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2020, Número 4

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Rev Nefrol Dial Traspl 2020; 40 (4)


Vitamina D, sus Acciones “No Clásicas” y su Utilidad en la Pandemia del COVID-19

Mansur JL

Idioma: Español
Referencias bibliográficas: 59
Paginas: 330-340
Archivo PDF: 381.79 Kb.


RESUMEN

El descubrimiento de que la síntesis de 1,25 vitamina D no fue solo renal, la enzima 1 alfa hidroxilasa se encuentra en numerosos tejidos del organismo, además de la evidencia de que la asociación entre el déficit de vitamina D y la presencia de enfermedades no óseas (cáncer, esclerosis múltiple, enfermedades autoinmunes, etc.) nos ofrece la posibilidad de intentar prevenir estas afecciones. Los estudios de suplementación contra placebo no han dado resultados positivos para algunas afecciones, aunque algunos de esos trials se realizaron en población “suficiente” y no “deficiente” de vitamina D. Sin embargo, otros metaanálisis han demostrado prevención en los grupos suplementados con déficit para algunas patologías (infecciones respiratorias, prediabetes). Además, existe evidencia de efecto antiviral de la misma. La acción antiinfecciosa e inmunomoduladora que ejerce y su efecto sobre el sistema renina angiotensina, estimulando la enzima convertidora de angiotensina 2 (que es el receptor virus del SARS-CoV), permiten sospechar, actualmente, que con niveles elevados podría ser más difícil, o menos grave, la infección por COVID-19. La suplementación con vitamina D es conveniente para prevenir enfermedades en sujetos con déficit, pero en medio de la grave pandemia 2020 administrarla, aún sin tener un dosaje previo en las poblaciones de mayor riesgo, podría disminuir la chance de esta enfermedad.


REFERENCIAS (EN ESTE ARTÍCULO)

  1. Rosen CJ, Abrams SA, Aloia JF, Brannon PM, ClintonSK, Durazo-Arvizu RA, et al. IOM committeemembers respond to Endocrine Society vitamin Dguideline. J Clin Endocrinol Metab. 2012;97(4):1146-52. doi: 10.1210/jc.2011-2218.

  2. Holick MF, Binkley NC, Bischoff-Ferrari HA, GordonCM, Hanley DA, Heaney RP, et al. Guidelines forpreventing and treating vitamin D deficiency andinsufficiency revisited. J Clin Endocrinol Metab.2012;97(4):1153-8. doi: 10.1210/jc.2011-2601.

  3. Manson JE, Cook NR, Lee IM, Christen W, Bassuk SS,Mora S, et al. Vitamin D supplements and preventionof cancer and cardiovascular disease. N Engl J Med.2019;380(1):33-44. doi: 10.1056/NEJMoa1809944.

  4. Pittas AG, Dawson-Hughes B, Sheehan P, Ware JH,Knowler WC, Aroda VR, et al.; D2d Research Group.Vitamin D supplementation and prevention of type2 diabetes. N Engl J Med. 2019;381(6):520-530. doi:10.1056/NEJMoa1900906.

  5. Mansur JL. Vitamin D supplementation andprevention of type 2 diabetes. N Engl J Med.2019;381(18):1785. doi: 10.1056/NEJMc1912185.

  6. Martineau AR, Jolliffe DA, Hooper RL, Greenberg L,Aloia JF, Bergman P, et al. Vitamin D supplementationto prevent acute respiratory tract infections: systematicreview and meta-analysis of individual participantdata. BMJ. 2017;356:i6583. doi: 10.1136/bmj.i6583.

  7. Barbarawi M, Zayed Y, Barbarawi O, Bala A,Alabdouh A, Gakhal I, et al. Effect of vitamin Dsupplementation on the incidence of diabetes mellitus.J Clin Endocrinol Metab. 2020;105(8):dgaa335. doi:10.1210/clinem/dgaa335.

