References

medsovet

Медицинский Совет

Meditsinskiy sovet = Medical Council

2079-701X2658-5790

REMEDIUM GROUP Ltd.

10.21518/ms2024-007

medsovet-8081

Research Article

БРОНХОПУЛЬМОНОЛОГИЯ И ОТОЛАРИНГОЛОГИЯ

BRONCHOPULMONOLOGY, OTORHINOLARYNGOLOGY

Обеспеченность витамином D, респираторные вирусные инфекции и персистирующие хрипы у детей: насколько значима взаимосвязь?

Vitamin D supply, respiratory viral infections and persistent wheezing in children: how significant is the relationship?

https://orcid.org/0000-0002-4069-0566

Барычева

Л. Ю.

Barycheva

L. Yu.

Барычева Людмила Юрьевна, д.м.н., профессор, заведующая кафедрой иммунологии с курсом дополнительного профессионального образования; врач аллерголог- иммунолог

355017, Ставрополь, ул. Мира, д. 310

355029, Ставрополь, ул. Семашко, д. 3

Liudmila Yu. Barycheva, Dr. Sci. (Med.), Professor, Head of the Department of Immunology with a Course of Additional Professional Education; Allergist- Immunologist

310, Mira St., Stavropol, 355017

3, Semashko St., Stavropol, 355029

ludmila@inbox.ru

https://orcid.org/0000-0002-2056-153X

Долбня

С. В.

Dolbnya

S. V.

Долбня Светлана Викторовна, к.м.н., доцент кафедры факультетской педиатрии; врач-пульмонолог

355017, Ставрополь, ул. Мира, д. 310

355029, Ставрополь, ул. Семашко, д. 3

Svetlana V. Dolbnya, Cand. Sci. (Med.), Associate Professor, Department of Faculty Pediatrics; Pulmonologist

310, Mira St., Stavropol, 355017

3, Semashko St., Stavropol, 355029

svet-lana.dolbnya@yandex.ru

https://orcid.org/0000-0001-6983-0967

Толкунова

А. А.

Tolkunova

A. A.

Толкунова Анна Александровна, ассистент факультетской педиатрии; врач-пульмонолог

355017, Ставрополь, ул. Мира, д. 310

355029, Ставрополь, ул. Семашко, д. 3

Anna A. Tolkunova, Resident of the Department of Pediatrics named after Academician G.N. Speransky

310, Mira St., Stavropol, 355017

3, Semashko St., Stavropol, 355029

anndiatlova@mail.ru

https://orcid.org/0000-0001-7248-1614

Климов

Л. Я.

Klimov

L. Ya.

Климов Леонид Яковлевич, д.м.н., профессор, заведующий кафедрой факультетской педиатрии, Ставропольский государственный медицинский университет

355017, Ставрополь, ул. Мира, д. 310

Leonid Ya. Klimov, Dr. Sci. (Med.), Professor, Head of the Department of Faculty Pediatrics

310, Mira St., Stavropol, 355017

klimov_leo@mail.ru

https://orcid.org/0009-0003-5246-0527

Кузнецова

В. В.

Kuznetsova

V. V.

Кузнецова Вера Валентиновна, ассистент кафедры иммунологии с курсом дополнительного профессионального образования; врач аллерголог-иммунолог

355017, Ставрополь, ул. Мира, д. 310

355029, Ставрополь, ул. Семашко, д. 3

Vera V. Kuznetsova, Resident of the Department of Immunology with a Course of Additional Professional Education; Allergist- Immunologist

310, Mira St., Stavropol, 355017

3, Semashko St., Stavropol, 355029

kuznetsovavera96@mail.ru

https://orcid.org/0009-0007-9505-3349

Понамарева

В. Р.

Ponamaryova

V. R.

Понамарева Виктория Романовна, студент педиатрического факультета

355017, Ставрополь, ул. Мира, д. 310

Viktoriya R. Ponamaryova, Student of Pediatric Faculty

310, Mira St., Stavropol, 355017

viktoriaponamarevaaa@yandex.ru

https://orcid.org/0000-0003-4200-4598

Захарова

И. Н.

