¿Podría la vitamina D ser una aliada en la lucha contra el dolor crónico? ¿Qué dice la evidencia?

  1. Ricardo Hernández Balboa
  2. Luis Miguel Torres Morera 1
  3. Sara Borrego Martín
  4. Ramón Eizaga Rebollar
  5. Rafael García Hernández
  1. 1 Universidad de Cádiz
    info

    Universidad de Cádiz

    Cádiz, España

    ROR https://ror.org/04mxxkb11

Revue:
MPJ Multidisciplinary Pain Journal

ISSN: 2697-2263

Année de publication: 2024

Número: 1

Type: Article

DOI: 10.20986/MPJ.2023.1061/2023 DIALNET GOOGLE SCHOLAR lock_openAccès ouvert editor

D'autres publications dans: MPJ Multidisciplinary Pain Journal

Résumé

La vitamina D, generada en la piel al exponerse a la luz solar, desempeña funciones cruciales en numerosos mecanismos fisiológicos del ser humano, de forma análoga a otras hormonas. En esta revisión narrativa exploramos cómo esta vitamina podría influir en distintos tipos de dolor, específicamente el nociceptivo e inflamatorio. Diversos estudios han señalado que una carencia de vitamina D puede correlacionarse con un incremento del dolor y con la administración de dosis superiores de analgésicos opioides. Recientes investigaciones destacan que añadir suplementos de vitamina D podría ser útil en el tratamiento del dolor oncológico y el dolor musculoesquelético, particularmente en individuos que manifiestan un déficit inicial de esta sustancia. Se postula que la vitamina D actúa atenuando agentes inflamatorios como prostaglandinas y citoquinas, y modulando la reacción de células del sistema inmune, como las células T. Un hallazgo de relevancia es la capacidad de la vitamina D para inhibir la prostaglandina E2 (PGE2), proporcionando una base razonable para entender su mecanismo de acción. Tras una revisión detallada de las fuentes bibliográficas actuales, deducimos que aquellos pacientes con niveles considerablemente bajos de vitamina D (inferiores a 30 nmol/l de 25-hidroxivitamina D) podrían obtener mayores beneficios de la suplementación. Sin embargo, aquellos con niveles óptimos (superiores a 50 nmol/l) posiblemente no experimenten una mejora notable. Finalizamos sosteniendo que la vitamina D representa una estrategia potencial para ayudar a paliar el dolor en personas con insuficiencia de dicha vitamina, aunque se requieren estudios más rigurosos para confirmar su eficacia.