  8. Zhang Y, Tan H, Tang J, Li J, Chong W, Hai Y, et al.Effects of vitamin D supplementation on preventionof type 2 diabetes in patients with prediabetes: asystematic review and meta-analysis. Diabetes Care.2020;43(7):1650-8. doi: 10.2337/dc19-1708

  9. Holick MF, Binkley NC, Bischoff-Ferrari HA, GordonCM, Hanley DA, Heaney RP, et al. Evaluation,treatment, and prevention of vitamin D deficiency:an Endocrine Society Clinical Practice Guideline.J Clin Endocrinol Metab. 2011;96(7):1911-30. doi:

  10. 10.1210/jc.2011-0385. Erratum in: J Clin EndocrinolMetab. 2011;96(12):3908.10) Sánchez A, Oliveri B, Mansur JL, Fradinger E,Mastaglia S. Diagnóstico, prevención y tratamientode la hipovitaminosis D. Rev Argent EndocrinolMetab. 2013;50(2):140-55.

  11. Rondanelli M, Miccono A, Lamburghini S, AvanzatoI, Riva A, Allegrini P, et al. Self-care for common colds:the pivotal role of vitamin D, vitamin C, zinc, andechinacea in three main immune interactive clusters(physical barriers, innate and adaptive immunity)involved during an episode of common coldspracticaladvice on dosages and on the time to takethese nutrients/botanicals in order to prevent or treatcommon colds. Evid Based Complement Alternat Med.2018;2018:5813095. doi: 10.1155/2018/5813095.

  12. Schwalfenberg GK. A review of the critical role ofvitamin D in the functioning of the immune systemand the clinical implications of vitamin D deficiency.Mol Nutr Food Res. 2011;55(1):96-108. doi: 10.1002/mnfr.201000174.

  13. Kast JI, McFarlane AJ, Głobińska A, Sokolowska M,Wawrzyniak P, Sanak M, et al. Respiratory syncytialvirus infection influences tight junction integrity.Clin Exp Immunol. 2017;190(3):351-9. doi: 10.1111/cei.13042.

  14. Mora JR, Iwata M, von Andrian UH. Vitamineffects on the immune system: vitamins A and D takecentre stage. Nat Rev Immunol. 2008;8(9):685-98.doi: 10.1038/nri2378.

  15. Van Belle TL, Gysemans C, Mathieu C. VitaminD in autoimmune, infectious and allergic diseases:a vital player? Best Pract Res Clin Endocrinol Metab.2011;25(4):617-32. doi: 10.1016/j.beem.2011.04.009.

  16. Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y,et al. Clinical features of patients infected with2019 novel coronavirus in Wuhan, China. Lancet.2020;395(10223):P497-506. doi: 10.1016/S0140-6736(20)30183-5.

  17. Sharifi A, Vahedi H, Nedjat S, Rafiei H,Hosseinzadeh-Attar MJ. Effect of single-doseinjection of vitamin D on immune cytokines inulcerative colitis patients: a randomized placebocontrolledtrial. APMIS. 2019;127(10):681-7. doi:10.1111/apm.12982.

  18. Lemire JM, Adams JS, Kermani-Arab V, BakkeAC, Sakai R, Jordan SC. 1,25-DihydroxyvitaminD3 suppresses human T helper/inducer lymphocyteactivity in vitro. J Immunol. 1985;134(5):3032-5.

  19. Kalil AC, Thomas PG. Influenza virus-relatedcritical illness: pathophysiology and epidemiology.Crit Care. 2019;23(1):258. doi: 10.1186/s13054-019-2539-x.

  20. Cannell JJ, Vieth R, Umhau JC, Holick MF, GrantWB, Madronich S, et al. Epidemic influenza andvitamin D. Epidemiol Infect. 2006;134(6):1129-40.doi: 10.1017/S0950268806007175.