Zakharova

I. N.

Захарова Ирина Николаевна, д.м.н., профессор, заслуженный врач Российской Федерации, заведующая кафедрой педиатрии имени академика Г.Н. Сперанского

125993, Москва, ул. Баррикадная, д. 2/1, стр. 1

Irina N. Zakharova, Dr. Sci. (Med.), Professor, Honored Doctor of the Russian Federation, Head of the Department of Pediatrics named after Academician G.N. Speransky

2/1, Вldg. 1, Barrikadnaya St., Moscow, 125993

zakharova-rmapo@yandex.ru

Ставропольский государственный медицинский университет; Краевая детская клиническая больницаРоссияStavropol State Medical University; Regional Children’s Clinical HospitalRussian Federation

Ставропольский государственный медицинский университетРоссияStavropol State Medical UniversityRussian Federation

Российская медицинская академия непрерывного профессионального образованияРоссияRussian Medical Academy of Continuing Professional EducationRussian Federation

2024

26022024

72–81

2024

Барычева Л.Ю., Долбня С.В., Толкунова А.А., Климов Л.Я., Кузнецова В.В., Понамарева В.Р., Захарова И.Н.

Barycheva L.Y., Dolbnya S.V., Tolkunova A.A., Klimov L.Y., Kuznetsova V.V., Ponamaryova V.R., Zakharova I.N.

This work is licensed under a Creative Commons Attribution 4.0 License.

https://www.med-sovet.pro/jour/article/view/8081

В обзоре обсуждено многостороннее влияние витамина D на противовирусный иммунитет, индукцию антимикробных пептидов, функциональную активность иммунокомпетентных клеток, процессы аутофагии, клиренс вирусов и вирусных фрагментов. Рассмотрены взаимоотношения витамина D и клеток аллергического воспаления, его модулирующий и толерогенный потенциал. Показано ингибирующее влияние витамина D на эозинофилы, тучные клетки, продукцию провоспалительных и проаллергических медиаторов, синтез IgE. Установлена протективная роль витамина D в развитии ремоделирования и гиперреактивности дыхательных путей за счет снижения количества бокаловидных клеток, гиперсекреции слизи, экспрессии металлопротеиназ. Продемонстрированы эффекты витамина D на репликацию респираторных вирусов и устойчивость к ним в эксперименте путем индукции противомикробных пептидов и других механизмов. Приведены данные клинических исследований о профилактическом влиянии витамина D на частоту респираторных инфекций и эпизодов персистирующих хрипов у детей. Дети с респираторно-синцитиальной инфекцией и дефицитом витамина D чаще нуждались в респираторной поддержке и искусственной вентиляции легких. Показана профилактическая роль витамина D в развитии обструктивного бронхита у детей и тяжелого бронхиолита у младенцев. Установлено, что нормальные показатели 25(OH)D у матери существенно уменьшают риск развития бронхиальной обструкции у ребенка. Обсуждены альтернативные данные, не подтвердившие защитного эффекта витамина D на респираторную заболеваемость и свистящие хрипы у детей. Целесообразны дальнейшие мониторинговые исследования, учитывающие географическое положение, анализ применяемой дозы холекальциферола для оценки его профилактической роли в развитии свистящих хрипов и бронхиальной астмы у детей.

The review discusses the multifaceted effect of vitamin D on antiviral immunity, induction of antimicrobial peptides, functional activity of immunocompetent cells, autophagy processes, clearance of viruses and viral fragments. The relationship between vitamin D and allergic inflammatory cells, its modulating and tolerogenic potential is considered. The inhibitory effect of vitamin D on eosinophils, mast cells, the production of pro-inflammatory and proallergic mediators, and the synthesis of IgE has been shown. The protective role of vitamin D in the development of remodeling and hyperresponsiveness of the respiratory tract has been established by reducing the number of goblet cells, mucus hypersecretion, and the expression of metalloproteinases. The effects of vitamin D on the replication of respiratory viruses and experimental resistance to them through the induction of antimicrobial peptides and other mechanisms have been demonstrated. Data from clinical studies on the preventive effect of vitamin D on the incidence of respiratory infections and episodes of persistent wheezing in children are presented. Children with respiratory syncytial infection and vitamin D deficiency were more likely to require respiratory support and mechanical ventilation. The preventive role of vitamin D in the development of obstructive bronchitis in children and severe bronchiolitis in infants has been shown. It has been established that normal levels of 25(OH)D in the mother significantly reduce the risk of developing bronchial obstruction in the child. Alternative data that do not support a protective effect of vitamin D on respiratory morbidity and wheezing in children are discussed. Further monitoring studies that take into account geographic location and analysis of the dose of cholecalciferol used to assess its preventive role in the development of wheezing and bronchial asthma in children are advisable.

витамин Dхолекальциферолврожденный и адаптивный иммунный ответреспираторные вирусные инфекциисиндром бронхиальной обструкции

vitamin Dcholecalciferoinnate and adaptive immune responserespiratory viral infectionsbronchial obstruction syndrome

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