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Aktuelle Ernährungsmedizin 2015; 40(04): 240-246
DOI: 10.1055/s-0035-1552694
Übersicht
© Georg Thieme Verlag KG Stuttgart · New York

Vitamin D und Infektanfälligkeit

Vitamin D and Susceptibility to Infection
A. Zittermann
1   Klinik für Thorax- und Kardiovaskularchirurgie, Herz- und Diabeteszentrum NRW, Ruhr-Universität Bochum, Deutschland
,
S. Pilz
2   Abteilung für Endokrinologie und Stoffwechsel, Medizinische Universität Graz, Österreich
,
W. März
3   Klinisches Institut für Medizinische und Chemische Labordiagnostik, Medizinische Universität Graz, Österreich
4   Medizinische Klinik V (Nephrologie, Hypertensiologie, Rheumatologie, Endokrinologie, Diabetologie), Medizinische Fakultät Mannheim, Universität Heidelberg, Deutschland
5   Synlab Akademie für Ärztliche Fortbildung, Mannheim und Synlab Services GmbH, Augsburg, Deutschland
› Institutsangaben
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Publikationsverlauf

Publikationsdatum:
06. August 2015 (online)

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Zusammenfassung

Bereits in früheren Jahrhunderten sind Lebertran und UVB-Strahlung, von denen man heutzutage weiß, dass sie die effizientesten Vitamin-D-Quellen für den Menschen sind, erfolgreich zur Behandlung der Tuberkulose eingesetzt worden.

Der vorliegende Artikel gibt einen Überblick über die Funktionen von Vitamin D im Immunsystem sowie über die Datenlage zum Einfluss von Vitamin D auf Infektionen.

Einige randomisierte kontrollierte Studien, wenn auch nicht alle, unterstützen die Hypothese, dass Vitamin D das Tuberkuloserisiko reduzieren kann. Eine Metaanalyse randomisierter kontrollierter Studien hat ergeben, dass durch Supplementierung mit Vitamin D die Anfälligkeit gegenüber Infektionen des oberen Respirationstrakts im Mittel um etwa ein Drittel gesenkt werden kann. Hierbei ist offensichtlich die tägliche Gabe effektiver als die Bolusgabe von Vitamin D. Bekanntlich treten in Europa und Nordamerika insbesondere im Winterhalbjahr häufig Infektionen des oberen Respirationstrakts auf. Prospektive Kohortenstudien lassen vermuten, dass das Infektionsrisiko bei 25-Hydroxyvitamin-D-Konzentrationen unter 25 nmol/l (10 ng/ml) am höchsten, bei Konzentrationen über 75 nmol/l (30 ng/ml) am geringsten ist. Bei einer Reihe weiterer Infektionserkrankungen ist denkbar, dass die Vitamin-D-Versorgung das Erkrankungsrisiko beeinflusst, die Datenlage ist aber für eine abschließende Bewertung noch nicht ausreichend.

In der Gesamtschau sind die Ergebnisse zur Reduzierung der Infektanfälligkeit des oberen Respirationstrakts durch Vitamin D wahrscheinlich. In Übereinstimmung mit Empfehlungen verschiedener Ernährungsgesellschaften schließen wir, dass bei unzureichender Vitamin-D-Versorgung (z. B. 25-Hydroxyvitamin-D-Spiegel < 50 nmol/l oder 20 ng/ml) Vitamin D am besten täglich supplementiert werden sollte. Die Zufuhr sollte in der Größenordnung von 1000 internationalen Einheiten liegen.

Abstract

It has long been known that both cod liver oil and solar UVB radiation, which are nowadays known as the most potent vitamin D sources, can be successfully used to treat tuberculosis.

The present article gives an overview about the effects of vitamin D on the immune system. Moreover, current evidence regarding vitamin D and infections is summarized.

Some, but not all randomized controlled trials support the hypothesis that vitamin D may reduce the risk of tuberculosis. A meta-analysis of randomized controlled trials has demonstrated that vitamin D supplements can reduce susceptibility against upper respiratory tract infections by approximately one third. Daily supplements seem to be more effective than bolus administration of vitamin D. It is well-known that upper respiratory tract infections are most prevalent in Europe and North America in the winter half-year. Prospective cohort studies suggest that the risk of infection is highest in those individuals with deficient circulating 25-hydroxyvitamin D levels (< 25 nmol/l) and is lowest in those with 25-hydroxyvitamin D levels (> 75 nmol/l). In a number of other infectious disorders it seems to be possible that vitamin D status may influence disease risk. For a substantiated appraisal, however, available data is insufficient at present.

In total, results regarding risk reduction of upper respiratory tract infection by vitamin D can be considered likely. In line with recommendations of different nutrition societies it is concluded that in case of insufficient vitamin D status (e. g. 25-hydroxyvitamin D levels < 50 nmol/l or < 20 ng/ml), (supplemental) oral daily vitamin D intake should be ensued. Intake should be in the order of 1000 international units.

Schlüsselwörter

Vitamin D - 25-Hydroxyvitamin D - Infektionen - Immunabwehr

Keywords

vitamin D - 25-hydroxyvitamin D - infection - immune defense
 

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