Références bibliographiques

  • Hewison M. Antibacterial effects of vitamin D. Nat Rev Endocrinol. 2011;7(6):337-45. DOI: 10.1038/nrendo.2010.226.
  • Wang TT, Nestel FP, Bourdeau V, Nagai Y, Wang Q, Liao J, et al. Cutting edge: 1,25-dihydroxyvitamin D3 is a direct inducer of antimicrobial peptide gene expression. J Immunol. 2004;173(5):2909-12. DOI: 10.4049/jimmunol.173.5.2909.
  • Liu X, Nelson A, Wang X, Farid M, Gunji Y, Ikari J, et al. Vitamin D modulates prostaglandin E2 synthesis and degradation in human lung fibroblasts. Am J Respir Cell Mol Biol. 2014;50(1):40-50. DOI: 10.1165/rcmb.2013-0211OC.
  • Bergman P, Sperneder S, Höijer J, Bergqvist J, Björkhem-Bergman L. Low vitamin D levels are associated with higher opioid dose in palliative cancer patients--results from an observational study in Sweden. PLoS One. 2015;10(5):e0128223. DOI: 10.1371/journal.pone.0128223.
  • Björkhem-Bergman L, Bergman P. Vitamin D and patients with palliative cancer. BMJ Support Palliat Care. 2016;6(3):287-91. DOI: 10.1136/bmjspcare-2015-000921.
  • Gendelman O, Itzhaki D, Makarov S, Bennun M, Amital H. A randomized double-blind placebo-controlled study adding high dose vitamin D to analgesic regimens in patients with musculoskeletal pain. Lupus. 2015;24(4-5):483-9. DOI: 10.1177/0961203314558676.
  • Ovesjö ML, Skilving I, Bergman P, Rane A, Ekström L, Björkhem-Bergman L. Low Vitamin D Levels and Genetic Polymorphism in the Vitamin D Receptor are Associated with Increased Risk of Statin-Induced Myopathy. Basic Clin Pharmacol Toxicol. 2016;118(3):214-8. DOI: 10.1111/bcpt.12482.
  • Shipton EE, Shipton EA. Vitamin D Deficiency and Pain: Clinical Evidence of Low Levels of Vitamin D and Supplementation in Chronic Pain States. Pain Ther. 2015;4(1):67-87. DOI: 10.1007/s40122-015-0036-8.
  • Wepner F, Scheuer R, Schuetz-Wieser B, Machacek P, Pieler-Bruha E, Cross HS, et al. Effects of vitamin D on patients with fibromyalgia syndrome: a randomized placebo-controlled trial. Pain. 2014;155(2):261-8. DOI: 10.1016/j.pain.2013.10.002.
  • Whitehurst JL, Reid CM. Vitamin D deficiency as a cause of chronic pain in the palliative medicine clinic: two case reports. Palliat Med. 2014;28(1):87-9. DOI: 10.1177/0269216313511142.
  • The need of a taxonomy. Pain. 1979;6(3):247-52. DOI: 10.1016/0304-3959(79)90046-0. DOI: 10.1016/0304-3959(79)90046-0.
  • Gatenby P, Lucas R, Swaminathan A. Vitamin D deficiency and risk for rheumatic diseases: an update. Curr Opin Rheumatol. 2013;25(2):184-91. DOI: 10.1097/BOR.0b013e32835cfc16.
  • Tanik N, Balbaloğlu Ö, Ucar M, Sarp U, Atalay T, Çelikbilek A, et al. Does vitamin D deficiency trigger carpal tunnel syndrome? J Back Musculoskelet Rehabil. 2016;29(4):835-9. DOI: 10.3233/BMR-160696.
  • Harari M, Dramsdahl E, Shany S, Baumfeld Y, Ingber A, Novack V, Sukenik S. Increased vitamin D serum levels correlate with clinical improvement of rheumatic diseases after Dead Sea climatotherapy. Isr Med Assoc J. 2011;13(4):212-5.
  • Hawamdeh MZ, Al-Ajlouni JM. The clinical pattern of knee osteoarthritis in Jordan: a hospital based study. Int J Med Sci. 2013;10(6):790-5. DOI: 10.7150/ijms.5140.
  • Hollis BW. Measuring 25-hydroxyvitamin D in a clinical environment: challenges and needs. Am J Clin Nutr. 2008;88(2):507S-510S. DOI: 10.1093/ajcn/88.2.507S.
