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Ali A, Cui X, Eyles D. Developmental vitamin D deficiency and autism: Putative pathogenic mechanisms. J Steroid Biochem Mol Biol 2018; 175:108-118. [PMID: 28027915 DOI: 10.1016/j.jsbmb.2016.12.018] [Citation(s) in RCA: 53] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2016] [Revised: 10/31/2016] [Accepted: 12/23/2016] [Indexed: 01/08/2023]
Abstract
Autism is a neurodevelopmental disease that presents in early life. Despite a considerable amount of studies, the neurobiological mechanisms underlying autism remain obscure. Both genetic and environmental factors are involved in the development of autism. Vitamin D deficiency is emerging as a consistently reported risk factor in children. One reason for the prominence now being given to this risk factor is that it would appear to interact with several other epidemiological risk factors for autism. Vitamin D is an active neurosteroid and plays crucial neuroprotective roles in the developing brain. It has important roles in cell proliferation and differentiation, immunomodulation, regulation of neurotransmission and steroidogenesis. Animal studies have suggested that transient prenatal vitamin D deficiency is associated with altered brain development. Here we review the potential neurobiological mechanisms linking prenatal vitamin D deficiency and autism and also discuss what future research targets must now be addressed.
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Affiliation(s)
- Asad Ali
- Queensland Brain Institute, University of Queensland, Qld 4072, Australia
| | - Xiaoying Cui
- Queensland Brain Institute, University of Queensland, Qld 4072, Australia
| | - Darryl Eyles
- Queensland Brain Institute, University of Queensland, Qld 4072, Australia; Queensland Centre for Mental Health Research, Wacol, Qld 4076, Australia.
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52
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Chawla D, Fuemmeler B, Benjamin-Neelon SE, Hoyo C, Murphy S, Daniels JL. Early prenatal vitamin D concentrations and social-emotional development in infants. J Matern Fetal Neonatal Med 2017; 32:1441-1448. [PMID: 29157031 DOI: 10.1080/14767058.2017.1408065] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
BACKGROUND Many pregnant women in the United States have suboptimal vitamin D, but the impact on infant development is unclear. Moreover, no pregnancy-specific vitamin D recommendations have been widely accepted. AIMS Given the ubiquitous expression of vitamin D receptors in the brain, we investigated the association between early prenatal plasma 25-hydroxyvitamin D (25(OH)D) concentrations and children's social and emotional development in the Newborn Epigenetic Study, a prospective study of pregnancies from 2009 to 2011 in Durham, North Carolina. METHODS We measured 25(OH)D concentrations in first or second trimester plasma samples and categorized 25(OH)D concentrations into quartiles. Covariates were derived from maternal questionnaires. Mothers completed the Infant Toddler Social-Emotional Development Assessment when children were 12-24 months of age. We used multivariable linear regression to evaluate associations between 25(OH)D and specific behavior scores, adjusted for season of blood draw, maternal age, education, parity, smoking, marital status, prepregnancy BMI, and infant gender. We investigated effect-measure modification by race/ethnicity. RESULTS Of the 218 mother-infant pairs with complete data, Black mothers had much lower 25(OH)D concentrations as compared to White and Hispanic mothers. After adjustment, lower prenatal 25(OH)D was associated with slightly higher (less favorable) Internalizing scores among White children, but lower (more favorable) Internalizing scores among Black and Hispanic children. Lower prenatal 25(OH)D also appears to be associated with higher (less favorable) dysregulation scores, though only among White and Hispanic children. CONCLUSIONS Though imprecise, preliminary results warrant further investigation regarding a role for prenatal vitamin D on children's early social and emotional development.
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Affiliation(s)
- Devika Chawla
- a Department of Epidemiology , University of North Carolina at Chapel Hill , Chapel Hill , NC , USA
| | - Bernard Fuemmeler
- b Department of Health Behavior and Policy , Virginia Commonwealth University , Richmond , VA , USA
| | - Sara E Benjamin-Neelon
- c Department of Health, Behavior and Society , Johns Hopkins University , Baltimore , MD , USA
| | - Cathrine Hoyo
- d Department of Biological Sciences , North Carolina State University , Raleigh , NC , USA
| | - Susan Murphy
- e Department of Obstetrics and Gynecology , Duke University School of Medicine , Durham , NC , USA
| | - Julie L Daniels
- a Department of Epidemiology , University of North Carolina at Chapel Hill , Chapel Hill , NC , USA
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Knabl J, Vattai A, Ye Y, Jueckstock J, Hutter S, Kainer F, Mahner S, Jeschke U. Role of Placental VDR Expression and Function in Common Late Pregnancy Disorders. Int J Mol Sci 2017; 18:ijms18112340. [PMID: 29113124 PMCID: PMC5713309 DOI: 10.3390/ijms18112340] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2017] [Revised: 10/24/2017] [Accepted: 10/26/2017] [Indexed: 12/14/2022] Open
Abstract
Vitamin D, besides its classical role in bone metabolism, plays a distinct role in multiple pathways of the feto-maternal unit. Calcitriol is the major active ligand of the nuclear vitamin D receptor (VDR). The vitamin D receptor (VDR) is expressed in different uteroplacental parts and exerts a variety of functions in physiologic pregnancy. It regulates decidualisation and implantation, influences hormone secretion and placental immune modulations. This review highlights the role of the vitamin D receptor in physiologic and disturbed pregnancy, as preeclampsia, fetal growth restriction, gestational diabetes and preterm birth. We discuss the existing literature regarding common VDR polymorphisms in these pregnancy disorders.
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Affiliation(s)
- Julia Knabl
- Department of Obstetrics and Gynecology, University Hospital, Ludwig-Maximilians Universität München, 80337 Munich, Germany.
- Department of Obstetrics and Gynecology, Klinik Hallerwiese, 90419 Nürnberg, Germany.
| | - Aurelia Vattai
- Department of Obstetrics and Gynecology, University Hospital, Ludwig-Maximilians Universität München, 80337 Munich, Germany.
| | - Yao Ye
- Department of Obstetrics and Gynecology, University Hospital, Ludwig-Maximilians Universität München, 80337 Munich, Germany.
| | - Julia Jueckstock
- Department of Obstetrics and Gynecology, University Hospital, Ludwig-Maximilians Universität München, 80337 Munich, Germany.
| | - Stefan Hutter
- Department of Obstetrics and Gynecology, University Hospital, Ludwig-Maximilians Universität München, 80337 Munich, Germany.
| | - Franz Kainer
- Department of Obstetrics and Gynecology, Klinik Hallerwiese, 90419 Nürnberg, Germany.
| | - Sven Mahner
- Department of Obstetrics and Gynecology, University Hospital, Ludwig-Maximilians Universität München, 80337 Munich, Germany.
| | - Udo Jeschke
- Department of Obstetrics and Gynecology, University Hospital, Ludwig-Maximilians Universität München, 80337 Munich, Germany.
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Hollis BW, Wagner CL. Vitamin D supplementation during pregnancy: Improvements in birth outcomes and complications through direct genomic alteration. Mol Cell Endocrinol 2017; 453:113-130. [PMID: 28188842 DOI: 10.1016/j.mce.2017.01.039] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2016] [Revised: 01/23/2017] [Accepted: 01/24/2017] [Indexed: 12/16/2022]
Abstract
Pregnancy represents a time of rapid change, including dramatic shifts in vitamin D metabolism. Circulating concentrations of the active form of vitamin D-1,25(OH)2D skyrocket early in pregnancy to levels that would be toxic to a nonpregnant adult, signaling a decoupling of vitamin D from the classic endocrine calcium metabolic pathway, likely serving an immunomodulatory function in the mother and her developing fetus. In this review, we summarize the unique aspects of vitamin D metabolism and the data surrounding vitamin D requirements during this important period. Both observational and clinical trials are reviewed in the context of vitamin D's health effects during pregnancy that include preeclampsia, preterm birth, and later disease states such as asthma and multiple sclerosis. With enhanced knowledge about vitamin D's role as a preprohormone, it is clear that recommendations about supplementation must mirror what is clinically relevant and evidence-based. Future research that focuses on the critical period(s) leading up to conception and during pregnancy to correct deficiency or maintain optimal vitamin D status remains to be studied. In addition, what effects vitamin D has on genetic signatures that minimize the risk to the mother and her developing fetus have not been elucidated. Clearly, while there is much more research that needs to be performed, our understanding of vitamin D requirements during pregnancy has advanced significantly during the last few decades.
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Affiliation(s)
- Bruce W Hollis
- Medical University of South Carolina, Division of Neonatology, Department of Pediatrics, 173 Ashley Avenue, MSC 514, Charleston, SC 29425, United States.
| | - Carol L Wagner
- Medical University of South Carolina, Division of Neonatology, Department of Pediatrics, 173 Ashley Avenue, MSC 514, Charleston, SC 29425, United States
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Meisgen S, Tingström J, Skog Andreasson A, Sonesson SE, Kockum I, Wahren-Herlenius M. Environmental and lifestyle factors influencing risk of congenital heart block during pregnancy in anti-Ro/SSA-positive women. RMD Open 2017; 3:e000520. [PMID: 28955500 PMCID: PMC5604703 DOI: 10.1136/rmdopen-2017-000520] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2017] [Revised: 06/21/2017] [Accepted: 06/22/2017] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES Congenital heart block (CHB) occurs in 1%-2% of anti-Ro/SSA antibody-positive pregnancies. A population-based recurrence rate of 12% indicates that factors other than maternal autoantibodies influence CHB development. Here we report the first investigation to identify environmental and lifestyle factors influencing the risk of CHB. METHODS A questionnaire focused on environmental and lifestyle factors was distributed to anti-Ro/SSA antibody-positive women who had given birth to at least one child with CHB, and additional data were retrieved from national health registers. Statistical analysis was performed comparing pregnancies resulting in a child with CHB (n=81) and pregnancies resulting in unaffected siblings (n=108). RESULTS Analysis of maternal body mass index and weight gain during pregnancy as well as medication intake and sun exposure did not reveal significant differences between CHB-affected and non-CHB pregnancies. By contrast, we found that reports of infections and stressful events were significantly more frequent in CHB-affected pregnancies than in non-CHB affected pregnancies (OR 17.9, 95% CI 4.1 to 162.8, p<0.001 and OR 5.5, 95% CI 1.1 to 55.1, p<0.05, respectively). Notably, outdoor activity a few hours per day emerged as a protective factor (OR 0.52, 95% CI 0.27 to 0.99, p<0.05). The previously reported factor seasonal timing of pregnancy was confirmed (OR 2.2, 95% CI 1.1 to 4.2, p<0.05), and multivariate analysis revealed that this association was partly explained by infection and outdoor activity. CONCLUSIONS In this retrospective study, infections, stressful events and time spent with outdoor activities emerged as potential environmental and lifestyle factors influencing the risk of CHB, warranting confirmation in prospective studies.
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Affiliation(s)
- Sabrina Meisgen
- Department of Medicine, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | - Joanna Tingström
- Department of Medicine, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | - Amanda Skog Andreasson
- Department of Medicine, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | - Sven-Erik Sonesson
- Department of Women and Child Health, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | - Ingrid Kockum
- Department of Clinical Neuroscience, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | - Marie Wahren-Herlenius
- Department of Medicine, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
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Johns LE, Ferguson KK, Cantonwine DE, McElrath TF, Mukherjee B, Meeker JD. Urinary BPA and Phthalate Metabolite Concentrations and Plasma Vitamin D Levels in Pregnant Women: A Repeated Measures Analysis. ENVIRONMENTAL HEALTH PERSPECTIVES 2017; 125:087026. [PMID: 28934718 PMCID: PMC5783673 DOI: 10.1289/ehp1178] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/03/2016] [Revised: 05/10/2017] [Accepted: 05/12/2017] [Indexed: 05/05/2023]
Abstract
BACKGROUND In addition to its well-established role in maintaining skeletal health, vitamin D has essential regulatory functions in female reproductive and pregnancy outcomes. Phthalates and bisphenol A (BPA) are endocrine disruptors, and previous research has suggested that these chemical agents may disrupt circulating levels of total 25(OH)D in adults. OBJECTIVES We investigated the relationships between repeated measures of urinary phthalate metabolites and BPA and circulating total 25(OH)D in a prospective cohort of pregnant women. METHODS The present study population includes participants (n=477) in a nested case-control study of preterm birth drawn from a prospective birth cohort of pregnant women at Brigham and Women's Hospital in Boston, Massachusetts. Urine and blood samples were collected for biomarker measurements at median 10 wk and 26 wk of gestation. RESULTS In repeated measures analysis, we observed that an interquartile range (IQR) increase in urinary mono-3-carboxypropyl phthalate (MCPP) was associated with a 4.48% decrease [95% confidence interval (CI): -7.37, -1.58] in total 25(OH)D. We also detected inverse associations for metabolites of di(2-ethylhexyl) phthalate (DEHP) [percent difference (%Δ)=-2.83 to -2.16]. For BPA, we observed a nonsignificant inverse association with total 25(OH)D in the overall population. Our sensitivity analysis revealed that the associations for some metabolites (e.g., MEHP) varied by race/ethnicity, which may reflect potential differences in susceptibility. In agreement with findings from repeated measures analysis, we reported that DEHP metabolites and BPA were significantly associated with an approximate 20% increase in the odds of vitamin D deficiency (≤20 ng/mL) [odds ratio (95% CI): 1.19 (1.06, 1.35) for molar sum of DEHP metabolites and 1.22 (1.01, 1.47) for BPA] at median 10 wk and 26 wk, respectively. CONCLUSIONS Our results provide suggestive evidence of the potential for environmental exposure to phthalates and/or BPA to disrupt circulating vitamin D levels in pregnancy. https://doi.org/10.1289/EHP1178.
