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The relevance of vitamin D in the oral health of HIV infected patients.
Mumena, CH, Mudhihiri, MH, Sasi, R, Mlawa, M, Nyerembe, S, Akimbekov, NS, Razzaque, MS
The Journal of steroid biochemistry and molecular biology. 2021;:105905
Abstract
HIV infection affects 36.9 million people globally, and vitamin D deficiency is a global public health concern for HIV patients. Approximately 70 %-80 % of HIV-infected patients have vitamin D deficiency. The deficiency is associated with many pathologies such as immune disorders, infectious diseases, chronic inflammation, oral diseases, as well as the fast progression of HIV. The causes of vitamin D deficiency in HIV infections include HIV itself, traditional factors such as less sun exposure, mal-absorption, hypercholesterolemia, seasonal variation, poor nutrition as well as some HAART drugs like efavirenz. Vitamin D has an immunomodulatory, anti-inflammatory, and anti-proliferative function. In the oral cavity, it plays a significant role in preventing oral infections such as periodontal and gum diseases, dental caries, and oral candidiasis. The consequences of vitamin D deficiency are bone resorption, increased productions of pro-inflammatory cytokines, T-lymphocytes, increased T-helper-1 functions, and decreased T-helper-2 functions. Consequently, this leads to increased infections, chronic inflammation, and the occurrence of oral diseases such as oral candidiasis, periodontal and gum diseases, and dental caries. The majority of these oral diseases are encountered in HIV patients. Vitamin D deficiency is significantly found in HIV patients. There is a lack of studies that directly link vitamin D to most oral diseases in HIV patients; however, the role of vitamin D in immunoregulation, prevention of oral diseases, and HIV infection is substantiated.
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Vitamin D and Allergy Susceptibility during Gestation and Early Life.
Briceno Noriega, D, Savelkoul, HFJ
Nutrients. 2021;(3)
Abstract
Worldwide, the prevalence of allergies in young children, but also vitamin D deficiency during pregnancy and in newborns is rising. Vitamin D modulates the development and activity of the immune system and a low vitamin D status during pregnancy and in early life might be associated with an increased risk to develop an allergy during early childhood. This review studies the effects of vitamin D during gestation and early life, on allergy susceptibility in infants. The bioactive form of vitamin D, 1,25(OH)2D, inhibits maturation and results in immature dendritic cells that cause a decreased differentiation of naive T cells into effector T cells. Nevertheless, the development of regulatory T cells and the production of interleukin-10 was increased. Consequently, a more tolerogenic immune response developed against antigens. Secondly, binding of 1,25(OH)2D to epithelial cells induces the expression of tight junction proteins resulting in enhanced epithelial barrier function. Thirdly, 1,25(OH)2D increased the expression of anti-microbial peptides by epithelial cells that also promoted the defense mechanism against pathogens, by preventing an invasive penetration of pathogens. Immune intervention by vitamin D supplementation can mitigate the disease burden from asthma and allergy. In conclusion, our review indicates that a sufficient vitamin D status during gestation and early life can lower the susceptibility to develop an allergy in infants although there remains a need for more causal evidence.
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Low vitamin D and risk of bacterial pneumonias: Mendelian randomisation studies in two population-based cohorts.
