PDF(Pubmed)
Abstract：
Autoimmune thyroid diseases (AITD) are among the most frequent autoimmune disorders, with a multifactorial etiology in which both genetic and environmental determinants are probably involved. Celiac disease (CeD) also represents a public concern, given its increasing prevalence due to the recent improvement of screening programs, leading to the detection of silent subtypes. The two conditions may be closely associated due to common risk factors, including genetic setting, changes in the composition and diversity of the gut microbiota, and deficiency of nutrients like vitamin D. This comprehensive review discussed the current evidence on the pivotal role of vitamin D in modulating both gut microbiota dysbiosis and immune system dysfunction, shedding light on the possible relevance of an adequate intake of this nutrient in the primary prevention of AITD and CeD. While future technology-based strategies for proper vitamin D supplementation could be attractive in the context of personalized medicine, several issues remain to be defined, including standardized assays for vitamin D determination, timely recommendations on vitamin D intake for immune system functioning, and longitudinal studies and randomized controlled trials to definitely establish a causal relationship between serum vitamin D levels and the onset of AITD and CeD.
摘要：
自身免疫性甲状腺疾病（AITD）是最常见的自身免疫性疾病之一，具有多因素病因，其中可能涉及遗传和环境决定因素。乳糜泻(CeD)也是公众关注的问题，鉴于由于最近筛查程序的改进，其患病率越来越高，导致检测到沉默的亚型。由于共同的风险因素，这两种情况可能密切相关，包括基因设置，肠道微生物群的组成和多样性的变化，以及维生素D等营养素的缺乏。这篇综合综述讨论了维生素D在调节肠道微生物群失调和免疫系统功能障碍方面的关键作用的当前证据，阐明在AITD和CeD的一级预防中摄入足够的这种营养素的可能相关性。虽然未来基于技术的适当补充维生素D的策略在个性化医疗的背景下可能具有吸引力，还有几个问题有待定义，包括维生素D测定的标准化测定法，及时建议摄入维生素D以促进免疫系统功能，以及纵向研究和随机对照试验，以明确确定血清维生素D水平与AITD和CeD发病之间的因果关系。
