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        • Витамин D как эссенциальный иммунонутриент – обновление доказательной базы

        Витамин D как эссенциальный иммунонутриент – обновление доказательной базы

        Витамин D как эссенциальный иммунонутриент – обновление доказательной базы

        Макарова С.Г., Емельяшенков Е.Е., Ясаков Д.С., Пронина И.Ю., Ерешко О.А., Гордеева И.Г., Галимова А.А., Чумбадзе Т.Р., Лебедева А.М. ­Витамин D как эссенциальный иммунонутриент – обновление доказательной базы. Педиатрия. Consilium Medicum. 2022;2. DOI: 10.26442/26586630.2022.2.201682

        ________________________________________________

        Makarova SG, Emelyashenkov EE, Yasakov DS, Pronina IYu, Ereshko OA, Gordeeva IG, Galimova AA, Chumbadze TR, Lebedeva AM. Vitamin D as the essential immunonutrient – the evidence base update: A review. Pediatrics. Consilium Medicum. 2022;2. DOI: 10.26442/26586630.2022.2.201682

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          Витамин D как эссенциальный иммунонутриент – обновление доказательной базы

        Материалы доступны только для специалистов сферы здравоохранения. Авторизуйтесь или зарегистрируйтесь.

        • Аннотация
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        • Список литературы
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        Аннотация
        Роль микронутриентного статуса является ключевой для формирования адекватного иммунного ответа, в том числе при заболеваниях, вызванных респираторными вирусами. Многочисленные исследования, проведенные с начала пандемии COVID-19, изучающие влияние обеспеченности микронутриентами, показали их значение в профилактике этого заболевания. Наибольшее количество публикаций посвящено витамину D, в результате менее чем за 2 года опубликовано 17 метаанализов и аналитических обзоров, посвященных роли витамина D и обеспеченности данным микронутриентом различных групп населения в снижении заболеваемости, частоты развития тяжелых форм COVID-19 и смертности. В обзоре в ходе анализа данных литературы подтверждается, что витамин D обладает наибольшей доказательной базой как микронутриент, снижающий риск заболевания тяжелыми формами COVID-19, а также приводятся рекомендации по дотации витамина D пациентам взрослого и детского возраста.

        Ключевые слова: микронутриенты, вирусные инфекции, новая коронавирусная инфекция, витамин D, COVID-19, SARS-CoV-2, пандемия, иммунный ответ

        ________________________________________________

        The micronutrient status plays a key role for adequate immune response, including in diseases caused by respiratory viruses. Numerous studies conducted since the beginning of the COVID-19 pandemic, examining the impact of micronutrient availability, have shown their importance in the prevention of this disease. The largest number of publications is devoted to vitamin D. As a result, in less than two years, 17 meta-analyses and analytical reviews were published on the role of vitamin D and the availability of this micronutrient in various population groups in reducing the incidence, incidence of severe forms of COVID-19 and mortality. This review summarizes the results of published meta-analyses and systematic reviews. The analysis of literature data confirms that vitamin D has the highest evidence base as a micronutrient that reduces the risk of disease and the occurrence of severe forms of COVID-19. It also provides up-to-date recommendations on vitamin D supplementation for adult and pediatric patients.

        Keywords: micronutrients, viral infections, coronavirus disease, vitamin D, COVID-19, SARS-CoV-2, pandemic, immune response

        Полный текст

        Материалы доступны только для специалистов сферы здравоохранения. Авторизуйтесь или зарегистрируйтесь.

