perinatologyРоссийский вестник перинатологии и педиатрииRossiyskiy Vestnik Perinatologii i Pediatrii (Russian Bulletin of Perinatology and Pediatrics)1027-40652500-2228Ltd. “The National Academy of Pediatric Science and Innovation”10.21508/1027-4065-2017-62-1-26-32perinatology-448Research ArticleОБЗОР ЛИТЕРАТУРЫREVIEWSВитамин D и аутоиммунные заболеванияVitamin D and autoimmune diseasesПотроховаЕ. А.PotrokhovaE. A.

д.м.н., зав. педиатрическим отделением Научно-исследовательского клинического института педиатрии им. акад. Ю.Е. Вельтищева, ведущий научный сотрудник отдела радиационной экопатологии детского возраста 125412 Москва, ул. Талдомская, д. 2

СоботюкН. В.SobotyukN. V.

к.м.н., профессор кафедры педиатрии Омского государственного медицинского университета

БочанцевС. В.BochantsevS. V.

к.м.н., доцент, заведующий кафедрой педиатрии Омского государственного медицинского университета

ГапоненкоВ. П.GaponenkoV. P.

ординатор кафедры педиатрии Омского государственного медицинского университета 644043 Омск, ул. Ленина, д. 12

ОСП «Научно-исследовательский клинический институт педиатрии имени академика Ю.Е. Вельтищева» ФГБОУ ВО РНИМУ имени Н.И. Пирогова Минздрава РФРоссияAcademician Yu.E. Veltishchev Research Clinical Institute of Pediatrics, N.I. Pirogov Russian National Research Medical University, Ministry of Health of the Russian FederationRussian FederationГБОУ ВПО «Омский государственный медицинский университет» Минздрава РФРоссияOmsk State Medical University, Ministry of Health of the Russian FederationRussian Federation2017060420176212631Copyright © Ltd. “The National Academy of Pediatric Science and Innovation”, 20172017Ltd. “The National Academy of Pediatric Science and Innovation”Ltd. “The National Academy of Pediatric Science and Innovation”https://www.ped-perinatology.ru/jour/about/submissions#copyrightNoticehttps://www.ped-perinatology.ru/jour/article/view/448

В обзоре обсуждается влияние витамина D на модуляцию иммунного ответа в сторону толерогенности, его взаимосвязь с клетками моноцитарно-макрофагального ряда, включая дендритные клетки, моноциты и макрофаги, с позиции влияния на экспрессию противовоспалительных и провоспалительных цитокинов при некоторых аутоиммунных заболеваниях (ревматоидный артрит, системная склеродермия, рассеянный склероз, сахарный диабет 1-го типа, системная красная волчанка, болезнь Крона). Обсуждается роль витамина D в становлении врожденного и адаптивного иммунитета. Несмотря на некоторые противоречивые данные, в целом иммунорегуляторная функция витамина D направлена на ингибирование компонентов врожденного и приобретенного иммунитета, отвечающих за индукцию аутоиммунных реакций. В связи с этим растет число публикаций, посвященных вопросам обеспеченности витамином D пациентов с аутоиммунными заболеваниями, влияния профилактического приема витамина D на риск возникновения патологии и лечебных доз витамина – на ее течение. Показано, что для осуществления иммунорегуляторной функции требуется поддержание порогового значения сывороточного уровня 25(OH)D3 не менее 30 нг/мл, что достигается при использовании суточной дозы витамина D около 2000 МЕ. Представленные данные поднимают вопрос о необходимости пересмотра российских норм, касающихся рекомендуемого суточного потребления витамина D, в том числе за счет фортификации продуктов детского питания.

The review discusses the effect of vitamin D on the tolerogenic modulation of an immune response, its relationship to cells of the monocyte-macrophage series, including dendritic cells, monocytes, and macrophages, in the context of the impact of the expression of anti-inflammatory proinflammatory cytokines in some autoimmune diseases (rheumatoid arthritis, systemic scleroderma, multiple sclerosis, type 1 diabetes mellitus, systemic lupus erythematosus, and Crohn`s disease). It discusses the role of vitamin D in the development of innate and adaptive immunity. Despite some conflicting evidence, the immune regulatory function of vitamin D is generally directed toward inhibition of the components of innate and acquired immunity, which are responsible for the induction of autoimmune reactions; in this connection there are a growing number of publications devoted to the issues of vitamin D supplementation in patients with autoimmune diseases, the preventive effect of vitamin D intake on the risk of an abnormality and that of therapeutic doses of the vitamin on its course. The maintenance of the threshold value for serum 25(OH)D3 at least 30 ng/ml, which is achieved by the intake of about 2000 IU of vitamin D, is shown to be required for its immune regulatory function. The data given raise the question as to whether it is necessity to revise the Russian recommended daily dietary allowances for vitamin D through its infant food fortification.

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The authors declare that there are no conflicts of interest present.