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Affiliation(s)
- Lauren E Johns
- Department of Environmental Health Sciences, University of Michigan School of Public Health , Ann Arbor, Michigan, USA
| | - Kelly K Ferguson
- Department of Environmental Health Sciences, University of Michigan School of Public Health , Ann Arbor, Michigan, USA
- Department of Environmental Health Sciences, University of Michigan School of Public Health , Ann Arbor, Michigan, USA
| | - David E Cantonwine
- Epidemiology Branch, National Institute of Environmental Health Sciences , National Institutes of Health, Department of Health and Human Services, Research Triangle Park, North Carolina, USA
| | - Thomas F McElrath
- Epidemiology Branch, National Institute of Environmental Health Sciences , National Institutes of Health, Department of Health and Human Services, Research Triangle Park, North Carolina, USA
| | - Bhramar Mukherjee
- Division of Maternal-Fetal Medicine, Brigham and Women's Hospital, Harvard Medical School , Boston, Massachusetts, USA
| | - John D Meeker
- Department of Environmental Health Sciences, University of Michigan School of Public Health , Ann Arbor, Michigan, USA
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New insights into the vitamin D requirements during pregnancy. Bone Res 2017; 5:17030. [PMID: 28868163 PMCID: PMC5573964 DOI: 10.1038/boneres.2017.30] [Citation(s) in RCA: 75] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2016] [Revised: 03/10/2017] [Accepted: 04/22/2017] [Indexed: 12/22/2022] Open
Abstract
Pregnancy represents a dynamic period with physical and physiological changes in both the mother and her developing fetus. The dramatic 2–3 fold increase in the active hormone 1,25(OH)2D concentrations during the early weeks of pregnancy despite minimal increased calcium demands during that time of gestation and which are sustained throughout pregnancy in both the mother and fetus suggests an immunomodulatory role in preventing fetal rejection by the mother. While there have been numerous observational studies that support the premise of vitamin D's role in maintaining maternal and fetal well-being, until recently, there have been few randomized clinical trials with vitamin D supplementation. One has to exhibit caution, however, even with RCTs, whose results can be problematic when analyzed on an intent-to-treat basis and when there is high non-adherence to protocol (as if often the case), thereby diluting the potential good or harm of a given treatment at higher doses. As such, a biomarker of a drug or in this case “vitamin” or pre-prohormone is better served. For these reasons, the effect of vitamin D therapies using the biomarker circulating 25(OH)D is a far better indicator of true “effect.” When pregnancy outcomes are analyzed using the biomarker 25(OH)D instead of treatment dose, there are notable differences in maternal and fetal outcomes across diverse racial/ethnic groups, with improved health in those women who attain a circulating 25(OH)D concentration of at least 100 nmol·L−1 (40 ng·mL−1). Because an important issue is the timing or initiation of vitamin D treatment/supplementation, and given the potential effect of vitamin D on placental gene expression and its effects on inflammation within the placenta, it appears crucial to start vitamin D treatment before placentation (and trophoblast invasion); however, this question remains unanswered. Additional work is needed to decipher the vitamin D requirements of pregnant women and the optimal timing of supplementation, taking into account a variety of lifestyles, body types, baseline vitamin D status, and maternal and fetal vitamin D receptor (VDR) and vitamin D binding protein (VDBP) genotypes. Determining the role of vitamin D in nonclassical, immune pathways continues to be a challenge that once answered will substantiate recommendations and public health policies.
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Rejnmark L, Bislev LS, Cashman KD, Eiríksdottir G, Gaksch M, Grübler M, Grimnes G, Gudnason V, Lips P, Pilz S, van Schoor NM, Kiely M, Jorde R. Non-skeletal health effects of vitamin D supplementation: A systematic review on findings from meta-analyses summarizing trial data. PLoS One 2017; 12:e0180512. [PMID: 28686645 PMCID: PMC5501555 DOI: 10.1371/journal.pone.0180512] [Citation(s) in RCA: 163] [Impact Index Per Article: 23.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2017] [Accepted: 06/18/2017] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND A large number of observational studies have reported harmful effects of low 25-hydroxyvitamin D (25OHD) levels on non-skeletal outcomes. We performed a systematic quantitative review on characteristics of randomized clinical trials (RCTs) included in meta-analyses (MAs) on non-skeletal effects of vitamin D supplementation. METHODS AND FINDINGS We identified systematic reviews (SR) reporting summary data in terms of MAs of RCTs on selected non-skeletal outcomes. For each outcome, we summarized the results from available SRs and scrutinized included RCTs for a number of predefined characteristics. We identified 54 SRs including data from 210 RCTs. Most MAs as well as the individual RCTs reported null-findings on risk of cardiovascular diseases, type 2 diabetes, weight-loss, and malignant diseases. Beneficial effects of vitamin D supplementation was reported in 1 of 4 MAs on depression, 2 of 9 MAs on blood pressure, 3 of 7 MAs on respiratory tract infections, and 8 of 12 MAs on mortality. Most RCTs have primarily been performed to determine skeletal outcomes, whereas non-skeletal effects have been assessed as secondary outcomes. Only one-third of the RCTs had low level of 25OHD as a criterion for inclusion and a mean baseline 25OHD level below 50 nmol/L was only present in less than half of the analyses. CONCLUSIONS Published RCTs have mostly been performed in populations without low 25OHD levels. The fact that most MAs on results from RCTs did not show a beneficial effect does not disprove the hypothesis suggested by observational findings on adverse health outcomes of low 25OHD levels.
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Affiliation(s)
- Lars Rejnmark
- Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus, Denmark
| | - Lise Sofie Bislev
- Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus, Denmark
| | - Kevin D. Cashman
- Cork Centre for Vitamin D and Nutrition Research, School of Food and Nutritional Sciences, University College Cork, Cork, Ireland
| | | | - Martin Gaksch
- Division of Endocrinology and Diabetology, Department of Internal Medicine, Medical University of Graz, Graz, Austria
| | - Martin Grübler
- Division of Endocrinology and Diabetology, Department of Internal Medicine, Medical University of Graz, Graz, Austria
- Swiss Cardiovascular Centre Bern, Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Guri Grimnes
- Tromsø Endocrine Research Group, Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Vilmundur Gudnason
- Icelandic Heart Association, Kopavogur, Iceland
- Faculty of Medicine, School of Health Sciences, University of Iceland, Reykjavik, Iceland
| | - Paul Lips
- Department of Internal Medicine, Section of Endocrinology, Vrije University Medical Center, Amsterdam, Netherlands
| | - Stefan Pilz
- Division of Endocrinology and Diabetology, Department of Internal Medicine, Medical University of Graz, Graz, Austria
| | - Natasja M. van Schoor
- Amsterdam Public Health Research Institute, Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, Netherlands
| | - Mairead Kiely
- Cork Centre for Vitamin D and Nutrition Research, School of Food and Nutritional Sciences, University College Cork, Cork, Ireland
| | - Rolf Jorde
- Tromsø Endocrine Research Group, Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway
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Zhang H, Huang Z, Xiao L, Jiang X, Chen D, Wei Y. Meta-analysis of the effect of the maternal vitamin D level on the risk of spontaneous pregnancy loss. Int J Gynaecol Obstet 2017; 138:242-249. [PMID: 28500757 DOI: 10.1002/ijgo.12209] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2016] [Revised: 03/26/2017] [Accepted: 05/10/2017] [Indexed: 12/20/2022]
Abstract
BACKGROUND The association between vitamin D deficiency and early spontaneous pregnancy loss (SPL) is unclear. OBJECTIVES To assess the association of serum 25-hydroxyvitamin D (25(OH)D) and SPL. SEARCH STRATEGY Embase, PubMed, and Web of Science were searched for relevant papers published before February 20, 2016, using search terms including "vitamin D" and "pregnancy loss." SELECTION CRITERIA Case-control and cohort studies investigating the relationship of maternal serum 25(OH)D and SPL were included. DATA COLLECTION AND ANALYSIS Two authors independently extracted original data from the selected papers. The DerSimonian-Laird random-effects model was used to perform the meta-analysis. Heterogeneity was assessed by calculating I2 . MAIN RESULTS Five studies, including 10 630 pregnant women, met the inclusion criteria. There was no significant association between a low 25(OH)D level and an increased risk of SPL. In a subgroup analysis, an extremely low 25(OH)D level (<20 ng/mL) was significantly associated with an increased risk of SPL in the first trimester (relative risk 2.24, 95% confidence interval 1.15-4.37); the heterogeneity across studies was not significant (I2 =0.0%, P=0.355). CONCLUSIONS Severe Vitamin D deficiency could be detrimental to early embryonic development and increase the risk of early SPL.
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Affiliation(s)
- Heng Zhang
- Wuxi Hospital for Maternal and Child Health Care, The Affiliated Hospital of Nanjing Medical University, Wuxi, China
| | - Zhaohui Huang
- Anhui Provincial Family Planning Institute of Science and Technology, Hefei, China
| | - Limin Xiao
- Second Hospital of Anhui Medical University, Hefei, China
| | - Xinye Jiang
- Wuxi Hospital for Maternal and Child Health Care, The Affiliated Hospital of Nanjing Medical University, Wuxi, China
| | - Daozhen Chen
- Wuxi Hospital for Maternal and Child Health Care, The Affiliated Hospital of Nanjing Medical University, Wuxi, China
| | - Yarong Wei
- Wuxi Hospital for Maternal and Child Health Care, The Affiliated Hospital of Nanjing Medical University, Wuxi, China
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Ji JL, Muyayalo KP, Zhang YH, Hu XH, Liao AH. Immunological function of vitamin D during human pregnancy. Am J Reprod Immunol 2017; 78. [PMID: 28585734 DOI: 10.1111/aji.12716] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2017] [Accepted: 05/04/2017] [Indexed: 12/21/2022] Open
Abstract
The well-established classic role of vitamin D is implicated in the regulation of the balance between calcium and phosphorus. Furthermore, vitamin D is also involved in many non-classic physiological processes, mainly including the regulation of cell proliferation, differentiation, apoptosis and immune function, participation in the inflammatory response and maintenance of genome stability function. During pregnancy, vitamin D receptor and its metabolic enzymes are expressed at the placenta and decidua, indicating the potential role in the mechanism of immunomodulation at the maternal-fetal interface. The insufficiency or deficiency of vitamin D may affect the mother directly and is related to specific pregnancy outcomes, such as preeclampsia, gestational diabetes, and recurrent miscarriage. This article reviews the effects of vitamin D on immune regulation during pregnancy.
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Affiliation(s)
- Jin-Lu Ji
- Family Planning Research Institute, Center for Reproductive Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Kahinho P Muyayalo
- Family Planning Research Institute, Center for Reproductive Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yong-Hong Zhang
- Family Planning Research Institute, Center for Reproductive Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xiao-Hui Hu
- Family Planning Research Institute, Center for Reproductive Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Ai-Hua Liao
- Family Planning Research Institute, Center for Reproductive Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Tamblyn JA, Susarla R, Jenkinson C, Jeffery LE, Ohizua O, Chun RF, Chan SY, Kilby MD, Hewison M. Dysregulation of maternal and placental vitamin D metabolism in preeclampsia. Placenta 2017; 50:70-77. [PMID: 28161064 PMCID: PMC5463036 DOI: 10.1016/j.placenta.2016.12.019] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2016] [Revised: 11/27/2016] [Accepted: 12/17/2016] [Indexed: 12/17/2022]
Abstract
INTRODUCTION Epidemiology has linked preeclampsia (PET) to decreased maternal serum 25-hydroxyvitamin D3 (25(OH)D3). However, alterations in systemic and placental/decidual transport and metabolism of 25(OH)D3 during pregnancy suggest that other forms of vitamin D may also contribute to the pathophysiology of PET. METHODS In a cross sectional analysis of normal pregnant women at 1st (n = 25) and 3rd trimester (n = 21), pregnant women with PET (n = 22), and non-pregnant female controls (n = 20) vitamin D metabolites were quantified in paired maternal serum, placental, and decidual tissue. RESULTS Serum 25(OH)D3 was not significantly different in sera across all four groups. In normal 3rd trimester pregnant women serum active 1,25-dihydroxyvitamin D3 (1,25(OH)2D3) was significantly higher than non-pregnant, normal 1st trimester pregnant, and PET women. Conversely, PET sera showed highest levels of the catabolites 3-epi-25(OH)D3 and 24,25-dihydroxyvitamin D3 (24,25(OH)2D3). Serum albumin was significantly lower in normal 3rd trimester pregnant women and PET relative to normal 1st trimester pregnant women, but there was no change in free/bioavailable 25(OH)D3. In PET placental tissue, 25(OH)D3 and 3-epi-25(OH)D3 were lower than normal 3rd trimester tissue, whilst placental 24,25(OH)2D3 was highest in PET. Tissue 1,25(OH)2D3 was detectable in 1st trimester decidua, which also showed 10-fold higher 25(OH)D3 relative to paired placentae. 3-epi-25(OH)D3 and 24,25(OH)2D3 were not different for decidua and placenta. In normal 3rd trimester pregnant women, total, free and bioavailable maternal 25(OH)D3 correlated with placental 25(OH)D3, but this was not conserved for PET. DISCUSSION These data indicate that PET is associated with decreased activation, increased catabolism, and impaired placental uptake of 25(OH)D3.
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Affiliation(s)
- J A Tamblyn
- Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, B15 2TT, UK; Fetal Medicine Centre, Birmingham Women's Foundation Trust, Edgbaston, Birmingham, B15 2TG, UK; Centre for Women's & Newborn Health, Birmingham Health Partners, Birmingham, B15 2TH, UK
| | - R Susarla
- Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, B15 2TT, UK
| | - C Jenkinson
- Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, B15 2TT, UK
| | - L E Jeffery
- Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, B15 2TT, UK
| | - O Ohizua
- Women, Children and Sexual Health Directorate, Walsall Hospitals NHS Trust, Walsall, WS2 9PS, UK
| | - R F Chun
- Department of Orthopaedic Surgery, University of California Los Angeles, Los Angeles, CA 90095, USA
| | - S Y Chan
- Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, B15 2TT, UK; Department of Obstetrics and Gynecology, National University of Singapore, 119228, Singapore
| | - M D Kilby
- Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, B15 2TT, UK; Fetal Medicine Centre, Birmingham Women's Foundation Trust, Edgbaston, Birmingham, B15 2TG, UK; Centre for Women's & Newborn Health, Birmingham Health Partners, Birmingham, B15 2TH, UK; Centre for Endocrinology Diabetes and Metabolism, Birmingham Health Partners, Birmingham, B15 2TH, UK
| | - M Hewison
- Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, B15 2TT, UK; Centre for Women's & Newborn Health, Birmingham Health Partners, Birmingham, B15 2TH, UK; Centre for Endocrinology Diabetes and Metabolism, Birmingham Health Partners, Birmingham, B15 2TH, UK.
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Yates N, Crew RC, Wyrwoll CS. Vitamin D deficiency and impaired placental function: potential regulation by glucocorticoids? Reproduction 2017; 153:R163-R171. [PMID: 28137896 DOI: 10.1530/rep-16-0647] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2016] [Revised: 01/22/2017] [Accepted: 01/30/2017] [Indexed: 12/17/2022]
Abstract
Maternal vitamin D deficiency has been implicated in a range of pregnancy complications including preeclampsia, preterm birth and intrauterine growth restriction. Some of these adverse outcomes arise from alterations in placental function. Indeed, vitamin D appears critical for implantation, inflammation, immune function and angiogenesis in the placenta. Despite these associations, absence of the placental vitamin D receptor in mice provokes little effect. Thus, interactions between maternal and fetal compartments are likely crucial for instigating adverse placental changes. Indeed, maternal vitamin D deficiency elicits changes in glucocorticoid-related parameters in pregnancy, which increase placental and fetal glucocorticoid exposure. As in utero glucocorticoid excess has a well-established role in eliciting placental dysfunction and fetal growth restriction, this review proposes that glucocorticoids are an important consideration when understanding the impact of vitamin D deficiency on placental function and fetal development.
