Entrevista em TV com o Dr. Cícero Galli Coimbra, professor neurologista da Universidade Federal de São Paulo – Unifesp.
Comentário: a principal razão pela qual a medicina atual desdenha estes importantes conhecimentos médicos já antigos e com ampla fundamentação na história recente da medicina e confirmados em vários países, através de diversas publicações, é simplesmente porque ela está subordinada aos interesses extremamente gananciosos da indústria farmacêutica internacional. O SIMERS do RS costuma usar a frase de divulgação de sua existência como “A verdade faz bem para a saúde!”, nos meios de comunicação.
Lembrem que há Resoluções do CFM proibindo a divulgação do conhecimento médico para a população e outras que simplesmente atropelam a realidade do conhecimento médico, como, por exemplo, a Resolução 1752/2004 do Conselho Federal de Medicina, hoje revogada, e que permitia o aborto dos anencéfalos, onde, em seus considerandos, redefinia morte encefálica como sendo morte cerebral e de exclusivo diagnóstico clínico.
Assista estes outros vídeos:
Vitamina D – Sem Censura – Dr. Cicero Galli Coimbra e Daniel Cunha
https://www.youtube.com/watch?v=cIwIWim4hNM&list=UU5grjCGNi25VAR8J0eVuxVQ&index=1&feature=plcp
Celso Galli Coimbra
Celso Galli Coimbra - OABRS 11352 
28/03/2011 às 16:59
Obrigado pela oportunidade de conhecer mais sobre o assunto e de uma forma simples e moderna. Parabéns , Vamos socializar esse material.
01/05/2011 às 16:59
muito bom este material, doenças que estão presente em em nossas vidas que o conhecimento divulgado nos ajuda para lidarmos com elas e a nos previnir.
obrigada
13/11/2011 às 16:59
Agora entendemos porque o Altruismo, saber ter gratidao e nao guardar ressentimentos
contribuem para nossa saúde física e mental
04/02/2012 às 16:59
[…] aspecto emocional tranquilo –, voltam a nascer células-tronco, e novos neuronios, todos os dias. Informações médicas sobre a prevenção e tratamento de doenças neurodegenerativas e autoimunes,… https://biodireitomedicina.wordpress.com/category/doencas-autoimunes/ […]
19/02/2012 às 16:59
[…] http://www.caasp.org.br/Noticias.asp?cod_noticia=1679 *Matéria publicada originalmente no Jornal do Advogado, edição de maio de 2010. Vitamina D pode combater males que mais matam pessoas no mundo __ https://biodireitomedicina.wordpress.com/2011/03/23/informacoes-medicas-sobre-a-prevencao-e-tratament… […]
19/02/2012 às 16:59
[…] edição de maio de 2010. Vitamina D pode combater males que mais matam pessoas no mundo __ https://biodireitomedicina.wordpress.com/2011/03/23/informacoes-medicas-sobre-a-prevencao-e-tratament… __ Share this:RedditTwitterTumblrStumbleUponDiggFacebookLinkedInGostar disso:GostoSeja o primeiro […]
26/02/2012 às 16:59
[…] https://biodireitomedicina.wordpress.com/2011/03/23/informacoes-medicas-sobre-a-prevencao-e-tratament… […]
26/02/2012 às 16:59
[…] https://biodireitomedicina.wordpress.com/2011/03/23/informacoes-medicas-sobre-a-prevencao-e-tratament… […]
27/02/2012 às 16:59
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27/02/2012 às 16:59
[…] https://biodireitomedicina.wordpress.com/2011/03/23/informacoes-medicas-sobre-a-prevencao-e-tratament… […]
29/02/2012 às 16:59
~ Importancia da vitamina D e do metabolismo ~
O que os cientistas e pesquisadores têm certeza há anos, a contar dos primeiros anos da década de 2000 e antes já sabiam, é da importancia da vitamina D para doenças autoimunes, cardiovasculares, câncer e diabetes. Porque, como muitos explicaram, Collen Hayes e Cícero Galli Coimbra, dentre cientistas por exemplo, foi preciso descobrir o motivo porque, mesmo em territórios de clima temperado, alguns grupos de pessoas desenvolviam esclerose múltipla e outros não. Alimentação apropriada foi a explicação. O alto consumo de peixes de águas geladas, cuja gordura é rica em Vitamina D, Omega3, como também o consumo de óleo de fígado de bacalhau, forneceu ao sangue humano a hormona 25hidroxivitamin D e as pessoas não desenvolveram nem raquitismo nem esclerose múltipla, embora tivessem a herança genética da doença. Hoje já se sabe que a vitamina D é o link que faltava também para o Alzheimer.
MUITOS AUTORES EXPOEM PESQUISA NO MESMO SENTIDO
Lembro quando da noticia destas pesquisas. Há quem escreveu, li na internet, que isto não é verdade. Porem, “The role of vitamin D in multiple sclerosis” é pesquisa acompanhada de centenas e milhares de outras varias em idêntico sentido. Doutores, de todos os países do planeta, vêm mostrando a importancia da vitamina D para outras doenças também, muito alem da esclerose múltipla. Basta fazer pesquisa e escrever: vitamin d multiple sclerosis ou vitamin d Alzheimer ou o mesmo com qualquer outra patollogia que se pretenda pesquisar, câncer, diabetes, artrite reumatoide, psoriase, e muitas outras.
A internet brasileira tem informação em portugues. Aqui no Brasil, o primeiro médico a oferecer este conhecimento publicamente foi Dr. Cícero Galli Coimbra [PHD Médico Neurologista e Professor Livre-Docente, Departamento de Neurologia e Neurocirurgia – Universidade Federal de São Paulo – Unifesp/EPM]. Alguns artigos e entrevista com Dr. Cícero Galli Coimbra:
Vitamina D é importantíssima para a saúde
Disponível em https://biodireitomedicina.wordpress.com/category/a-prevencao-de-doencas-neurodegenerativas/
Vitamina D pode revolucionar o tratamento da esclerose múltipla*
https://biodireitomedicina.wordpress.com/2010/08/03/vitamina-d-pode-revolucionar-o-tratamento-da-esclerose-multipla/
*Dr. Cícero Galli Coimbra
PHD Médico Neurologista e Professor Livre-Docente
A cura com Dr. Cícero Galli Coimbra. Estresse emocional, depressão, doenças autoimunes e neurodegenerativas. A importancia da Vitamina D.
“Comentário: a principal razão pela qual a medicina atual desdenha estes importantes conhecimentos médicos já antigos e com ampla fundamentação na história recente da medicina e confirmados em vários países, através de diversas publicações, é simplesmente porque ela está subordinada aos interesses extremamente gananciosos da indústria farmacêutica internacional.”
https://biodireitomedicina.wordpress.com/2011/03/23/informacoes-medicas-sobre-a-prevencao-e-tratamento-de-doencas-neurodegenerativas-e-auto-imunes-como-parkinson-alzheimer-lupus-psoriase-vitiligo-depressao/
https://biodireitomedicina.wordpress.com/category/doencas-autoimunes/
—-
O que é possível dizer em breves palavras, já oferece um quadro preocupante. A insuficiência de vitamina D tem desenvolvido muitas outras doenças, alem do raquitismo e da osteoporose, que já são aceitas como “comuns” e típicas da medicina das doenças crônicas.
