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4«ШУШМУМ-ШУГМаУ» #35(158), 2022 / MEDICAL SCIENCES
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MEDICAL SCIENCES
УДК 612.3
Срешкта М.В., Баланюк 1.В., Гончарук Л.М., Телехова Д.В.
Буковинський державний медичний утверситет DOI: 10.24412/2520-6990-2022-35158-11-12 РОЛЬ В1ТАМ1НУ D ТА ПЕРСПЕКТИВИ ЙОГО ВИКОРИСТАННЯ У ПРОФШАКТИЦ1 ТА
Л1КУВАНН1 COVID-19
Yereshkina М. V., Balaniuk I. V., Honcharuk L.M., Telekhova D. V.
Bukovynian State Medical University
PROSPECTS OF VITAMIN D USE AND ROLE IN PREVENTION AND TREATMENT OF COVID-19
Анотацш.
У 1929 роц1 Фредерк Хопкт отримав Нобелгвську премт за в1дкриття одного з найважливших втамШв для людського оргатзму - вгтамту D - стерогдного гормону, який виробляеться ендогенним шляхом тд впливом ультрафюлетового випромгнювання шк1ри або доступний з екзогенних джерел (гжа або харчовi добавки). [1]. Втамт D загальновгдомий своею роллю в тдтримщ здоров'я юсток i обмтг кальцгю i фосфору, але нещодавно було виявлено багато iнших ролей цього гормону, наприклад, модулю-вання iмунноl вiдповiдi, як при тфекцшних захворюваннях. 1нтерес до потенцтног ролi втамту D у профтактищ або лжувант гострих рестраторних тфекцш бере початок у 1930-х роках, коли риб'ячий жир вивчався як споаб зменшити прогули через застуду. Дефщит втамту D - це проблема здоров 'я, яка вражае понад мтьярд людей у всьому свiтi i супроводжуеться порушенням захисних сил орган1зму та пiдвищеним ризиком вiрусних i бактерiальних захворювань.
Abstract
In 1929, Fredericks Hopkin won the Nobel Prize for discovering one of the most essential vitamins for the human body - vitamin D - a steroid hormone produced endogenously by ultraviolet radiation on the skin or available from exogenous sources (food or food supplements). [1]. Vitamin D is generally known for its role in maintaining bone health and calcium and phosphorus metabolism, but many other roles of this hormone have recently been discovered, such as modulating the immune response as in infectious diseases. Interest in the potential role of vitamin D in the prevention or treatment of acute respiratory infections dates back to the 1930s, when cod liver oil was studied as a way to reduce absenteeism due to colds. Vitamin D deficiency is a health problem that affects more than a billion people worldwide and is accompanied by disruption of the body's defenses and increased risk of viral and bacterial diseases. [2].
Ключовi слова: втамт D, коронавiрусна хвороба, лкування.
Key words: vitamin D, COVID-19, treatment.
Introduction. During the current pandemic of COVID-19, given the biological role of vitamin D in maintaining antiviral immunity, the question of its use in the prevention and possible treatment of this infection becomes relevant. In immunocompromised individuals, a new coronavirus infection leads to the development of pneumonia and acute respiratory failure. There is a relationship between the development of these complications and the provision of their body with micronutrients vitamin D, C, B1, zinc, folate, omega-3 fatty acids. [3]. It should be noted that these vitamins and trace elements have the ability to smooth out the toxic effects and side effects of some antiviral drugs used in the treatment of infectious diseases. It was also studied that the transition from severe vitamin D deficiency to moderate 3 times reduces the likelihood of transferring a patient with pneumonia to intensive
care and 11 times reduces the risk of mechanical ventilation in such a patient.