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Affiliation(s)
| | - Rachael C Crew
- School of Human SciencesThe University of Western Australia, Perth, Australia
| | - Caitlin S Wyrwoll
- School of Human SciencesThe University of Western Australia, Perth, Australia
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Nandi AA, Wadhwani NS, Joshi SR. Altered metabolic homeostasis between vitamin D and long chain polyunsaturated fatty acids in preeclampsia. Med Hypotheses 2017; 100:31-36. [PMID: 28236844 DOI: 10.1016/j.mehy.2017.01.009] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2016] [Revised: 12/15/2016] [Accepted: 01/15/2017] [Indexed: 12/13/2022]
Abstract
Sub-optimal maternal nutrition may result in pregnancy complications like preeclampsia. Preeclampsia is known to be of placental origin and a major cause of maternal morbidity and mortality worldwide. Our earlier studies suggest that altered metabolism of folic acid, vitamin B12 and long chain polyunsaturated fatty acid (LCPUFAs) in the one carbon cycle increases homocysteine levels in preeclampsia. Recent reports indicate that vitamin D deficiency may also have a role in preeclampsia, although the mechanisms are unclear. A disturbed one carbon cycle can influence methylation patterns of various genes involved in placental development. Altered expression of cystathionine beta synthase (CBS) gene can result in hyperhomocystenemia. Higher homocysteine levels are known to increase reactive oxygen species (ROS) production which in turn leads to increased expression of phospholipase A2 (PLA2) and cyclooxygenase-2 (COX-2). Higher expression of PLA2 and COX-2 can influence the release of arachidonic acid (AA) from membrane phospholipid and result in increased conversion to thromboxane. Vitamin D [1,25(OH)2D3] is known to induce the CBS gene expression while it can suppress the oxidative stress-induced COX-2 up-regulation and thromboxane production. Based on this, we propose a novel hypothesis that a disturbed vitamin D and LCPUFA metabolism influence the regulation of the one carbon cycle which will trigger inflammation through oxidative stress in preeclampsia. This may lead to altered feto-placental growth and development in preeclampsia.
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Affiliation(s)
- Anindita A Nandi
- Department of Nutritional Medicine, Interactive Research School for Health Affairs (IRSHA), Bharati Vidyapeeth Deemed University, Pune 411043, India
| | - Nisha S Wadhwani
- Department of Nutritional Medicine, Interactive Research School for Health Affairs (IRSHA), Bharati Vidyapeeth Deemed University, Pune 411043, India
| | - Sadhana R Joshi
- Department of Nutritional Medicine, Interactive Research School for Health Affairs (IRSHA), Bharati Vidyapeeth Deemed University, Pune 411043, India.
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Zhou Y, Chen YH, Fu L, Yu Z, Xia MZ, Hu XG, Wang H, Xu DX. Vitamin D3 pretreatment protects against lipopolysaccharide-induced early embryo loss through its anti-inflammatory effects. Am J Reprod Immunol 2017; 77. [PMID: 28045211 DOI: 10.1111/aji.12620] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2016] [Accepted: 11/19/2016] [Indexed: 12/22/2022] Open
Abstract
PROBLEM Increasing evidence demonstrates that inflammatory cytokines are involved in LPS-induced adverse pregnant outcomes including early embryo loss. Vitamin D3 (VitD3) has anti-inflammatory activity. We aimed to investigate the effects of vitamin D3 (VitD3) on LPS-induced early embryo loss in mice. METHOD OF STUDY All pregnant mice except controls were intraperitoneally (ip) injected with LPS on GD7. In VitD3 alone and LPS+VitD3 groups, pregnant mice were pretreated with VitD3 by gavage daily from GD5 to GD7. RESULTS LPS caused 62.5% pregnant mice with early embryo loss. Interestingly, the rate of abortion dropped to 14.3% when pregnant mice were pretreated with VitD3. Additional experiment showed that VitD3 significantly attenuated LPS-evoked elevation on TNF-α, IFN-γ, MIP-2, and nitrate plus nitrite in maternal serum. In addition, VitD3 alleviated LPS-induced COX-2 expression in the decidua and attenuated the elevation of PGF2α in maternal serum. Although VitD3 had no effect on IL-10 in maternal serum, it induced further elevation of serum IL-10 level in LPS-treated mice. Further analysis showed that VitD3 activated VDR signaling, simultaneously inhibited LPS-induced nuclear translocation of NF-κB p65 subunits in the decidua. CONCLUSIONS VitD3 protects mice from LPS-induced early embryo loss at least partially through its anti-inflammatory effects.
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Affiliation(s)
- Yan Zhou
- Department of Toxicology, Anhui Medical University, Hefei, China
| | - Yuan-Hua Chen
- Department of Histology and Embryology, Anhui Medical University, Hefei, China.,Anhui Provincial Key Laboratory of Population Health & Aristogenics, Hefei, China
| | - Lin Fu
- Department of Toxicology, Anhui Medical University, Hefei, China.,Anhui Provincial Key Laboratory of Population Health & Aristogenics, Hefei, China
| | - Zhen Yu
- Department of Toxicology, Anhui Medical University, Hefei, China.,Anhui Provincial Key Laboratory of Population Health & Aristogenics, Hefei, China
| | - Mi-Zhen Xia
- School of Biological Science, Anhui Medical University, Hefei, China
| | - Xiao-Guang Hu
- Department of Toxicology, Anhui Medical University, Hefei, China
| | - Hua Wang
- Department of Toxicology, Anhui Medical University, Hefei, China.,Anhui Provincial Key Laboratory of Population Health & Aristogenics, Hefei, China
| | - De-Xiang Xu
- Department of Toxicology, Anhui Medical University, Hefei, China.,Anhui Provincial Key Laboratory of Population Health & Aristogenics, Hefei, China
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Wang LQ, Yan XT, Yan CF, Zhang XW, Hui LY, Xue M, Yu XW. Women with Recurrent Miscarriage Have Decreased Expression of 25-Hydroxyvitamin D3-1α-Hydroxylase by the Fetal-Maternal Interface. PLoS One 2016; 11:e0165589. [PMID: 28033387 PMCID: PMC5199009 DOI: 10.1371/journal.pone.0165589] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2016] [Accepted: 10/16/2016] [Indexed: 12/31/2022] Open
Abstract
Background Effects of vitamin D deficiency in pregnancy have been associated with some adverse pregnancy outcomes. The 25-hydroxyvitamin D3-1α-hydroxylase (CYP27B1) is integral to the vitamin D metabolic pathway. The enzyme catalyzes localized conversion of pro-hormone 25-hydroxyvitamin D3 to active 1,25-dihydroxyvitamin D3. Our aim was to investigate the expression of CYP27B1 at the fetal-maternal interface in the first trimester pregnancy and to determine whether CYP27B1 was associated with recurrent miscarriage (RM). Methods Expressions of CYP27B1 mRNA and protein in villi and decidua from 20 women undergoing primary miscarriage, 20 women with RM and 20 women with normal pregnancy were evaluated by western blot, and quantitative real-time PCR. The co-localization of CYP27B1 and certain cytokines including IL-10, IFN-γ, TNF-α, and IL-2 expression were examined using immunohistochemistry and confocal microscopy. Results Women with RM had a significantly lower expression of CYP27B1 mRNA and protein in villous and decidual tissues compared with the normal pregnant women (P = 0.000 in villus, P = 0.002 in decidua for mRNA; P = 0.036 in villus, P = 0.007 in decidua for protein.). Compared with the normal pregnancy, immunostaining for CYP27B1 was significantly decreased in villous trophoblasts and decidual glandular epithelial cells in RM women. No significant differences in the localization of CYP27B1, IL-10, IFN-γ, TNF-α, and IL-2 expression were identified between the normal pregnant and RM women. Conclusions Women with RM have a lower level of CYP27B1 expression in chorionic villi and decidua compared with normal pregnant women, suggesting that reduced CYP27B1 expression may be associated with RM. The consistent localization of CYP27B1 and IL-10, IFN-γ, TNF-α, and IL-2 expression in villous and decidual tissues suggests the importance of the local production of 1,25(OH)2D3 at the fetal-maternal interface to regulate cytokine responses.
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Affiliation(s)
- Li-qin Wang
- Department of Obstetrics and Gynecology in First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
- Nursing Department in Xi’an Medical College, Xi’an, China
| | - Xiao-ting Yan
- Department of Obstetrics and Gynecology in First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Chun-fang Yan
- Reproductive Center in Fourth Hospital of Xi'an, Xi’an, China
| | - Xin-wen Zhang
- Department of Obstetrics and Gynecology in First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
- Reproductive Center in Fourth Hospital of Xi'an, Xi’an, China
| | - Ling-yun Hui
- Laboratory Department in First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Mingzhan Xue
- Clinical Sciences Research Lab, Translational Medicine Section, Division of Biomedical Sciences, Warwick Medical School, University of Warwick, University Hospital, Coventry, United Kingdom
| | - Xue-wen Yu
- Department of Obstetrics and Gynecology in First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
- * E-mail:
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Maternal vitamin D deficiency during pregnancy affects expression of adipogenic-regulating genes peroxisome proliferator-activated receptor gamma (PPARγ) and vitamin D receptor (VDR) in lean male mice offspring. Eur J Nutr 2016; 57:723-730. [PMID: 28004271 DOI: 10.1007/s00394-016-1359-x] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2016] [Accepted: 12/06/2016] [Indexed: 02/06/2023]
Abstract
PURPOSE Maternal vitamin D deficiency during pregnancy is a widespread issue that may have long-lasting consequences on offspring adiposity. We sought to determine how maternal vitamin D deficiency during the perinatal period would affect offspring adipose tissue development and gene expression. METHODS Female C57BL/6 J mice were fed either a vitamin D deficient (VDD) or control diet from 4 weeks before pregnancy (periconception) until 7 days postparturition. Male offspring were weighed and euthanized at 75 days of age (early adult period), at which point serum was collected for biochemical analyses, and perigonadal and subcutaneous white adipose tissue (PGAT and SQAT, respectively) were excised, weighed, then flash-frozen for later histology and analyses of adipogenic gene expression. RESULTS All adult male offspring were nonobese; there were no significant differences in body weight, adipose pad weight, or adipocyte size. However, VDD-exposed offspring had greater expression of the adipogenic-regulating genes peroxisome proliferator-activated receptor gamma (Pparg) and vitamin D receptor (Vdr). CONCLUSIONS This study suggests that exposure to vitamin D deficiency during the perinatal period can directly affect genes involved in the development of adipose tissue in nonobese offspring. These novel findings invite further investigation into the mechanisms by which maternal vitamin D status during pregnancy affects adipose development and metabolic health of offspring.
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Clinical Recommendations for the Use of Islet Cell Autoantibodies to Distinguish Autoimmune and Non-Autoimmune Gestational Diabetes. Clin Rev Allergy Immunol 2016; 50:23-33. [PMID: 25392235 DOI: 10.1007/s12016-014-8461-8] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Gestational diabetes mellitus (GDM) is defined as carbohydrate intolerance that begins or is first recognized during pregnancy. The prevalence of GDM is highly variable, depending on the population studied, and reflects the underlying pattern of diabetes in the population. GDM manifests by the second half of pregnancy and disappears following delivery in most cases, but is associated with the risk of subsequent diabetes development. Normal pregnancy induces carbohydrate intolerance to favor the availability of nutrients for the fetus, which is compensated by increased insulin secretion from the maternal pancreas. Pregnancy shares similarities with adiposity in metabolism to save energy, and both conditions favor the development of insulin resistance (IR) and low-grade inflammation. A highly complicated network of modified regulatory mechanisms may primarily affect carbohydrate metabolism by promoting autoimmune reactions to pancreatic β cells and affecting insulin function. As a result, diabetes development during pregnancy is facilitated. Depending on a pregnant woman's genetic susceptibility to diabetes, autoimmune mechanisms or IR are fundamental to the development autoimmune or non-autoimmune GDM, respectively. Pregnancy may facilitate the identification of women at risk of developing diabetes later in life; autoimmune and non-autoimmune GDM may be early markers of the risk of future type 1 and type 2 diabetes, respectively. The most convenient and efficient way to discriminate GDM types is to assess pancreatic β-cell autoantibodies along with diagnosing diabetes in pregnancy.
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Yan X, Wang L, Yan C, Zhang X, Hui L, Sheng Q, Xue M, Yu X. Decreased expression of the vitamin D receptor in women with recurrent pregnancy loss. Arch Biochem Biophys 2016; 606:128-33. [PMID: 27477959 DOI: 10.1016/j.abb.2016.07.021] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2016] [Revised: 07/25/2016] [Accepted: 07/27/2016] [Indexed: 12/31/2022]
Abstract
The multiple functions of vitamin D3 have stimulated interest in the role that this vitamin may play during pregnancy. The present study investigated the expression of the vitamin D receptor (VDR) in women during the first trimester of pregnancy in order to determine whether VDR is associated with recurrent pregnancy loss (RPL). Forty women at 7-10 weeks gestation with RPL and 40 women of similar gestational age with a healthy pregnancy were recruited. VDR mRNA and protein in chorionic villi and decidua were evaluated by immunohistochemistry, confocal laser scanning microscopy (CLSM), western blot, and quantitative real-time polymerase chain reaction. The serum levels of VDR were measured by an enzyme-linked immunosorbent assay. Women with RPL had a significantly weaker expression of VDR mRNA in villi and decidual tissues compared with the control women (both p < 0.0001). Western blot analysis showed an approximately 46% decrease in VDR expression in villi and a 52% decrease in decidua in the RPL vs. the controls. Serum VDR levels were also significantly lower in the RPL group than in the control group (p = 0.003). Compared with the controls, immunohistochemical and CLSM analysis revealed significantly lower VDR expression in villous cytotrophoblasts and stromal cells, as well as in decidual glandular epithelial and stromal cells (all p < 0.05). In conclusion, these observations show that women with RPL have lower levels of VDR expression in chorionic villi, decidua and serum compared with normal pregnant women, suggesting that decreased VDR expression in the first trimester pregnancy may be associated with RPL.
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Affiliation(s)
- Xiaoting Yan
- Department of Obestetrics and Gynecology in First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, China
| | - Liqin Wang
- Nursing Department in Xi'an Medical College, Xi'an, 710021, China
| | - Chunfang Yan
- Center of Reproduction Medicine in Fourth Hospital of Xi'an City, Xi'an, 710004, China
| | - Xinwen Zhang
- Department of Obestetrics and Gynecology in First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, China; Center of Reproduction Medicine in Fourth Hospital of Xi'an City, Xi'an, 710004, China
| | - Lingyun Hui
- Laboratory Department in First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, China
| | - Qiu Sheng
- Department of Obestetrics and Gynecology in First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, China
| | - Mingzhan Xue
- Clinical Sciences Research Lab, Warwick Medical School, University of Warwick, University Hospital, Coventry, CV2 2DX, UK
| | - Xuewen Yu
- Department of Obestetrics and Gynecology in First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, China.
