1.
Vitamin D deficiency in association with endothelial dysfunction: Implications for patients with COVID-19.
Zhang, J, McCullough, PA, Tecson, KM
Reviews in cardiovascular medicine. 2020;(3):339-344
Abstract
There is emerging evidence to suggest that vitamin D deficiency is associated with adverse outcomes in COVID-19 patients. Conversely, vitamin D supplementation protects against an initial alveolar diffuse damage of COVID-19 becoming progressively worse. The mechanisms by which vitamin D deficiency exacerbates COVID-19 pneumonia remain poorly understood. In this review we describe the rationale of the putative role of endothelial dysfunction in this event. Herein, we will briefly review (1) anti-inflammatory and anti-thrombotic effects of vitamin D, (2) vitamin D receptor and vitamin D receptor ligand, (3) protective role of vitamin D against endothelial dysfunction, (4) risk of vitamin D deficiency, (5) vitamin D deficiency in association with endothelial dysfunction, (6) the characteristics of vitamin D relevant to COVID-19, (7) the role of vitamin D on innate and adaptive response, (8) biomarkers of endothelial cell activation contributing to cytokine storm, and (9) the bidirectional relationship between inflammation and homeostasis. Finally, we hypothesize that endothelial dysfunction relevant to vitamin D deficiency results from decreased binding of the vitamin D receptor with its ligand on the vascular endothelium and that it may be immune-mediated via increased interferon 1 α. A possible sequence of events may be described as (1) angiotensin II converting enzyme-related initial endothelial injury followed by vitamin D receptor-related endothelial dysfunction, (2) endothelial lesions deteriorating to endothelialitis, coagulopathy and thrombosis, and (3) vascular damage exacerbating pulmonary pathology and making patients with vitamin D deficiency vulnerable to death.
2.
Effect of nut consumption on vascular endothelial function: A systematic review and meta-analysis of randomized controlled trials.
Xiao, Y, Huang, W, Peng, C, Zhang, J, Wong, C, Kim, JH, Yeoh, EK, Su, X
Clinical nutrition (Edinburgh, Scotland). 2018;(3):831-839
Abstract
OBJECTIVE nut consumption has consistently been found to be associated with a reduced risk of cardiovascular diseases (CVD) and mortality in prospective studies. However, its effect on endothelial function, a prognostic marker of CVD, is still controversial in clinical trials. This meta-analysis of randomized controlled trials (RCTs) aimed to quantitatively assess the effect of nuts on vascular endothelial function. METHODS Major electronic databases were searched for published RCTs that reported the effect of nuts on flow mediated dilation (FMD) as a measurement of endothelial function in the adult population (age eighteen years or over). We calculated the pooled estimates of weighted mean differences (WMDs) and their 95% confidence intervals (CIs) by using random-effects models. RESULTS A total of nine papers (10 trials) involving 374 participants were included. The pooled estimates found that nut consumption significantly improved FMD (WMD: 0.41%; 95% CI: 0.18%, 0.63%; P = 0.001). Moderate and marginally significant heterogeneity was observed among the studies (I2 = 39.5%, P = 0.094). Subgroup analyses indicated that walnuts significantly improved FMD (WMD: 0.39%; 95% CI: 0.16%, 0.63%; P = 0.001). In addition, nut consumption had a significant effect on FMD in the trials with study duration <18 weeks, nut dose <67 g/d, or subjects with baseline FMD ≥8.6%. CONCLUSIONS Nut consumption significantly improved endothelial function. However, the beneficial effect was limited to walnuts. More studies examining the effect of other nuts on endothelial function are needed in the future.
3.
[Effects of xuefu zhuyu decoction on functions of vascular endothelium in patients with unstable angina pectoris].
Wang, BX, Dong, XM, Guo, AM, Zhang, J
Zhong xi yi jie he xue bao = Journal of Chinese integrative medicine. 2006;(3):256-9
Abstract
OBJECTIVE To evaluate the effects of Xuefu Zhuyu Decoction (XFZYD) on functions of vascular endothelium in patients with unstable angina pectoris (UAP). METHODS Fifty patients with UAP were randomly divided into two groups: XFZYD-treated group with 32 cases and control group with 18 cases. The patients in the control group were given regular therapy, while the patients in the XFZYD-treated group were given XFZYD additionally on the basis of regular therapy. All patients in both groups were treated for 8 weeks. Then the contents of serum endothelin (ET), nitric oxide (NO), soluble vascular cell adhesive molecule-1 (sVCAM-1) and soluble intercellular adhesion molecule-1 (sICAM-1) were examined by radioimmunoassay, enzymic method and enzyme-linked immunosorbent assay (ELISA) respectively. RESULTS The total response rate in the XFZYD-treated group was 93.75%, which was significantly higher than 66.67% in the control group (P<0.05). The contents of serum ET, sVCAM-1 and sICAM-1 in the XFZYD-treated group were much lower than those in the control group (P<0.01), while the content of serum NO was obviously higher than that in the control group (P<0.01). CONCLUSION XFZYD can improve the functions of vascular endothelium by lowering the levels of endothelium-derived contracting substances, enhancing the levels of endothelium-derived relaxing substances, and reducing the cell adhesions, and hence to raise the therapeutic effects on UAP.