects of 1,25-dihydroxyvitamin D3 on human B cell differentiation.[J].Journal of immunology (Baltimore, Md.: 1950),2007,179(3):1634-47.
[36] 郑荣浩,刘冬蕾,黄力,等.过敏性紫癜患儿25-羟维生素D的表达及与免疫功能的关系[J].中国妇幼健康研究,2018,29(11):1392-1396.
[37] 张远达,董青伟,李荣敏,等.过敏性紫癜患儿25-羟基维生素D_3水平变化及意义[J].中国当代儿科杂志,2017,19(3):292-295.
[2] Mirentxu I , Daniela H , Rodrigo N , et al. Immune Response Modulation by Vitamin D: Role in Systemic Lupus Erythematosus[J]. Frontiers in Immunology, 2015, 6:513.
[3] 李金潺,卫丹丹,李小峰,等.维生素D在自身免疫性疾病中的作用[J]. 中国全科医学,2015(18):2184-2187.
[4] Colotta F , Jansson B , Bonelli F . Modulation of inflammatory and immune responses by vitamin D[J]. Journal of Autoimmunity, 2017.
[5] Liu L J , Yu J , Li Y N . Clinical characteristics of Henoch-Schnlein purpura in children[J]. Zhongguo dang dai er ke za zhi = Chinese journal of contemporary pediatrics, 2015, 17(10):1079.
[6] Narchi, H. Risk of long term renal impairment and duration of follow up recommended for Henoch-Schnlein purpura with normal or minimal urinary findings: a systematic review[J]. Archives of Disease in Childhood,2005,90(9):916.
[7] González LM, Janniger C K , Schwartz R A . Pediatric Henoch-Schonlein purpura[J]. International Journal of Dermatology, 2009, 48(11):1157-1165.
[8] Baeke F , Takiishi T , Korf H , et al. Vitamin D: modulator of the immune system[J]. Current Opinion in Pharmacology, 2010, 10(4):482-496.
[9] Dusso A S , Brown A J , Slatopolsky E . Vitamin D[J]. ajp-renal physiology,2005,289(1):F8-28.
[10] Charles H , Antonio F . The Non-Genomic Actions of Vitamin D[J]. Nutrients,2016,8(3):135.
[11] Norman Anthony W,Minireview: vitamin D receptor: new assignments for an already busy receptor[J] .Endocrinology, 2006, 147: 5542-8.
[12] Gil, ángel, Plaza-Diaz J , Mesa, María?Dolores. Vitamin D: Classic and Novel Actions[J]. Annals of Nutrition and Metabolism, 2018:87-95.
[13] Kassem S , Yousra S , Abdulla W , et al. Vitamin D, autoimmunity and recurrent pregnancy loss: More than an association[J]. American Journal of Reproductive Immunology, 2018:e12991.
[14] Xavier Guillot and Luca Semerano and Nathalie Saidenberg-Kermanac’h and Géraldine Falgarone and Marie-Christophe Boissier. Vitamin D and inflammation[J]. Joint Bone Spine, 2010.
[15] Dickie L J , Church L D , Coulthard L R , et al. 1,25(OH)2D3 down-regulates intra-cellular Toll-like receptor 9-induced IL-6 production in human monocytes[J]. Rheumatology, 2010, 49(8):1466-1471.
[16] Jung Y O , Cho M L , Lee S Y , et al. Synergism of toll-like receptor 2 (TLR2), TLR4, and TLR6 ligation on the production of tumor necrosis factor (TNF)-α in a spontaneous arthritis animal model of interleukin (IL)-1 receptor antagonist-deficient mice[J]. Immunology Letters, 2009, 123(2):138-143.
[17] Chang H , Zhang Q Y , Lin Y , et al. Correlation of TLR2 and TLR4 expressions in peripheral blood mononuclear cells to Th1- and Th2-type immune responses in children with henoch-schönlein purpura[J]. International Journal of Clinical & Experimental Medicine, 2015, 8(8):13532.
[18] Ferreira G B , Kleijwegt F S , Waelkens E , et al. Differential protein pathways in 1,25-dihydroxyvitamin d(3) and dexamethasone modulated tolerogenic human dendritic cells[J]. Journal of Proteome Research, 2011, 11(2).