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Qin LL, Lu FG, Yang SH, Xu HL, Luo BA. Does Maternal Vitamin D Deficiency Increase the Risk of Preterm Birth: A Meta-Analysis of Observational Studies. Nutrients 2016; 8:nu8050301. [PMID: 27213444 PMCID: PMC4882713 DOI: 10.3390/nu8050301] [Citation(s) in RCA: 88] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2016] [Revised: 04/28/2016] [Accepted: 05/11/2016] [Indexed: 02/07/2023] Open
Abstract
There are disagreements among researchers about the association between vitamin D deficiency during pregnancy and preterm birth (PTB). Therefore, we conducted a meta-analysis of observational studies to evaluate this association. We performed a systematic literature search of PubMed, MEDLINE and the Cochrane Library through August 2015 with the following keywords: “vitamin D” or “cholecalciferol” or “25-hydroxyvitamin D” or “25(OH)D” in combination with “premature birth” or “preterm birth” or “PTB” or “preterm delivery” or “PTD” or “prematurity”. Our meta-analysis of 10 studies included 10,098 participants and found that pregnant women with vitamin D deficiency (maternal serum 25 (OH) D levels < 20 ng/mL) experienced a significantly increased risk of PTB (odds ratio (OR) = 1.29, 95% confidence intervals(CI): 1.16, 1.45) with low heterogeneity (I2 = 25%, p = 0.21). Sensitivity analysis showed that exclusion of any single study did not materially alter the overall combined effect. In the subgroup analyses, we found that heterogeneity was obvious in prospective cohort studies (I2 = 60%, p = 0.06). In conclusion, pregnant women with vitamin D deficiency during pregnancy have an increasing risk of PTB.
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Affiliation(s)
- Lu-Lu Qin
- Department of Prevention Medicine and Pathogenic Biology, Medical School, Hunan University of Chinese Medicine, Changsha 410208, China; (L.-L.Q.); lufangguo0731@163 (F.-G.L.); (S.-H.Y.)
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha 410078, China;
| | - Fang-Guo Lu
- Department of Prevention Medicine and Pathogenic Biology, Medical School, Hunan University of Chinese Medicine, Changsha 410208, China; (L.-L.Q.); lufangguo0731@163 (F.-G.L.); (S.-H.Y.)
| | - Sheng-Hui Yang
- Department of Prevention Medicine and Pathogenic Biology, Medical School, Hunan University of Chinese Medicine, Changsha 410208, China; (L.-L.Q.); lufangguo0731@163 (F.-G.L.); (S.-H.Y.)
| | - Hui-Lan Xu
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha 410078, China;
| | - Bang-An Luo
- Department of Mental Health, Brain Hospital of Hunan Province, Changsha 410007, China
- Correspondence: ; Tel.: +86-0731-8523-2282
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Abstract
OBJECTIVES Metabolites of vitamin D in maternal-neonatal dyads remain relatively unexplored. The goal of this study was to evaluate concentrations of 25(OH)D3, 24,25(OH)2D3, and 3-epi-25(OH)D3 in maternal-infant pairs at delivery. METHODS Serum samples of maternal and infant cord blood were collected on 131 mother-infant pairs at delivery. Vitamin D metabolites were analyzed in triplicate using liquid chromatography-tandem mass spectrometry. Statistical analysis was conducted using the Fisher exact test, Wilcoxon rank sum test, and Spearman correlation coefficients. RESULTS Mean 25(OH)D3 concentrations in maternal and cord blood were 32.9 and 18.5 ng/mL, respectively; mean maternal and cord 24,25(OH)2D3 were 2.0 versus 1.1 ng/mL, respectively. Absolute concentrations of 3-epi-25(OH)D3 were similar in maternal and cord samples (2.4 vs 2.2 ng/mL), whereas the proportion of the total 25(OH)D as the 3-epimer was 6.5% in maternal samples and 10.5% in cord samples. This suggests that the fetus contributes significantly to 3-epi-25(OH)D3 production. In contrast, the ratio of 25(OH)D3:24,25(OH)2D3 was identical in maternal and cord samples (18.5) suggesting equivalent CYP24A1 activity in mother and fetus. Maternal and cord metabolite levels were highly correlated (r = 0.78, 0.90, 0.89 for 25(OH)D3, 24,25(OH)2D3, and 3-epi-25(OH)D3, respectively, P = 0.001 for all). Serum concentrations of all metabolites were lower in nonwhite infants compared with white infants. Maternal and cord concentrations of 25(OH)D3 were positively associated with birth weight (r = 0.21, P = 0.02; r = 0.25, P = 0.003, respectively). CONCLUSIONS This data suggests that although maternal and cord concentrations of vitamin D metabolites are highly correlated, regulation of specific vitamin D metabolites in the mother and the neonate may be mediated independently.
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Palaniswamy S, Williams D, Järvelin MR, Sebert S. Vitamin D and the Promotion of Long-Term Metabolic Health from a Programming Perspective. Nutr Metab Insights 2016; 8:11-21. [PMID: 26843814 PMCID: PMC4737521 DOI: 10.4137/nmi.s29526] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2015] [Revised: 11/04/2015] [Accepted: 11/06/2015] [Indexed: 01/14/2023] Open
Abstract
Studies linking vitamin D and long-term metabolic health have generated much debate. Recommendations for the intake of vitamin D by the general public and by the health care professionals have been complicated by a number of inconsistencies in the literature. These caveats relate to the methodological approaches, differences in the populations (and the species) of study, and the definitions used for thresholds of vitamin D status. This review addresses current evidence available for assessing the potential programming of long-term metabolic health of offspring by maternal vitamin D status in pregnancy. It summarizes knowledge on the early origins of metabolic health and analyzes evidence for an association between the vitamin D status in pregnancy and maternal and fetal health status. In addition, we analyze the link between the regulation of inflammation and the vitamin D status in the general population to inform on the general mechanisms through which early vitamin D might affect the programming of long-term health. The evidence suggests an association between the vitamin D status in early life and the programming of long-term health. However, to the best of our knowledge, the current finding is insufficient to draw a final conclusion for evidence-based preventive actions. The data warrant replication in prospective studies and additional research substantiating the causal factors and pathways.
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Affiliation(s)
- Saranya Palaniswamy
- Center for Life-Course Health Research, Faculty of Medicine, University of Oulu, Oulu, Finland.; Biocenter Oulu, Faculty of Medicine, University of Oulu, Oulu, Finland
| | - Dylan Williams
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College, London, UK
| | - Marjo-Riitta Järvelin
- Center for Life-Course Health Research, Faculty of Medicine, University of Oulu, Oulu, Finland.; Biocenter Oulu, Faculty of Medicine, University of Oulu, Oulu, Finland.; Department of Epidemiology and Biostatistics, School of Public Health, Imperial College, London, UK.; MRC-PHE Centre for Environment & Health, School of Public Health, Imperial College, London, UK.; Unit of Primary Care, Oulu University Hospital, Oulu, Finland
| | - Sylvain Sebert
- Center for Life-Course Health Research, Faculty of Medicine, University of Oulu, Oulu, Finland.; Biocenter Oulu, Faculty of Medicine, University of Oulu, Oulu, Finland
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Inflammation and functional iron deficiency regulate fibroblast growth factor 23 production. Kidney Int 2016; 89:135-46. [PMID: 26535997 PMCID: PMC4854810 DOI: 10.1038/ki.2015.290] [Citation(s) in RCA: 347] [Impact Index Per Article: 43.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2014] [Revised: 08/11/2015] [Accepted: 08/13/2015] [Indexed: 12/11/2022]
Abstract
Circulating levels of fibroblast growth factor 23 (FGF23) are elevated in patients with chronic kidney disease (CKD), but the mechanisms are poorly understood. Here we tested whether inflammation and iron deficiency regulate FGF23. In wild-type mice, acute inflammation induced by single injections of heat-killed Brucella abortus or interleukin-1β (IL-1β) decreased serum iron within 6 h, and was accompanied by significant increases in osseous Fgf23 mRNA expression and serum levels of C-terminal FGF23, but no changes in intact FGF23. Chronic inflammation induced by repeated bacteria or IL-1β injections decreased serum iron, increased osseous Fgf23 mRNA, and serum C-terminal FGF23, but modestly increased biologically active, intact FGF23 serum levels. Chronic iron deficiency mimicked chronic inflammation. Increased osseous FGF23 cleavage rather than a prolonged half-life of C-terminal FGF23 fragments accounted for the elevated C-terminal FGF23 but near-normal intact FGF23 levels in inflammation. IL-1β injection increased Fgf23 mRNA and C-terminal FGF23 levels similarly in wildtype and Col4a3(ko) mice with CKD but markedly increased intact FGF23 levels only in the CKD mice. Inflammation increased Fgf23 transcription by activating Hif1α signaling. Thus, inflammation and iron deficiency stimulate FGF23 production. Simultaneous upregulation of FGF23 cleavage in osteocytes maintains near-normal levels of biologically active, intact circulating FGF23, whereas downregulated or impaired FGF23 cleavage may contribute to elevated intact serum FGF23 in CKD.
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Christakos S, Dhawan P, Verstuyf A, Verlinden L, Carmeliet G. Vitamin D: Metabolism, Molecular Mechanism of Action, and Pleiotropic Effects. Physiol Rev 2016; 96:365-408. [PMID: 26681795 PMCID: PMC4839493 DOI: 10.1152/physrev.00014.2015] [Citation(s) in RCA: 1084] [Impact Index Per Article: 135.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
1,25-Dihydroxvitamin D3 [1,25(OH)2D3] is the hormonally active form of vitamin D. The genomic mechanism of 1,25(OH)2D3 action involves the direct binding of the 1,25(OH)2D3 activated vitamin D receptor/retinoic X receptor (VDR/RXR) heterodimeric complex to specific DNA sequences. Numerous VDR co-regulatory proteins have been identified, and genome-wide studies have shown that the actions of 1,25(OH)2D3 involve regulation of gene activity at a range of locations many kilobases from the transcription start site. The structure of the liganded VDR/RXR complex was recently characterized using cryoelectron microscopy, X-ray scattering, and hydrogen deuterium exchange. These recent technological advances will result in a more complete understanding of VDR coactivator interactions, thus facilitating cell and gene specific clinical applications. Although the identification of mechanisms mediating VDR-regulated transcription has been one focus of recent research in the field, other topics of fundamental importance include the identification and functional significance of proteins involved in the metabolism of vitamin D. CYP2R1 has been identified as the most important 25-hydroxylase, and a critical role for CYP24A1 in humans was noted in studies showing that inactivating mutations in CYP24A1 are a probable cause of idiopathic infantile hypercalcemia. In addition, studies using knockout and transgenic mice have provided new insight on the physiological role of vitamin D in classical target tissues as well as evidence of extraskeletal effects of 1,25(OH)2D3 including inhibition of cancer progression, effects on the cardiovascular system, and immunomodulatory effects in certain autoimmune diseases. Some of the mechanistic findings in mouse models have also been observed in humans. The identification of similar pathways in humans could lead to the development of new therapies to prevent and treat disease.
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Affiliation(s)
- Sylvia Christakos
- Department of Microbiology, Biochemistry and Molecular Genetics, Rutgers, The State University of New Jersey, New Jersey Medical School, Newark, New Jersey; and Laboratory of Clinical and Experimental Endocrinology, KU Leuven, Leuven, Belgium
| | - Puneet Dhawan
- Department of Microbiology, Biochemistry and Molecular Genetics, Rutgers, The State University of New Jersey, New Jersey Medical School, Newark, New Jersey; and Laboratory of Clinical and Experimental Endocrinology, KU Leuven, Leuven, Belgium
| | - Annemieke Verstuyf
- Department of Microbiology, Biochemistry and Molecular Genetics, Rutgers, The State University of New Jersey, New Jersey Medical School, Newark, New Jersey; and Laboratory of Clinical and Experimental Endocrinology, KU Leuven, Leuven, Belgium
| | - Lieve Verlinden
- Department of Microbiology, Biochemistry and Molecular Genetics, Rutgers, The State University of New Jersey, New Jersey Medical School, Newark, New Jersey; and Laboratory of Clinical and Experimental Endocrinology, KU Leuven, Leuven, Belgium
| | - Geert Carmeliet
- Department of Microbiology, Biochemistry and Molecular Genetics, Rutgers, The State University of New Jersey, New Jersey Medical School, Newark, New Jersey; and Laboratory of Clinical and Experimental Endocrinology, KU Leuven, Leuven, Belgium
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74
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Triunfo S, Lanzone A. Potential impact of maternal vitamin D status on obstetric well-being. J Endocrinol Invest 2016; 39:37-44. [PMID: 26062522 DOI: 10.1007/s40618-015-0330-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2015] [Accepted: 06/01/2015] [Indexed: 01/23/2023]
Abstract
Despite its discovery 100 years ago, vitamin D (VD) has emerged as one of the most controversial nutrients and prohormones of the 21st century. In the past few years, a growing interest in VD has been observed in the biomedical literature due to evidences demonstrating a relevant relationship not only between regulation of calcium and phosphorus homeostasis, but also multiple disease states and low VD status in the population. Indeed, several studies carried out to decipher its role in the body in almost every cell, tissue, and different organs. Recent findings suggested a significant implication of VD in different physiologic processes , such as vascular health, immune function, metabolism, and placental function. In the attempt to focus the attention on effect of VD on female reproductive health, there has been a paucity of data from randomized controlled trials to establish clear beneficial. Human and animal data suggest that low VD status is associated with impaired fertility, endometriosis, and polycystic ovary syndrome. Findings from observational studies show higher rates of preeclampsia, gestational diabetes, preterm birth, and bacterial vaginosis in women with low VD levels. By recent evidences, this review explored the association between maternal VD status and selected effects on maternal, perinatal, and infant health, and the impact of VD supplementation during pregnancy on obstetric well-being.