Associadas á deficiencia de vitamina D estão o câncer, as diabetes, problemas cardiovasculares, transtorno bipolar, autismo, mal de Alzheimer e esquizofrenia, psoríase, depressão. O comercio industrial multimilionário da farmácia, não traz a cura, apresenta medicação cara e talvez paliativa. Diz assim a medicina das doenças crônicas: “a sua doença não tem cura”… E, no entanto, todas essas doenças graves sequer teriam desenvolvido nas pessoas, se existisse o cuidado com a medicina preventiva com a suplementação da vitamina D.
Os médicos vêm apresentando pesquisa que aponta o aumento de epidemias em todo planeta, por causa da falta de investimento dos governos em saúde preventiva com suplementação da vitamina D.
Vitamin D deficiency: a global perspective http://objetodignidade.wordpress.com/2011/08/15/vitamin-d-deficiency-a-global-perspective/
Deficiência de vitamina D: uma epidemia global
http://objetodignidade.wordpress.com/2011/08/15/deficiencia-de-vitamina-d-uma-epidemia-global/
Symposium: Vitamin D Insufficiency: A Significant Risk Factor in Chronic Diseases and Potential Disease-Specific Biomarkers of Vitamin D Sufficiency Vitamin D Intake: A Global Perspective of Current Status
http://objetodignidade.wordpress.com/2011/08/15/symposium-vitamin-d-insufficiency-a-significant-risk-factor-in-chronic-diseases-and-potential-disease-specific-biomarkers-of-vitamin-d-sufficiency-vitamin-d-intake-a-global-perspective-of-current-s/
Brasil ainda investe pouco em saúde País investe apenas 8,7% do valor arrecadado com impostos em saúde. Número é inferior ao de países como Argentina, Chile e Venezuela Um estudo realizado pela Fundação Instituto de Administração da Universidade de São Paulo (USP)
http://objetodignidade.wordpress.com/2011/08/05/brasil-ainda-investe-pouco-em-saude/
O aumento da Deficiência de vitamina D geralmente se apresentava como deformidade óssea (raquitismo) ou hipocalcemia na infância e como dor músculoesquelética e fraqueza em adultos.
Hoje os estudos são avançados e os médicos constataram muitos outros problemas de saúde, incluindo doenças cardiovasculares, diabetes, vários tipos de câncer, e autoimunes como mal de Alzheimer e esclerose múltipla, hipo e hipertireoidismo, artrite, vitiligo, associadas á alta insuficiência de vitamina D no sangue.
O status da vitamina D é mais confiável determinado pelo ensaio de soro de 25-hidroxivitamina D (25-OHD).
O consenso entre os médicos definiu a medida da nanoterapia como ideal acima de 50. Abaixo de 50 já existe deficiencia mesmo que a pessoa ainda não apresente qualquer sintoma de doença. Isto significa que há meio de baixo custo para a prevenção de epidemias. A suplementação e reposição da colecalciferol, a vitamina D3 a vitamina D3, deve ser feita em altas doses. Muito alem das convencionadas mg da medicina do passado, para ter uma idéia uma gota da solução de colecalciferol tem 1.000 UI [unidade internacional].
O espectro dessas doenças comuns e graves, é particularmente preocupante porque os estudos observacionais têm demonstrado que a insuficiência de vitamina D, Raquitismo em crianças e osteomalacia em adultos são apenas manifestações clássicas de deficiência de vitamina D profunda. Nos últimos anos, no entanto, aparecem doenças não músculoesqueléticas condições incluindo câncer, síndrome metabólica, infecciosas e doenças autoimunes, esclerose múltipla, doenças que também foram encontrados associados aos baixos níveis de vitamina D. O Aumento da prevalência de distúrbios ligados à deficiência de vitamina D, é refletida no aumento do numero de crianças doentes.
Epidemias crescem se não for dada nutrição adequada e suplementos á toda população. Este é o cuidado que o governo brasileiro deve ter com todas as pessoas, indistintamente, em todas as idades.
Dilma e Lula não sabem disso, e desde 2008 favorecem pesquisas com células de embriões e abortos.
—
“É interessante notar que as geografias de raquitismo (Hess, 1929) e MS são muito semelhantes, a geografia do raquitismo levou Sniadecki (citado por Holick, 1995) para sugerir em 1822 que o sol pode curar o raquitismo. Lamentavelmente, diz Hayes, o raquitismo continuou a aleijar crianças por um século inteiro antes de investigadores demonstrarem os benefícios da luz solar ou óleo de fígado de bacalhau (Hess & Unger, 1921; Chick et al. 1922). Hoje o óleo de fígado de bacalhau tornou-se a proteção do “inverno” para as crianças que vivem em latitudes setentrionais.”
Ver Vitamin D: a natural inhibitor of multiple sclerosis, de Collen Hayes:
Disponivel em http://journals.cambridge.org/action/displayFulltext?type=1&fid=796912&jid=PNS&volumeId=59&issueId=04&aid=796900
“A evidência de que a vitamina D pode ser um inibidor natural de MS ou E.M. é irresistível. Examinando o benefício da suplementação de vitamina D para a prevenção de MS, a recusa desta verdade vai exigir um grande esforço por parte da comunidade científica, mas é claramente justificada diante dos atuais investimentos político-economicos”, diz Collen Hayes.
Ver Vitamin D: a natural inhibitor of multiple sclerosis, de Collen Hayes:
Disponivel em http://journals.cambridge.org/action/displayFulltext?type=1&fid=796912&jid=PNS&volumeId=59&issueId=04&aid=796900—-
As pessoas que têm doenças como Alzheimer, esclerose múltipla, lúpus, hipo e hipertireoidismo, artrite, vitiligo, diabetes, câncer e outras doenças autoimunitárias, hoje são orientadas por médicos e pesquisadores a consumir a solução oleosa [óleo de girassol ou oliva] de colecalciferol, a vitamina D3. A 25hidroxivitamin D3 é de fácil absorção pelo organismo. Passando do fígado aos rins e, depois de transformada em ativa, é absorvida por todas as células de todos os tecidos do corpo humano, como cálcio, fósforo e outras substancias, fortalecendo e recuperando inclusive o tecido neural.
A DEFICIENCIA ou INSUFICIENCIA DA VITAMINA D é verificada em exame de sangue, o 25[OH]D3 que o sistema de saúde publica do Brasil não oferece. O consenso entre os médicos definiu a medida da nanoterapia como ideal acima de 50. Abaixo de 50 já existe deficiencia mesmo que a pessoa ainda não apresente qualquer sintoma de doença. Isto significa que há meio de baixo custo para a prevenção de epidemias. A suplementação e reposição da colecalciferol, a vitamina D3, deve ser feita em altas doses. Muito alem das convencionadas 30 mg pela medicina do passado, para ter uma idéia uma gota da solução de colecalciferol tem 1.000 UI [unidade internacional].
E há SIM UM DISTURBIO METABOLICO, pois, se as pessoas com resultado do exame de sangue abaixo de 50, já estiverem recebendo alimentação apropriada, existe indicio de dificuldade digestiva na absorção dos alimentos, depressão, estresse e tristeza que impedem a neurogenesis.
—
“Revisando-se a literatura, verificamos que a carne vermelha libera, durante a digestão, a substância hemina, que possui propriedades tóxicas, porque penetra as membranas celulares carregando ferro para o interior das células, onde este eleva a produção de radicais livres. Para evitar tal efeito, a hemina é destruída, em sua maior parte, na própria célula intestinal (e o restante, no fígado), utilizando a vitamina B2. Tornou-se claro, então, que o indivíduo absorve a hemina, não tendo então a B2 para destruí-la. Assim, solicitamos a parada completa da ingestão de carne”. Coimbra acrescenta que o tratamento tradicional contra a doença, à base de medicamentos, deve ser concomitante à dieta proposta pelos pesquisadores.