        Список литературы
        1. Hidden Hunger: Malnutrition and the First 1,000 Days of Life: Causes, Consequences and Solutions. Hardback World Review of Nutrition and Dietetics. Ed. by B Koletzko, HK Biesalski, RE Black, 2016. 
        2. Calder PC, Carr AC, Gombart AF, Eggersdorfer M. Optimal Nutritional Status for a Well-Functioning Immune System Is an Important Factor to Protect against Viral Infections. Nutrients. 2020;12(4):1181. DOI:10.3390/nu12041181
        3. Фисенко А.П., Макарова С.Г. Обеспеченность микронутриентами, иммунный ответ, COVID-19. Российский педиатрический журнал. 2020;23(3):183-90 [Fisenko AP, Makarova SG. Micronutrients availability, immune response, and COVID-19. Russian Pediatric Journal. 2020;23(3):183-90 (in Russian)]. DOI:10.18821/1560-9561-2020-23-3-183-190
        4. Calder P. Conferenceon ‘Transforming the nutrition landscape in Africa’. Plenary Session 1: Feeding the immune system. Proc Nutr Soc. 2013;72:299-309. 
        5. Gombart AF, Pierre A, Maggini S. A Review of Micronutrients and the Immune System–Working in Harmony to Reduce the Risk of Infection. Nutrients. 2020;12:236. DOI:10.3390/nu12010236
        6. Wishart K. Increased micronutrient requirements during physiologically demanding situations: Review of the current evidence. Vitamin Miner. 2017;6:1‑16.
        7. Carr AC, Shaw GM, Fowler AA., Natarajan R. Ascorbate-dependent vasopressor synthesis: а rationale for vitamin C administration in severe sepsis and septic shock? Crit Care. 2015;19:418.
        8. Gröber U, Holick MF. The coronavirus disease (COVID-19) – а supportive approach with selected micronutrients. Int J Vitam Nutr Res. 2022;92(1):13-34.
        DOI:10.1024/0300-9831/a000693
        9. Kumar P, Kumar M, Bedi O, et al. Role of vitamins and minerals as immunity boosters in COVID-19. Inflammopharmacology. 2021;29(4):1001-16.
        DOI:10.1007/s10787-021-00826-7 
        10. Singh V. Can Vitamins, as Epigenetic Modifiers, Enhance Immunity in COVID-19 Patients with Non-communicable Disease? Curr Nutr Rep. 2020;9(3):202-9.
        DOI:10.1007/s13668-020-00330-4 
        11. Pedrosa LFC, Barros ANAB, Leite-Lais L. Nutritional risk of vitamin D, vitamin C, zinc, and selenium deficiency on risk and clinical outcomes of COVID-19: A narrative review. Clin Nutr ESPEN. 2022;47:9-27. DOI:10.1016/j.clnesp.2021.11.003
        12. Torshin IY, Gromova OA, Chuchalin AG. Computational systematics of nutritional support of vaccination against viral and bacterial pathogens as prolegomena to vaccinations against COVID-19. medRxiv. 2021. DOI:10.1101/2021.09.10.21263398
        13. Khajavi A, Amirhakimi GH. The rachitic lung. Pulmonary findings in 30 infants and children with malnutritional rickets. Clin Pediatr (Phila). 1977;16(1):36-8. DOI:10.1177/000992287701600106
        14. Grant WB, Lahore H, McDonnell ShL, et al. Evidence that Vitamin D Supplementation Could Reduce Risk of Influenza and COVID-19 Infections and Deaths. Nutrients. 2020;12(4):988. DOI:10.3390/nu12040988
        15. Ginde AA, Mansbach JM, Camargo CA Jr. Association between serum 25-hydroxyvitamin D level and upper respiratory tract infection in the Third National Health and Nutrition Examination Survey. Arch Intern Med. 2009;169:384-90. DOI:10.1001/archinternmed.2008.560 
        16. Laaksi I, Ruohola JP, Tuohimaa P, et al. An association of serum vitamin D concentrations <40 nmol/L with acute respiratory tract infection in young Finnish men. Am J Clin Nutr. 2007;86:714-7.
        17. Sabetta JR, DePetrillo P, Cipriani RJ, et al. Serum 25-Hydroxyvitamin D and the Incidence of Acute Viral Respiratory Tract Infections in Healthy Adults. PLoS ONE. 2010;5:e11088. DOI:10.1371/journal.pone.0011088 
        18. Science M, Maguire JL, Russell ML, et al. Low serum 25-hydroxyvitamin D level and risk of upper respiratory tract infection in children and adolescents. Clin Infect Dis. 2013;57:392-7. DOI:10.1093/cid/cit289 
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        20. Martineau AR, Jolliffe DA, Hooper RL, et al. Vitamin D supplementation to prevent acute respiratory tract infections: Systematic review and meta-analysis of individual participant data. BMJ. 2017;356:i6583. 
        21. Rejnmark L, Bislev LS, Cashman KD, et al. Non-skeletal health effects of vitamin D supplementation: A systematic review on findings from meta-analyses summarizing trial data. PLoS ONE. 2017;12:e0180512.
        22. Bergman P, Lindh Å, Björkhem-Bergman L, Lindh J. Vitamin D and respiratory tract infections: A systematic review and meta-analysis of randomized controlled trials. PLoS ONE. 2013;8:e65835.
        23. Charan J, Goyal J, Saxena D, Yadav P. Vitamin D for prevention of respiratory tract infections: A systematic review and meta-analysis. J Pharmacol Pharmacother. 2012;3:300-3. 
        24. Vuichard Gysin D, Dao D, Gysin CM, et al. Effect of Vitamin D3 Supplementation on Respiratory Tract Infections in Healthy Individuals: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. PLoS ONE. 2016;11:e0162996. DOI:10.1371/journal.pone.0162996
        25. Dancer RC, Parekh D, Lax S, et al. Vitamin D deficiency contributes directly to the acute respiratory distress syndrome (ARDS). Thorax. 2015;70:617-24. 
        26. Han JE, Jones JL, Tangpricha V, et al. High Dose Vitamin D Administration in Ventilated Intensive Care Unit Patients: A Pilot Double Blind Randomized Controlled Trial. J Clin Transl Endocrinol. 2016;4:59-65.
        27. Xiao L, Xing C, Yang Z, et al. Vitamin D supplementation for the prevention of childhood acute respiratory infections: A systematic review of randomised controlled trials. Br J Nutr. 2015;114:1026-34.
        28. Yakoob MY, Salam RA, Khan FR, Bhutta ZA. Vitamin D supplementation for preventing infections in children under five years of age. Cochrane Database Syst Rev. 2016;11:CD008824.
        29. Das RR, Singh M, Naik SS. Vitamin D as an adjunct to antibiotics for the treatment of acute childhood pneumonia. Cochrane Database Syst Rev. 2018;7:CD011597.
        30. Yamshchikov AV, Desai NS, Blumberg HM, et al. Vitamin D for treatment and prevention of infectious diseases: A systematic review of randomized controlled trials. Endocr Pract. 2009;15:438-49.
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        ________________________________________________

