Vitamin D und Immunsystem

Zusammenfassung

Vitamin D ist ein essenzieller Mitspieler im Knochenstoffwechsel und notwendig für eine physiologische Knochenmineralisation. In den vergangenen Jahren wurden aber auch wichtige Erkenntnisse über die Rolle von Vitamin D im Immunsystem gewonnen. Vitamin D kann die Entwicklung und Funktion der unspezifischen und spezifischen Abwehr beeinflussen. So fördert Vitamin D die Produktion von antimikrobiellen Peptiden wie dem Cathelicidin. Auch die T-Zell-Entwicklung kann in experimentellen Systemen durch Vitamin D signifikant beeinflusst werden. Ein Vitamin-D-Mangel wird sowohl mit Abwehrschwäche als auch Anfälligkeit für die Entwicklung von Autoimmunerkrankungen in Zusammenhang gebracht. Prospektive Studien zeigten eine Assoziation von wenig Sonnenexposition oder reduzierter Vitamin-DZufuhr und der Entwicklung von Autoimmun - erkrankungen wie der Multiplen Sklerose. Im Gegensatz zu diesen experimentellen Studien und klinischen Beobachtungen ist allerdings unklar, ob eine therapeutische Beeinflussung des Vitamin-D-Stoffwechsels positive Effekte auf die vorgenannten Erkrankungen hat oder diese sogar verhindern kann. Randomisierte kontrollierte Studien zur Prophylaxe von Atemwegsinfektionen mit Vitamin D bei gesunden Erwachsenen haben großteils negative Ergebnisse gezeigt. Ob sich eine Vitamin-D-Gabe, abgesehen von Effekten auf den Knochenstoffwechsel, positiv auf Autoimmunerkrankungen wie die rheumatoide Arthritis oder Multiple Sklerose auswirkt, ist bisher nicht ausreichend untersucht.

Summary

Vitamin D is essential for physiological mineralization of bone. In the past years, an important role for vitamin D in the immune system was suggested. Vitamin D influences innate and adaptive immunity on multiple levels. For instance, vitamin D enhances production of antimicrobial peptides such as cathelicidin, which may be important for antituberculostatic actions of vitamin D. Also, vitamin D significantly alters T cell polarization in experimental systems. Vitamin D deficiency is associated with susceptibility to respiratory infections but also development of autoimmune diseases such as rheumatoid arthritis or multiple sclerosis. Prospective observational studies showed an association of reduced sun exposure or vitamin D intake with development of autoimmune disorders. In contrast to observational studies and experimental evidence, it remains unclear whether therapy with vitamin D can actually influence the aforementioned diseases. Recent evidence does not suggest significant protection from respiratory tract infections in otherwise healthy adults upon vitamin D supplementation. Also, we do not know if vitamin D can positively influence autoimmune disorders such as rheumatoid arthritis and multiple sclerosis apart from bone metabolism.

Schlüsselwörter

Vitamin D - Osteoimmunologie - rheumatoide Arthritis

Keywords

Vitamin D - osteoimmunology - rheumatoid arthritis

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