[…]
SBPC/Labjor – Brasil
Disponível em http://www.comciencia.br/noticias/2003/06jun03/parkinson.htm
——
Vitamina D pode revolucionar o tratamento da esclerose múltipla*
https://biodireitomedicina.wordpress.com/2010/08/03/vitamina-d-pode-revolucionar-o-tratamento-da-esclerose-multipla/
*Dr. Cícero Galli Coimbra
PHD Médico Neurologista e Professor Livre-Docente
Informações médicas sobre a prevenção e tratamento de doenças neurodegenerativas e autoimunes, como Parkinson, Alzheimer, Lupus, Psoríase, Vitiligo, depressão
Dr. Cícero Galli Coimbra
PHD Médico Neurologista e Professor Livre-Docente
https://biodireitomedicina.wordpress.com/category/doencas-autoimunes/
Sistema nervoso – 06/02/2009. Entrevista com Dr. Cícero Galli Coimbra. Evitar o envelhecimento e a perda de neuronios.
http://www.youtube.com/watch?v=yRQkITHjZ5k&feature=player_embedded# —-
“a situação fundamental é a mesma: a existência de um DISTÚRBIO METABÓLICO evidente e corrigível, capaz de explicar os eventos fisiopatológicos conhecidos, e cuja correção pode deter a progressão da doença (interrompendo a continuidade da morte neuronal crônica, recuperando células neuronais já afetadas pelo processo neurodegenerativo – mas que não atingiram ainda o ponto de irreversibilidade), promover a recuperação total em casos de início recente, ou ao menos parcial das deficiências neurológicas nos casos mais avançados (minimizando seqüelas permanentes) e impedir a morte.” [1]
[1] Dr. Cícero Galli Coimbra
PHD Médico Neurologista e Professor Livre-Docente
Departamento de Neurologia e Neurocirurgia – Universidade Federal de São Paulo – Unifesp/EPM – Sofrimento emocional. – Em defesa da administração de doses elevadas de riboflavina associada à eliminação dos fatores desencadeantes no tratamento (…).
Disponivel em
http://www.unifesp.br/dneuro/nexp/riboflavina/
—-
Dr. Cícero Galli Coimbra
PHD Médico Neurologista e Professor Livre-Docente
https://biodireitomedicina.wordpress.com/category/doencas-autoimunes/
—-
Vitamin D: a natural inhibitor of multiple sclerosis From Colleen E. Hayes Department of Biochemistry, University of Wisconsin-Madison, 433 Babcock
Disponivel em http://journals.cambridge.org/action/displayFulltext?type=1&fid=796912&jid=PNS&volumeId=59&issueId=04&aid=796900——
Vitamin D: its role and uses in immunology
HECTOR F. DELUCA2 and MARGHERITA T. CANTORNA*
Department of Biochemistry, University of Wisconsin-Madison, Madison, Wisconsin 53706, USA; and
* Department of Nutrition, Pennsylvania State University, University Park, Pennsylvania 16802, USA
http://www.fasebj.org/cgi/content/full/15/14/2579 http://www.drtheo.com/vitaminD/documents/VitaminD-itsroleandusesinimmunology.pdf
(The FASEB Journal. 2001;15:2579-2585.)
—-
High prevalence of vitamin D deficiency and reduced bone mass in multiple sclerosis
http://www.huffingtonpost.com/dr-david-perlmutter-md/vitamin-d-benefits_b_818912.html
High prevalence of vitamin D deficiency and reduced bone mass in multiple sclerosis
1. J. Nieves, PhD,
2. F. Cosman, MD,
3. J. Herbert, MD,
4. V. Shen, PhD and
5. R. Lindsay, MD
—-
Vitamin D and the immune system: new perspectives on an old theme
Endocrinol Metab Clin North Am. 2010 June; 39(2):
365–379.
Endocrinol Metab Clin North Am. Author manuscript; available in PMC 2011 June 1.Published in final edited form as:Endocrinol Metab Clin North Am. 2010 June; 39(2): 365–379. doi: 10.1016/j.ecl.2010.02.010
Martin Hewison, PhD
Martin Hewison, Professor in Residence, Department of Orthopaedic Surgery and Molecular Biology Institute, David Geffen School of Medicine at UCLA, 615 Charles E. Young Drive South, Los Angeles, CA 90095, USA;
National Center for Biotechnology Information, U.S. National Library of Medicine 8600 Rockville Pike, Bethesda MD, 20894 USA
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2879394/?tool=pubmed
—-
Lack of Vitamin D Linked to Alzheimer’s and Vascular Dementia
Friday, June 05, 2009 by: Sherry Baker, Health Sciences Editor
Sherry Baker is a widely published writer whose work has appeared in Newsweek, Health, the Atlanta Journal and Constitution, Yoga Journal, Optometry, Atlanta, Arthritis Today, Natural Healing Newsletter, OMNI, UCLA’s “Healthy Years” newsletter, Mount Sinai School of Medicine’s “Focus on Health Aging” newsletter, the Cleveland Clinic’s “Men’s Health Advisor” newsletter and many others.
Learn more: http://www.naturalnews.com/026392_Vitamin_D_Alzheimers_disease.html#ixzz3HnBD71Qg
http://www.naturalnews.com/026392_Vitamin_D_Alzheimers_disease.html
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Factors in human vitamin D nutrition and in the production and cure of classical rickets Sítio canadense sobre e.m. DIRECT-MS
Fatores nutricionais e suplementares relacionados à esclerose múltipla. http://www.direct-ms.org/
—-
“It is plausible that some 200 cases a year of MS might be prevented in Scotland alone by giving vitamin D to mothers and children,” he wrote.
disponivel em http://www.timesonline.co.uk/tol/life_and_style/health/article5663483.ece-Vitamin D is ray of sunshine for multiple sclerosis patient
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Vitamin D in preventive medicine: are we ignoring the evidence? Vitamin D in preventive medicine: are we ignoring the evidence? A vitamina D em medicina preventiva: estamos ignorando as provas? Vitamina D em medicina preventiva: estamos ignorando as provas?