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Affiliation(s)
- S Triunfo
- BCNatal-Barcelona Center for Maternal-Fetal and Neonatal Medicine, Hospital Clínic and Hospital Sant Joan de Deu, University of Barcelona, Sabino de Arana, 1 08028, Barcelona, Spain.
| | - A Lanzone
- Department of Obstetrics and Gynecology, Catholic University of the Sacred Heart, Rome, Italy
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Is first trimester vitamin D status in nulliparous women associated with pregnancy related hypertensive disorders? Midwifery 2015; 34:117-122. [PMID: 26805604 DOI: 10.1016/j.midw.2015.12.007] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2015] [Revised: 12/11/2015] [Accepted: 12/15/2015] [Indexed: 11/20/2022]
Abstract
OBJECTIVES this study aimed to explore if maternal vitamin D status in early pregnancy was associated with pre-eclampsia and pregnancy-induced hypertension. Relationships between vitamin D status and blood pressure at the start of pregnancy as well as the occurrence of a mid-pregnancy drop in blood pressure were also explored. This secondary analysis was completed to investigate a possible mechanism for the association between vitamin D status and pregnancy related hypertensive disorders. DESIGN AND SETTING data were obtained from the Amsterdam Born Children and their Development study, a prospective community-based cohort study based in Amsterdam, The Netherlands. PARTICIPANTS a total of 2074 nulliparous women without pre-existing hypertension and with a known vitamin D status before 17 weeks gestation were included in the study. Vitamin D status was categorized into four groups: "normal" (≥50nmol/L), "insufficient" (30-49.9nmol/L) "deficient" (20-29.9nmol/L) or "severely deficient" (<20nmol/L). MEASUREMENTS logistic regression analysis was used to investigate if vitamin D status was related to the odds of experiencing pre-eclampsia or pregnancy-induced hypertension. Models were corrected for maternal age, ethnicity, pre-pregnancy BMI, smoking and socioeconomic status. χ(2) and ANOVA tests were used to investigate relationships between vitamin D status and the blood pressure parameters. FINDINGS when compared to women with a normal vitamin D status, women who were severely deficient had an increased risk for pre-eclampsia (OR 2.08; 95% CI, 1.05-4.13), but the association was rendered non-significant after correction (OR 1.88; 95% CI 0.79-4.48). There were no associations between vitamin D status and pregnancy-induced hypertension, starting blood pressure or the occurrence of a mid-pregnancy drop in blood pressure. KEY CONCLUSIONS no strong evidence was found for an association between first trimester vitamin D status and pregnancy related hypertensive disorders in nulliparous women. IMPLICATIONS FOR PRACTICE at this time, vitamin D supplementation is not warranted for the specific purpose of preventing pregnancy related hypertensive disorders.
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Sarkar S, Hewison M, Studzinski GP, Li YC, Kalia V. Role of vitamin D in cytotoxic T lymphocyte immunity to pathogens and cancer. Crit Rev Clin Lab Sci 2015; 53:132-45. [PMID: 26479950 DOI: 10.3109/10408363.2015.1094443] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
The discovery of vitamin D receptor (VDR) expression in immune cells has opened up a new area of research into immunoregulation by vitamin D, a niche that is distinct from its classical role in skeletal health. Today, about three decades since this discovery, numerous cellular and molecular targets of vitamin D in the immune system have been delineated. Moreover, strong clinical associations between vitamin D status and the incidence/severity of many immune-regulated disorders (e.g. infectious diseases, cancers and autoimmunity) have prompted the idea of using vitamin D supplementation to manipulate disease outcome. While much is known about the effects of vitamin D on innate immune responses and helper T (T(H)) cell immunity, there has been relatively limited progress on the frontier of cytotoxic T lymphocyte (CTL) immunity--an arm of host cellular adaptive immunity that is crucial for the control of such intracellular pathogens as human immunodeficiency virus (HIV), tuberculosis (TB), malaria, and hepatitis C virus (HCV). In this review, we discuss the strong historical and clinical link between vitamin D and infectious diseases that involves cytotoxic T lymphocyte (CTL) immunity, present our current understanding as well as critical knowledge gaps in the realm of vitamin D regulation of host CTL responses, and highlight potential regulatory connections between vitamin D and effector and memory CD8 T cell differentiation events during infections.
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Affiliation(s)
- Surojit Sarkar
- a Department of Pediatrics, Division of Hematology and Oncology , University of Washington School of Medicine , Seattle , WA , USA .,b Seattle Children's Research Institute, Ben Towne Center for Childhood Cancer Research , Seattle , WA , USA
| | - Martin Hewison
- c Centre for Endocrinology, Diabetes and Metabolism (CEDAM), The University of Birmingham , Birmingham , UK
| | - George P Studzinski
- d Department of Pathology and Laboratory Medicine , Rutgers New Jersey Medical School , Newark , NJ , USA , and
| | - Yan Chun Li
- e Department of Medicine, Division of Biological Sciences , The University of Chicago , Chicago , IL , USA
| | - Vandana Kalia
- a Department of Pediatrics, Division of Hematology and Oncology , University of Washington School of Medicine , Seattle , WA , USA .,b Seattle Children's Research Institute, Ben Towne Center for Childhood Cancer Research , Seattle , WA , USA
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77
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Mirzakhani H, Al-Garawi A, Weiss ST, Litonjua AA. Vitamin D and the development of allergic disease: how important is it? Clin Exp Allergy 2015; 45:114-25. [PMID: 25307157 DOI: 10.1111/cea.12430] [Citation(s) in RCA: 93] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Vitamin D has known effects on lung development and the immune system that may be important in the development, severity, and course of allergic diseases (asthma, eczema, and food allergy). Vitamin D deficiency is prevalent worldwide and may partly explain the increases in asthma and allergic diseases that have occurred over the last 50-60 years. In this review, we explore past and current knowledge on the effect of vitamin D on lung development and immunomodulation and present the evidence of its role in allergic conditions. While there is growing observational and experimental evidence for the role of vitamin D, well-designed and well-powered clinical trials are needed to determine whether supplementation of vitamin D should be recommended in these disorders.
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Affiliation(s)
- H Mirzakhani
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
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78
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Hrudey EJ, Reynolds RM, Oostvogels AJJM, Brouwer IA, Vrijkotte TGM. The Association between Maternal 25-Hydroxyvitamin D Concentration during Gestation and Early Childhood Cardio-metabolic Outcomes: Is There Interaction with Pre-Pregnancy BMI? PLoS One 2015; 10:e0133313. [PMID: 26244505 PMCID: PMC4526575 DOI: 10.1371/journal.pone.0133313] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2015] [Accepted: 06/24/2015] [Indexed: 11/18/2022] Open
Abstract
Both maternal 25-hydroxyvitamin D(25OHD) status and pre-pregnancy BMI(pBMI) may influence offspring cardio-metabolic outcomes. Lower 25OHD concentrations have been observed in women with both low and high pBMIs, but the combined influence of pBMI and 25OHD on offspring cardio-metabolic outcomes is unknown. Therefore, this study investigated the role of pBMI in the association between maternal 25OHD concentration and cardio-metabolic outcomes in 5-6 year old children. Data were obtained from the ABCD cohort study and 1882 mother-child pairs were included. The offspring outcomes investigated were systolic and diastolic blood pressure, heart rate, BMI, body fat percentage(%BF), waist-to-height ratio, total cholesterol, LDL cholesterol, HDL cholesterol, triglycerides, glucose, C-peptide, and insulin resistance(HOMA2-IR). 62% of the C-peptide samples were below the detection limit and were thus imputed using survival analysis. Models were corrected for maternal and offspring covariates and tested for interaction with pBMI. Interaction with pBMI was observed in the associations with insulin resistance markers: in offspring of overweight mothers(≥25.0kg/m2), a 10 nmol/L increase in maternal 25OHD was associated with a 0.007(99%CI:-0.01,-0.001) nmol/L decrease in C-peptide and a 0.02(99%CI:-0.03,-0.004) decrease in HOMA2-IR. When only non-imputed data were analyzed, there was a trend for interaction in the relationship but the results lost significance. Interaction with pBMI was not observed for the other outcomes. A 10 nmol/L increase in maternal 25OHD was significantly associated with a 0.13%(99%CI:-0.3,-0.003) decrease in %BF after correction for maternal and child covariates. Thus, intrauterine exposure to both low 25OHD and maternal overweight may be associated with increased insulin resistance in offspring, while exposure to low 25OHD in utero may be associated with increased offspring %BF with no interactive effects from pBMI. Due to the limitations of this study, these results are not conclusive, however the observations of this study pose important research questions for future studies to investigate.
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Affiliation(s)
- E. Jessica Hrudey
- Department of Public Health, Academic Medical Center, University of Amsterdam, 1100 DD Amsterdam, The Netherlands
- * E-mail:
| | - Rebecca M. Reynolds
- BHF Centre for Cardiovascular Science, Queen’s Medical Research Institute, University of Edinburgh, Edinburgh, United Kingdom
| | - Adriëtte J. J. M. Oostvogels
- Department of Public Health, Academic Medical Center, University of Amsterdam, 1100 DD Amsterdam, The Netherlands
| | - Ingeborg A. Brouwer
- Department of Health Sciences, VU University, de Boelelaan 1085, 1081HV, Amsterdam, The Netherlands
| | - Tanja G. M. Vrijkotte
- Department of Public Health, Academic Medical Center, University of Amsterdam, 1100 DD Amsterdam, The Netherlands
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79
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Vitamin D Receptor Gene Ablation in the Conceptus Has Limited Effects on Placental Morphology, Function and Pregnancy Outcome. PLoS One 2015; 10:e0131287. [PMID: 26121239 PMCID: PMC4488298 DOI: 10.1371/journal.pone.0131287] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2015] [Accepted: 06/01/2015] [Indexed: 01/17/2023] Open
Abstract
Vitamin D deficiency has been implicated in the pathogenesis of several pregnancy complications attributed to impaired or abnormal placental function, but there are few clues indicating the mechanistic role of vitamin D in their pathogenesis. To further understand the role of vitamin D receptor (VDR)-mediated activity in placental function, we used heterozygous Vdr ablated C57Bl6 mice to assess fetal growth, morphological parameters and global gene expression in Vdr null placentae. Twelve Vdr+/- dams were mated at 10–12 weeks of age with Vdr+/- males. At day 18.5 of the 19.5 day gestation in our colony, females were euthanised and placental and fetal samples were collected, weighed and subsequently genotyped as either Vdr+/+, Vdr+/-or Vdr-/-. Morphological assessment of placentae using immunohistochemistry was performed and RNA was extracted and subject to microarray analysis. This revealed 25 genes that were significantly differentially expressed between Vdr+/+ and Vdr-/- placentae. The greatest difference was a 6.47-fold change in expression of Cyp24a1 which was significantly lower in the Vdr-/- placentae (P<0.01). Other differentially expressed genes in Vdr-/- placentae included those involved in RNA modification (Snord123), autophagy (Atg4b), cytoskeletal modification (Shroom4), cell signalling (Plscr1, Pex5) and mammalian target of rapamycin (mTOR) signalling (Deptor and Prr5). Interrogation of the upstream sequence of differentially expressed genes identified that many contain putative vitamin D receptor elements (VDREs). Despite the gene expression differences, this did not contribute to any differences in overall placental morphology, nor was function affected as there was no difference in fetal growth as determined by fetal weight near term. Given our dams still expressed a functional VDR gene, our results suggest that cross-talk between the maternal decidua and the placenta, as well as maternal vitamin D status, may be more important in determining pregnancy outcome than conceptus expression of VDR.
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80
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Chen YH, Yu Z, Fu L, Wang H, Chen X, Zhang C, Lv ZM, Xu DX. Vitamin D3 inhibits lipopolysaccharide-induced placental inflammation through reinforcing interaction between vitamin D receptor and nuclear factor kappa B p65 subunit. Sci Rep 2015; 5:10871. [PMID: 26065916 PMCID: PMC4464284 DOI: 10.1038/srep10871] [Citation(s) in RCA: 56] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2015] [Accepted: 05/01/2015] [Indexed: 01/14/2023] Open
Abstract
It is increasingly recognized that vitamin D3 (VitD3) has an anti-inflammatory activity. The present study investigated the effects of maternal VitD3 supplementation during pregnancy on LPS-induced placental inflammation and fetal intrauterine growth restriction (IUGR). All pregnant mice except controls were intraperitoneally injected with LPS (100 μg/kg) daily from gestational day (GD)15–17. In VitD3 + LPS group, pregnant mice were orally administered with VitD3 (25 μg/kg) before LPS injection. As expected, maternal LPS exposure caused placental inflammation and fetal IUGR. Interestingly, pretreatment with VitD3 repressed placental inflammation and protected against LPS-induced fetal IUGR. Further analysis showed that pretreatment with VitD3, which activated placental vitamin D receptor (VDR) signaling, specifically suppressed LPS-induced activation of nuclear factor kappa B (NF-κB) and significantly blocked nuclear translocation of NF-κB p65 subunit in trophoblast gaint cells of the labyrinth layer. Conversely, LPS, which activated placental NF-κB signaling, suppressed placental VDR activation and its target gene expression. Moreover, VitD3 reinforced physical interaction between placental VDR and NF-κB p65 subunit. The further study demonstrates that VitD3 inhibits placental NF-κB signaling in VDR-dependent manner. These results provide a mechanistic explanation for VitD3-mediated anti-inflammatory activity. Overall, the present study provides evidence for roles of VDR as a key regulator of placental inflammation.
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Affiliation(s)
- Yuan-Hua Chen
- 1] School of Public Health, Anhui Medical University, Hefei, China [2] Anhui Provincial Key Laboratory of Population Health &Aristogenics, Anhui Medical University, Hefei, China [3] School of Basic Medical Science, Anhui Medical University, Hefei, 230032, China
| | - Zhen Yu
- 1] School of Public Health, Anhui Medical University, Hefei, China [2] Anhui Provincial Key Laboratory of Population Health &Aristogenics, Anhui Medical University, Hefei, China
| | - Lin Fu
- School of Public Health, Anhui Medical University, Hefei, China
| | - Hua Wang
- 1] School of Public Health, Anhui Medical University, Hefei, China [2] Anhui Provincial Key Laboratory of Population Health &Aristogenics, Anhui Medical University, Hefei, China
| | - Xue Chen
- School of Public Health, Anhui Medical University, Hefei, China
| | - Cheng Zhang
- 1] School of Public Health, Anhui Medical University, Hefei, China [2] Anhui Provincial Key Laboratory of Population Health &Aristogenics, Anhui Medical University, Hefei, China
| | - Zheng-Mei Lv
- School of Basic Medical Science, Anhui Medical University, Hefei, 230032, China
| | - De-Xiang Xu
- 1] School of Public Health, Anhui Medical University, Hefei, China [2] Anhui Provincial Key Laboratory of Population Health &Aristogenics, Anhui Medical University, Hefei, China
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81
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Chen YH, Yu Z, Fu L, Xia MZ, Zhao M, Wang H, Zhang C, Hu YF, Tao FB, Xu DX. Supplementation with vitamin D3 during pregnancy protects against lipopolysaccharide-induced neural tube defects through improving placental folate transportation. Toxicol Sci 2015; 145:90-7. [PMID: 25673501 PMCID: PMC4833037 DOI: 10.1093/toxsci/kfv036] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Several reports demonstrated that maternal lipopolysaccharide (LPS) exposure at middle gestational stage caused neural tube defects (NTDs). This study investigated the effects of supplementation with vitamin D3 (VitD3) during pregnancy on LPS-induced NTDs. Pregnant mice except controls were ip injected with LPS (25 μg/kg) daily from gestational day (GD)8 to GD12. In LPS+VitD3 group, pregnant mice were orally administered with VitD3 (25 μg/kg) before LPS injection. As expected, a 5-day LPS injection resulted in 62.5% (10/16) of dams and 20.3% of fetuses with NTDs. Additional experiment showed that a 5-day LPS injection downregulated placental proton-coupled folate transporter (pcft) and reduced folate carrier 1 (rfc1), 2 major folate transporters in placentas. Consistent with downregulation of placental folate transporters, folate transport from maternal circulation into embryos was disturbed in LPS-treated mice. Interestingly, VitD3 not only inhibited placental inflammation but also attenuated LPS-induced downregulation of placental folate transporters. Correspondingly, VitD3 markedly improved folate transport from maternal circulation into the embryos. Importantly, supplementation with VitD3 during pregnancy protected mice from LPS-induced NTDs. Taken together, these results suggest that supplementation with VitD3 during pregnancy prevents LPS-induced NTDs through inhibiting placental inflammation and improving folate transport from maternal circulation into the embryos.