        1. Hidden Hunger: Malnutrition and the First 1,000 Days of Life: Causes, Consequences and Solutions. Hardback World Review of Nutrition and Dietetics. Ed. by B Koletzko, HK Biesalski, RE Black, 2016. 
        2. Calder PC, Carr AC, Gombart AF, Eggersdorfer M. Optimal Nutritional Status for a Well-Functioning Immune System Is an Important Factor to Protect against Viral Infections. Nutrients. 2020;12(4):1181. DOI:10.3390/nu12041181
        3. Фисенко А.П., Макарова С.Г. Обеспеченность микронутриентами, иммунный ответ, COVID-19. Российский педиатрический журнал. 2020;23(3):183-90 [Fisenko AP, Makarova SG. Micronutrients availability, immune response, and COVID-19. Russian Pediatric Journal. 2020;23(3):183-90 (in Russian)]. DOI:10.18821/1560-9561-2020-23-3-183-190
        4. Calder P. Conferenceon ‘Transforming the nutrition landscape in Africa’. Plenary Session 1: Feeding the immune system. Proc Nutr Soc. 2013;72:299-309. 
        5. Gombart AF, Pierre A, Maggini S. A Review of Micronutrients and the Immune System–Working in Harmony to Reduce the Risk of Infection. Nutrients. 2020;12:236. DOI:10.3390/nu12010236
        6. Wishart K. Increased micronutrient requirements during physiologically demanding situations: Review of the current evidence. Vitamin Miner. 2017;6:1‑16.
        7. Carr AC, Shaw GM, Fowler AA., Natarajan R. Ascorbate-dependent vasopressor synthesis: а rationale for vitamin C administration in severe sepsis and septic shock? Crit Care. 2015;19:418.
        8. Gröber U, Holick MF. The coronavirus disease (COVID-19) – а supportive approach with selected micronutrients. Int J Vitam Nutr Res. 2022;92(1):13-34.
        DOI:10.1024/0300-9831/a000693
        9. Kumar P, Kumar M, Bedi O, et al. Role of vitamins and minerals as immunity boosters in COVID-19. Inflammopharmacology. 2021;29(4):1001-16.
        DOI:10.1007/s10787-021-00826-7 
        10. Singh V. Can Vitamins, as Epigenetic Modifiers, Enhance Immunity in COVID-19 Patients with Non-communicable Disease? Curr Nutr Rep. 2020;9(3):202-9.
        DOI:10.1007/s13668-020-00330-4 
        11. Pedrosa LFC, Barros ANAB, Leite-Lais L. Nutritional risk of vitamin D, vitamin C, zinc, and selenium deficiency on risk and clinical outcomes of COVID-19: A narrative review. Clin Nutr ESPEN. 2022;47:9-27. DOI:10.1016/j.clnesp.2021.11.003
        12. Torshin IY, Gromova OA, Chuchalin AG. Computational systematics of nutritional support of vaccination against viral and bacterial pathogens as prolegomena to vaccinations against COVID-19. medRxiv. 2021. DOI:10.1101/2021.09.10.21263398
        13. Khajavi A, Amirhakimi GH. The rachitic lung. Pulmonary findings in 30 infants and children with malnutritional rickets. Clin Pediatr (Phila). 1977;16(1):36-8. DOI:10.1177/000992287701600106
        14. Grant WB, Lahore H, McDonnell ShL, et al. Evidence that Vitamin D Supplementation Could Reduce Risk of Influenza and COVID-19 Infections and Deaths. Nutrients. 2020;12(4):988. DOI:10.3390/nu12040988
        15. Ginde AA, Mansbach JM, Camargo CA Jr. Association between serum 25-hydroxyvitamin D level and upper respiratory tract infection in the Third National Health and Nutrition Examination Survey. Arch Intern Med. 2009;169:384-90. DOI:10.1001/archinternmed.2008.560 