Dispoível em
http://64.233.163.132/translate_c?hl=pt-BR&langpair=en%7Cpt&u=http://www.ncbi.nlm.nih.gov/pubmed/12720576&prev=/translate_s%3Fhl%3Dpt-BR%26q%3DVitamina%2BD%2Be%2Bdepress%25C3%25A3o%26sl%3Dpt%26tl%3Den&rurl=translate.google.com.br&usg=ALkJrhjspQEBlxCMyClVGNWHjrZsYK2BOA
Vitamin D supplementation: Recommendations for Canadian mothers and infants. A suplementação de vitamina D: Recomendações para as mães e bebês canadenses.. Paediatr Child Health. . Paediatr Child Health. 2007 Sep; 12(7):583-98. 2007 Sep; 12 (7) :583-98.[Paediatr Child Health. [Paediatr Child Health. 2007] 2007]
Review Vitamin D and disease prevention with special reference to cardiovascular disease. Review vitamina D e prevenção de doenças, com especial referência à doença cardiovascular.Prog Biophys Mol Biol. Prog Biophys Mol Biol. 2006 Sep; 92(1):39-48. 2006 Sep; 92 (1) :39-48. Epub 2006 Feb 28. Epub 2006 Feb 28.[Prog Biophys Mol Biol. [Prog Biophys Mol Biol. 2006] 2006]
Vitamin D in health and disease. Vitamina D na saúde e na doença.Clin J Am Soc Nephrol. Clin J Am Soc Nephrol. 2008 Sep; 3(5):1535-41. 2008 Sep; 3 (5) :1535-41. Epub 2008 Jun 4. Epub 2008 Jun 4.[Clin J Am Soc Nephrol. [Clin J Am Soc Nephrol. 2008] 2008]
Review Sunlight and vitamin D for bone health and prevention of autoimmune diseases, cancers, and cardiovascular disease. Review Luz solar e vitamina D para a saúde óssea e prevenção de doenças auto-imunes, câncer e doenças cardiovasculares.Am J Clin Nutr. Am J Clin Nutr. 2004 Dec; 80(6 Suppl):1678S-88S. 2004 Dec; 80 (6 Suppl): 1678S-88S.[Am J Clin Nutr. [Am J Clin Nutr. 2004] 2004]
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29/02/2012 às 16:59
[…] https://biodireitomedicina.wordpress.com/2011/03/23/informacoes-medicas-sobre-a-prevencao-e-tratament… […]
01/03/2012 às 16:59
Nos países eslavos, a população movimenta-se para que o governo forneça as vitaminas, especialmente a D. Nos EUA, os cientistas requerem ao governo – ver a Times -, a suplementação de vitamina D para assegurar a população do desenvolvimento de varias doenças, alem da esclerose múltipla, o cancro, as diabetes e outras autoimunes. Custa mais caro, em termos de desperdício em recursos financeiros e humanos, deixar uma nação com altos índices de pessoas doentes, do que investir na Medicina Preventiva e oferecer uma dieta verdadeiramente saudável.
A neurodegeneração é resultado de distúrbio metabólico. Há meio de prevenir a degeneração do sistema nervoso central: basta exame de dosagem das vitaminas no sangue – como a B2 ou Riboflavina, a D – e a eliminação de outros fatores desencadeantes: evitar o desgaste emocional e eliminar da dieta alimentar a carne vermelha.
Baixos índices de vitamina D no sangue estão diretamente associados ao estresse emocional ou sofrimento. Em casos de doenças auto-imunitárias, tais como a esclerose múltipla, artrite reumatoide, psoriase, hipertireoidismo, hipotireoidismo, lupus, vitiligo, por exemplo, existe deficiência de vitamina D confirmada em exames de sangue.
◊ Dr. Cícero Galli Coimbra
Médico Neurologista e Professor Livre-Docente
Departamento de Neurologia e Neurocirurgia – Universidade Federal de São Paulo – Unifesp/EPM – Sofrimento emocional. – Em defesa da administração de doses elevadas de riboflavina associada à eliminação dos fatores desencadeantes no tratamento (…).
Disponivel em
http://www.unifesp.br/dneuro/nexp/riboflavina/c.htm
◊ Parkinson – riboflavin and the elimination of dietary red meat promote the recovery
Abstract:
“Abnormal riboflavin status in the absence of a dietary deficiency was detected in 31 consecutive outpatients with Parkinson’s disease (PD), while the classical determinants of homocysteine levels (B6, folic acid, and B12)… received riboflavin orally (30 mg)”.
Disponivel em
http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0100-879X2003001000019&lng=pt&nrm=iso
POR Dr. Cícero Galli Coimbra
Vitamina D pode revolucionar o tratamento da esclerose múltipla*
https://biodireitomedicina.wordpress.com/2010/08/03/vitamina-d-pode-revolucionar-o-tratamento-da-esclerose-multipla/
Vitamina D pode revolucionar o tratamento da esclerose múltipla* « Celso Galli Coimbra – OABRS 11352
http://www.caasp.org.br/Noticias.asp?cod_noticia=1679
*Matéria publicada originalmente no Jornal do Advogado, edição de maio de 2010.
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A Entrevista com Dr. Cícero Galli Coimbra. Evitar o envelhecimento e a perda de neuronios. Cura de doenças neurodegenerativas e autoimunitarias
http://mais.uol.com.br/view/85r7d735pwrw/sistema-nervoso-0402336EE4B96346?types=Ahttp://mais.uol.com.br/view/85r7d735pwrw/sistema-nervoso-0402336EE4B96346?types=A
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POR Dr. Cícero Galli Coimbra
“Pesquisas do Mount Sinai Hospital, do Canadá, indicariam que doenças como transtorno bipolar, autismo, mal de Alzheimer e esquizofrenia são mais comuns em pessoas que nascem em estações do ano como outono e inverno, quando receberiam menos sol, isto é, uma quantidade menor da fonte natural de vitamina D.”
Vitamina D é importantíssima para a saúde
https://biodireitomedicina.wordpress.com/2009/09/22/vitamina-d-e-importantissima-para-a-saude/
“Estudos realizados no Brasil e no exterior apontam a importância da substância na prevenção e no tratamento do câncer, diabetes e de doenças neurológicas, cardiovasculares e até degenerativas, como a esclerose múltipla.”
“Antigamente indicada para evitar o raquitismo na infância (quem não ouviu falar do famoso óleo de fígado de bacalhau?), a ciência ‘redescobre’ a vitamina D como poderoso preventivo da osteoporose e outras doenças do envelhecimento. “Pesquisas recentes também revelaram a ação positiva da substância nos sistemas nervoso e imununológico”, diz o neurologista Cícero Galli Coimbra, coordenador do Laboratório de Fisiopatologia Clínica e Experimental da Universidade Federal de São Paulo (Unifesp). Coimbra destaca que apenas sobre a esclerose múltipla, por exemplo, existem cerca de 700 artigos médicos internacionais, que atribuem a essa vitamina o papel de estimular as conexões dos neurônios. “Isso sem falar de estudos que mostram também a sua contribuição para a melhoria da qualidade de vida dos portadores de câncer, artrite reumatóide, vitiligo, psoríase, hiper e hipotireoidismo, entre outras patologias”, acrescenta.”
A Vitamina D é importantíssima para a saúde 22/09/2009
Estudos realizados no Brasil e no exterior apontam a importância da substância na prevenção e no tratamento do câncer, diabetes e de doenças neurológicas, cardiovasculares e até degenerativas, como a esclerose múltipla.
https://biodireitomedicina.wordpress.com/category/a-prevencao-de-doencas-neurodegenerativas/
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A importância da colina para a regeneração neuronal
“A colina é especialmente importante na gravidez. “Vários estudos já mostraram que ela é tão ou mais importante do que o ácido fólico durante a gestação”
Cícero Galli Coimbra
http://veja.abril.com.br/041006/p_104.html
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17/05/2012 às 16:59
Vitamin D and the immune system: new perspectives on an old theme
Martin Hewison, PhD
PUBMED CENTRAL Journal List – NIH Public Access – Autor Manuscript
Vitamin D and the immune system: new perspectives on an old theme
Martin Hewison, PhD
PUBMED CENTRAL Journal List – NIH Public Access – Autor Manuscript
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Disponivel em
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2879394/?tool=pubmed
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Vitamin D and the immune system: new perspectives on an old theme
Martin Hewison, PhD
PUBMED CENTRAL Journal List – NIH Public Access – Autor Manuscript
—
Disponivel em
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2879394/?tool=pubmed
Journal List > NIHPA Author Manuscripts
Endocrinol Metab Clin North Am. Author manuscript; available in PMC 2011 June 1.
