Role of Vitamin D Supplementation in Prevention and Treatment of COVID-19
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LETTER TO THE EDITOR
Role of Vitamin D Supplementation in Prevention and Treatment of COVID-19 Aakriti Khemka1 • Arpita Suri2 • Naveen Kumar Singh2 • Sanjiv Kumar Bansal2
Received: 22 May 2020 / Accepted: 18 June 2020 Ó Association of Clinical Biochemists of India 2020
Dear Editor, The outbreak of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has become a primary concern among the nations worldwide as the virus is highly contagious. Hence, there is a pressing need to develop effective preventive and therapeutic strategies to combat this global public health problem. COVID-19 infection is associated with the increased production of pro-inflammatory cytokines, increased risk of pneumonia, sepsis and acute respiratory distress syndrome. Accumulating evidence suggests that Vitamin D has antiviral, immunomodulatory and anti-inflammatory actions [1]. Therefore, I would like to underline the importance of Vitamin D levels in COVID-19 patients. Calcitriol (1,25dihydroxycholecalciferol) which is the active form of vitamin D acts as an immune system modulator by providing effective physical barrier and strengthening both innate and adaptive immunity. It maintains epithelial barrier integrity by restoring tight & Sanjiv Kumar Bansal [email protected] Aakriti Khemka [email protected] Arpita Suri [email protected] Naveen Kumar Singh [email protected] 1
Department of Oral Pathology, SGT College Hospital and Research Institute, Near Sultanpur Bird Sanctuary Village, Budhera, Gurugram, Haryana 122505, India
2
Department of Biochemistry, SGT Medical College Hospital and Research Institute, Near Sultanpur Bird Sanctuary Village, Budhera, Gurugram, Haryana 122505, India
junctions, gap junctions, and adherens junctions [2]. In addition to this, Vitamin D enhances innate immunity by increasing the production of Antimicrobial Peptides such as cathelicidin (LL-37) in respiratory epithelial cells which has the ability to disrupt bacterial membranes via electrostatic interactions [3]. It also induces cellular immunity by increasing the production of anti-inflammatory cytokines and suppressing pro-inflammatory cytokines such as TNFalpha and interferon-gamma. This prevents the generation of cytokine storm which is the underlying mechanism of acute respiratory distress syndrome. Moreover it also affects the adaptive immunity by decreasing the production of pro-inflammatory cytokines during both TH1 and TH2 response and suppresses the pro-inflammatory Th17 cells. In addition to this, it binds to the non-coding region of FoxP3 increasing the production of regulatory Treg cells and IL-10, thus reducing inflammation. Studies suggest that Vitamin D has a potential role in protecting against viral respiratory infections especially against enveloped viruses. The immunoregulatory functions of vitamin D are mediated via enhancing the level of virus specific CD8 ? T cells in respiratory viral infections such as Epstein Barr Virus and Influenza. Furthermore, it also boosts the macrophage maturatio
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