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Affiliation(s)
- Yuan-Hua Chen
- *Department of Toxicology, Anhui Provincial Key Laboratory of Population Health & Aristogenics, School of Basic Medical Science and School of Life Science, Anhui Medical University, Hefei 230032, China *Department of Toxicology, Anhui Provincial Key Laboratory of Population Health & Aristogenics, School of Basic Medical Science and School of Life Science, Anhui Medical University, Hefei 230032, China *Department of Toxicology, Anhui Provincial Key Laboratory of Population Health & Aristogenics, School of Basic Medical Science and School of Life Science, Anhui Medical University, Hefei 230032, China
| | - Zhen Yu
- *Department of Toxicology, Anhui Provincial Key Laboratory of Population Health & Aristogenics, School of Basic Medical Science and School of Life Science, Anhui Medical University, Hefei 230032, China *Department of Toxicology, Anhui Provincial Key Laboratory of Population Health & Aristogenics, School of Basic Medical Science and School of Life Science, Anhui Medical University, Hefei 230032, China
| | - Lin Fu
- *Department of Toxicology, Anhui Provincial Key Laboratory of Population Health & Aristogenics, School of Basic Medical Science and School of Life Science, Anhui Medical University, Hefei 230032, China
| | - Mi-Zhen Xia
- *Department of Toxicology, Anhui Provincial Key Laboratory of Population Health & Aristogenics, School of Basic Medical Science and School of Life Science, Anhui Medical University, Hefei 230032, China
| | - Mei Zhao
- *Department of Toxicology, Anhui Provincial Key Laboratory of Population Health & Aristogenics, School of Basic Medical Science and School of Life Science, Anhui Medical University, Hefei 230032, China
| | - Hua Wang
- *Department of Toxicology, Anhui Provincial Key Laboratory of Population Health & Aristogenics, School of Basic Medical Science and School of Life Science, Anhui Medical University, Hefei 230032, China *Department of Toxicology, Anhui Provincial Key Laboratory of Population Health & Aristogenics, School of Basic Medical Science and School of Life Science, Anhui Medical University, Hefei 230032, China
| | - Cheng Zhang
- *Department of Toxicology, Anhui Provincial Key Laboratory of Population Health & Aristogenics, School of Basic Medical Science and School of Life Science, Anhui Medical University, Hefei 230032, China
| | - Yong-Fang Hu
- *Department of Toxicology, Anhui Provincial Key Laboratory of Population Health & Aristogenics, School of Basic Medical Science and School of Life Science, Anhui Medical University, Hefei 230032, China
| | - Fang-Biao Tao
- *Department of Toxicology, Anhui Provincial Key Laboratory of Population Health & Aristogenics, School of Basic Medical Science and School of Life Science, Anhui Medical University, Hefei 230032, China
| | - De-Xiang Xu
- *Department of Toxicology, Anhui Provincial Key Laboratory of Population Health & Aristogenics, School of Basic Medical Science and School of Life Science, Anhui Medical University, Hefei 230032, China *Department of Toxicology, Anhui Provincial Key Laboratory of Population Health & Aristogenics, School of Basic Medical Science and School of Life Science, Anhui Medical University, Hefei 230032, China
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82
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Olmos-Ortiz A, Noyola-Martínez N, Barrera D, Zaga-Clavellina V, Avila E, Halhali A, Biruete B, Larrea F, Díaz L. IL-10 inhibits while calcitriol reestablishes placental antimicrobial peptides gene expression. J Steroid Biochem Mol Biol 2015; 148:187-93. [PMID: 25088189 DOI: 10.1016/j.jsbmb.2014.07.012] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2014] [Revised: 07/25/2014] [Accepted: 07/29/2014] [Indexed: 01/22/2023]
Abstract
IL-10 and calcitriol help to achieve a successful pregnancy by suppressing active maternal immunity; however, these factors exert opposite effects upon microbial infections. In the skin and immune cells, IL-10 downregulates β-defensins while calcitriol induces cathelicidin gene expression in various tissues including placenta. Though, the regulation of human placental β-defensins by IL-10 and calcitriol has not been studied. Therefore, we explored the regulation of these antimicrobial peptides expression in cultured placental cells by calcitriol and IL-10 alone and combined. Real time PCR showed that calcitriol stimulated, while IL-10 inhibited, β-defensins and cathelicidin gene expression (P<0.05). In coincubations studies, calcitriol was able to maintain antimicrobial peptides gene expression above control values, overriding IL-10 inhibitory effects. Calcitriol downregulated endogenous IL-10 secretion. Interestingly, calcitriol and TNF-α cooperatively enhanced β-defensins, while TNF-α reduced basal and calcitriol-stimulated cathelicidin gene expression. In summary, calcitriol and IL-10 exerted opposite effects on antimicrobial peptides expression in the human placenta, suggesting that unbalanced production of IL-10 and calcitriol could be deleterious to innate immune responses during gestation. Our results suggest that calcitriol enhancement of placental defenses involves two mechanisms: (1) downregulation of IL-10 secretion and (2) direct upregulation of β-defensins and cathelicidin gene expression. Considering that IL-10 and calcitriol differentially regulate the innate immune response in the placenta, in the case of an infection, calcitriol might restrict IL-10 permissive actions towards microbial invasion while restrains inflammation, allowing for pregnancy to continue in quiescence. These results strongly advice maternal vitamin D sufficiency during pregnancy.
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Affiliation(s)
- Andrea Olmos-Ortiz
- Departamento de Biología de la Reproducción, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Vasco de Quiroga No. 15, México City, Tlalpan 14000, Mexico
| | - Nancy Noyola-Martínez
- Departamento de Biología de la Reproducción, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Vasco de Quiroga No. 15, México City, Tlalpan 14000, Mexico
| | - David Barrera
- Departamento de Biología de la Reproducción, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Vasco de Quiroga No. 15, México City, Tlalpan 14000, Mexico
| | - Verónica Zaga-Clavellina
- Departamento de Inmunobioquímica, Instituto Nacional de Perinatología Isidro Espinosa de los Reyes, Montes Urales No. 800, México City, Col. Lomas de Virreyes 11000, Mexico
| | - Euclides Avila
- Departamento de Biología de la Reproducción, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Vasco de Quiroga No. 15, México City, Tlalpan 14000, Mexico
| | - Ali Halhali
- Departamento de Biología de la Reproducción, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Vasco de Quiroga No. 15, México City, Tlalpan 14000, Mexico
| | - Benjamín Biruete
- División de Obstetricia, Hospital de Ginecología y Obstetricia del IMSS "Luis Castelazo Ayala", Río Magdalena No. 289, México City, Tizapán 01090, Mexico
| | - Fernando Larrea
- Departamento de Biología de la Reproducción, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Vasco de Quiroga No. 15, México City, Tlalpan 14000, Mexico
| | - Lorenza Díaz
- Departamento de Biología de la Reproducción, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Vasco de Quiroga No. 15, México City, Tlalpan 14000, Mexico.
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83
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Tamblyn JA, Hewison M, Wagner CL, Bulmer JN, Kilby MD. Immunological role of vitamin D at the maternal-fetal interface. J Endocrinol 2015; 224:R107-21. [PMID: 25663707 DOI: 10.1530/joe-14-0642] [Citation(s) in RCA: 122] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
During pregnancy, immune activity is tightly regulated so that antimicrobial protection of the mother and fetus is balanced with the need for immune tolerance to prevent fetal rejection. In this setting, the maternal-fetal interface, in the form of the uterine decidua, provides a heterogeneous immune cell population with the potential to mediate diverse activities throughout pregnancy. Recent studies have suggested that vitamin D may be a key regulator of immune function during pregnancy, with the fetal-maternal interface representing a prominent target. Among its non-classical actions are potent immunomodulatory effects, including induction of antibacterial responses and modulation of T-lymphocytes to suppress inflammation and promote tolerogenesis. Thus, vitamin D may play a pivotal role in normal decidual immune function by promoting innate responses to infection, while simultaneously preventing an over-elaboration of inflammatory adaptive immunity. Research to date has focused upon the potential role of vitamin D in preventing infectious diseases such as tuberculosis, as well as possibly suppressing of autoimmune disease. Nevertheless, vitamin D may also influence facets of immune function not immediately associated with primary innate responses. This review summarises our current understanding of decidual immune function with respect to the vitamin D metabolism and signalling, and as to how this may be affected by variations in maternal vitamin D status. There has recently been much interest in vitamin D supplementation of pregnant women, but our knowledge of how this may influence the function of decidua remains limited. Further insight into the immunomodulatory actions of vitamin D during pregnancy will help shed light upon this.
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Affiliation(s)
- J A Tamblyn
- College of Medical and Dental SciencesCentre for Women's and Children's HealthCollege of Medical and Dental SciencesCentre of Endocrinology, Diabetes and Metabolism (CEDAM), University of Birmingham, Edgbaston, Birmingham B15 2TT, UKDepartments of PediatricsBiochemistry, and Molecular Biology, Medical University of South Carolina, Charleston, South Carolina 29425, USAReproductive and Vascular Biology GroupInstitute of Cellular Medicine, Newcastle University, Newcastle upon Tyne NE2 4HH, UKFetal Medicine CentreBirmingham Women's Foundation Trust, Birmingham B15 2TG, UK College of Medical and Dental SciencesCentre for Women's and Children's HealthCollege of Medical and Dental SciencesCentre of Endocrinology, Diabetes and Metabolism (CEDAM), University of Birmingham, Edgbaston, Birmingham B15 2TT, UKDepartments of PediatricsBiochemistry, and Molecular Biology, Medical University of South Carolina, Charleston, South Carolina 29425, USAReproductive and Vascular Biology GroupInstitute of Cellular Medicine, Newcastle University, Newcastle upon Tyne NE2 4HH, UKFetal Medicine CentreBirmingham Women's Foundation Trust, Birmingham B15 2TG, UK
| | - M Hewison
- College of Medical and Dental SciencesCentre for Women's and Children's HealthCollege of Medical and Dental SciencesCentre of Endocrinology, Diabetes and Metabolism (CEDAM), University of Birmingham, Edgbaston, Birmingham B15 2TT, UKDepartments of PediatricsBiochemistry, and Molecular Biology, Medical University of South Carolina, Charleston, South Carolina 29425, USAReproductive and Vascular Biology GroupInstitute of Cellular Medicine, Newcastle University, Newcastle upon Tyne NE2 4HH, UKFetal Medicine CentreBirmingham Women's Foundation Trust, Birmingham B15 2TG, UK
| | - C L Wagner
- College of Medical and Dental SciencesCentre for Women's and Children's HealthCollege of Medical and Dental SciencesCentre of Endocrinology, Diabetes and Metabolism (CEDAM), University of Birmingham, Edgbaston, Birmingham B15 2TT, UKDepartments of PediatricsBiochemistry, and Molecular Biology, Medical University of South Carolina, Charleston, South Carolina 29425, USAReproductive and Vascular Biology GroupInstitute of Cellular Medicine, Newcastle University, Newcastle upon Tyne NE2 4HH, UKFetal Medicine CentreBirmingham Women's Foundation Trust, Birmingham B15 2TG, UK
| | - J N Bulmer
- College of Medical and Dental SciencesCentre for Women's and Children's HealthCollege of Medical and Dental SciencesCentre of Endocrinology, Diabetes and Metabolism (CEDAM), University of Birmingham, Edgbaston, Birmingham B15 2TT, UKDepartments of PediatricsBiochemistry, and Molecular Biology, Medical University of South Carolina, Charleston, South Carolina 29425, USAReproductive and Vascular Biology GroupInstitute of Cellular Medicine, Newcastle University, Newcastle upon Tyne NE2 4HH, UKFetal Medicine CentreBirmingham Women's Foundation Trust, Birmingham B15 2TG, UK
| | - M D Kilby
- College of Medical and Dental SciencesCentre for Women's and Children's HealthCollege of Medical and Dental SciencesCentre of Endocrinology, Diabetes and Metabolism (CEDAM), University of Birmingham, Edgbaston, Birmingham B15 2TT, UKDepartments of PediatricsBiochemistry, and Molecular Biology, Medical University of South Carolina, Charleston, South Carolina 29425, USAReproductive and Vascular Biology GroupInstitute of Cellular Medicine, Newcastle University, Newcastle upon Tyne NE2 4HH, UKFetal Medicine CentreBirmingham Women's Foundation Trust, Birmingham B15 2TG, UK College of Medical and Dental SciencesCentre for Women's and Children's HealthCollege of Medical and Dental SciencesCentre of Endocrinology, Diabetes and Metabolism (CEDAM), University of Birmingham, Edgbaston, Birmingham B15 2TT, UKDepartments of PediatricsBiochemistry, and Molecular Biology, Medical University of South Carolina, Charleston, South Carolina 29425, USAReproductive and Vascular Biology GroupInstitute of Cellular Medicine, Newcastle University, Newcastle upon Tyne NE2 4HH, UKFetal Medicine CentreBirmingham Women's Foundation Trust, Birmingham B15 2TG, UK College of Medical and Dental SciencesCentre for Women's and Children's HealthCollege of Medical and Dental SciencesCentre of Endocrinology, Diabetes and Metabolism (CEDAM), University of Birmingham, Edgbaston, Birmingham B15 2TT, UKDepartments of PediatricsBiochemistry, and Molecular Biology, Medical University of South Carolina, Charleston, South Carolina 29425, USAReproductive and Vascular Biology GroupInstitute of Cellular Medicine, Newcastle University, Newcastle upon Tyne NE2 4HH, UKFetal Medicine CentreBirmingham Women's Foundation Trust, Birmingham B15 2TG, UK
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84
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Debnath M, Venkatasubramanian G, Berk M. Fetal programming of schizophrenia: select mechanisms. Neurosci Biobehav Rev 2015; 49:90-104. [PMID: 25496904 PMCID: PMC7112550 DOI: 10.1016/j.neubiorev.2014.12.003] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2014] [Revised: 11/24/2014] [Accepted: 12/01/2014] [Indexed: 12/16/2022]
Abstract
Mounting evidence indicates that schizophrenia is associated with adverse intrauterine experiences. An adverse or suboptimal fetal environment can cause irreversible changes in brain that can subsequently exert long-lasting effects through resetting a diverse array of biological systems including endocrine, immune and nervous. It is evident from animal and imaging studies that subtle variations in the intrauterine environment can cause recognizable differences in brain structure and cognitive functions in the offspring. A wide variety of environmental factors may play a role in precipitating the emergent developmental dysregulation and the consequent evolution of psychiatric traits in early adulthood by inducing inflammatory, oxidative and nitrosative stress (IO&NS) pathways, mitochondrial dysfunction, apoptosis, and epigenetic dysregulation. However, the precise mechanisms behind such relationships and the specificity of the risk factors for schizophrenia remain exploratory. Considering the paucity of knowledge on fetal programming of schizophrenia, it is timely to consolidate the recent advances in the field and put forward an integrated overview of the mechanisms associated with fetal origin of schizophrenia.