Published in final edited form as:
Endocrinol Metab Clin North Am. 2010 June; 39(2): 365–379.
doi: 10.1016/j.ecl.2010.02.010
PMCID: PMC2879394
NIHMSID: NIHMS180153
Copyright notice and Disclaimer
Vitamin D and the immune system: new perspectives on an old theme
Martin Hewison, PhD
Martin Hewison, Professor in Residence, Department of Orthopaedic Surgery and Molecular Biology Institute, David Geffen School of Medicine at UCLA, 615 Charles E. Young Drive South, Los Angeles, CA 90095, USA;
Corresponding author for proof and reprints: Martin Hewison, PhD, Department of Orthopaedic Surgery, David Geffen School of Medicine UCLA, 615 Charles E. Young Drive South, Los Angeles, CA 90095, USA, Tel: 310 206 1625, Fax: 310 825 5409, Email: mhewison@mednet.ucla.edu
The publisher’s final edited version of this article is available at Endocrinol Metab Clin North Am
• Other Sections▼
o Synopsis
o Introduction
o Vitamin D and innate immunity
o Vitamin D and adaptive immunity
o Vitamin D, the immune system and human health
o Conclusions
o References
Synopsis
Interaction with the immune system is one of the most well-established non-classical effects of vitamin D. For many years this was considered to be a manifestation of granulomatous diseases such sarcoidosis, where synthesis of active 1,25-dihydroxyvitamin D3 (1,25(OH)2D3) is known to be dysregulated. However, recent reports have supported a role for 1,25(OH)2D3 in mediating normal function of both the innate and adaptive immune systems. Crucially, these effects appear to be mediated via localized autocrine or paracrine synthesis of 1,25(OH)2D3 from precursor 25-hydroxyvitamin D3 (25OHD3), the main circulating metabolite of vitamin D. As such, the ability of vitamin D to influence normal human immunity will be highly dependent on the vitamin D status of individuals, and may lead to aberrant response to infection or autoimmunity in those who are vitamin D-insufficient. The potential health significance of this has been underlined by increasing awareness of impaired vitamin D status in populations across the globe. The following review article will describe in more detail some of the recent developments with respect to vitamin D and the immune system, together with possible clinical implications.
Keywords: vitamin D, CYP27b1, toll-like receptor, macrophage, cathelicidin, regulatory T-cells
o Vitamin D, the immune system and human health
Introduction
Historical perspective
Non-classical actions of vitamin D were first recognized thirty years ago when receptors for active 1,25-dihydroxyvitamin D3 (1,25(OH)2D3) were detected in various neoplastic cells lines 23,59. Other studies immediately following this showed that binding of 1,25(OH)2D3 to the vitamin D receptor (VDR) promoted antiproliferative and prodifferentiation responses in cancer cells 1,18, highlighting an entirely new facet of vitamin D action. The spectrum of non-classical responses to vitamin D was then extended to include actions on cells from the immune system 2,13. This interaction was further endorsed by the observation that some patients with the granulomatous disease sarcoidosis present with elevated circulating levels of 1,25(OH)2D3 and associated hypercalcemia 11,72. In these patients the high serum 1,25(OH)2D3 is due to increased activity of the enzyme 25-hydroxyvitamin D-1α-hydrooxylase (1α-hydroxylase). However, in contrast to normal subjects where 1α-hydroxylase is classically localized in the kidney, the increased synthesis of 1,25(OH)2D3 in patients with sarcoidosis involves 1α-hydroxylase activity in disease-associated macrophages 4,6,9. Thus, it was concluded that the immune system had the potential to both synthesize 1,25(OH)2D3 and elicit autocrine or paracrine responses from immune cells expressing the vitamin D receptor 38.
Despite these early advances, the precise nature of the interaction between vitamin D and the immune system remained unresolved for many years. Some pieces of the puzzle were easier to complete than others. For example, it became evident that dysregulation of 1,25(OH)2D3 was not restricted to sarcoidosis but was a common feature of many granulomatous disorders and some forms of cancer 39. Likewise, at least in vitro, it was possible to potently regulate a range of immune cell functions using 1,25(OH)2D3 or its synthetic analogs 35,97. However, the key remaining question concerned whether or not vitamin D could act as a physiological regulator of normal immune responses. Answers to this question began to appear about five years ago and new information on the fundamental nature of vitamin D sufficiency/insufficiency has provided a fresh perspective on non-classical actions of vitamin D. As a consequence, there is now a much broader acceptance that vitamin D plays an active role in regulating specific facets of human immunity. This will be detailed in the following review together with discussion on the possible impact of vitamin D insufficiency and vitamin D supplementation on normal immune function and human disease.
• Other Sections▼
o Synopsis
o Introduction
o Vitamin D and innate immunity
o Vitamin D and adaptive immunity
o Vitamin D, the immune system and human health
o Conclusions
o References
Vitamin D and innate immunity
Macrophages, vitamin D and cathelicidin
Consistent with the earlier seminal observations of extra-renal 1α-hydroxylase activity in patients with sarcoidosis, the effects of vitamin D on macrophage function have been central to many of the new observations implicating vitamin D in the regulation of immune responses. In common with natural killer cells (NK) and cytotoxic T-lymphocytes (cytotoxic T-cells), macrophages and their monocyte precursors play a central role in initial non-specific immune responses to pathogenic organisms or tissue damage – so called cell-mediated immunity. Their role is to phagocytose pathogens or cell debris and then eliminate or assimilate the resulting waste material. In addition, macrophages can interface with the adaptive immune system by utilizing phagocytic material for antigen presentation to T-lymphocytes (T-cells).
For many years, the key action of vitamin D on macrophages was thought to be its ability to stimulate differentiation of precursor monocytes to more mature phagocytic macrophages 1,2,45,93. This concept was supported by observations showing differential expression of VDR and 1α-hydroxylase during the differentiation of human monocytes macrophages 49. The latter report also emphasized early studies showing that normal human macrophages were able to synthesize 1,25(OH)2D3 when stimulated with interferon gamma (IFNγ) 46. Localized activation of vitamin D, coupled with expression of endogenous VDR was strongly suggestive of an autocrine or intracrine system for vitamin D action in normal monocytes/macrophages.
However, confirmation of such a mechanism was only obtained in 2006 when Robert Modlin and colleagues carried out DNA array analyses to define innate immunity genes that were specifically modulated in monocytes by Mycobacterium tuberculosis (M. tb). In a seminal investigation both the VDR and the gene for 1α-hydroxylase (CYP27B1) were shown to be induced following activation of the principal pathogen recognition receptor for M. tb, toll-like receptor 2/1 (TLR2/1) 56. Subsequent experiments confirmed that precursor 25OHD3 was able to induce intracrine VDR responses in monocytes that had been treated with a TLR2/1 activator. In particular, the TLR2/1–25OHD3 combination stimulated expression of the antibacterial protein cathelicidin, so that vitamin D was able to promote monocyte killing of M. tb 56. Notably, the ability to promote expression of the antibacterial protein following a TLR2/1 challenge was directly influenced by the 25OHD3 status of the donor serum used for monocyte culture 56. More recently, we have shown that vitamin D supplementation in vivo can also enhance TLR2/1-induced cathelicidin expression 5. Cathelicidin was identified several years ago as a target for transcriptional regulation by 1,25(OH)2D3-liganded VDR, in that its gene promoter contains a functional vitamin D response element (VDRE) 30,100. Interestingly, this VDRE occurs within a small interchangeable nuclear element (SINE) sequence which only appears to be present in the cathelicidin gene promoter of higher primates, suggesting that vitamin D regulation of this facet of innate immunity is a relatively recent evolutionary development 30.