        16. Laaksi I, Ruohola JP, Tuohimaa P, et al. An association of serum vitamin D concentrations <40 nmol/L with acute respiratory tract infection in young Finnish men. Am J Clin Nutr. 2007;86:714-7.
        17. Sabetta JR, DePetrillo P, Cipriani RJ, et al. Serum 25-Hydroxyvitamin D and the Incidence of Acute Viral Respiratory Tract Infections in Healthy Adults. PLoS ONE. 2010;5:e11088. DOI:10.1371/journal.pone.0011088 
        18. Science M, Maguire JL, Russell ML, et al. Low serum 25-hydroxyvitamin D level and risk of upper respiratory tract infection in children and adolescents. Clin Infect Dis. 2013;57:392-7. DOI:10.1093/cid/cit289 
        19. Autier P, Mullie P, Macacu A, et al. Effect of vitamin D supplementation on non-skeletal disorders: A systematic review of meta-analyses and randomised trials. Lancet Diabetes Endocrinol. 2017;5:986-1004. 
        20. Martineau AR, Jolliffe DA, Hooper RL, et al. Vitamin D supplementation to prevent acute respiratory tract infections: Systematic review and meta-analysis of individual participant data. BMJ. 2017;356:i6583. 
        21. Rejnmark L, Bislev LS, Cashman KD, et al. Non-skeletal health effects of vitamin D supplementation: A systematic review on findings from meta-analyses summarizing trial data. PLoS ONE. 2017;12:e0180512.
        22. Bergman P, Lindh Å, Björkhem-Bergman L, Lindh J. Vitamin D and respiratory tract infections: A systematic review and meta-analysis of randomized controlled trials. PLoS ONE. 2013;8:e65835.
        23. Charan J, Goyal J, Saxena D, Yadav P. Vitamin D for prevention of respiratory tract infections: A systematic review and meta-analysis. J Pharmacol Pharmacother. 2012;3:300-3. 
        24. Vuichard Gysin D, Dao D, Gysin CM, et al. Effect of Vitamin D3 Supplementation on Respiratory Tract Infections in Healthy Individuals: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. PLoS ONE. 2016;11:e0162996. DOI:10.1371/journal.pone.0162996
        25. Dancer RC, Parekh D, Lax S, et al. Vitamin D deficiency contributes directly to the acute respiratory distress syndrome (ARDS). Thorax. 2015;70:617-24. 
        26. Han JE, Jones JL, Tangpricha V, et al. High Dose Vitamin D Administration in Ventilated Intensive Care Unit Patients: A Pilot Double Blind Randomized Controlled Trial. J Clin Transl Endocrinol. 2016;4:59-65.
        27. Xiao L, Xing C, Yang Z, et al. Vitamin D supplementation for the prevention of childhood acute respiratory infections: A systematic review of randomised controlled trials. Br J Nutr. 2015;114:1026-34.
        28. Yakoob MY, Salam RA, Khan FR, Bhutta ZA. Vitamin D supplementation for preventing infections in children under five years of age. Cochrane Database Syst Rev. 2016;11:CD008824.
        29. Das RR, Singh M, Naik SS. Vitamin D as an adjunct to antibiotics for the treatment of acute childhood pneumonia. Cochrane Database Syst Rev. 2018;7:CD011597.
        30. Yamshchikov AV, Desai NS, Blumberg HM, et al. Vitamin D for treatment and prevention of infectious diseases: A systematic review of randomized controlled trials. Endocr Pract. 2009;15:438-49.
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        Авторы
        С.Г. Макарова*1,2, Е.Е. Емельяшенков1, Д.С. Ясаков1, И.Ю. Пронина1,3, О.А. Ерешко1, И.Г. Гордеева1, А.А. Галимова1, Т.Р. Чумбадзе1, А.М. Лебедева1,4