  • Holick MF. Vitamin D deficiency. N Engl J Med. 2007;357(3):266-81. DOI: 10.1056/NEJMra070553.
  • Ross AC, Manson JE, Abrams SA, Aloia JF, Brannon PM, Clinton SK, et al. The 2011 report on dietary reference intakes for calcium and vitamin D from the Institute of Medicine: what clinicians need to know. J Clin Endocrinol Metab. 2011;96(1):53-8. DOI: 10.1210/jc.2010-2704.
  • Martineau AR, Jolliffe DA, Hooper RL, Greenberg L, Aloia JF, Bergman P, et al. Vitamin D supplementation to prevent acute respiratory tract infections: systematic review and meta-analysis of individual participant data. BMJ. 2017;356:i6583. DOI: 10.1136/bmj.i6583.
  • Hewison M. Vitamin D and immune function: an overview. Proc Nutr Soc. 2012;71(1):50-61. DOI: 10.1017/S0029665111001650.
  • Lee YH, Bae SC. Vitamin D level in rheumatoid arthritis and its correlation with the disease activity: a meta-analysis. Clin Exp Rheumatol. 2016;34(5):827-33.
  • Gianfrancesco MA, Stridh P, Rhead B, Shao X, Xu E, Graves JS, et al. Evidence for a causal relationship between low vitamin D, high BMI, and pediatric-onset MS. Neurology. 2017;88(17):1623-9. DOI: 10.1212/WNL.0000000000003849.
  • Pierrot-Deseilligny C, Souberbielle JC. Vitamin D and multiple sclerosis: An update. Mult Scler Relat Disord. 2017;14:35-45. DOI: 10.1016/j.msard.2017.03.014.
  • Rhead B, Bäärnhielm M, Gianfrancesco M, Mok A, Shao X, Quach H, et al. Mendelian randomization shows a causal effect of low vitamin D on multiple sclerosis risk. Neurol Genet. 2016;2(5):e97. DOI: 10.1212/NXG.0000000000000097.
  • Colotta F, Jansson B, Bonelli F. Modulation of inflammatory and immune responses by vitamin D. J Autoimmun. 2017;85:78-97. DOI: 10.1016/j.jaut.2017.07.007.
  • Gifondorwa DJ, Thompson TD, Wiley J, Culver AE, Shetler PK, Rocha GV, et al. Vitamin D and/or calcium deficient diets may differentially affect muscle fiber neuromuscular junction innervation. Muscle Nerve. 2016;54(6):1120-32. DOI: 10.1002/mus.25146.
  • Kuru P, Akyuz G, Yagci I, Giray E. Hypovitaminosis D in widespread pain: its effect on pain perception, quality of life and nerve conduction studies. Rheumatol Int. 2015;35(2):315-22. DOI: 10.1007/s00296-014-3099-7.
  • Maser RE, Lenhard MJ, Pohlig RT. Vitamin D Insufficiency is Associated with Reduced Parasympathetic Nerve Fiber Function in Type 2 Diabetes. Endocr Pract. 2015;21(2):174-81. DOI: 10.4158/EP14332.OR.
  • Karras S, Rapti E, Matsoukas S, Kotsa K. Vitamin D in Fibromyalgia: A Causative or Confounding Biological Interplay? Nutrients. 2016;8(6):343. DOI: 10.3390/nu8060343.
  • Qin W, Smith C, Jensen M, Holick MF, Sauter ER. Vitamin D favorably alters the cancer promoting prostaglandin cascade. Anticancer Res. 2013;33(9):3861-6.
  • Grösch S, Niederberger E, Geisslinger G. Investigational drugs targeting the prostaglandin E2 signaling pathway for the treatment of inflammatory pain. Expert Opin Investig Drugs. 2017;26(1):51-61. DOI: 10.1080/13543784.2017.1260544.
  • Fell GL, Robinson KC, Mao J, Woolf CJ, Fisher DE. Skin β-endorphin mediates addiction to UV light. Cell. 2014;157(7):1527-34. DOI: 10.1016/j.cell.2014.04.032.
