Journal
FRONTIERS IN ENDOCRINOLOGY
Volume 12, Issue -, Pages -Publisher
FRONTIERS MEDIA SA
DOI: 10.3389/fendo.2021.644298
Keywords
COVID-19; pancreatic cancer; pancreatic stellate cell; superagonist; vitamin D; paricalcitol
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Vitamin D is a powerful steroid hormone that has widespread effects on gene expression and biological pathways, but its utility as a therapeutic agent is limited by hypercalcemic effects. Vitamin D superagonists show promise in treatment, but require agonists with high cell-tissue specificity to be successful.
Vitamin D is a potent steroid hormone that induces widespread changes in gene expression and controls key biological pathways. Here we review pathophysiology of vitamin D with particular reference to COVID-19 and pancreatic cancer. Utility as a therapeutic agent is limited by hypercalcemic effects and attempts to circumvent this problem have used vitamin D superagonists, with increased efficacy and reduced calcemic effect. A further caveat is that vitamin D mediates multiple diverse effects. Some of these (anti-fibrosis) are likely beneficial in patients with COVID-19 and pancreatic cancer, whereas others (reduced immunity), may be beneficial through attenuation of the cytokine storm in patients with advanced COVID-19, but detrimental in pancreatic cancer. Vitamin D superagonists represent an untapped resource for development of effective therapeutic agents. However, to be successful this approach will require agonists with high cell-tissue specificity.
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