Otoimmün Hastalıklarda Çinko ve D Vitamini
Özet
İmmün sistemin kendi dokularını yabancı olarak algılamasıyla gelişen otoimmün hastalıklar, dünya genelinde artış gösterirken çinko ve D vitamini bu süreçlerde kilit düzenleyiciler olarak öne çıkmaktadır. Hem çinko hem de D vitamini eksikliği; bağışıklık hücrelerinin fonksiyonlarını bozarak tolerans kaybına ve kronik inflamasyonun tetiklenmesine neden olurken, pek çok hastada bu değerlerin sağlıklı bireylere göre anlamlı derecede düşük olduğu gözlenmiştir. Bu mikro besinlerin takviyesi, genetik yatkınlığı olan bireylerde hastalık riskini azaltma ve semptomları iyileştirme potansiyeline sahip olsa da tedavi edici etkileri optimize etmek için altta yatan moleküler mekanizmaların tam olarak aydınlatılması gerekmektedir.
Autoimmune diseases develop when the immune system misidentifies its own tissues as foreign, with zinc and vitamin D playing pivotal regulatory roles in these processes. Deficiencies in both zinc and vitamin D impair immune cell functions, leading to a loss of tolerance and the triggering of chronic inflammation, and these levels are significantly lower in many patients compared to healthy individuals. While supplementing these micronutrients has the potential to reduce disease risk and improve symptoms in genetically predisposed individuals, fully uncovering the underlying molecular mechanisms is essential to optimize their therapeutic effects.
Referanslar
Elias K, Siegel R, O’shea J. Molecular and Cellular Basis of Immunity and Immunological Diseases. Klippel JH, Stone JH, Crofford LJ, White PH (ed.) Primer on the Rheumatic Diseases içinde. New York,NY: Springer; 2008. P94-108
Songu M. , Katılmış H. Enfeksiyondan korunma ve immün sistem. Journal of Medical Updates. 2012; 2(1): 31-42.
Abbas, A.K., Lichtman, A.H., Pillai, S. Molecular and Cellular Immunology (6.bs.). (2007). Philadelphia: Saunders Elsevier
Sekkı̇n M. Normal, Oto‐İmmün Hastalıklı ve Vasküler Hastalıklı Annelerı̇n Bebeklerı̇nı̇n Göbek Kordonu Dokularındakı̇ Bağışıklık Sı̇stemı̇ Hücrelerı̇nı̇n Dağılımının İncelenmesı̇. Hacettepe Ünı̇versı̇tesı̇ Sağlık Bı̇lı̇mlerı̇ Enstı̇tüsü Doktora tezi 2010
Goodnow, C., Sprent, J., de St Groth, B. et al. Cellular and genetic mechanisms of self tolerance and autoimmunity. Nature. 2005;435, 590–597. https://doi.org/10.1038/nature03724
Rose NR. Prediction and Prevention of Autoimmune Disease in the 21st Century: A Review and Preview. American Journal Of Epidemiology. 2016 Mar 1;183(5):403-6. doi: 10.1093/aje/kwv292.
Adams Waldorf, K.M.,Nelson, J.L. Autoimmune disease during pregnancy and the microchimerism legacy of pregnancy. Immunological Investigations. 2008; 37 (5), 631-644.
Mattoso-Barbosa, A. M. , Sathler-Avelar, R. , Coelho-dos-Reis, J. A. , et al. Physiology and Pathology of Infectious Diseases: The Autoimmune Hypothesis of Chagas Disease. In: Rezaei, N. (ed). Physiology and Pathology of Immunology [Internet]. London: 2017.I ntechOpen
Wessels I, Rink L. Micronutrients in autoimmune diseases: possible therapeutic benefits of zinc and vitamin D. The Journal of Nutritional Biochemistry. 2020 Mar; 77:108240. doi:10.1016/j.jnutbio.
Clarke K, Chintanaboina J. Allergic and Immunologic Perspectives of Inflammatory Bowel Disease. Clinical Reviews in Allergy & Immunology. 2019 Oct; 57(2):179-193. doi:10.1007/s12016-018-8690-3.
Wessels I, Maywald M, Rink L. Zinc as a Gatekeeper of Immune Function. Nutrients. 2017 Nov 25; 9(12):1286. doi: 10.3390/nu9121286.
Prasad AS. Effects of zinc deficiency on Th1 and Th2 cytokine shifts. The Journal Of Infectious Diseases. 2000 Sep;182 Suppl 1:S62-8. doi: 10.1086/315916.
Prasad AS. Zinc in human health: effect of zinc on immune cells. Journal of Molecular Medicine 2008 May-Jun;14(5-6):353-7. doi: 10.2119/2008-00033.
Sanna A, Firinu D, Zavattari P, et al. Zinc Status and Autoimmunity: A Systematic Review and Meta-Analysis. Nutrients. 2018 Jan 11;10(1):68. doi: 10.3390/nu10010068.
Pawlitzki M, Uebelhör J, Sweeney-Reed CM, et al. Lower Serum Zinc Levels in Patients with Multiple Sclerosis Compared to Healthy Controls. Nutrients. 2018 Jul 26;10(8):967. doi: 10.3390/nu10080967.