  21. Lang PO, Samaras D. Aging adults and seasonalinfluenza: does the vitamin d status (h)armthe body? J Aging Res. 2012;2012:806198. doi:10.1155/2012/806198.

  22. Ginde AA, Mansbach JM, Camargo CA Jr.Association between serum 25-hydroxyvitamin Dlevel and upper respiratory tract infection in theThird National Health and Nutrition ExaminationSurvey. Arch Intern Med. 2009;169(4):384-90. doi:10.1001/archinternmed.2008.560.

  23. Gruber-Bzura BM. Vitamin D and influenzapreventionor therapy? Int J Mol Sci. 2018;19(8):2419.doi: 10.3390/ijms19082419.

  24. Urashima M, Segawa T, Okazaki M, KuriharaM, Wada Y, Ida H. Randomized trial of vitamin Dsupplementation to prevent seasonal influenza A inschoolchildren. Am J Clin Nutr. 2010;91(5):1255-60.doi: 10.3945/ajcn.2009.29094.

  25. Arihiro S, Nakashima A, Matsuoka M, Suto S,Uchiyama K, Kato T, et al. Randomized trial ofvitamin D supplementation to prevent seasonalinfluenza and upper respiratory infection in patientswith inflammatory bowel disease. Inflamm BowelDis. 2019;25(6):1088-95. doi: 10.1093/ibd/izy346.

  26. GrassrootsHealth Nutrient Research Institute.Scientists’ Call to D*action – The Vitamin DDeficiency Epidemic [Internet]. Disponibleen: (consulta: 25/07/2020).

  27. Mansur JL, Tajer C, Mariani J, Inserra F, Ferder L,Manucha W. Vitamin D high doses supplementationcould represent a promising alternative to prevent ortreat COVID-19 infection. Clin Investig Arterioscler.2020:S0214-9168(20)30048-6. doi: 10.1016/j.arteri.2020.05.003.

  28. Grant WB, Lahore H, McDonnell SL, BaggerlyCA, French CB, Aliano JL, et al. Vitamin Dsupplementation could prevent and treat influenza,coronavirus, and pneumonia infections. [Preprintfrom Preprints.org, Version 2: 29 Mar 2020]. doi:10.20944/preprints202003.0235.v2.

  29. Grant WB, Lahore H, McDonnell SL, Baggerly CA,French CB, Aliano JL, et al. Evidence that vitaminD supplementation could reduce risk of influenzaand COVID-19 infections and deaths. Nutrients.2020;12(4):988. doi: 10.3390/nu12040988.

  30. Mansur JL. Letter: low population mortality fromCOVID-19 in countries south of latitude 35 degreesnorth supports vitamin D as a factor determiningseverity. Aliment Pharmacol Ther. 2020;52(2):411-2.doi: 10.1111/apt.15820.

  31. Theron M, Huang KJ, Chen YW, Liu CC, Lei HY.A probable role for IFN-gamma in the developmentof a lung immunopathology in SARS. Cytokine.2005;32(1):30-8. doi: 10.1016/j.cyto.2005.07.007.

  32. Li W, Moore MJ, Vasilieva N, Sui J, Kee Wong S,Berne MA, et al. Angiotensin-converting enzyme 2is a functional receptor for the SARS coronavirus.Nature. 2003;426(6965):450-4. doi: 10.1038/nature02145.

  33. Kuba K, Imai Y, Rao S, Gao H, Guo F, Guan B, etal. A crucial role of angiotensin converting enzyme2 (ACE2) in SARS coronavirus-induced lung injury.Nat Med. 2005;11(8):875-9. doi: 10.1038/nm1267.

  34. Fosbøl EL, Butt JH, Østergaard L, AnderssonC, Selmer C, Kragholm K, et al. Associationof angiotensin-converting enzyme inhibitor orangiotensin receptor blocker use with COVID-19diagnosis and mortality. JAMA. 2020;324(2):168-77.doi: 10.1001/jama.2020.11301.

