维生素D对胎儿与新生儿肺发育的影响及机制研究进展  

Progress on effect of vitamin D on fetal and neonatal lung development and its mechanism

作　　者：罗四维 孙波[2] Luo Siwei;Sun Bo(Department of Pediatric Internal Medicine,Children's Hospital of Fudan University(National Children's Medical Center),Shanghai 201102,China;Institute of Pediatrics,Children's Hospital of Fudan University(National Children's Medical Center,Key Laboratory of Neonatal Diseases,National Commission of Health),Shanghai 201102,China)

机构地区：[1]复旦大学附属儿科医院儿内科(国家儿童医学中心),上海201102 [2]复旦大学附属儿科医院儿科研究院(国家儿童医学中心,国家卫健委新生儿疾病重点实验室),上海201102

出　　处：《中华围产医学杂志》2022年第12期1005-1009,共5页Chinese Journal of Perinatal Medicine

基　　金：国家自然科学基金青年科学基金(82201899)。

摘　　要：近年来维生素D对胎儿及新生儿肺发育及慢性肺疾病发生发展的作用与机制受到关注。母体是胎儿维生素D的唯一来源。胎儿及新生儿肺脏作为维生素D作用的靶器官也有着自身维生素D代谢的特点,并可旁分泌具有生物活性的1,25-二羟基维生素D 3调控肺发育。维生素D可促进胎儿及新生儿肺表面活性物质蛋白及磷脂合成,促进肺上皮-间质相互作用和肺泡形成等肺成熟过程,还可通过调节免疫、改善胎盘功能间接影响肺发育。研究发现,维生素D缺乏及维生素D受体多态性不利于肺泡的发育,并与新生儿呼吸窘迫综合征、支气管肺发育不良(bronchopulmonary dysplasia,BPD)等常见呼吸系统疾病发生相关。动物实验显示产前补充维生素D可促胎肺成熟,生后补充维生素D可减轻高氧所致肺的炎症反应及降低BPD的发生风险,但维生素D促肺成熟的机制、给药时机、给药剂量及影响因素均需进一步的高质量实验与临床研究。The role and mechanism of vitamin D in fetal and neonatal lung development and chronic lung diseases development have raised attention in recent years.The placental transfer of vitamin D is the major source of vitamin D to the developing fetus.The lung,as a target organ for vitamin D,has its capacity for vitamin D metabolism and can form biologically active 1,25 dihydroxyvitamin D3 in a paracrine manner to regulate lung development.Studies have shown that vitamin D is directly involved in the synthesis of lung surfactant proteins and phospholipids and promotes lung maturation such as lung epithelial-mesenchymal interactions and alveolar formation.Furthermore,it regulates immunity and improves placental function,which indirectly affects lung development.Vitamin D deficiency and vitamin D receptor polymorphisms have been found to be detrimental to the development of alveoli,and are associated with respiratory diseases such as neonatal respiratory distress syndrome and bronchopulmonary dysplasia(BPD).Experimental studies in animals have shown that antenatal vitamin D supplementation promotes lung maturation in preterm rats and postnatal vitamin D supplementation can alleviate the hyperoxia-induced inflammatory response in the lung and reduce BPD occurrence.Further high-quality research are needed to explore the dosing,timing,and impact factors of vitamin D for promoting fetal and neonatal lung maturation and clarify the mechanism of its prophylactic and therapeutic action.

关 键 词：维生素D 肺 生长和发育 胎儿器官成熟度 呼吸窘迫综合征 新生儿 支气管肺发育不良 肺表面活性物质相关蛋白质 

分 类 号：R722.1[医药卫生—儿科]