Wessels I, Cousins RJ. Zinc dyshomeostasis during polymicrobial sepsis in mice involves zinc transporter Zip14 and can be overcome by zinc supplementation. The American Journal of Physiology-Gastrointestinal and Liver Physiology 2015 Nov 1; 309(9):G768-78. doi: 10.1152/ajpgi.00179.
Nishi Y, Kawate R, Usui T. Zinc metabolism in thyroid disease. Postgraduate Medical Journal 1980 Dec;56(662):833-7. doi: 10.1136/pgmj.56.662.833.
Ertek S, Cicero AF, Caglar O, et al. Relationship between serum zinc levels, thyroid hormones and thyroid volume following successful iodine supplementation. Hormones (Athens). 2010 Jul-Sep; 9(3):263-8. doi: 10.14310/horm.2002.1276.
Kruis W, Phuong Nguyen G. Iron Deficiency, Zinc, Magnesium, Vitamin Deficiencies in Crohn's Disease: Substitute or Not? Dig Dis. 2016; 34(1-2): 105-11. doi: 10.1159/000443012.
Zuliani, Cristinaa | Preto, Silviaa | Andretta, Elenab | Baroni, Lucianac Vitamin D and multiple sclerosis: an update. Mediterranean Journal of Nutrition and Metabolism. 2010; vol. 3, no. 2, pp. 115-119,
Dankers W, Colin EM, van Hamburg JP, Lubberts E. Vitamin D in Autoimmunity: Molecular Mechanisms and Therapeutic Potential. Frontiers in Immunology. 2017 Jan 20; 7:697. doi:10.3389/fimmu.2016.00697.
Wessels I, Fleischer D, Rink L, Uciechowski P. Changes in chromatin structure and methylation of the human interleukin-1beta gene during monopoiesis. Immunology. 2010 Jul; 130(3):410-7. doi:10.1111/j.1365-2567.2009.03243
Song GG, Bae SC, Lee YH. Association between vitamin D intake and the risk of rheumatoid arthritis: a meta-analysis. Clinical Rheumatology. 2012 Dec; 31(12):1733-9. doi: 10.1007/s10067-012-2080-7.
Tao C, Simpson S Jr, van der Mei I et al. MSBase Study Group. Higher latitude is significantly associated with an earlier age of disease onset in multiple sclerosis. Journal of Neurology, Neurosurgery and Psychiatry. 2016 Dec; 87(12):1343-1349. doi: 10.1136/jnnp-2016-314013.
Mohr SB, Garland CF, Gorham ED et al. The association between ultraviolet B irradiance, vitamin D status and incidence rates of type 1 diabetes in 51 regions worldwide. Diabetologia. 2008 Aug; 51(8):1391-8. doi: 10.1007/s00125-008-1061-5.
Szilagyi A, Leighton H, Burstein B et al. Latitude, sunshine, and human lactase phenotype distributions may contribute to geographic patterns of modern disease: the inflammatory bowel disease model. The Journal of Clinical Epidemiology. 2014 May 27; 6:183-98. doi:10.2147/CLEP.S59838.
Dobson R, Giovannoni G, Ramagopalan S. The month of birth effect in multiple sclerosis: systematic review, meta-analysis and effect of latitude. Journal of Neurology, Neurosurgery and Psychiatry. 2013 Apr; 84(4):427-32. doi:10.1136/jnnp-2012-303934.
Sahebari M, Nabavi N, Salehi M. Correlation between serum 25(OH)D values and lupus disease activity: an original article and a systematic review with meta-analysis focusing on serum VitD confounders. Lupus. 2014 Oct; 23(11):1164-77. doi: 10.1177/0961203314540966.
Duan S, Lv Z, Fan X et al. Vitamin D status and the risk of multiple sclerosis: a systematic review and meta-analysis. Neuroscience Letters 2014 Jun 6; 570:108-13. doi:10.1016/j.neulet.2014.04.021.
Tizaoui K, Kaabachi W, Hamzaoui A, Hamzaoui K. Contribution of VDR polymorphisms to type 1 diabetes susceptibility: Systematic review of case-control studies and meta-analysis. The Journal of Steroid Biochemistry and Molecular Biology 2014 Sep; 143:240-9. doi:10.1016/j.jsbmb.2014.03.011.
Lee YH, Bae SC, Choi SJ, et al. Associations between vitamin D receptor polymorphisms and susceptibility to rheumatoid arthritis and systemic lupus erythematosus: a meta-analysis. Molecular Biology Reports. 2011 Aug; 38(6):3643-51. doi:10.1007/s11033-010-0477-4.
Lu M, Taylor BV, Körner H. Genomic Effects of the Vitamin D Receptor: Potentially the Link between Vitamin D, Immune Cells, and Multiple Sclerosis. Frontiers in Immunology. 2018 Mar 12; 9:477. doi: 10.3389/fimmu.2018.00477.
Zipitis CS, Akobeng AK. Vitamin D supplementation in early childhood and risk of type 1 diabetes: a systematic review and meta-analysis. Archives of Disease in Childhood 2008; 93:512-51. doi: 10.1136/adc.2007.128579.