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Affiliation(s)
- Monojit Debnath
- Department of Human Genetics, National Institute of Mental Health & Neurosciences, Bangalore 560029, India.
| | - Ganesan Venkatasubramanian
- Translational Psychiatry Laboratory, Neurobiology Research Centre and Department of Psychiatry, National Institute of Mental Health & Neurosciences, Hosur Road, Bangalore 560029, India
| | - Michael Berk
- IMPACT Strategic Research Centre, School of Medicine, Deakin University, Barwon Health, Geelong, Victoria, Australia; Department of Psychiatry, The Florey Institute of Neuroscience and Mental Health, and Orygen, The National Centre of Excellence in Youth Mental Health, University of Melbourne, Parkville, Australia
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85
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Bodnar LM, Platt RW, Simhan HN. Early-pregnancy vitamin D deficiency and risk of preterm birth subtypes. Obstet Gynecol 2015; 125:439-447. [PMID: 25569002 PMCID: PMC4304969 DOI: 10.1097/aog.0000000000000621] [Citation(s) in RCA: 100] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
OBJECTIVE To estimate the association between maternal 25-hydroxyvitamin D concentrations and risk of preterm birth subtypes. METHODS We performed a case-cohort study using data and banked samples from patients at a teaching hospital in Pittsburgh, Pennsylvania. Eligible participants were women with a prenatal aneuploidy screening serum sample at or before 20 weeks of gestation who subsequently delivered a singleton, liveborn neonate. Of the 12,861 eligible women, we selected 2,327 at random as well as all remaining preterm birth cases for a total of 1,126 cases. Serum 25-hydroxyvitamin D was measured using liquid chromatography-tandem mass spectrometry. Multivariable log-binomial regression models were used to estimate associations between maternal vitamin D status and preterm birth at 37 weeks of gestation (separately by spontaneous or indicated) and preterm birth at less than 34 weeks of gestation. RESULTS The incidence of preterm birth at less than 37 weeks of gestation was 8.6% overall and 11.3%, 8.6%, and 7.3% among mothers with serum 25-hydroxyvitamin D less than 50, 50-74.9, and 75 nmol/L or greater, respectively (P<.01). After adjustment for maternal race and ethnicity, prepregnancy body mass index, season, smoking, and other confounders, the risk of preterm birth at less than 37 weeks of gestation significantly decreased as 25-hydroxyvitamin D increased to approximately 90 nmol/L and then plateaued (test of nonlinearity P<.01). Results were similar when limiting to cases that were medically indicated or occurred spontaneously and cases occurring at less than 34 weeks of gestation. CONCLUSION Our data support a protective association maternal vitamin D sufficiency and preterm birth that combined with extant epidemiologic data may provide justification for a randomized clinical trial of maternal vitamin D replacement or supplementation to prevent preterm birth.
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Affiliation(s)
- Lisa M. Bodnar
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA
- Department of Obstetrics, Gynecology, and Reproductive Sciences, School of Medicine, University of Pittsburgh, Pittsburgh, PA
- Magee-Womens Research Institute, Pittsburgh, PA
| | - Robert W. Platt
- Departments of Pediatrics and Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Quebec, Canada
| | - Hyagriv N. Simhan
- Department of Obstetrics, Gynecology, and Reproductive Sciences, School of Medicine, University of Pittsburgh, Pittsburgh, PA
- Magee-Womens Research Institute, Pittsburgh, PA
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86
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Maternal immune response to helminth infection during pregnancy determines offspring susceptibility to allergic airway inflammation. J Allergy Clin Immunol 2014; 134:1271-1279.e10. [DOI: 10.1016/j.jaci.2014.05.034] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2013] [Revised: 05/16/2014] [Accepted: 05/27/2014] [Indexed: 02/01/2023]
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87
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Fabris A, Pacheco A, Cruz M, Puente JM, Fatemi H, Garcia-Velasco JA. Impact of circulating levels of total and bioavailable serum vitamin D on pregnancy rate in egg donation recipients. Fertil Steril 2014; 102:1608-12. [DOI: 10.1016/j.fertnstert.2014.08.030] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2014] [Revised: 08/12/2014] [Accepted: 08/26/2014] [Indexed: 10/24/2022]
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88
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Bobbitt KR, Peters RM, Li J, Rao SD, Woodcroft KJ, Cassidy-Bushrow AE. Early pregnancy vitamin D and patterns of antenatal inflammation in African-American women. J Reprod Immunol 2014; 107:52-8. [PMID: 25453750 DOI: 10.1016/j.jri.2014.09.054] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2014] [Revised: 08/29/2014] [Accepted: 09/18/2014] [Indexed: 10/24/2022]
Abstract
Vitamin D is essential for the health of both mother and fetus during pregnancy. In the nonpregnant state, vitamin D demonstrates anti-inflammatory effects, but little is known about this relationship during pregnancy. African-American women are at a higher risk of vitamin D deficiency and for altered inflammatory responses during pregnancy. Therefore, we investigated the association of early pregnancy vitamin D nutrition, as assessed by serum 25-hydroxyvitamin D (25-OHD), with second-trimester inflammatory biomarkers (high-sensitivity C-reactive protein, IL-6, IL-10, IL-1β and TNF-α) in 178 pregnant African-American women. Mean serum 25-OHD was 13.4±8.4 ng/ml, and most women (n=147, 82.6%) had inadequate or deficient levels of 25-OHD (<20 ng/ml). Both serum 25-OHD and some inflammatory cytokines (IL-1β and TNF-α) demonstrated significant seasonal variation. In univariate models, log transformed 25-OHD was significantly and inversely associated with log transformed IL-1β (p=0.002) and log transformed IL-6 (p=0.032). After adjusting for covariates, including seasonality, only the inverse association with IL-1β remained statistically significant (p=0.027). Early pregnancy vitamin D nutrition is associated with some inflammatory biomarkers in mid-pregnancy. Additional studies are needed to determine if low vitamin D nutrition is associated with birth outcomes via an inflammatory-mediated pathway.
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Affiliation(s)
- Kevin R Bobbitt
- Department of Public Health Sciences, Henry Ford Hospital, One Ford Place, Detroit, MI 48202, USA.
| | - Rosalind M Peters
- College of Nursing, Wayne State University, 358 Cohn, Detroit, MI 48202, USA.
| | - Jia Li
- Department of Public Health Sciences, Henry Ford Hospital, One Ford Place, Detroit, MI 48202, USA.
| | - Sudhaker D Rao
- Bone & Mineral Research Laboratory, Henry Ford Hospital, E&R Building 7th Floor, 2799 West Grand Boulevard, Detroit, MI 48202, USA.
| | - Kimberley J Woodcroft
- Department of Public Health Sciences, Henry Ford Hospital, One Ford Place, Detroit, MI 48202, USA.
| | - Andrea E Cassidy-Bushrow
- Department of Public Health Sciences, Henry Ford Hospital, One Ford Place, Detroit, MI 48202, USA.
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89
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Aydogmus S, Kelekci S, Aydogmus H, Eriş S, Desdicioğlu R, Yilmaz B, Sağlam G. High prevalence of vitamin D deficiency among pregnant women in a Turkish population and impact on perinatal outcomes. J Matern Fetal Neonatal Med 2014; 28:1828-32. [PMID: 25260128 DOI: 10.3109/14767058.2014.969235] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE Maternal vitamin D deficiency is a major public health problem. The aim of this study is to investigate the influence of vitamin D deficiency on perinatal results in primigravida. METHODS One-hundred fifty-two healthy nullipar women were included in the study. Pregnant women with serum vitamin D levels <15ng/ml were defined as Group I and ≥15 ng/dl were defined as Group II; data were evaluated retrospectively. Type of delivery, gestational age at birth, birth weight, intensive care of the newborn, peri-and postpartum complications were recorded. Statistical analyses were performed with SPSS for Windows (version 16.0 ). Categorical variables were assessed using chi-squared test. The numeric variables were analyzed using Student's t-test and one-way ANOVA. RESULTS 44.6% of pregnant women were found to have vitamin D deficiency. The mean serum vitamin D levels for Groups I and II were 10.8 ± 3.8 and 23.8 ± 13.3 ng/ml, respectively. SGA deliveries were detected in 16.66% and 4.87% of the primigravidas with and without vitamin D deficiency, respectively. CONCLUSIONS This study has shown that maternal vitamin D deficiency is related with an increased risk of SGA delivery. Further studies are needed to explain the relationship with vitamin D deficiency and poor perinatal outcomes.
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Affiliation(s)
- Serpil Aydogmus
- a Department of Obstetrics and Gynecology Izmi , School of Medicine
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90
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Chun RF, Blatter E, Elliott S, Fitz-Gibbon S, Rieger S, Sagasti A, Adams JS, Hewison M. Cloning of a functional 25-hydroxyvitamin D-1α-hydroxylase in zebrafish (Danio rerio). Cell Biochem Funct 2014; 32:675-82. [PMID: 25290078 DOI: 10.1002/cbf.3071] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2014] [Revised: 09/17/2014] [Accepted: 09/18/2014] [Indexed: 12/14/2022]
Abstract
Activation of precursor 25-hydroxyvitamin D3 (25D) to hormonal 1,25-dihydroxyvitamin D3 (1,25D) is a pivotal step in vitamin D physiology, catalysed by the enzyme 25-hydroxyvitamin D-1α-hydroxylase (1α-hydroxylase). To establish new models for assessing the physiological importance of the 1α-hydroxylase-25D-axis, we used Danio rerio (zebrafish) to characterize expression and biological activity of the gene for 1α-hydroxylase (cyp27b1). Treatment of day 5 zebrafish larvae with inactive 25D (5-150 nM) or active 1,25D (0.1-10 nM) induced dose responsive expression (15-95-fold) of the vitamin D-target gene cyp24a1 relative to larvae treated with vehicle, suggesting the presence of Cyp27b1 activity. A full-length zebrafish cyp27b1 cDNA was then generated using RACE and RT-PCR methods. Sequencing of the resulting clone revealed an open reading frame encoding a protein of 505 amino acids with 54% identity to human CYP27B1. Transfection of a cyp27b1 expression vector into HKC-8, a human kidney proximal tubular epithelial cell line, enhanced intracrine metabolism of 25D to 1,25D resulting in greater than twofold induction of CYP24A1 mRNA expression and a 25-fold increase in 1,25D production compared to empty vector. These data indicate that we have cloned a functional zebrafish CYP27B1, representing a phylogenetically distant branch from mammals of this key enzyme in vitamin D metabolism. Further analysis of cyp27b1 expression and activity in zebrafish may provide new perspectives on the biological importance of 25D metabolism.
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Affiliation(s)
- Rene F Chun
- Department of Orthopaedic Surgery, UCLA-Orthopaedic Hospital, Los Angeles, CA, 90095, United States
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91
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Gysler SM, Mulla MJ, Stuhlman M, Sfakianaki AK, Paidas MJ, Stanwood NL, Gariepy A, Brosens JJ, Chamley LW, Abrahams VM. Vitamin D Reverses aPL-induced Inflammation and LMWH-induced sFlt-1 Release by Human Trophoblast. Am J Reprod Immunol 2014; 73:242-50. [DOI: 10.1111/aji.12301] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2014] [Accepted: 07/07/2014] [Indexed: 11/26/2022] Open
Affiliation(s)
- Stefan M. Gysler
- Department of Obstetrics; Gynecology & Reproductive Sciences; Yale School of Medicine, New Haven CT USA
| | - Melissa J. Mulla
- Department of Obstetrics; Gynecology & Reproductive Sciences; Yale School of Medicine, New Haven CT USA
| | - Meredith Stuhlman
- Department of Obstetrics; Gynecology & Reproductive Sciences; Yale School of Medicine, New Haven CT USA
| | - Anna K. Sfakianaki
- Department of Obstetrics; Gynecology & Reproductive Sciences; Yale School of Medicine, New Haven CT USA
| | - Michael J. Paidas
- Department of Obstetrics; Gynecology & Reproductive Sciences; Yale School of Medicine, New Haven CT USA
| | - Nancy L. Stanwood
- Department of Obstetrics; Gynecology & Reproductive Sciences; Yale School of Medicine, New Haven CT USA
| | - Aileen Gariepy
- Department of Obstetrics; Gynecology & Reproductive Sciences; Yale School of Medicine, New Haven CT USA
| | - Jan J. Brosens
- Division of Reproductive Health; Clinical Sciences Research Laboratories; Warwick Medical School; Coventry UK
| | - Lawrence W. Chamley
- Department of Obstetrics and Gynecology; The University of Auckland; Auckland New Zealand
| | - Vikki M. Abrahams
- Department of Obstetrics; Gynecology & Reproductive Sciences; Yale School of Medicine, New Haven CT USA
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Knabl J, Hüttenbrenner R, Hutter S, Günthner-Biller M, Riedel C, Hiden U, Kainer F, Desoye G, Jeschke U. Gestational diabetes mellitus upregulates vitamin D receptor in extravillous trophoblasts and fetoplacental endothelial cells. Reprod Sci 2014; 22:358-66. [PMID: 25028176 DOI: 10.1177/1933719114542020] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
OBJECTIVE Gestational diabetes mellitus (GDM) is often accompanied by low maternal vitamin D, that is, calcitriol (1,25[OH]2 vitamin D3), levels. Here, we tested the hypothesis that the placental vitamin D receptor (VDR) is regulated by calcitriol and altered in GDM with distinct changes in different placental cell types. Specifically, we aimed to localize VDR in human term placentas from normal and GDM pregnancies, to quantify its cellular expression and to study in vitro its regulation by its physiological agonist calcitriol. STUDY DESIGN Placental tissue slides of 80 patients (40 with GDM/40 controls) were double stained for VDR and human leukocyte antigen G to identify extravillous trophoblasts (EVTs). Staining intensity was semiquantified. Quantitative real time-polymerase chain reaction and Western blotting measured VDR messenger RNA (mRNA) and protein in decidual tissue. The trophoblast cell line BeWo was used to study in vitro VDR regulation by calcitriol (0.01, 0.1, and 1 nmol/mL). RESULTS Vitamin D receptor protein and mRNA levels are upregulated (P < .05) in EVT (1.8-fold) as well as in placental endothelium (5.8-fold) of patients with GDM. Expression of VDR is regulated by calcitriol in a bimodal manner: high doses (0.1 and 1 nmol/mL) caused downregulation, whereas the low dose (0.01 nmol/mL) resulted in VDR upregulation. CONCLUSION Vitamin D receptor is upregulated in EVT and endothelium of GDM placentas. This could be due to low maternal vitamin D levels in patients with GDM because in vitro low calcitriol doses upregulate VDR in trophoblast cells.