Çolak, Y, Nordestgaard, BG, Afzal, S
Thorax. 2021;(5):468-478
Abstract
BACKGROUND Vitamin D may regulate the innate immune system, and randomised controlled trials suggest a beneficial effect of vitamin D supplementation against acute respiratory tract infections. By using a Mendelian randomisation approach, we tested the hypothesis that low 25-hydroxyvitamin D is associated with increased risk of bacterial pneumonia in observational and genetic analyses. METHODS We genotyped 116 335 randomly chosen white Danes aged 20 to 100 from the Copenhagen City Heart Study and Copenhagen General Population Study for plasma 25-hydroxyvitamin D decreasing genetic variants around CYP2R1 (rs117913124, rs12794714 and rs10741657), DHCR7 (rs7944926 and rs11234027), GEMIN2 (rs2277458) and HAL (rs3819817). Information on plasma 25-hydroxyvitamin D was available on 35 833 individuals. Individuals were followed from 1981 through 2018 for hospital diagnoses of bacterial pneumonias. RESULTS During up to 38 years follow-up, we observed 6342 bacterial pneumonias in observational analyses and 13 916 in genetic analyses. In observational analyses, multivariable adjusted HR for bacterial pneumonias was 1.27 (95% CI: 1.16 to 1.40) for individuals with 25-hydroxyvitamin D<25 nmol/L compared with those with ≥25 nmol/L. In genetic analyses, the OR for bacterial pneumonia per 10 nmol/L lower plasma 25-hydroxyvitamin D was 1.12 (95% CI: 1.02 to 1.23) in Wald's ratio, 1.12 (95% CI: 1.04 to 1.20) in inverse-variance weighted, 1.63 (95% CI: 0.96 to 2.78) in MR-Egger and 1.15 (95% CI: 1.05 to 1.26) in weighted median instrumental variable analysis. This association was strongest for genetic variants around CYP2R1. There was no observational or genetic evidence to support that 25-hydroxyvitamin D is associated with risk of urinary tract infections, skin infections, sepsis or gastroenteritis, which were used as negative control outcomes. CONCLUSIONS Low vitamin D is associated observationally and genetically with increased risk of bacterial pneumonias.
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Features of the 1st trimester of pregnancy course with severe deficiency of 25(OH)D.
Bakleicheva, M, Bespalova, O, Kovaleva, I
Gynecological endocrinology : the official journal of the International Society of Gynecological Endocrinology. 2021;(sup1):49-53
Abstract
INTRODUCTION The course of physiological pregnancy is provided by many complementary factors. Thus, a deficiency in one of the links of the metabolic network contributes to the development of an imbalance in the work of the whole organism, which ensures the growth and development of the embryo from the first days of gestation. It has been demonstrated that vitamin D can act as an immune regulator during implantation, providing a protective effect in the entire period of pregnancy. OBJECTIVE The aim of this study is to assess the features of the course of pregnancy in patients with different levels of vitamin D in the blood in the first trimester. MATERIALS AND METHODS A prospective multicenter randomized study was conducted in the North-West region of the Russian Federation among 88 pregnant women in the first trimester of gestation (up to 13 weeks). All patients were divided into 3 groups depending on the initial level of vitamin D (group 1-14 women with a 25(OH)D < 10 ng/ml, group 2-62 pregnant women from 10 to 30 ng/ml, group 3-12 pregnant women with a vitamin D content >30 ng/ml). INTERVENTIONS Criteria of inclusion: pregnant women from 20 to 44 years of the first trimester of gestation (up to 13 weeks) with the studied level of vitamin D in the blood serum; singleton pregnancy; BMI ≤30 kg/m2; signing by the patient of informed consent for inclusion in the study group. MAIN OUTCOME MEASURES AND RESULTS In group 1, 86% of patients with severe vitamin D deficiency were diagnosed with threatened miscarriage, which is significantly higher than in group 3 (85.7% and 33.3%, χ2 = 7.490, p = .007). At the same time, retrochorial hematoma in group 1 occurred 3.5 times more often than in group 3 (57.1% and 16.67%, respectively, χ2 = 4.473, p = .035). Subsequently, every 4th woman from the group with vitamin D deficiency gave birth earlier than expected, which was not observed among patients from group 3 (25%, 0%, χ2 = 1.231, p = .268). CONCLUSION Prescribing cholecalciferol vitamin replacement therapy as part of complex preserving therapy for threatening miscarriage, followed by monitoring its blood level and deviating from normal parameters, contributing to a favorable course of pregnancy and improving perinatal outcomes.
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Vitamin D: Vitamin or Hormone?
