Relação entre vitamina D e Lupus Eritematoso Sistêmico Juvenil: uma revisão sistemática de literatura

Abstract

Introduction: Systemic Lupus Erythematosus (SLE) is a chronic inflammatory autoimmune disease, with a multisystemic involvement and etiology not yet well known, that there seems to be interaction of genetic, hormonal, environmental and immunological factors for the development of the disease. Vitamin D is conceptually a prehormone, but its deficiency may be associated with a higher incidence of autoimmune diseases, including Juvenile Systemic Lupus Erythematosus. Main objective: To analyze scientific articles that discuss the relation of vitamin D, emphasizing its immunomodulatory role, with Juvenile Systemic Lupus Erythematosus. Methodology: This is a systematic review of literature, with a search in the Lilacs, Medline and Scielo databases. Original studies published between 2010 and 2018 will be included. Results: 196 studies were initially identified through the electronic databases. Of these, six articles were included. Of these studies, four are cross-sectional observational and two are interventional studies. The results of the two intervention studies showed that vitamin D supplementation increases serum vitamin levels. The four observational studies showed a significant difference between levels of 25 (OH) concentration among patients with Systemic Lupus Erythematosus and Juvenile Systemic Lupus Erythematosus. Conclusions: The reviewed studies were heterogeneous in several aspects, including samples, sample sizes, disease activity evaluation, vitamin D dosing method, cut-off points for vitamin D deficiency / insufficiency classification, and neutralization of possible confounding variables. The results suggest that supplementation improves serum vitamin D levels, but does not point to a strong association between vitamin D deficiency and SLE activity. Thus, the best scheme of supplementation can not yet be determined. More studies are needed, including longitudinal and interventional analyzes, in order to establish a causal relationship between vitamin D deficiency and autoimmune diseases such as Juvenile Systemic Lupus Erythematosus.