Vnitřní lékařství 8/2020

PŘEHLEDOVÉ ČLÁNKY Suplementácia vitamínu D ako dôležitý faktor v prevencii a liečbe ochorenia COVID-19: aké máme dôkazy? 500 | VNITŘNÍ LÉKAŘSTVÍ / Vnitř Lék 2020; 66(8): 494–500  /  www.casopisvnitrnilekarstvi.cz Veľmi dôležité je opakovane zdôrazniť potrebu adekvátneho denného prí‑ sunu vitamínu D podľa odporúčaní odborných spoločností (400–1000 IU denne v závislosti od veku). Tieto odporúčania existujú na základe pre‑ svedčivých údajov o benefite vitamínu D na muskuloskeletálny systém (61). V kontexte prebiehajúcej pandémie COVID-19 sa však každýmdňom objavuje viac dát o tom, že vitamín D by mohol zmierniť celospoločenský dopad pandémie najmä u skupín pacientov, kde je jeho deficit najzávaž‑ nejší (čo je zároveň populácia najviac náchylná na ťažký priebeh infekcie COVID-19). U týchto pacientov je rozumné počas pandémie ochorenia COVID-19 zvážiť podávanie vyšších dávok vitamínu D z „off label“ indikácie, horná hranica dennej dávky by mohla byť 4000 IU (najvyššia odporúčaná dávka z „muskuloskeletálnej“ indikácie) minimálne do objavenia sa väčšie‑ homnožstva dát z prospektívnych, intervenčných štúdií (randomizované placebom kontrolované štúdie). Vitamín D zrejme nebude „zázračnou molekulou“ ale iba jedným z viacerých faktorov ovplyvňujúcich priebeh a závažnosť ochorenia COVID-19. Adekvátna suplementácia vitamínom D je však z celospoločenského hľadiska jednoduché, lacné a bezpečné opatrenie s potenciálnym významným zdravotným benefitom. LITERATURA 1. Martineau AR, Forouhi NG. Vitamin D for COVID-19: a case to answer? The Lancet Dia‑ betes and Endocrinology 2020; 8(9): 735–736. 2. Hewison M. An update on vitamin D and human immunity. Clin Endocrinol 2012; 76(3): 315–325. 3. Barbour GL, Coburn JW, et al. Hypercalcemia in an aneprhic patient with sarcoido‑ sis: evidence for extrarenal generation of 1,25-dihydroxyvitamin D. N Engl J Med 1981; 305(8): 440–443. 4. Haussler MR, Whitfield GK, Kaneko I, et al. Molecular mechanisms of vitamin D action. Calcified Tissue International 2013; 92: 77–98. 5. Greiller CL, Martineau AR. Modulation of the immune response to respiratory viruses by vitamin D. Nutrients 2015; 7(6): 4240–4270. 6. Hansdottir S, Monick MM, Hinde SL, et al. Respiratory epithelial cells convert inactive vitamin D to its active form: potential effects on host defense. J Immunol 2008; 181(10): 7090–7099. 7. Arababadi MK, Nosratabadi R, Asadikaram G. Vitamin D and toll like receptors. Life sci‑ ences 2017; 203: 105–111. 8. Liu PT, Stenger S, Li H, et al. Toll‑like receptor triggering of a vitamin D‑mediated human antimicrobial response. Science 2006; 311(5768): 1770–1773. 9. Bilezikian JO, Bikle D, Hewison M, et al. Vitamin D and COVID-19. Eur J Endocrinol 2020; 183(5): R133–R147. 10. Mao J, Lin E, He L, et al. Autophagy and viral infection. Advances in Experimental Me‑ dicine and Biology 2019; 1209: 55–78. 11. Dancer RC, Parekh D, Lax S, et al. Vitamin D deficiency contributes directly to the acu‑ te respiratory distress syndrome (ARDS). Thorax 2015; 70(7): 617–624. 12. Herr C, Shaykhiev R, Bals R. The role of cathelicidin and defensins in pulmonary in‑ flammatory diseases. Expert Opin Biol Ther 2007; 7(9): 1449–1461. 13. Šterzl I. D vitamin a imunita. Vnitr Lek 2012; 58(5): 405–410. 14. Hansdottir S, Monick M. Vitamin D effects on lung immunity and respiratory diseases. Vitam Horm 2011; 86: 217–237. 