Vitamin D may possibly “turn off” pneumonia

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Researchers have discovered that a form of vitamin D can help reduce pneumonia in COVID-19. Zoonar RF / Getty Images
  • A particular form of vitamin D – not found over the counter (OTC) – may be able to fight pneumonia caused by immune cells, a new study suggests.
  • Research shows that vitamin D has an “extinction mechanism” for inflammation that can work with severe COVID-19.
  • However, clinical trials are needed before vitamin D can be used to treat COVID-19 or other respiratory diseases.
  • Researchers warn that people are taking more than the recommended amount of vitamin D in hopes of averting COVID-19 infection.

Researchers share insights into how vitamin D can help in severe COVID-19 cases by revealing how the vitamin works to reduce hyperinflammation caused by immune cells.

A new joint study from Purdue University and the National Institutes of Health (NIH) shows how an active metabolite of vitamin D – not a form sold OTC – is involved in “turning off” inflammation in the body during infections such as COVID-19.

“Since inflammation in severe cases of COVID-19 is a key cause of morbidity and mortality, we decided to take a closer look at lung cells from COVID-19 patients,” said lead authors Dr. Behdad (Ben) Afzali, head of the Immunoregulatory Section of the NIH’s National Institute of Diabetes and Digestive and Kidney Diseases, and Dr. Majid Kazemian, Assistant Professor of Biochemistry and Computer Science at Purdue University.

The study is published in the journal Natural immunology.

As part of the study, researchers analyzed individual lung cells from eight people with COVID-19.

They found that in these cells, part of the immune response to SARS-CoV-2 – the virus that causes COVID-19 – was exaggerating and exacerbating inflammation in the lungs.

After giving vitamin D in test tube experiments, they observed reduced pneumonia.

They then dived further into how the vitamin achieved this.

They did this by targeting T helper cells – also known as CD4 + cells – which are a type of immune cell that stimulates them to “kill” T cells and other white blood cells to trigger an immune response.

T cells are known to play a role in severe and dangerous cases of COVID-19 by going into overdrive and leading to an often fatal phenomenon known as a cytokine storm.

Normal vs. COVID-19 infection

The researchers found that in normal infections, Th1 cells, which are a subset of helper T cells that fight microbes in the cell, go through a pro-inflammatory phase. In this phase, the body clears the infection.

Shortly after, the system shuts down to enter the anti-inflammatory phase.

The researchers discovered that vitamin D is the key to speeding up this transition.

“We found that in healthy T cells, the activation of the inflammatory gene program coincided with the activation of a vitamin D system in these cells. We therefore investigated how this vitamin D system works and what it does. for healthy T cells before we tried to relate it back to COVID-19, ”said Dr. Afzali and Dr. Kazemian Medical news today.

Whereas in COVID-19 infections, the researchers saw that the pro-inflammatory phase of Th1 cells did not go out. They attributed this to either a vitamin D deficiency or an abnormality in the cell’s response to vitamin D.

“As expected, we found that their cells were in an inflammatory state by studying which genes were ‘turned on’ in the immune cells of the lungs of eight patients,” the co-authors said.

Dr. Afzali and Dr. Kazemian said they were somewhat surprised to identify the intracellular vitamin D system.

“[T]traditionally, vitamin D has been thought of as dependent on the kidneys to activate it before it becomes functional. We found that T cells had an independent system to both fully activate and respond to vitamin D independently of the kidneys, ”they said.

The researchers believed that adding a highly concentrated intravenous vitamin D metabolite to existing treatments could further help people recover from COVID-19. However, they have not yet tested this theory in clinical trials.

Former surveys establish correlations between the ability of vitamin D to reduce inflammation caused by T cells and the severity of COVID-19.

But the authors stress that people should not take these results as a treatment recommendation and much more work is needed.

“[I]It is very important to note that this study did not test vitamin D treatment in humans, but analyzed lung cells from eight people who had severe COVID-19, ”said Dr. Afzali and Dr. Kazemian.

“While the results are interesting, they should not be seen as an indication that vitamin D is beneficial for either the prevention or treatment of COVID-19, or that it is a substitute for other preventive and effective means of COVID-19 prevention. , including vaccines, masks, and social distancing. ”

– Dr. Ben Afzali and Dr. Majid Kazemian

Dr. Donald J. Alcendor, associate professor of pathology, microbiology and immunology at Vanderbilt University School of Medicine, said the study hinted at a possible mechanism that would need larger-scale validation.

“There is a widespread belief among the public that consuming megadoses of vitamin D can protect you before or after testing positive for COVID-19. The science that supports these claims is still evolving and will require a large-scale clinical trial “Even more, the mechanism by which vitamin D affects COVID-19 is still unknown,” he said.

Dr. Alcendor said that although vitamin D is known to have immunomodulatory functions, it does not justify its use as a protective measure against COVID-19 infection, especially if one ignores COVID-19 attenuation practices.

He warned that trying to take higher doses of fat-soluble vitamins such as vitamin D could be problematic for some people.

“A normal diet with a daily generic multivitamin will give you the necessary vitamin D,” he said.

The study suggests that vitamin D could be a therapeutic option for COVID-19 thanks to its role in hyperinflammation.

“This study reveals a potentially unique role that vitamin D plays in the activation of T cell functions that regulate inflammation in COVID-19, and understanding these regulatory pathways can provide information that will lead to the development of new therapies for the treatment of acute COVID-19, ”said Dr. Alcendor.

“This key finding could lead to the development of new therapies for multiple respiratory viruses. The potential for this study could be groundbreaking.”

– Dr. Donald Alcendor

Dr. Kazemian and Dr. Afzali maintains that we will have to wait for clinical trials for results.

“There are a number of clinical trials that are actively studying the potential of vitamin D as a complementary therapy to the treatment of COVID-19. Once these studies have reported in, we will have a much better idea of ​​the therapeutic role of vitamin D. can play in inflammation caused by COVID-19, “they said.

Dr. Alcendor said, however, that future research would have to answer a number of questions:

“[I]is this mechanism specific for COVID-19, or does it apply to other respiratory infections? If this study were performed with samples from flu patients, would you get a similar result? Could this key finding provide information that would lead to new therapies for multiple respiratory viruses? ”

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