方法：查阅Medline和EMBASE数据库，出版日期为1973年1月~2011年10月，检索词为 "维生素D"; "自身免疫病"; "自身免疫"; "类风湿关节炎"; "系统性红斑狼疮"; "硬皮病"; "系统性硬化症"; "1型188bet在线平台网址 "; "多发性硬化";和 "未分化结缔组织病"。选择维生素D与自身免疫病之间的环境、遗传和流行病学相关研究。应用以上检索策略，检索出1268篇文章，根据题目剔除331篇文章，根据摘要剔除703篇文章，因为与该研究目的不相关。对剩下的234篇章进行全文阅读，进一步剔除15项研究，因已被证实或被最近研究所取代，最后，剩下的219篇文章对如下问题进行了系统综述：维生素D水平与自身免疫病；维生素D补充对自身免疫病的干预；维生素D水平或摄入对自身免疫病风险相关的前瞻性研究。

　　结果：病理生理研究证实，维生素D低水平可损害遗传易感个体的树突状细胞、调节T淋巴细胞和Th1细胞调节而损害自身免疫耐受。交叉研究显示，有不少的自身免疫病患者和正常人 (30%~77%)有低维生素D水平（<30ng/mL），且缺乏严重者(<10ng/mL)与症状的恶化相关。遗传学研究显示，维生素D受体多态性与多种自身免疫病相关。对人类的试验研究中，仅证实婴儿用维生素D治疗7个月后可明显降低1型188bet在线平台网址 的风险(OR 0.71, 95% CI, 0.60- 0.84)，并有剂量反应效应。

　　结论：基础、遗传和流行病学研究显示，维生素D在防止自身免疫病中发挥作用，但尚需患者或有风险者补充维生素D的临床疗效的RCT研究来证实。

　　附原文：Abstract OBJECTIVE: To evaluate whether vitamin D levels are related to the risk of developing autoimmune diseases and whether supplementation with vitamin D can modify the course of the diseases. METHODS: We reviewed the most relevant papers published from January 1973 to October 2011, using Medline and EMBASE and the search terms "vitamin D"; "autoimmune disease"; "autoimmunity"; "rheumatoid arthritis"; "systemic lupus erythematosus"; "scleroderma"; "systemic sclerosis"; "type 1 diabetes"; "multiple sclerosis"; and "undifferentiated connective tissue disease". We selected studies on the environmental, genetic and epidemiologic association of vitamin D with autoimmune diseases. Using the strategy described, we identified 1268 articles. 331 articles were eliminated on the basis of the title and another 703 on the basis of the abstract, since they were considered irrelevant for the purposes of the study. Full-text examination was performed on the remaining 234 studies, and a further 15 studies were excluded from the review, since the results had been confirmed or superseded by more recent research. Finally, a systematic review was conducted on 219 articles concerning cross-sectional data on: vitamin D levels and autoimmune diseases; interventional data on vitamin D supplementation in autoimmune diseases; prospective data linking vitamin D level or intake to autoimmune disease risk. RESULTS: Physiopathology studies confirm that hypovitaminosis D, in genetically predisposed subjects, can impair self tolerance by compromising the regulation of dendritic cells, of regulatory T-lymphocytes and of Th1 cells. Cross-sectional studies show that levels of vitamin D <30ng/mL are present in a significant percentage, not only in patients with autoimmune disease, but also in healthy subjects (30-77%), and link profound deficiency (<10ng/mL) with aggravation of symptomatology, while genetic studies associate polymorphism of vitamin D receptors to various autoimmune diseases. Among experimental studies on humans, only those on type-1 diabetes prove that the risks are significantly reduced in infants treated with vitamin D after the 7th month (OR 0.71, 95% CI, 0.60 to 0.84) and that a dose-response effect exists. CONCLUSIONS: Basic, genetic, and epidemiological studies indicate a potential role of vitamin D in the prevention of autoimmune diseases, but randomized and controlled trials are necessary to establish the clinical efficacy of vitamin D supplementation in ill or at-risk subjects.

　　引自：Antico A, Tampoia M, Tozzoli R, Bizzaro N. Can supplementation with vitamin D reduce the risk or modify the course of autoimmune diseases? A systematic review of the literature. Autoimmun Rev. 2012 Dec;12(2):127-36. doi: 10.1016/j.autrev.2012.07.007. Epub 2012 Jul 7.