15. Sigmundsdottir H, Pan J, et al. DCs metabolize sunlight‑induced vitamin D3 to „pro‑ gram“ T cell attraction to the epidermal chemokine CCL27. Nat Immunol 2007; 8(3): 285–293. 16. Hrubišková K, Jackuliak P, Payer J. Vitamín D a imunitný system. Klinická imunológia a alergológia 2011; 21(4): 19–24. 17. Shoenfeld Y, Giacomelli R, Azrielant S, et al. Vitamin D and systemic lupus erythema‑ tosus – The hype and the hope. Autoimmun Rev 2018; 17(1): 19–23. 18. Alva‑Murillo N, Tellez‑Perez AD, Medina‑Estrada I, et al. Modulation of the inflamma‑ tory response of bovine mammary epithelial cells by cholecalciferol during Staphylococ‑ cus aureus internalization. Microbial pathogenesis 2014; 77: 24–30. 19. Li P, Xu X, Cao E, et al. Vitamin D deficiency causes defective resistance to Aspergillus fumigatus in mice via aggravated and sustained inflammation. PloS one 2014; 9:e99805. 20. Choi B, Lee E, Sohn S. Vitamin D3 ameliorates herpes simplex virus‑induced Beh‑ cet’s disease‑like inflammation in a mouse model through down‑regulation of Toll‑like receptors. Clin Experiment Rheumatol 2010; 29: S13–19. 21. Channappanavar R, Perlman S. Pathogenic human coronavirus infections: causes and consequences of cytokine storm and immunopathology. Seminars in Immunopathology 2017; 39: 529–539. 22. Martinez‑Moreno J, Hernandez JC, Urcuqui‑Inchima S. Effect of high doses of vitamin D supplementation on dengue virus replication, toll.like receptor expression, and cytoki‑ ne profiles on dendritic cells. Mol Cell Biochem 2020; 464(1–2):169–180. 23. Mock CK, Ng YL, Ahidjo BA, et al. Calcitriol, the active form of a vitamin D, is a promising candidate for COVID-19 prophylaxis. bioRxiv 2020; publikované online 22. júna (preprint). 24. Xu J, Yang J, Chen J, et al. Vitamin D alleviates lipopolysaccharide induced acute lung injury via regulation of the renin‑angiotensin system. Mol Med Rep 2017; 16(5): 7432–7483. 25. Kulda V. Metabolizmus vitaminu D. Vnitr Lek 2012; 58(5): 400–404. 26. Lanham‑New SA, Webb AR, Cahman KD, et al. Vitamin D and SARS‑CoV-2 virus/CO‑ VID-19 disease. BMJ Nutrition, Prevention and Health 2020; 0. 27. Amrein K, Papinutti A, Mathew E, et al. Vitamin D and critical illness: what endocrinology can learn from intensive care and vice versa. Endocrine Connections 2018; 7(12): R303–R315. 28. Shaman J, Pitzer VE, Vibou C, et al. Absolute humidity and the seasonal onset of in‑ fluenza in the continental United States. PLoS Biol 2010; 8(2): e1000316. 29. Fisher BJ, Seropian IM, Kraskauskas D, et al. Ascorbic acid attenuates lipopolysaccharide­ ‑induced acute lung injury. Crit Care Med 2011; 39(6): 1454–1460. 30. Calder PC, Carr AC, Gombart AF, et al. Optimal nutritional status for a well‑functioning im‑ mune system is an important factor to protect against viral infections. Nutrients 2020; 12(4). 31. Martineau AR, Jolliffe DA, Hooper RL, et al. Vitamin D supplementation to prevent acu‑ te respiratory tract infections: Systematic review and meta‑analysis of individual partici‑ pant data. BMJ 2017; 356: i6583. 32. Jolliffe D, Camargo Jr CA, Sluyter J, et al. Vitamin D supplementation to prevent acute respiratory infections: systematic review and meta‑analysis of aggregated data from ran‑ domized controlled trials. medRxiv 2020, publikované online 17. júla (preprint). 