  35. Lykkedegn S, Sorensen GL, Beck-Nielsen SS,Christesen HT. The impact of vitamin D on fetal andneonatal lung maturation. A systematic review. Am JPhysiol Lung Cell Mol Physiol. 2015;308(7):L587-602.doi: 10.1152/ajplung.00117.2014.

  36. Lin M, Gao P, Zhao T, He L, Li M, Li Y, et al.Calcitriol regulates angiotensin-converting enzymeand angiotensin converting-enzyme 2 in diabetickidney disease. Mol Biol Rep. 2016;43(5):397-406.doi: 10.1007/s11033-016-3971-5.

  37. Xu J, Yang J, Chen J, Luo Q, Zhang Q, Zhang H.Vitamin D alleviates lipopolysaccharide‑induced acutelung injury via regulation of the renin‑angiotensinsystem. Mol Med Rep. 2017;16(5):7432-8. doi:10.3892/mmr.2017.7546.

  38. Gatera VA, Abdulah R, Musfiroh I, JudistianiRTD, Setiabudiawan B. Updates on the status ofvitamin D as a risk factor for respiratory distresssyndrome. Adv Pharmacol Sci. 2018;2018:8494816.doi: 10.1155/2018/8494816.

  39. Skov J, Persson F, Frøkiær J, Christiansen JS. Tissuerenin-angiotensin systems: a unifying hypothesisof metabolic disease. Front Endocrinol (Lausanne).2014;5:23. doi: 10.3389/fendo.2014.00023.

  40. Ferder M, Inserra F, Manucha W, Ferder L. The worldpandemic of vitamin D deficiency could possibly beexplained by cellular inflammatory response activityinduced by the renin-angiotensin system. Am J PhysiolCell Physiol. 2013;304(11):C1027-39. doi: 10.1152/ajpcell.00403.2011.

  41. D’Avolio A, Avataneo V, Manca A, Cusato J, DeNicolò A, Lucchini R, et al. 25-Hydroxyvitamin DConcentrations Are Lower in Patients with PositivePCR for SARS-CoV-2. Nutrients. 2020;12(5):1359.doi: 10.3390/nu12051359.

  42. Faul JL, Kerley CP, Love B, O’Neill E, CodyC, Tormey W, et al. Vitamin D Deficiency andARDS after SARS-CoV-2 Infection. Ir Med J.2020;113(5):84.

  43. De Smet K, De Smet D, Ryckaert T, Laridon E,Heremans B, Vandenbulcke R, et al. Diagnosticperformance of chest CT for SARS-CoV-2 infectionin individuals with or without COVID-19 symptoms.Radiology. [In press. Published Online: Aug 10 2020].doi: 10.1148/radiol.2020202708.

  44. Panagiotou G, Tee SA, Ihsan Y, Athar W, MarchitelliG, Kelly D, et al. Low serum 25‐hydroxyvitaminD (25[OH]D) levels in patients hospitalised withCOVID‐19 are associated with greater diseaseseverity. Clin Endocrinol (Oxf). 2020 Jul 3: 10.1111/cen.14276. doi: 10.1111/cen.14276.

  45. Merzon E, Tworowski D, Gorohovski A, Vinker S,Golan Cohen A, Green I, et al. Low plasma 25(OH)vitamin D level is associated with increased risk ofCOVID‐19 infection: an Israeli population‐basedstudy. FEBS J. 2020 Jul 3:10.1111/febs.15495. doi:10.1111/febs.15495.

  46. Meltzer DO, Best TJ, Zhang H, Vokes T, AroraV, Solway J. Association of vitamin D status andother clinical characteristics with COVID-19 testresults. JAMA Netw Open. 2020;3(9):e2019722. doi:10.1001/jamanetworkopen.2020.19722.

  47. Alipio, M. Vitamin D supplementation couldpossibly improve clinical outcomes of patientsinfected with Coronavirus-2019 (COVID-19). SSRNElectronic J. 2020 May 18. doi: 10.2139/ssrn.3571484.

