维生素D,以其在钙和骨骼稳态中的重要作用而闻名,在骨架之外有多种效果,包括调节免疫和调节自身免疫过程。一些报告显示,患有不同炎症和自身免疫性风湿性疾病的人血清25羟维生素D[25(OH)D]水平欠佳。和25(OH)D水平之间的关联,疾病活动和结果。尽管大多数可用数据与成年人有关,见解通常扩展到儿童。青少年风湿性疾病(JRD)是生长过程中的一个重要健康问题,因为它们的发病机制复杂。慢性性质,多系统参与,和长期后果。到目前为止,没有明确或明确的证据来证实维生素D补充剂在JRD中的预防或治疗效果,因为随机对照试验(RCT)的结果不一致.本文旨在探讨和讨论维生素D在某些JRD治疗中的潜在作用。Medline/PubMed,EMBASE,和Scopus在2023年6月进行了全面搜索,以了解维生素D在治疗最常见JRD中的补充作用。我们使用了以下关键词:“维生素D”结合术语“幼年特发性关节炎”,“青少年系统性硬皮病”,“青少年系统性红斑狼疮”,“青少年炎症性肌病”,“白塞病”,“周期性发热综合征”和“青少年风湿性疾病”。观察性研究发现,幼年特发性关节炎患者血清25(OH)D浓度较低,幼年系统性红斑狼疮,青少年系统性硬皮病,白塞病和促炎细胞因子浓度较高。这表明补充维生素D可能是有益的,然而,目前的数据不足以明确证实维生素D在JRD治疗中的补充作用.考虑到世界范围内维生素D缺乏的高患病率,根据目前的建议,应鼓励儿童和青少年补充维生素D.更多的介入研究,特别是精心设计的RCT,评估特定疾病中的剂量反应效应和辅助效应,需要确定维生素D在JRD治疗中的潜在意义。
Vitamin D, known for its essential role in calcium and bone homeostasis, has multiple effects beyond the skeleton, including regulation of immunity and modulation of autoimmune processes. Several reports have shown suboptimal serum 25 hydroxyvitamin D [25(OH)D] levels in people with different inflammatory and autoimmune rheumatic conditions, and an association between 25(OH)D levels, disease activity and outcomes. Although most available data pertain to adults, insights often are extended to children. Juvenile rheumatic diseases (JRDs) are a significant health problem during growth because of their complex pathogenesis, chronic nature, multisystemic involvement, and long-term consequences. So far, there is no definitive or clear evidence to confirm the preventive or therapeutic effect of vitamin D supplementation in JRDs, because results from randomized controlled trials (RCTs) have produced inconsistent outcomes. This review aims to explore and discuss the potential role of vitamin D in treating selected JRDs. Medline/PubMed, EMBASE, and Scopus were comprehensively searched in June 2023 for any study on vitamin D supplementary role in treating the most common JRDs. We used the following keywords: \"vitamin D\" combined with the terms \"juvenile idiopathic arthritis\", \"juvenile systemic scleroderma\", \"juvenile systemic lupus erythematosus\", \"juvenile inflammatory myopathies\", \"Behcet disease\", \"periodic fever syndromes\" and \"juvenile rheumatic diseases\". Observational studies have found that serum 25(OH)D concentrations are lower in juvenile idiopathic arthritis, juvenile systemic lupus erythematosus, juvenile systemic scleroderma, Behcet disease and proinflammatory cytokine concentrations are higher. This suggests that vitamin D supplementation might be beneficial, however, current data are insufficient to confirm definitively the complementary role of vitamin D in the treatment of JRDs. Considering the high prevalence of vitamin D deficiency worldwide, children and adolescents should be encouraged to supplement vitamin D according to current recommendations. More interventional studies, especially well-designed RCTs, assessing the dose-response effect and adjuvant effect in specific diseases, are needed to determine the potential significance of vitamin D in JRDs treatment.