Significance of vitamin D for human health


Authors: S. Skácelová
Authors‘ workplace: Revmatologický ústav Praha
Published in: Čes. Revmatol., 18, 2010, No. 1, p. 26-40.
Category: Overview Reports

Overview

Vitamin D is usually perceived as a nutrition component necessary for correct skeletogenesis in the period of growth and for the sustainment of healthy bones in adults. However, it is of much greater significance. The active from of vitamin D, calcitriol, is a product of the metabolism of vitamin D in the organism. As to the structure, metabolism and mechanisms of action, calcitriol is closely related to steroid hormones. An interaction between calcitriol and its receptor takes place in the cell nucleus. Vitamin D receptor is actually a nuclear transcription factor, which is present in virtually every human cell with a nucleus. Following complicated interactions in the cell nucleus with the participation of complexes of coregulatory molecules, the gene transcription of more than 500 target genes is modulated. Calcitriol circulating in the blood stream is produced by the cells of the proximal tubule of the kidney. This secretion is regulated by the serum levels of calcium and phosphate, calcium releasing hormones and mediators, and, most of all, by the serum level of calcitriol alone. Hydroxylases, enzymes necessary for both the synthesis and degradation of calcitriol, can be expressed in a large number of tissues and cells. However, this paracrine/autocrine secretion of calcitriol is subject to other regulatory mechanisms, which explains the pleiotropic effects of vitamin D on the human organism. Lack of vitamin D is linked with higher occurrence of malignant tumours, most of all breast, prostate, and colorectal cancer, with higher occurrence of some cardiovascular risk factors, and increased occurrence of heart failure and sudden cardiac death. Calcitriol has a significant immunomodulatory effect. It plays a protective role in the development of autoimmune diseases such as type I diabetes, multiple sclerosis or idiopathic inflammatory bowel disease. It also plays a dominant role in innate immune reactions. It induces the antimicrobial peptide cathelicidin, which decreases the viability of intracellular pathogens, e.g. Mycobacterium tuberculosis. Calcium-phosphate metabolism and metabolism of the bone and the growth plate are regarded as the typical sphere of action of calcitriol. The right vitamin D saturation is essential for an optimal strength and coordination of muscles. Vitamin D supplementation, which leads to a calcidiol serum level of 75 nmol/l at least, is effective in prevention of fractures.

Key words:
vitamin D, calcitriol, VDR


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