通过保持循环25(OH)D浓度高于50 ng/mL,克服包括新冠肺炎在内的感染

IF 0.8 Q4 PATHOLOGY
S. Wimalawansa
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引用次数: 3

摘要

老年人和患有肺部、心血管、代谢和肾脏疾病等潜在慢性疾病(即合并症)的人更容易感染败血症,包括COVID-19。SARS-CoV-2病毒破坏肺细胞,引起急性呼吸窘迫综合征(ARDS)和缺氧。它进一步损害内皮细胞,改变凝血机制,导致血管内溶血、微血管血栓形成和微栓塞,增加死亡风险。大约75%的人体免疫系统功能依赖于维生素D和足够数量的维生素D代谢物[维生素D和25(OH)D]浓度从血液进入免疫细胞。这样的浓度可以通过阳光照射、有针对性的食物强化计划以及每天或每周补充足够的维生素D来实现。这将允许产生1,25(OH) 2d(非激素形式的骨化三醇)在细胞内的外周靶细胞,如免疫细胞。这使得免疫细胞的生理功能得以实现,包括分泌内/自分泌和分泌旁信号过程。这启动并维持强大的免疫功能,如形成抗体和抗菌肽,抑制炎症,增加抗炎和抗氧化基因的表达,从而增强免疫功能。维生素D缺乏症的情况正好相反,它增加了感染的易感性,并因此而死亡。因此,各国政府应使人口获得足够的免疫保健品——微量营养素,特别是维生素D和其他微量营养素:这是保持人口健康的最具成本效益的干预措施。与住院人数增加和过早死亡相关的费用相比,此类干预措施的费用微不足道。假设像作者提议的那样,在2020年中期实施这样的计划,我们估计50%的住院治疗(以及相关的医疗费用)和三分之一的COVID死亡是可以避免的。本文描述了使用维生素D来实现和维持血清d3和25(OH)D浓度的成本效益策略,这对维持强大的免疫系统、改善一般健康、最大限度地减少疾病严重程度和死亡以及降低医疗成本至关重要。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Overcoming Infections Including COVID-19, by Maintaining Circulating 25(OH)D Concentrations Above 50 ng/mL
: The elderly and those with underlying chronic diseases (i.e., comorbidities) such as pulmonary, cardiovascular, metabolic, and renal diseases, increase their susceptibility to sepsis, including COVID-19. The SARS-CoV-2 virus damages pulmonary cells, causing acute respiratory distress syndrome (ARDS) and hypoxia. It further damages endothelial cells, altering clotting mechanisums causing intravascular hemolysis, microvascular thrombosis, and micro-embolization, contributing to the risk of death. Approximately 75% of the immune system functions of humans depend on vitamin D and the availability of sufficient amounts of vitamin D metabolites [vitamin D and 25(OH)D] concentrations to enter immune cells from the bloodstream. Such concentrations are achievable through sun exposure, targeted food fortification programs, and adequate daily or weekly vitamin D supplements. That would allow for generating 1,25(OH) 2 D (non-hormonal form of calcitriol) intracellularly in peripheral target cells like immune cells. This enables immune cells’ physiological functions, including intracrine/autocrine and paracrine signaling processes. This initiates and maintains robust immune functions, such as forming antibodies and antimicrobial peptides, suppressing inflammation, and increasing the expression of anti-inflammatory and antioxidant genes, thus, strengthening immune functions. The opposite occurs in hypovitaminosis D, increasing vulnerability to infections and dying from it. Therefore, governments should make the population sufficient with immunoceuticals—micronutrients, especially vitamin D, and other micronutrients: the most cost-effective intervention to keep the population healthy. The cost of such interventions are minuscule compared to the expenses related to increased hospitalizations and premature deaths. Supposed such a program was implemented in mid-2020 as the author proposed, we estimated that 50% of hospitalizations (and the associated healthcare costs) and a third of deaths from COVID could have been prevented. Described herein are cost-effective strategies using vitamin D to achieve and sustain serum D 3 and 25(OH)D concentrations crucial for maintaining a robust immune system, improving general health, minimizing disease severities and deaths, and reducing healthcare costs.
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