Recent reports have underlined the importance of cathelicidin as a target for vitamin D but also suggest that this mechanism may be more complex than initially thought. As yet, the precise signal system by which TLR activation induces expression of VDR and 1α-hydroxylase remains unclear. Promoter-reporter analysis of the events involved in transcriptional regulation of CYP27B1 suggest that TLR4-mediated induction of the enzyme involves JAK-STAT, MAP kinase and nuclear factor kappB (NF-κB) pathways, and that these synergize with IFNγ-mediated induction of CYP27B192. However, other studies have proposed that TLR2/1 induction of 1α-hydroxylase occurs indirectly as a consequence of TLR2/1 induced interleukin-15 (IL-15) which is a potent inducer of CYP27B1 and 1α-hydroxylase activity 50. In a similar fashion, interleukin 17A (IL-17A) has been shown to enhance 1,25(OH)2D3-mediated induction of cathelicidin, although this response does not appear to involve transcriptional regulation of 1α-hydroxylase or increased VDR sensitivity 77. One pathway that has been poorly studied in this regard concerns the enzyme 24-hydroxylase, which is conventionally considered to function by inactivating 1,25(OH)2D3. The gene for 24-hydroxylase (CYP24) is potently induced by 25OHD3 following TLR2/1 activation of monocytes 56 but, as yet, it is unclear whether this involves the non-metabolic splice variant form of CYP24 known to be expressed by macrophages 82.
Regulation of the antibacterial protein by 1,25(OH)2D3 has been described for a wide variety of cell types other than macrophages, including keratinocytes 84,85,100, lung epithelial cells 104, myeloid cell lines 30,85,100 and placental trophoblasts 54. In some cases 54,84, this appears to involve an intracrine response similar to that reported for monocytes. However, the mechanisms controlling local synthesis of 1,25(OH)2D3 in these cells vary considerably. In keratinocytes, low baseline expression of 1α-hydroxylase is enhanced following epidermal wounding by transforming growth factor beta (TGFβ) 84. The resulting rise in 1,25(OH)2D3 concentrations upregulates expression of TLR2 and TLR4 by keratinocytes, thereby priming these cells for further innate immune responses to pathogens or tissue damage 84. By contrast, in trophoblasts, induction of cathelicidin and subsequent bacterial killing by 25OHD3 appears to be due to constitutive 1α-hydroxylase activity, which is not further enhanced by TLR activation 54. The latter may be due to the rapid non-immune induction of 1α-hydroxylase and VDR which occurs within the placenta during early gestation 24.
Although most of the studies of vitamin D-mediated innate immunity have focused on the role of 1,25(OH)2D3-bound VDR as a pivotal transcriptional regulator of cathelicidin, it is also important to recognize that other ligands may interact with the VDR 58. For example, recent studies of bilary epithelial cells have shown that cathelicidin expression can be induced in a VDR-dependent fashion by bile salts 19. This provides a mechanism for maintaining bilary sterility, although additive effects of 1,25(OH)2D3 also highlight a novel therapeutic application for vitamin D in the treatment of primary bilary cirrhosis. Conversely, other compounds may act to disrupt normal 1,25(OH)2D3-VDR-mediated immunity. The polycyclic aromatic hydrocarbon benzo(A)pyrene, a prominent product of cigarette smoking, has been shown to attenuate vitamin D-mediated induction of macrophage cathelcidin in a VDR-dependent fashion by stimulating expression of 24-hydroxylase, and vitamin D catabolism 64. The precise mechanism by which this occurs has yet to be determined but these data suggest that some toxic compounds are actively detrimental to vitamin D-mediated immunity.
The observations detailed above show clearly that vitamin D is a potent stimulator of mechanisms associated with pathogen elimination. In subsequent sections the clinical importance of this with respect to vitamin D insufficiency and immune-related diseases is discussed in more detail. However, one key question that immediately arises from the current observations is why there is a need to involve the vitamin D system in the TLR-induction of innate immunity. As previously described, VDR-mediated transcriptional regulation of cathelicidin is a relatively recent evolutionary change and was presumably advantageous when primates (including early Homo sapiens) were exposed to abundant sunlight, thereby priming high serum levels of vitamin D. Other benefits of incorporating vitamin D into innate immune regulation include the fact that it is associated with key feedback control pathways. As already mentioned, vitamin D has its own catabolic enzyme in the form of 24-hydroxylase which sensitively attenuates responses to 1,25(OH)2D3 and, in the case of the CYP24 splice variant, may also attenuate synthesis of this vitamin D metabolite 82. However, vitamin D may also provide feedback regulation of immune activation pathways in that 1,25(OH)2D3 has been shown to potently downregulate expression of monocyte TLR2 and TLR4, thereby suppressing inflammatory responses that are normally activated by these receptors 83. Thus, by utilizing both CYP24 and TLR regulatory mechanisms, vitamin D may help to promote appropriate innate immune responses whilst preventing an over-elaboration of innate immune responses and the tissue damage frequently associated with this.
Dendritic cells and antigen presentation
In addition to the phagocytic acquisition and elimination of pathogens and cell debris, innate immunity also involves the presentation of resultant antigen to cells involved in the adaptive arm of the immune system (see Figure 1). Although several cells are able to do this, the most well-recognized group of professional antigen presenting cells (APCs) are dendritic cells (DCs). Expression of VDR by purified tissue DCs was first reported in 198715. Subsequent studies using populations of DCs isolated from skin (Langerhans cells) provided evidence that 1,25(OH)2D3 could act to attenuate antigen presentation 20. However, it was not until the later advent of in vitro monocyte-derived DC models that the effects of vitamin D metabolites on antigen presentation were fully elucidated. In 2000 parallel studies by the Adorini and Kumar groups showed that 1,25(OH)2D376 and its synthetic analogs 34 inhibited the maturation of monocyte-derived DCs, thereby suppressing their capacity to present antigen to T-cells. Based on these observations, it was proposed that vitamin D could act to promote tolerance and this was endorsed by studies of pancreatic islet transplantation in which lower rejection rates were observed in 1,25(OH)2D3-treated mice 32. Crucially this response to 1,25(OH)2D3 appeared to be due to decreased DC maturation and concomitant enhancement of suppressor or regulatory T-cells (Treg) 32. Further studies have underlined the importance of Treg generation 68 as part of the interaction between vitamin D and the immune system and this is discussed in greater detail in later sections of this review.
Effects of vitamin D on innate and adaptive immunity
Although regulation of DC maturation represents at potential target for 1,25(OH)2D3 and its synthetic analogs as treatment for autoimmune disease and host-graft rejection, another perspective was provided by the observation that DCs express 1α-hydroxylase in a similar fashion to macrophages 25,40. Data from monocyte-derived DCs showed that 1α-hydroxylase expression and activity increases as DCs differentiate towards an a mature phenotype 40. Functional analyses showed that treatment with 25OHD3 suppresses DC maturation and inhibits T-cell proliferation, confirming the existence of an intracrine pathway for vitamin D similar to that observed for macrophages 40. Interestingly, mature DCs showed lower levels of VDR than immature DCs or monocytes 40. This reciprocal organization of 1α-hydroxylase and VDR expression may be advantageous in that mature antigen-presenting DCs may be relatively insensitive to 1,25(OH)2D3, thereby allowing induction of an initial T-cell response. However, the high levels of 1,25(OH)2D3 being synthesized by these cells will be able to act on VDR-expressing immature DCs and thus prevent their further development 41. In this way, paracrine action of locally produced 1,25(OH)2D3 will allow initial presentation of antigen to T-cells whilst preventing continued maturation of DCs and over-stimulation of T-cells.
