The Role Of Vitamin D And Vitamin D Supplementation In The Prevention And Management Of Pneumonia

Vitamin D takes effect through the binding between its activated form 1, 25-(OH)2D3 and the vitamin D receptor (VDR). VDR can stimulate the expression of antibacterial peptides that resist bacterial and viral infections. VDD causes the reduction of VDR level in vivo and thereby the denaturation, cornification and proliferation of respiratory tract mucous membrane epithelia, damaging their clearance function and the accumulation of non-neutralized proinflammatory media; consequently, the inflammatory reactions could not be controlled, leading to injured pulmonary tissues and blocked gas exchange.

2) Recent studies have confirmed the very important immunomodulatory functions that vitamin D could directly regulate the human inherent immunity and adaptive immunity, and which is closely related with respiratory infectious diseases, such as tuberculosis and CAP. Vitamin D levels are significantly downregulated in critically ill patients with acute severe pneumonia or sepsis and are correlated with prognosis. In case of pulmonary infection, the pulmonary endothelial cells can convert the inactive vitamin D into its active form, and stimulate the expression of antibacterial peptides, thereby resisting infection. Moreover, vitamin D deficiency is directly correlated with lung function injuries and is one independent risk factor of pneumonia. Thus, vitamin D level affects not only the occurrence of lung diseases, but also the severity of CAP. Supplement with vitamin D might be able to reduce the occurrence and the severity of CAP.

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