Efeito das concentrações maternas de 25-hidroxicolecalciferol sobre o perfil de citocinas produzidas pelos linfócitos (Th1 e Th2) fetais: revisão sistemática da literatura

Abstract

Vitamin D has always been known for its classic functions, that is, linked to bone metabolism. However, the non-classical functions of this vitamin indicate that many tissues need it for normal performance of its activities, as it acts as a neuroendocrine regulator of the body, acting especially on the immune, cardiovascular, musculoskeletal, brain and placenta systems. This was one of the first organs to be studied for the non-classical functions of vitamin D, being an extrarenal tissue capable of converting 25 hydroxycholecalciferol into 1.25 (OH) 2D3, since both deciduous and fetal maternal placenta have 1α activity. hydroxylase. However, the key role of vitamin D in pregnancy is in the immune response of placentogenesis, where this micronutrient has unmatched functionality from preconception. Already after fertilization, the main placental immune phenomenon is given by the interaction between the maternal deciduous and the new fetal placental trophoblastic cells at the time of implantation, leading to the accumulation of cell subsets of bone marrow origin, including macrophages, dendritic cells, T cells. and natural uterine killer (uNK) / deciduous cells. From this, it is noted how 25-hydroxycholecalciferol is indispensable for the success of the entire reproductive process, since maternal concentrations of this vitamin are decisive for placental implantation, angiogenesis, immune function, oxidative stress, endothelial function, response. inflammatory, glucose homeostasis, consequently maternal tolerance to the fetus and, consequently, a healthy pregnancy. Therefore, in view of the non-classical effects of vitamin D, in which the placenta is a micronutrient-dependent organ for most of its functions, gestational diseases such as diabetes mellitus, preeclampsia and infections are common. cases of deficiency of this vitamin. Thus, it is believed that the response to the pathophysiological basis of these diseases may be linked to some disorder in the placental immune cascade, in which both innate and adaptive immunity do not respond as expected, that is, with the aim of increasing tolerogenic effect of the maternal host. Thus, it is necessary to understand the role of 25-hydroxycholecalciferol on the profile of cytokines produced by placental Th1 and Th2 lymphocytes. For this, a systematic review of the literature entitled “Effect of maternal 25-hydroxycholecalciferol concentrations on profile of cytokines produced by placental lymphocytes (Th1 and Th2): Systematic literature review. Of the 17.445 articles identified in the databases, 57 were read in full, and of these, 5 met the eligibility criteria, including 3 randomized controlled trials and 2 cohort studies. The 5 studies showed adequate methodological quality. Women with 25-hydroxycolecalciferol sufficiency in the cohorts, as well as those receiving supplementation from 2000 IU/day, had higher placental IL-10 concentrations. Thus, we conclude that vitamin D is associated with the anti-inflammatory profile of the placenta.