Ellison, DL, Moran, HR
The Nursing clinics of North America. 2021;(1):47-57
Abstract
Vitamin D can be obtained from diet, direct sunlight, or supplementation. The most common form is synthesized in the skin after exposure to ultraviolet B radiation. Nevertheless, the thought is that vitamin D is more of a multifunctional hormone or prohormone. This is because vitamin D plays contributes to many processes in the body. Calcitriol has been shown to have enhancing effects on the immune system, the cardiovascular system, the endocrine system, and other metabolic pathways. There is evidence that vitamin D has also a role in depression, pain, and cancer.
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Unraveling the roles of vitamin D status and melanin during Covid‑19 (Review).
Sidiropoulou, P, Docea, AO, Nikolaou, V, Katsarou, MS, Spandidos, DA, Tsatsakis, A, Calina, D, Drakoulis, N
International journal of molecular medicine. 2021;(1):92-100
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Abstract
As the coronavirus disease 2019 (COVID‑19) continues to spread worldwide, it has become evident that the morbidity and mortality rates clearly vary across nations. Although several factors may account for this disparity, striking differences within and between populations indicate that ethnicity might impact COVID‑19 clinical outcomes, reflecting the 'color of disease'. Therefore, the role of key biological variables that could interplay with viral spreading and severity indices has attracted increasing attention, particularly among non‑Caucasian populations. Although the links between vitamin D status and the incidence and severity of COVID-19 remain elusive, several lines of emerging evidence suggest that vitamin D signaling, targeting several immune‑mediated pathways, may offer potential benefits at different stages of SARS-CoV-2 infection. Given that the vitamin D status is modulated by several intrinsic and extrinsic factors, including skin type (pigmentation), melanin polymers may also play a role in variable COVID‑19 outcomes among diverse population settings. Moreover, apart from the well‑known limiting effects of melanin on the endogenous production of vitamin D, the potential crosstalk between the pigmentary and immune system may also require special attention concerning the current pandemic. The present review article aimed to shed light on a range of mostly overlooked host factors, such as vitamin D status and melanin pigments, that may influence the course and outcome of COVID‑19.
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Efficacy of high-dose versus low-dose vitamin D supplementation on serum levels of inflammatory factors and mortality rate in severe traumatic brain injury patients: study protocol for a randomized placebo-controlled trial.
Arabi, SM, Sedaghat, A, Ehsaei, MR, Safarian, M, Ranjbar, G, Rezaee, H, Rezvani, R, Tabesh, H, Norouzy, A
Trials. 2020;(1):685
Abstract
BACKGROUND Traumatic brain injury (TBI) is the most common trauma worldwide and is a leading cause of injury-related death and disability. Inflammation is initiated as a result of the TBI, which is in association with severity of illness and mortality in brain trauma patients, especially in subdural hemorrhage and epidural hemorrhage cases. A high percentage of adults admitted to the intensive care unit with TBI are diagnosed with vitamin D deficiency; this deficiency may induce impaired immune responses and increase the risk of infections. Vitamin D intervention has been shown to modulate pro- and anti-inflammatory cytokines in non-critically ill patients, but to date, there is no substantial data on the effectiveness of vitamin D for the improvement of immune function in traumatic brain injury patients. METHODS/DESIGN A randomized clinical trial (RCT) will be performed on 74 Iranian adults 18-65 years old with brain trauma and will be treated daily with vitamin D supplements (100,000 IU oral drop) or a similar placebo (1000 IU) for 5 days. DISCUSSION If this randomized clinical trial demonstrates reductions in inflammatory cytokines, it would provide evidence for a multicenter clinical trial to evaluate the efficacy of vitamin D supplementation in neurocritically ill patients. Since vitamin D supplements are inexpensive and safe, this clinical trial could have the potential to improve clinical outcomes in traumatic brain injury patients through reduction of inflammation and infection-associated morbidity and mortality rates. TRIAL REGISTRATION Iranian Registry of Clinical Trials, IRCT20180619040151N3 . Registered on 10 August 2019.
