Значение плейотропных эффектов витамина d в постшоковом периоде при тяжелой сочетанной травме

The review presents the role of systemic inflammation in the pathogenesis of immune suppression with serious injury. Clinically, many patients with symptoms of systemic inflammation and organ damage immunologically caused, i.e. in the phase anticipated activation of pro-inflammatory mediators are both very susceptible to secondary infections. Particularly significant features of both dual activation and suppression appear in neutrophils. Organ dysfunction in critical condition is largely caused by neutrophils. The interaction with the immune system is one of the important effects of vitamin D. The active form of vitamin D regulates the acquisition and innate immunity, as vitamin D receptors are presented in many cells of the immune system such as macrophages, dendritic cells, and T- and B-lymphocytes. Many studies confirmed that the lack of vitamin D or its receptors can cause disorders of the innate and adaptive immunity. Effect of vitamin D on the immune system may be caused by inverse connection paracrine mechanism by which an inflammatory response is reduced, and by the influence on the differentiation of T helper lymphocytes and suppression of their function. In this regard, it is extremely important to understand the epidemiology of vitamin D deficiency among the resuscitation patients to find out the value of its deficit in the formation of multiple organ dysfunction syndrome in post-shock period and prognosis in severe concomitant injury.