Identify 3 main areas of influence on COVID-19, provided by vitamin D: reduction of chronic inflammation in patients with comorbid pathologies, activation of interferon-dependent antiviral immunity, as well as prevention of "cytokine storm". Today, the mechanism of vitamin D counteraction in the risk of "cytokine storm" is actively studied pathological reaction of the immune system, which consists of excessive uncontrolled activation of cytokines by the immune and other systems, systemic inflammatory response and circulatory disorders (this syndrome . In viral influenza and SARS in the acute phase, patients experience edema localized in the nasopharynx and bronchi, but in COVID-19 these symptoms are significantly aggravated and are accompanied by active secretion of cytokines [4]. This
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process is initiated by the interaction of spike proteins located on the capsid of the virus with the receptors of human cells. The main factors that damage the alveolar-capillary membrane are: IL-1 p, IL-6, tumor necrosis factor a, adhesive molecules, nuclear factor k. Vitamin D is able to activate T-lymphocytes, mast and antigen-presenting cells, which weakens the inflammatory response by lowering cytokines, hista-mine, leukotrienes and Ig E. Vitamin metabolites are also known to support innate antiviral effector mechanisms, including induction of antimicrobials -phagia. [5]. To ensure this cellular immunity, vitamin D receptors and enzymes are needed, which must be contained in monocytes, macrophages, B and T lymphocytes.
There are several studies that emphasize that vitamin D deficiency can potentially lead to hypertension, diabetes, cancer, and the cardiovascular system, especially in the elderly. [6].There is evidence that obesity can lead to vitamin D deficiency, although there is an inverse relationship that vitamin deficiency itself can inhibit weight loss and induce obesity.
Based on this information, it is possible to trace a certain relationship between the level of vitamin D and the presence of pathologies against which infectious diseases have a complicated course. Clinically, COVID-19 may be asymptomatic, mild, moderate, or severe. Severe form most often occurs in people with chronic comorbid pathology, which is often formed on the background of vitamin D deficiency. At risk are those suffering from hypertension or other circulatory diseases, chronic lung disease, diabetes, severe obesity and people with weakened immune systems. [7].
Therefore, maintaining adequate levels of vitamins and minerals is essential and crucial in today's pandemic. Scientists are particularly interested in the use of vitamin D as a prevention and treatment of coro-navirus infection. Although at this stage of the study of the immunoregulatory function of this vitamin there is not enough work, but the available data clearly show the relationship between the level of vitamin D in humans and the severity (in particular, the presence of complications) of coronavirus infection. Adequate levels of this vitamin support the innate antiviral immunity and inhibit the development of "cytokine storm", which is the cause of serious complications of pneumonia and acute respiratory failure. RNA viruses (which include COVID-19) are more susceptible to mutations than
DNA viruses, which makes it difficult to make a vaccine and leads to a leading place to increase antiviral immunity, including with vitamin D. Individually, you can maintain the required level of vitamin intake products containing it in significant quantities - fatty fish (salmon, herring, mackerel), liver, egg yolks. Routine use of vitamin preparations D is not practiced, and such prevention and treatment is a promising direction in the fight against the pandemic and requires further detailed study.
References
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2. Hurwitz J.L., Jones B.G., Penkert R.R. et al. Low Retinol-Binding Protein and Vitamin D Levels Are Associated with Severe Outcomes in Children Hospitalized with Lower Respiratory Tract Infection and Respiratory Syncytial Virus or Human
Metapneumovirus Detection. J Pediatr. 2017;187:323-327.
3. Teymoori-Rad M., Marashi S. M. Vitamin D and Covid-19: From potential therapeutic effects to unanswered questions - Reviews in medical virology, 2020 - Wiley Online Librar.
4. Vyas N, Kurian SJ, Bagchi D, Manu MK, Saravu K, Unnikrishnan MK, et al. Vitamin D in prevention and treatment of COVID-19: current perspective and future prospects. J Am Coll Nutr. 2020.
5. Crane-Godreau MA, Clem KJ, Payne P, Fiering S. Vitamin D Deficiency and Air Pollution Exacerbate COVID-19 Through Suppression of Antiviral Peptide LL37.Front Public Health. 2020 May 28;8:232. doi: 10.3389/fpubh.2020.00232. eCollection 2020.PMID: 32671009
6. Xu Y, Baylink DJ, Chen CS, Reeves ME, Xiao J, Lacy C, Lau E, Cao H.J. The importance of vitamin d metabolism as a potential prophylactic, immunoregulatory and neuroprotective treatment for COVID-19. Transl Med. 2020 Aug 26;18(1):322. doi: 10.1186/s12967-020-02488-5.
7. Skrajnowska D, Brumer M, Kankowska S, Matysek M, Miazio N, Bobrowska-Korczak B.Covid 19: Diet Composition and Health. Nutrients. 2021 Aug 27;13(9):2980. doi: 10.3390/nu13092980.