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Vitamin D status and the immune assessment in 22q11.2 deletion syndrome.
Legitimo, A, Bertini, V, Costagliola, G, Baroncelli, GI, Morganti, R, Valetto, A, Consolini, R
Clinical and experimental immunology. 2020;(3):272-286
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Abstract
22q11.2 deletion syndrome (22q11.2DS) is characterized by a heterogeneous phenotype, including alterations in phospho-calcium metabolism and immunodeficiency. We analyzed vitamin D status and the immune assessment, focusing on T cell subpopulations and dendritic cells (DCs) in a cohort of 17 pediatric 22q11.2DS patients and 17 age-matched healthy subjects. As antigen-presenting cells, DCs are the main target of vitamin D, promoting a tolerogenic T cell response. Patients were subdivided into three groups according to the parameters of phospho-calcium metabolism and serum levels of 25OHD: normal values, vitamin D deficiency and hypoparathyroidism. Different degrees of T cell deficiency, ranging from normal to partial T cell numbers, were observed in the cohort of patients. The group with vitamin D deficiency showed a significant reduction of naive T cells and a significant increase of central memory T cells compared to controls. In this group the number of circulating DCs was significantly reduced. DC decrease affected both myeloid and plasmacytoid DC subsets (mDCs and pDCs), with the most relevant reduction involving pDCs. A direct correlation between 25OHD levels and recent thymic emigrant (RTE) and DC number was identified. Despite the limited cohort analyzed, our results show that deficiency of the pDC subset in patients with 22q11.2DS may be included among the causative factors of the progressive increase of risk of autoimmune diseases in these patients. As most patients suffer from increased susceptibility to infections and heightened prevalence of autoimmune disorders, we suggest a potential role of vitamin D supplementation in preventing autoimmune or proinflammatory diseases in 22q11.2DS.
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Vitamin D deficiency in patients with diabetes and COVID- 19 infection.
Singh, SK, Jain, R, Singh, S
Diabetes & metabolic syndrome. 2020;(5):1033-1035
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Abstract
BACKGROUND AND AIMS Data show that vitamin D deficiency may play a role in patients with diabetes mellitus and COVID-19 infection. In this article, we review evidence of vitamin D deficiency and COVID-19 infection in context of diabetes mellitus. METHODS A literature search was carried out by using the key term 'COVID 19' combined with 'Diabetes', 'Vitamin D', 'Extra skeletal effects', 'immunity', 'infection', 'India' from Pub Med (National Library of Medicine, Bethesda, MD and Google Scholar from December 2019 to May 2020. A manual search of the references was also carried out. RESULTS Vitamin D deficiency has been linked to increased morbidity and mortality in COVID -19 infections but convincing data on diabetic subgroup of patients in particular is still awaited. CONCLUSION Robust studies are required to ascertain if Vitamin D supplementation could be beneficial in patients with diabetes and COVID-19.
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Immunomodulatory Effects of Vitamin D in Thyroid Diseases.
Mele, C, Caputo, M, Bisceglia, A, Samà, MT, Zavattaro, M, Aimaretti, G, Pagano, L, Prodam, F, Marzullo, P
Nutrients. 2020;(5)
Abstract
Vitamin D is a secosteroid with a pleiotropic role in multiple physiological processes. Besides the well-known activity on bone homeostasis, recent studies suggested a peculiar role of vitamin D in different non-skeletal pathways, including a key role in the modulation of immune responses. Recent evidences demonstrated that vitamin D acts on innate and adaptative immunity and seems to exert an immunomodulating action on autoimmune diseases and cancers. Several studies demonstrated a relationship between vitamin D deficiency, autoimmune thyroid disorders, and thyroid cancer. This review aims to summarize the evidences on the immunomodulatory effect of vitamin D on thyroid diseases.