[19] 张爱飞,冯正平.维生素D免疫调节的研究进展[J].中国骨质疏松杂志,2019,25(4):564-569.
[20] Gregori S , Casorati M , Amuchastegui S , et al. Regulatory T cells induced by 1 alpha,25-dihydroxyvitamin D3 and mycophenolate mofetil treatment mediate transplantation tolerance[J]. Journal of Immunology, 2001, 167(4):1945-53.
[21] 陈燕媚,周继昌.维生素D对免疫系统作用机制的研究进展[J].营养学报,2020,42(03):301-307.
[22] 冯小倩,田秀英,罗亚瑞.过敏性紫癜与T淋巴细胞亚群及效应细胞因子的关系[J/OL].重庆医学:1-9[2020-10-11].http://kns.cnki.net/kcms/detail/50.1097.R.20200930.1958.016.html.
[23] 尹薇,陈晶.儿童过敏性紫癜免疫机制研究[J].中华实用儿科临床杂志,2017,032(021):1604-1607.
[24] Chen O , Zhu X B , Ren H , et al. The imbalance of Th17/Treg in Chinese children with Henoch-Schonlein purpura.[J]. International Immunopharmacology,2013,16(1):67-71.
[25] 王烨,梁庆红,张莹,等. CD4+T淋巴细胞亚群在儿童过敏性紫癜病理机制中的调控作用[J]. 中华实用儿科临床杂志, 2015(30):1614-1618.
[26] 黄丹琳,许自川,党西强,等. 儿童紫癜性肾炎肾组织Th1/Th2比值与肾脏微血管损伤的关系[J]. 中国当代儿科杂志, 2011(04):273-277.
[27] Cosmi Lorenzo,Liotta Francesco,Maggi Enrico et al. Th17 and non-classic Th1 cells in chronic inflammatory disorders: two sides of the same coin.[J] .Int Arch Allergy Immunol, 2014, 164: 171-7.
[28] 王强,史洋溢,曹玫,等. Th17细胞/Treg细胞失衡在儿童过敏性紫癜发病机制中的作用[J]. 中国实验血液学杂志, 2015(05):1391-1396.
[29] 邵晓珊,江超,李宇红,等.儿童紫癜性肾炎 CD4+CD25+调节性 T 细胞的功能研究[J].中华儿科杂志,2014,52(7):516-520.
[30] 李海园,刘志伟.维生素D的免疫调节作用与儿童疾病[J].临床儿科杂志,2012,30(8):792-794.
[31] Fawaz L, Mrad MF, Kazan JM, Sayegh S, Akika R, Khoury SJ. Comparative effect of 25(OH)D3 and 1,25(OH)2D3 on Th17 cell differentiation. Clin Immunol. 2016 May;166-167:59-71.
[32] Wen Hong-Yan,Luo Jing,Li Xiao-Feng et al. 1,25-Dihydroxyvitamin D modulates T cell differentiation and impacts on the production of cytokines from Chinese Han patients with early rheumatoid arthritis[J] .Immunol Res, 2019, 67: 48-57.
[33] 李琳,秦晨光,张么成,等.滤泡辅助性T细胞在系统性红斑狼疮发病机制中的研究进展[J].华南国防医学杂志,2018,032(009):664-668.
[34] Xiaochuan W , Haixia C . The Pathogenesis and Treatment of Pediatric Henoch-Schnlein Purpura Nephritis[J]. Journal of Pediatric Pharmacy, 2012.
[35] Sheng,Chen,Gary P,Sims,Xiao Xiang,Chen,Yue Ying,Gu,Shunle,Chen,Peter E,Lipsky.Modulatory effects of 1,25-dihydroxyvitamin D3 on human B cell differentiation.[J].Journal of immunology (Baltimore, Md.: 1950),2007,179(3):1634-47.
[36] 郑荣浩,刘冬蕾,黄力,等.过敏性紫癜患儿25-羟维生素D的表达及与免疫功能的关系[J].中国妇幼健康研究,2018,29(11):1392-1396.
[37] 张远达,董青伟,李荣敏,等.过敏性紫癜患儿25-羟基维生素D_3水平变化及意义[J].中国当代儿科杂志,2017,19(3):292-295.
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