  • Beer TM, Garzotto M, Katovic NM. High-dose calcitriol and carboplatin in metastatic androgen-independent prostate cancer. Am J Clin Oncol. 2004;27(5):535-41. DOI: 10.1097/01.coc.0000136020.27904.9c.
  • Helde-Frankling M, Höijer J, Bergqvist J, Björkhem-Bergman L. Vitamin D supplementation to palliative cancer patients shows positive effects on pain and infections-Results from a matched case-control study. PLoS One. 2017;12(8):e0184208. DOI: 10.1371/journal.pone.0184208.
  • Schreuder F, Bernsen RM, van der Wouden JC. Vitamin D supplementation for nonspecific musculoskeletal pain in non-Western immigrants: a randomized controlled trial. Ann Fam Med. 2012;10(6):547-55. DOI: 10.1370/afm.1402.
  • Van Veldhuizen PJ, Taylor SA, Williamson S, Drees BM. Treatment of vitamin D deficiency in patients with metastatic prostate cancer may improve bone pain and muscle strength. J Urol. 2000;163(1):187-90. DOI: 10.1016/S0022-5347(05)68001-9.
  • Atherton K, Berry DJ, Parsons T, Macfarlane GJ, Power C, Hyppönen E. Vitamin D and chronic widespread pain in a white middle-aged British population: evidence from a cross-sectional population survey. Ann Rheum Dis. 2009;68(6):817-22. DOI: 10.1136/ard.2008.090456.
  • Lotfi A, Abdel-Nasser AM, Hamdy A, Omran AA, El-Rehany MA. Hypovitaminosis D in female patients with chronic low back pain. Clin Rheumatol. 2007;26(11):1895-901. DOI: 10.1007/s10067-007-0603-4.
  • Mouyis M, Ostor AJ, Crisp AJ, Ginawi A, Halsall DJ, Shenker N, et al. Hypovitaminosis D among rheumatology outpatients in clinical practice. Rheumatology (Oxford). 2008;47(9):1348-51. DOI: 10.1093/rheumatology/ken203.
  • Plotnikoff GA, Quigley JM. Prevalence of severe hypovitaminosis D in patients with persistent, nonspecific musculoskeletal pain. Mayo Clin Proc. 2003;78(12):1463-70. DOI: 10.4065/78.12.1463.
  • Straube S, Andrew Moore R, Derry S, McQuay HJ. Vitamin D and chronic pain. Pain. 2009;141(1-2):10-3. DOI: 10.1016/j.pain.2008.11.010.
  • Straube S, Derry S, Straube C, Moore RA. Vitamin D for the treatment of chronic painful conditions in adults. Cochrane Database Syst Rev. 2015;2015(5):CD007771. DOI: 10.1002/14651858.CD007771.pub3.
  • Wu Z, Malihi Z, Stewart AW, Lawes CM, Scragg R. Effect of Vitamin D Supplementation on Pain: A Systematic Review and Meta-analysis. Pain Physician. 2016;19(7):415-27.
  • Martin KR, Reid DM. Is there role for vitamin D in the treatment of chronic pain? Ther Adv Musculoskelet Dis. 2017;9(6):131-5. DOI: 10.1177/1759720X17708124.
  • Salesi M, Farajzadegan Z. Efficacy of vitamin D in patients with active rheumatoid arthritis receiving methotrexate therapy. Rheumatol Int. 2012;32(7):2129-33. DOI: 10.1007/s00296-011-1944-5.
  • Der T, Bailey BA, Youssef D, Manning T, Grant WB, Peiris AN. Vitamin D and prostate cancer survival in veterans. Mil Med. 2014;179(1):81-4. DOI: 10.7205/MILMED-D-12-00540.
  • Dev R, Del Fabbro E, Schwartz GG, Hui D, Palla SL, Gutierrez N, et al. Preliminary report: vitamin D deficiency in advanced cancer patients with symptoms of fatigue or anorexia. Oncologist. 2011;16(11):1637-41. DOI: 10.1634/theoncologist.2011-0151.
  • Shi L, Nechuta S, Gao YT, Zheng Y, Dorjgochoo T, Wu J, et al. Correlates of 25-hydroxyvitamin D among Chinese breast cancer patients. PLoS One. 2014;9(1):e86467. DOI: 10.1371/journal.pone.0086467.