        1 ФГАУ «Национальный медицинский исследовательский центр здоровья детей» Минздрава России, Москва, Россия;
        2 ФГБОУ ВО «Московский государственный университет им. М.В. Ломоносова», Москва, Россия;
        3 ФГБУ «Национальный медицинский исследовательский центр эндокринологии» Минздрава России, Москва, Россия;
        4 ФГБУН «Федеральный исследовательский центр питания, биотехнологии и безопасности пищи», Москва, Россия
        *sm27@yandex.ru

        ________________________________________________

        Svetlana G. Makarova*1,2, Evgeny E. Emelyashenkov1, Dmitry S. Yasakov1, Irina Yu. Pronina1,3, Oksana A. Ereshko1, Irina G. Gordeeva1, Albina A. Galimova1, Tamara R. Chumbadze1, Ayina M. Lebedeva1,4

        1 National Medical Research Center for Children's Health, Moscow, Russia;
        2 Lomonosov Moscow State University, Moscow, Russia;
        3 Endocrinology Research Centre, Moscow, Russia;
        4 Federal Research Center of Nutrition, Biotechnology and Food Safety, Moscow, Russia
        *sm27@yandex.ru


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        Лектор: Жиров Игорь Витальевич – д.м.н., профессор, ведущий научный сотрудник отдела заболеваний миокарда и сердечной недостаточности ФГБУ «НМИЦ кардиологии» Минздрава России
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