Although DCs are heterogeneous in terms of their location, phenotype and function, they are broadly divided into two groups based on their origin. Myeloid (mDCs) and plasmacytoid (pDCs) express different types of cytokines and chemokines and appear to exert complementary effects on T-cell responses, with mDCs being the most effective APCs 57 and pDCs being more closely associated with immune tolerance 91. It is therefore interesting to note that 1,25(OH)2D3 preferentially regulates mDCs, suggesting that the key effect of vitamin D in this instance is to suppress activation of naïve T-cells. Although in this study pDCs showed no apparent immune response to 1,25(OH)2D3, this does not preclude a role for vitamin D in the regulation of tolerogenic responses. One possibility is that local, intracrine, synthesis of 1,25(OH)2D3 will be more effective in achieving these responses. Alternatively, 1,25(OH)2D3 synthesized by pDCs may regulate tolerance through paracrine effects on VDR-expressing T-cells. This is discussed in further detail in the following section.
Vitamin D and adaptive immunity
Vitamin D and T-cell function
Resting T-cells express almost undetectable levels of VDR, but levels of the receptor increase as T-cells proliferate following antigenic activation 44,66,78. As a consequence, initial studies of the effects of vitamin D on T-cells focused on the ability of 1,25(OH)2D3 to suppress T-cell proliferation 44,66,78. However, the recognition that CD4+ effector T-cells were capable of considerable phenotypic plasticity, suggested that vitamin D might also influence the phenotype of T-cells. Lemire and colleagues first reported that 1,25(OH)2D3 preferentially inhibited T-helper 1 (Th1) cells which are a subset of CD4+ effector T-cells closely associated with cellular, rather than humoral, immune responses 52. Subsequent studies confirmed this observation and demonstrated that the cytokine profile of 1,25(OH)2D3-treated human T-cells was consistent with Th2 cells, a subset of CD4+ T-cells associated with humoral (antibody)-mediated immunity 14,70. The conclusion from these observations was that vitamin D promotes a T-cell shift from Th1 to Th2 and thus might help to limit the potential tissue damage associated with Th1 cellular immune responses. However, the validity of this generalization was called into question by studies using mouse T-cells in which 1,25(OH)2D3 was shown to inhibit cytokines associated with both Th1 (IFNγ) and Th2 (interleukin-4, IL-4). Subsequent analysis of immune cells from the VDR gene knockout mouse added further confusion by showing that these animals had reduced (rather than the predicted elevated) levels of Th1 cells 69. Thus, whilst in vitro vitamin D appears to broadly support a shift from Th1 to Th2 in CD4+ cells, it seems likely that in vivo its effects on T-cells are more complex.
The T-cell repertoire has continued to expand with the characterization of another effector T-cell lineage distinct from Th1 or Th2 cells, termed Th17 cells because of their capacity to synthesize interleukin-17 (IL-17) 36,101. Th17 cells play an essential role in combating certain pathogens but they have also been linked to tissue damage and inflammation 12,48. The precise role of vitamin D as a regulator of Th17 cells has yet to be fully elucidated but it is interesting to note that studies of animal models of the gastrointestinal inflammatory disease colitis have shown that treatment with 1,25(OH)2D3 reduces expression of IL-1721, whilst loss of 1,25(OH)2D3 as a result of CYP27b1 gene ablation leads to elevated levels of this cytokine 55. Thus, it possible that vitamin D exerts some of its effects on inflammation and autoimmune disease through the regulation of Th17 cells.
A fourth group of CD4+ T-cells, exert suppressor rather than effector functions and are known as regulatory T-cells or Tregs. In view of its early recognition as a suppressor of T-cell proliferation, it was anticipated that vitamin D would have effects on Tregs, and indeed in 2002 O’Garra and colleagues demonstrated that 1,25(OH)2D3, in conjunction with glucocorticoids, potently stimulated the generation of interleukin-10 (IL-10)-producing CD4+/CD25+ Tregs 10. Subsequent reports indicated that 1,25(OH)2D3 alone can induce Tregs 31, and it appears that preferential differentiation of Tregs is a pivotal mechanism linking vitamin D and adaptive immunity, with potential beneficial effects for autoimmune disease and host-graft rejection 33,62,89. This immunosuppressive mechanism is likely to be mediated by the induction of tolerogenic DCs as described in the previous section of the review 7,22,32, but direct effects on T-cells may also be important 95. In this latter study, it was notable that 1,25(OH)2D3 increased both IL-10-secretion and TLR9 expression by Tregs, suggesting a novel link between innate and adaptive immune responses 95.
Relative to the wealth of literature on CD4+ effector cells, our understanding of the effects of vitamin D on CD8+ suppressor T-cells remains somewhat limited. In contrast to CD4+ cells, CD8+ show poor antiproliferative response to 1,25(OH)2D378,98,99. However, VDR expression appears to be abundant in CD8+ cells suggesting that they are still potential targets for 1,25(OH)2D3. Indeed subsequent reports have shown that 1,25(OH)2D3 actively regulates cytokine production by CD8+ cells 103, and can also regulate the proliferation of CD8+ cells following specific immune stimuli 43. Despite this, 1,25(OH)2D3 does not appear to have a significant impact on animal disease models such as experimental autoimmune encephalomyelitis where CD8+ cells have been implicated 65.
Although many of the studies linking 1,25(OH)2D3 with adaptive immunity have focused on changes in T-cell proliferation and phenotype, it is important to recognize that other facets of T-cell function may also be affected by the hormone. In particular recent studies have shown that vitamin D can exert powerful effects on the homing of T-cells to specific tissues. Initial studies suggested that 1,25(OH)2D3 acts to inhibit migration of T-cells to lymph nodes 94. However, more recent reports have demonstrated an active role for vitamin D in promoting homing of T-cells to the skin via upregulation of chemokine receptor 10 (CCR10), the ligand for which, CCL27, is expressed by epidermal keratinocytes 87. Notably this T-cell homing response was induced by 25OHD3 as well as 1,25(OH)2D3 and the author suggested that both DCs and T-cells were possible sources of the local 1α-hydroxylase activity 87. In contrast to its positive effect on epidermal T-cell homing, vitamin D appears to exert a negative effect on chemokines and chemokine receptors associated with the GI tract 87. However, it seems likely that this is will be highly T-cell selective as newer studies using the VDR gene knockout mouse have demonstrated aberrant GI migration of a subset of CD8+ cells, and this effects appears to be closely linked to the increased risk of colitis in VDR knockout mice 105.
Vitamin D and B-cell function
Like T-cells, active but not inactive B-cells express the VDR 79. Consequently, initial studies indicated that 1,25(OH)2D3 could directly regulate B-cell proliferation 86 and immunoglobulin (Ig) production 79. Subsequent work contradicted this, suggesting instead that the ability of 1,25(OH)2D3 to suppress proliferation and immunoglobulin (Ig) production was due to indirect effects mediated via helper T-cells 51. However, more recent reports have demonstrated that 1,25(OH)2D3 does indeed exert direct effects on B cell homeostasis 17. In addition to confirming direct VDR-mediated effects on B cell proliferation and Ig production, this study also highlighted the ability of 1,25(OH)2D3 to inhibit the differentiation of plasma cells and class switched memory cells, suggesting a potential role for vitamin D in B cell-related disorders such as systemic lupus erythamtosus. Notably, expression of CYP27b1 was also detected in B-cells, indicating that B-cells may be capable of autocrine/intracrine responses to vitamin D 17. Indeed, this may be common to lymphocytes in general as CYP27b1 expression has also been detected in T-cells 87.