  48. Raharusun P, Priambada S, Budiarti C, Agung E.Patterns of COVID-19 mortality and vitamin D: anindonesian study. SSRN Electronic J. 2020 Apr. 26.doi: 10.2139/ssrn.3585561.

  49. Maghbooli Z, Sahraian MA, Ebrahimi M,Pazoki M, Kafan S, Tabriz HM, et al. Vitamin Dsufficiency, a serum 25-hydroxyvitamin D at least30 ng/mL reduced risk for adverse clinical outcomesin patients with COVID-19 infection. PLoSOne. 2020;15(9):e0239799. doi: 10.1371/journal.pone.0239799.

  50. Sabetta JR, DePetrillo P, Cipriani RJ, Smardin J, BurnsLA, Landry ML. Serum 25-hydroxyvitamin d andthe incidence of acute viral respiratory tract infectionsin healthy adults. PLoS One. 2010;5(6):e11088. doi:10.1371/journal.pone.0011088.

  51. Quraishi SA, Bittner EA, Blum L, Hutter MM,Camargo CA Jr. Association between preoperative25-hydroxyvitamin D level and hospital-acquiredinfections following Roux-en-Y gastric bypasssurgery. JAMA Surg. 2014;149(2):112-8. doi: 10.1001/jamasurg.2013.3176.

  52. Laviano E, Sánchez Rubio M, González-Nicolás MT,Palacian MP, López J, Gilaberte Y, et al. Associationbetween preoperative levels of 25-hydroxyvitamin Dand hospital-acquired infections after hepatobiliarysurgery: A prospective study in a third-level hospital.PLoS One. 2020;15(3):e0230336. doi: 10.1371/journal.pone.0230336.

  53. Ekwaru JP, Zwicker JD, Holick MF, GiovannucciE, Veugelers PJ. The importance of body weight forthe dose response relationship of oral vitamin Dsupplementation and serum 25-hydroxyvitamin Din healthy volunteers. PLoS One. 2014;9(11):e111265.doi: 10.1371/journal.pone.0111265.

  54. Seijo M, Oliveri B. Importancia de la vitamina D enla época de COVID-19. Actual Osteol. 2020;16(2):[enprensa]. Disponible en: (consulta:25/07/2020).

  55. Amir E, Simmons CE, Freedman OC, Dranitsaris G,Cole DE, Vieth R, et al. A phase 2 trial exploring theeffects of high-dose (10,000 IU/day) vitamin D(3) inbreast cancer patients with bone metastases. Cancer.2010;116(2):284-91. doi: 10.1002/cncr.24749.

  56. Charoenngam N, Shirvani A, Kalajian TA, SongA, Holick MF. The effect of various doses of oralvitamin D3 supplementation on gut microbiota inhealthy adults: a randomized, double-blinded, doseresponsestudy. Anticancer Res. 2020;40(1):551-6. doi:10.21873/anticanres.13984.

  57. Shirvani A, Kalajian TA, Song A, Holick MF.Disassociation of vitamin D’s calcemic activityand non-calcemic genomic activity and individualresponsiveness: a randomized controlled double-blindclinical trial. Sci Rep. 2019;9:17685. doi: 10.1038/s41598-019-53864-1.

  58. McCullough PJ, Lehrer DS, Amend J. Dailyoral dosing of vitamin D3 using 5000 TO 50,000international units a day in long-term hospitalizedpatients: Insights from a seven year experience. JSteroid Biochem Mol Biol. 2019;189:228-39. doi:10.1016/j.jsbmb.2018.12.010.

  59. Schlingmann KP, Kaufmann M, Weber S, Irwin A,Goos C, John U, et al. Mutations in CYP24A1 andidiopathic infantile hypercalcemia. N Engl J Med.2011;365(5):410-21. doi: 10.1056/NEJMoa1103864.




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