  • Spedding S, Vanlint S, Morris H, Scragg R. Does vitamin D sufficiency equate to a single serum 25-hydroxyvitamin D level or are different levels required for non-skeletal diseases? Nutrients. 2013;5(12):5127-39. DOI: 10.3390/nu5125127.
  • Khan QJ, Reddy PS, Kimler BF, Sharma P, Baxa SE, O’Dea AP, et al. Effect of vitamin D supplementation on serum 25-hydroxy vitamin D levels, joint pain, and fatigue in women starting adjuvant letrozole treatment for breast cancer. Breast Cancer Res Treat. 2010;119(1):111-8. DOI: 10.1007/s10549-009-0495-x.
  • Singh S, Cuzick J, Mesher D, Richmond B, Howell A. Effect of baseline serum vitamin D levels on aromatase inhibitors induced musculoskeletal symptoms: results from the IBIS-II, chemoprevention study using anastrozole. Breast Cancer Res Treat. 2012;132(2):625-9. DOI: 10.1007/s10549-011-1911-6.
  • Waltman NL, Ott CD, Twiss JJ, Gross GJ, Lindsey AM. Vitamin D insufficiency and musculoskeletal symptoms in breast cancer survivors on aromatase inhibitor therapy. Cancer Nurs. 2009;32(2):143-50. DOI: 10.1097/01.NCC.0000339262.44560.92.
  • Khan QJ, Kimler BF, Reddy PS, Sharma P, Klemp JR, Nydegger JL, et al. Randomized trial of vitamin D3 to prevent worsening of musculoskeletal symptoms in women with breast cancer receiving adjuvant letrozole. The VITAL trial. Breast Cancer Res Treat. 2017;166(2):491-500. DOI: 10.1007/s10549-017-4429-8.
  • Helde-Frankling M, Bergqvist J, Klasson C, Nordström M, Höijer J, Bergman P, et al. Vitamin D supplementation to palliative cancer patients: protocol of a double-blind, randomised controlled trial ‘Palliative-D’. BMJ Support Palliat Care. 2017;7(4):458-63. DOI: 10.1136/bmjspcare-2017-001429.
  • Koundourakis NE, Avgoustinaki PD, Malliaraki N, Margioris AN. Muscular effects of vitamin D in young athletes and non-athletes and in the elderly. Hormones (Athens). 2016;15(4):471-88. DOI: 10.14310/horm.2002.1705.
  • Endo I, Inoue D, Mitsui T, Umaki Y, Akaike M, Yoshizawa T, et al. Deletion of vitamin D receptor gene in mice results in abnormal skeletal muscle development with deregulated expression of myoregulatory transcription factors. Endocrinology. 2003;144(12):5138-44. DOI: 10.1210/en.2003-0502.
  • Olsson K, Saini A, Strömberg A, Alam S, Lilja M, Rullman E, et al. Evidence for Vitamin D Receptor Expression and Direct Effects of 1α,25(OH)2D3 in Human Skeletal Muscle Precursor Cells. Endocrinology. 2016;157(1):98-111. DOI: 10.1210/en.2015-1685.
  • Campbell MJ. Bioinformatic approaches to interrogating vitamin D receptor signaling. Mol Cell Endocrinol. 2017;453:3-13. DOI: 10.1016/j.mce.2017.03.011.
  • Yilmaz R, Salli A, Cingoz HT, Kucuksen S, Ugurlu H. Efficacy of vitamin D replacement therapy on patients with chronic nonspecific widespread musculoskeletal pain with vitamin D deficiency. Int J Rheum Dis. 2016;19(12):1255-62. DOI: 10.1111/1756-185X.12960.
  • Warner AE, Arnspiger SA. Diffuse musculoskeletal pain is not associated with low vitamin D levels or improved by treatment with vitamin D. J Clin Rheumatol. 2008;14(1):12-6. DOI: 10.1097/RHU.0b013e31816356a9.
  • Mergenhagen K, Ott M, Heckman K, Rubin LM, Kellick K. Low vitamin D as a risk factor for the development of myalgia in patients taking high-dose simvastatin: a retrospective review. Clin Ther. 2014;36(5):770-7. DOI: 10.1016/j.clinthera.2014.02.023.