Vitamin D, the immune system and human health
For many years vitamin D status was defined simply by whether or not the patient in question exhibited symptoms of the bone disease rickets (osteomalacia in adults). However, an entirely new perspective on vitamin D status has arisen from the observation that serum levels of the main circulating form of vitamin D (25OHD3) as high as 75 nM correlate inversely with parathyroid hormone 16. This, has prompted the introduction of a new term – vitamin D ‘insufficiency’ – defined by serum levels of 25OHD3 that are sub-optimal (< 75 nM) but not necessarily rachitic ( Literature > PubMed Central
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Luz solar e vitamina D para a saúde óssea e prevenção de doenças auto-imunes, cânceres e doenças cardiovasculares.
Sunlight and vitamin D for bone health and prevention of autoimmune diseases, cancers, and cardiovascular disease.
Holick MF.
SourceDepartment of Medicine, Section of Endocrinology, Nutrition, and Diabetes, Vitamin D, Skin, and Bone Research Laboratory, Boston University Medical Center, Boston, MA 02118, USA. mfholick@bu.edu=
Abstract
PMID:15585788[PubMed – indexed for MEDLINE]
http://www.ncbi.nlm.nih.gov/pubmed/15585788
Luz solar e vitamina D para a saúde óssea e prevenção de doenças auto-imunes, cânceres e doenças cardiovasculares.
Am J Clin Nutr. 2004 Dez; 80 (6 Supl): 1678S-88s.
Holick MF.
SourceDepartment de Medicina, Secção de Endocrinologia, Nutrição e Diabetes, vitamina D, pele e osso Research Laboratory, Boston University Medical Center, Boston, MA 02118, EUA. mfholick@bu.edu
A maioria dos seres humanos depende da exposição ao sol para satisfazer suas necessidades de vitamina D. Os fótons solares ultravioletas B são absorvidas pelo 7-dehidrocolesterol na pele, levando a sua transformação em pré-vitamina D3, que é rapidamente convertido em vitamina D3.
Temporada, latitude, hora do dia, a pigmentação da pele, envelhecimento, uso de filtro solar e vidro correspondem a toda a influência na produção cutânea de vitamina D3.
Uma vez formada, a vitamina D3 é metabolizada no fígado em 25-hidroxivitamina D3 e, em seguida, no rim em sua forma biologicamente activa, 1,25-dihidroxivitamina D3.
A deficiência de vitamina D é uma epidemia não reconhecida entre crianças e adultos nos Estados Unidos, embora exista. A deficiência de vitamina D não só provoca o raquitismo nas crianças, mas também precipita e agrava a osteoporose em adultos e provoca a osteomalácia dolorosa, uma doença óssea.
A deficiência de vitamina D tem sido associada com o aumento dos riscos de cancro mortais, doença cardiovascular, esclerose múltipla, artrite reumatóide, e diabetes mellitus tipo 1. Manter as concentrações sanguíneas de 25-hidroxivitamina D acima de 80 nmol / L (aproximadamente 30 ng / mL), não só é importante para maximizar a absorção de cálcio intestinal, mas também pode ser importante para fornecer o extrarenal 1alfa-hidroxilase, que está presente na maioria dos tecidos para produzir 1 ,25-dihidroxivitamina D3.
Embora a exposição excessiva crônica ao sol aumente o risco de câncer de pele melanoma, evitar toda a exposição directa ao sol aumenta o risco de deficiência de vitamina D, que pode ter consequências graves.
Monitorização das concentrações séricas de 25-hidroxivitamina D anual deve ajudar a revelar deficiências de vitamina D. Exposição apreciável do sol (geralmente 5-10 minutos de exposição dos braços e pernas ou as mãos, braços e face, 2 ou 3 vezes por semana) e aumento da ingestão de vitamina D na dieta e suplementação são abordagens razoáveis para garantir a suficiência de vitamina D e prevenir doenças.
PMID: 15585788 [PubMed – indexado para o MEDLINE]
http://www.ncbi.nlm.nih.gov/pubmed/15585788
Am J Clin Nutr. 2004 Dez; 80 (6 Supl): 1678S-88s.
Luz solar e vitamina D para a saúde óssea e prevenção de doenças auto-imunes, cânceres e doenças cardiovasculares.
Holick MF.
SourceDepartment de Medicina, Secção de Endocrinologia, Nutrição e Diabetes, vitamina D, pele e osso Research Laboratory, Boston University Medical Center, Boston, MA 02118, EUA. mfholick@bu.edu
PMID: 15585788 [PubMed – indexado para o MEDLINE]
http://www.ncbi.nlm.nih.gov/pubmed/15585788
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SUNLIGHT AND VITAMIN D FOR BONE HEALTH AND PREVENTION OF AUTOIMMUNE DISEASES, CANCERS, AND CARDIOVASCULAR DISEASE.
Am J Clin Nutr. 2004 Dec;80(6 Suppl):1678S-88S.
Holick MF.
SourceDepartment of Medicine, Section of Endocrinology, Nutrition, and Diabetes, Vitamin D, Skin, and Bone Research Laboratory, Boston University Medical Center, Boston, MA 02118, USA. mfholick@bu.edu
Abstract
Most humans depend on sun exposure to satisfy their requirements for vitamin D. Solar ultraviolet B photons are absorbed by 7-dehydrocholesterol in the skin, leading to its transformation to previtamin D3, which is rapidly converted to vitamin D3. Season, latitude, time of day, skin pigmentation, aging, sunscreen use, and glass all influence the cutaneous production of vitamin D3.
Once formed, vitamin D3 is metabolized in the liver to 25-hydroxyvitamin D3 and then in the kidney to its biologically active form, 1,25-dihydroxyvitamin D3. Vitamin D deficiency is an unrecognized epidemic among both children and adults in the United States.
Vitamin D deficiency not only causes rickets among children but also precipitates and exacerbates osteoporosis among adults and causes the painful bone disease osteomalacia. Vitamin D deficiency has been associated with increased risks of deadly cancers, cardiovascular disease, multiple sclerosis, rheumatoid arthritis, and type 1 diabetes mellitus.
Maintaining blood concentrations of 25-hydroxyvitamin D above 80 nmol/L (approximately 30 ng/mL) not only is important for maximizing intestinal calcium absorption but also may be important for providing the extrarenal 1alpha-hydroxylase that is present in most tissues to produce 1,25-dihydroxyvitamin D3.
Although chronic excessive exposure to sunlight increases the risk of nonmelanoma skin cancer, the avoidance of all direct sun exposure increases the risk of vitamin D deficiency, which can have serious consequences. Monitoring serum 25-hydroxyvitamin D concentrations yearly should help reveal vitamin D deficiencies.
Sensible sun exposure (usually 5-10 min of exposure of the arms and legs or the hands, arms, and face, 2 or 3 times per week) and increased dietary and supplemental vitamin D intakes are reasonable approaches to guarantee vitamin D sufficiency.
PMID:15585788[PubMed – indexed for MEDLINE]
http://www.ncbi.nlm.nih.gov/pubmed/15585788
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