33. Han JE, Jones JL, Tangpricha V, et al. High dose vitamin D administration in ventilated intensive care unit patients: a pilot double blind randomized controlled trial. Journal of Clinical and Translational Endocrinology 2016; 4: 59–65. 34. Ginde AA, Brower RG, Caterino JM, et al. Early high‑dose vitamin D3 for critically ill, vitamin‑D deficient patients. N Eng J Med; 381: 2529–2540. 35. Amrein K, Parekh D, Westphal S, et al. Effect of high‑dose vitamin D3 on 28-day mortality in adult critically ill patients with severe vitamin D deficiency: a study protocol of a multi‑ centre, placebo‑controlled double‑blind phase III RCT (the VITDALIZE study); 9(11): e031083. 36. Laird E, Rhodes J, Kenny RA. Vitamin D and inflammation: potential implications for severity of COVID-19. Ir Med J 2020; 113(5): 81. 37. Ilie PC, Stefanescu S, Smith L. The role of vitamin D in the prevention of coronavirus di‑ sease 2019 infection and mortality. Aging Clin Exp Res 2020; 32: 1195–1198. 38. Ebadi M, Montano‑Loza. Perspective: improving vitamin D status in the management of COVID-19. European Journal of Clinical Nutrition 2020; 1–4. 39. D’Avolio A, Avataneo V, Manca A, et al. 25-hydroxyvitamin D concentrations are lower in patients with positive PCR for SARS‑CoV-2. Nutrients 2020; 12(5): e1359. 40. Merzon E, Tworowski D, Gorohovski A, et al. Low plasma 25(OH) vitamin D level is asso‑ ciated with increased risk COVID-19 infection: an Israeli population‑based study. medRxiv 2020; publikované online 3. júla (preptint). 41. Hastie CE, Mackay DF, Ho F, et al. Vitamin D concentrations and COVID-19 infection in UK Biobank. Diabetes Metab Syndr 2020; 14(4): 561–565. 42. Meltzer DO, Best TJ, Zhang H, et al. Association of vitamin D status and other clinical characteristics with COVID-19 test results. JAMA network open; 3(9): e2019722–e2019722. 43. Panagiotou G, Tee SA, Ihsan Y, et al. Low serum 25-hydroxyvitamin D (25(OH)D) levels in patients hospitalized with COVID-19 are associated with greater disease severity. Clin Endocrinol (Oxf) 2020, publikované online 3. júla. 44. Maghbooli Z, Sahraian MA, Ebrahimi M, et al. Vitamin D sufficiency, a serum 25-hyd‑ roxyvitamin D at least 30 ng/mL reduced risk for adverse clinical outcomes in patients with COVID-19 infection. PloS one 2020; 15(9): e0239799. 45. Exposed, silenced, attacked: Failures to protect health and essential workers during the COVID-19 pandemic. Amnesty International 2020; 14–25. 46. Youssef DA, Ranasinghe T, Grant WB, et al. Vitamin D’s potential to reduce the risk of hospital‑aquired infections. Derm Endocrinol 2012; 4(2): 167–175. 47. Grant WB, Lahore H, McDonnell SL, et al. Evidence that vitamin D supplementation cou‑ ld reduce risk of influenza and COVID-19 infections and deaths. Nutrients 2020; 12(4):988. 48. Wimalawansa SJ. Global epidemic of coronavirus – COVID-19: What we can do to mi‑ nimize risks. Eur J Biomed Pharm Sci 2020; 7(3): 432–438. 49. KimballS,ViethR,DoschHM,etal.CholecalciferolpluscalciumsuppressesabnormalPBMC reactivity in patients with multiple sclerosis. J Clin Endocrinol Metab 2011; 96(9): 2826–2834. 50. Henry HL. Regulation of vitamin D metabolism. Best Pract Res Clin Endocrinol Me‑ tab 2011; 25(4): 531–541. 51. National Institute for Health and Care Excellence. COVID-19 rapid evidence summary: vitamin D for COVID-19. Evidence summary 2020, publikované 29. júna. Další literatura u autora a na www.casopisvnitrnilekarstvi.cz