  • Palamaner Subash Shantha G, Ramos J, Thomas-Hemak L, Pancholy SB. Association of vitamin D and incident statin induced myalgia--a retrospective cohort study. PLoS One. 2014;9(2):e88877. DOI: 10.1371/journal.pone.0088877.
  • Ahmed W, Khan N, Glueck CJ, Pandey S, Wang P, Goldenberg N, et al. Low serum 25 (OH) vitamin D levels (32 ng/mL) are associated with reversible myositis-myalgia in statin-treated patients. Transl Res. 2009;153(1):11-6. DOI: 10.1016/j.trsl.2008.11.002.
  • Glueck CJ, Budhani SB, Masineni SS, Abuchaibe C, Khan N, Wang P, et al. Vitamin D deficiency, myositis-myalgia, and reversible statin intolerance. Curr Med Res Opin. 2011;27(9):1683-90. DOI: 10.1185/03007995.2011.598144.
  • Eisen A, Lev E, Iakobishvilli Z, Porter A, Brosh D, Hasdai D, Mager A. Low plasma vitamin D levels and muscle-related adverse effects in statin users. Isr Med Assoc J. 2014;16(1):42-5.
  • Kurnik D, Hochman I, Vesterman-Landes J, Kenig T, Katzir I, Lomnicky Y, et al. Muscle pain and serum creatine kinase are not associated with low serum 25(OH) vitamin D levels in patients receiving statins. Clin Endocrinol (Oxf). 2012;77(1):36-41. DOI: 10.1111/j.1365-2265.2011.04321.x.
  • Riphagen IJ, van der Veer E, Muskiet FA, DeJongste MJ. Myopathy during statin therapy in the daily practice of an outpatient cardiology clinic: prevalence, predictors and relation with vitamin D. Curr Med Res Opin. 2012;28(7):1247-52. DOI: 10.1185/03007995.2012.702102.
  • Heaney RP. Guidelines for optimizing design and analysis of clinical studies of nutrient effects. Nutr Rev. 2014;72(1):48-54. DOI: 10.1111/nure.12090.
  • Heaney RP. Vitamin D--baseline status and effective dose. N Engl J Med. 2012;367(1):77-8. DOI: 10.1056/NEJMe1206858.
  • Hollis BW. Short-term and long-term consequences and concerns regarding valid assessment of vitamin D deficiency: comparison of recent food supplementation and clinical guidance reports. Curr Opin Clin Nutr Metab Care. 2011;14(6):598-604. DOI: 10.1097/MCO.0b013e32834be798.
  • Sabetta JR, DePetrillo P, Cipriani RJ, Smardin J, Burns LA, Landry ML. Serum 25-hydroxyvitamin d and the incidence of acute viral respiratory tract infections in healthy adults. PLoS One. 2010;5(6):e11088. DOI: 10.1371/journal.pone.0011088.
  • Science M, Maguire JL, Russell ML, Smieja M, Walter SD, Loeb M. Low serum 25-hydroxyvitamin D level and risk of upper respiratory tract infection in children and adolescents. Clin Infect Dis. 2013;57(3):392-7. DOI: 10.1093/cid/cit289.
  • Balvers MG, Brouwer-Brolsma EM, Endenburg S, de Groot LC, Kok FJ, Gunnewiek JK. Recommended intakes of vitamin D to optimise health, associated circulating 25-hydroxyvitamin D concentrations, and dosing regimens to treat deficiency: workshop report and overview of current literature. J Nutr Sci. 2015;4:e23. DOI: 10.1017/jns.2015.10.
  • Bergman P, Norlin AC, Hansen S, Rekha RS, Agerberth B, Björkhem-Bergman L, et al. Vitamin D3 supplementation in patients with frequent respiratory tract infections: a randomised and double-blind intervention study. BMJ Open. 2012;2(6):e001663. DOI: 10.1136/bmjopen-2012-001663.
La source de données: Dialnet