Kronik obstrüktif akciğer hastalığı (KOAH) önemli bir halk sağlığı sorunudur ve dünya çapında morbidite ve mortalitenin ana nedenlerinden biridir. Dünya Sağlık Örgütü'nün verilerine göre; KOAH bulaşıcı olmayan hastalıklar arasında dünyadaki ölümlerin ve engelliliğe ayarlanmış yaşam yılının en önemli üç nedeninden biridir. Son zamanlarda yapılan çalışmalar KOAH'lı bireylerin kontrol grubundan daha yüksek D vitamini eksikliği prevalansına sahip olduklarını ve D vitamini eksikliğinin; akciğer fonksiyonlarında ve immünitede azalma ve inflamasyonda artış ile ilişkili olduğunu göstermektedir. D vitamini metabolizmasının KOAH patofizyolojisine nasıl bağlı olabileceğinin altında yatan mekanizmalar genellikle karmaşıktır ve tam olarak anlaşılamamıştır. D vitamini; uzun yıllardır bilinen kalsemik etkilerinin yanında, daha az bilinen antimikrobiyal, immünolojik, havayolu yeniden yapılanması ve epigenetik regülasyon gibi nonkalsemik etkileri ile de KOAH'da önemli bir yere sahiptir. Ayrıca, iskelet kası gücü ve inhale kortikosteroid kullanımı üzerine etkileri de son yıllarda dikkat çekmektedir. Henüz D vitamini ile KOAH arasındaki ilişki belirsiz olsa da D vitamini yetersizliği ile KOAH patogenezi, progresyon, alevlenmeler ve komorbiditeler arasındaki olası ilişki, D vitamini takviyesinin KOAH'ta yararlı olabileceğini düşündürmektedir. Ancak, D vitamini takviyesi birçok çalışmada KOAH'lı bireylere ek yarar sağlamamış, sadece şiddetli D vitamini eksikliği olan hastalarda alevlenme azalması bildirilmiştir. Bu çalışmada, epidemiyolojik bulgulara ve altta yatan mekanizmalara odaklanılarak KOAH'ta D vitaminin rolü hakkında bilimsel literatürü gözden geçirmek amaçlanmıştır.
Anahtar Kelimeler: KOAH; D vitamini; VDR; akciğer hastalıkları; inflamasyon
Chronic obstructive pulmonary disease (COPD) is an important public health problem and one of the main causes of morbidity and mortality worldwide. According to data from the World Health Organization; COPD is one of the three most important causes of death and disability-adjusted life-year among noncommunicable diseases in the world. Recent studies have shown that individuals with COPD have vitamin D deficiency and also vitamin D deficiency are associated with decreased lung function and immunity and increased inflammation. The mechanisms underlying how vitamin D metabolism may be linked to the pathophysiology of COPD are often complex and not fully understood. Vitamin D; has an important place in COPD with its known calcic effects for many years, as well as its noncalchemic effects such as lesser known antimicrobial, immunological, airway remodeling and epigenetic regulation. In addition, it has been noted in recent years for its effects on the use of skeletal muscle strength and inhaled corticosteroid. Although the relationship between vitamin D and COPD is unclear yet, the possible association between D vitamine insufficiency and COPD pathogenesis, progression, exacerbations and comorbidities suggests that vitamin D supplementation may be beneficial in COPD. However, vitamin D supplementation has reported no exacerbation benefit for COPD patients in many studies, only a reduction in exacerbations in patients with severe D vitamin deficiency. In this review, we aimed to review the scientific literature on the role of vitamin D in COPD by focusing on epidemiological findings and underlying mechanisms.
Keywords: COPD; Vitamin D; VDR; Lung Diseases; Inflammation
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