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Affiliation(s)
- Julia Knabl
- Department of Obstetrics and Gynecology, Ludwig-Maximilians-Universität, Munich, Germany
| | - Rebecca Hüttenbrenner
- Department of Obstetrics and Gynecology, Ludwig-Maximilians-Universität, Munich, Germany
| | - Stefan Hutter
- Department of Obstetrics and Gynecology, Ludwig-Maximilians-Universität, Munich, Germany
| | - Maria Günthner-Biller
- Department of Obstetrics and Gynecology, Ludwig-Maximilians-Universität, Munich, Germany
| | - Christina Riedel
- Department of Obstetrics and Gynecology, Ludwig-Maximilians-Universität, Munich, Germany Institut für Soziale Pädiatrie und Jugendmedizin, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Ursula Hiden
- Department of Obstetrics and Gynecology, Ludwig-Maximilians-Universität, Munich, Germany Department of Obstetrics and Gynecology, Medical University Graz, Graz, Austria
| | - Franz Kainer
- Department of Obstetrics and Gynecology, Ludwig-Maximilians-Universität, Munich, Germany
| | - Gernot Desoye
- Department of Obstetrics and Gynecology, Ludwig-Maximilians-Universität, Munich, Germany Department of Obstetrics and Gynecology, Medical University Graz, Graz, Austria
| | - Udo Jeschke
- Department of Obstetrics and Gynecology, Ludwig-Maximilians-Universität, Munich, Germany
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93
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Wöbke TK, Sorg BL, Steinhilber D. Vitamin D in inflammatory diseases. Front Physiol 2014; 5:244. [PMID: 25071589 PMCID: PMC4078458 DOI: 10.3389/fphys.2014.00244] [Citation(s) in RCA: 116] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2014] [Accepted: 06/12/2014] [Indexed: 02/06/2023] Open
Abstract
Changes in vitamin D serum levels have been associated with inflammatory diseases, such as inflammatory bowel disease (IBD), rheumatoid arthritis, systemic lupus erythematosus, multiple sclerosis (MS), atherosclerosis, or asthma. Genome- and transcriptome-wide studies indicate that vitamin D signaling modulates many inflammatory responses on several levels. This includes (i) the regulation of the expression of genes which generate pro-inflammatory mediators, such as cyclooxygenases or 5-lipoxygenase, (ii) the interference with transcription factors, such as NF-κB, which regulate the expression of inflammatory genes and (iii) the activation of signaling cascades, such as MAP kinases which mediate inflammatory responses. Vitamin D targets various tissues and cell types, a number of which belong to the immune system, such as monocytes/macrophages, dendritic cells (DCs) as well as B- and T cells, leading to individual responses of each cell type. One hallmark of these specific vitamin D effects is the cell-type specific regulation of genes involved in the regulation of inflammatory processes and the interplay between vitamin D signaling and other signaling cascades involved in inflammation. An important task in the near future will be the elucidation of the regulatory mechanisms that are involved in the regulation of inflammatory responses by vitamin D on the molecular level by the use of techniques such as chromatin immunoprecipitation (ChIP), ChIP-seq, and FAIRE-seq.
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Affiliation(s)
- Thea K Wöbke
- Institute of Pharmaceutical Chemistry, Goethe University Frankfurt Frankfurt, Germany
| | - Bernd L Sorg
- Institute of Pharmaceutical Chemistry, Goethe University Frankfurt Frankfurt, Germany
| | - Dieter Steinhilber
- Institute of Pharmaceutical Chemistry, Goethe University Frankfurt Frankfurt, Germany
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94
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Goltzman D, Hendy GN, White JH. Vitamin D and its receptor during late development. BIOCHIMICA ET BIOPHYSICA ACTA-GENE REGULATORY MECHANISMS 2014; 1849:171-80. [PMID: 24939836 DOI: 10.1016/j.bbagrm.2014.05.026] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/27/2014] [Revised: 05/06/2014] [Accepted: 05/27/2014] [Indexed: 12/26/2022]
Abstract
Expression of the vitamin D receptor (VDR) is widespread but may vary depending on the developmental stage of the animal, and therefore may differentially influence phenotypic function. Thus, the major role of the 1,25-dihydroxyvitamin D [1,25(OH)2D]/VDR system is to regulate mineral and skeletal homeostasis, although mainly after birth. Post-natally, under conditions of low dietary calcium, the 1,25(OH)2D/VDR system enhances intestinal transcellular transport of calcium and possibly paracellular calcium entry by regulating genes that are critical for these functions. This process, by providing adequate calcium, is essential for normal development of the skeletal growth plate and mineralization of bone. Furthermore, blood calcium and phosphorus homeostasis is maintained by an interplay between feedback loops of the 1,25(OH)2D/VDR system with parathyroid hormone and with fibroblast-growth factor (FGF) 23 respectively. The 1,25(OH)2D/VDR system can also modulate the expression of genes involved in both bone formation and resorption post-natally. Ligand independent activity of the VDR normally influences mammalian hair cycling after birth by potentiating Wnt and bone morphogenetic protein (BMP) signaling. Nevertheless ligand bound VDR may also modulate epidermal cell proliferation/differentiation by regulating the balance in function of c-MYC and its antagonist the transcriptional repressor MAD1/MXD1 in skin epithelia. The 1,25(OH)2D/VDR system can also modulate innate immune cells and promote a more tolerogenic immunological status and may therefore influence inflammation and the development of autoimmunity; whether this impacts the fetus is uncertain. This article is part of a Special Issue entitled: Nuclear receptors in animal development.
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Affiliation(s)
- D Goltzman
- Department of Medicine, McGill University, Montreal, QC H3A1A1, Canada; Department of Physiology, McGill University, Montreal, QC H3A1A1, Canada
| | - G N Hendy
- Department of Medicine, McGill University, Montreal, QC H3A1A1, Canada; Department of Physiology, McGill University, Montreal, QC H3A1A1, Canada
| | - J H White
- Department of Medicine, McGill University, Montreal, QC H3A1A1, Canada; Department of Physiology, McGill University, Montreal, QC H3A1A1, Canada
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O'Brien KO, Li S, Cao C, Kent T, Young BV, Queenan RA, Pressman EK, Cooper EM. Placental CYP27B1 and CYP24A1 expression in human placental tissue and their association with maternal and neonatal calcitropic hormones. J Clin Endocrinol Metab 2014; 99:1348-56. [PMID: 24471562 PMCID: PMC3973783 DOI: 10.1210/jc.2013-1366] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
CONTEXT Placental CYP27B1 may contribute to circulating maternal calcitriol concentrations across gestation, but determinants of CYP27B1 and CYP24A1 expression in term human placental tissue are not well established. OBJECTIVE We hypothesized that higher CYP27B1 protein expression would be associated with increased maternal calcitriol during gestation and that CYP27B1 expression would be impacted by substrate availability. DESIGN This was a prospective, longitudinal study. SETTING The study was completed in an urban, prenatal clinic located in Rochester, New York. PATIENTS The study was undertaken in a cohort of 70 pregnant adolescents (≤18 y of age) and their term neonates. INTERVENTION There was no intervention. MAIN OUTCOMES Protein and mRNA expressions of CYP27B1, CYP24A1, and vitamin D receptor were measured in term placental tissue and related to 25-hydroxyvitamin D [25(OH)D], 1,25-dihydroxyvitamin D, PTH, serum total calcium, IL-6, leptin, and osteoprotegerin measured in maternal serum at midgestation and delivery and in umbilical cord serum at birth. RESULTS Placental CYP27B1 protein expression was significantly positively associated with maternal 25(OH)D at both midgestation (n = 68, P = .009) and delivery (n=67, P = .006). Maternal serum 1,25-dihydroxyvitamin D concentrations at midgestation were positively correlated with term placental CYP27B1 mRNA expression (n = 49, P = .002). Significant positive associations were evident between placental CYP27B1 and CYP24A1 protein expression (P = .001, n = 70). Maternal PTH concentrations at midgestation or delivery did not significantly impact placental protein or transcript level of either enzyme. Variability in placental CYP27B1 protein expression was best captured by a model that included maternal midgestation 25(OH)D concentration, placental vitamin D receptor protein expression, and maternal midgestation IL-6 concentrations (P = .002, n = 60, R(2) = 0.22). CONCLUSIONS Higher maternal 25(OH)D during pregnancy was associated with significantly higher placental protein expression of CYP27B1 at term supportive of a link between substrate availability and placental production of calcitriol.
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Affiliation(s)
- Kimberly O O'Brien
- Division of Nutritional Sciences (K.O.O., S.L., C.C., T.K., B.V.Y.), Cornell University, Ithaca, New York 14853; The University of Rochester School of Medicine (R.A.Q., E.K.P., E.M.C.), Rochester, New York 14642
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96
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Xu L, Lee M, Jeyabalan A, Roberts JM. The relationship of hypovitaminosis D and IL-6 in preeclampsia. Am J Obstet Gynecol 2014; 210:149.e1-7. [PMID: 24080305 DOI: 10.1016/j.ajog.2013.09.037] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2013] [Revised: 08/30/2013] [Accepted: 09/25/2013] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Vitamin D deficiency has been linked to the pathogenesis of preeclampsia. Given the demonstrated antiinflammatory function of vitamin D in multiple organ systems including trophoblast cells and placenta, we hypothesized that vitamin D deficiency contributes to the development of preeclampsia through increased inflammation, as indicated by elevated interleukin (IL)-6 concentrations. STUDY DESIGN Plasma samples from a large preeclampsia cohort study were examined in 100 preeclamptic and 100 normotensive pregnant women. Comparisons of vitamin D and IL-6 concentrations used Student t test and χ(2) test or their nonparametric counterparts. A logistic regression model assessed the association among vitamin D, IL-6 concentrations, and preeclampsia risk. RESULTS The mean concentration of 25-hydroxyvitamin D was 49.4 ± 22.6 nmol/L in normotensives and 42.3 ± 17.3 nmol/L in preeclamptic women (P = .01). The median (interquartile range: Q1, Q3) concentrations of IL-6 were 2.0 (1.3, 3.4) pg/mL and 4.4 (2.2, 10.0) pg/mL in the control and preeclampsia groups, respectively (P < .01). We observed a significant association between IL-6 elevation and preeclampsia (odds ratio, 4.4; 95% confidence interval, 1.8-10.8; P < .01) and between vitamin D deficiency and preeclampsia (odds ratio, 4.2; 95% confidence interval, 1.4-12.8; P = .04). However, there was no association between vitamin D deficiency and IL-6 elevation. CONCLUSION Third-trimester IL-6 elevation and vitamin D deficiency were independently associated with the risk of preeclampsia. We found no evidence to support the hypothesis that vitamin D deficiency alters the pathogenesis of preeclampsia by activation of inflammation as assessed by IL-6 concentration.
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Affiliation(s)
- Lai Xu
- Department of Internal Medicine, University of Iowa Hospitals and Clinics, Iowa City, IA
| | - Minjae Lee
- Biostatistics/Epidemiology/Research Design Core, Center for Clinical and Translational Sciences, University of Texas Health Science Center, Houston, TX
| | - Arun Jeyabalan
- Magee-Womens Research Institute and Foundation, University of Pittsburgh School of Medicine, Pittsburgh, PA; Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - James M Roberts
- Magee-Womens Research Institute and Foundation, University of Pittsburgh School of Medicine, Pittsburgh, PA; Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, PA; Department of Epidemiology, University of Pittsburgh School of Medicine, Pittsburgh, PA; Clinical and Translational Research Institute, University of Pittsburgh School of Medicine, Pittsburgh, PA.
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97
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Bodnar LM, Klebanoff MA, Gernand AD, Platt RW, Parks WT, Catov JM, Simhan HN. Maternal vitamin D status and spontaneous preterm birth by placental histology in the US Collaborative Perinatal Project. Am J Epidemiol 2014; 179:168-76. [PMID: 24124195 DOI: 10.1093/aje/kwt237] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
The objective of this study was to determine the association between maternal 25-hydroxyvitamin D (25(OH)D) and the risk of spontaneous preterm birth (sPTB) before 35 weeks' gestation. A random subcohort from the US Collaborative Perinatal Project (1959-1965) was sampled (n = 2,629) and augmented with all remaining cases of sPTB before 35 weeks' gestation for a total of 767 cases. Banked serum samples collected at 26 weeks' gestation or earlier were assayed for 25(OH)D. Constructs for vascular histology and inflammatory histology were developed from placental pathology examinations. There was no relationship between 25(OH)D and sPTB among white women. Among nonwhite mothers, serum 25(OH)D levels of 30-<50, 50-<75, and ≥75 nmol/L were associated with reductions of 1.0-1.6 cases of sPTB per 100 live births and 20%-30% reductions in risk of sPTB compared with 25(OH)D levels less than 30 nmol/L after adjustment for prepregnancy body mass index (weight (kg)/height (m)(2)), season, and other confounders. This association was driven by inflammation-mediated cases of sPTB and sPTB cases without placental lesions. A sensitivity analysis for unmeasured confounding by exercise, fish intake, and skin color suggested some bias away from the null in the conventional results, but conclusions were generally supported. The vitamin D-sPTB relationship should be examined in modern cohorts with detailed data on skin pigmentation and other covariates.
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98
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Uriu-Adams JY, Obican SG, Keen CL. Vitamin D and maternal and child health: overview and implications for dietary requirements. ACTA ACUST UNITED AC 2014; 99:24-44. [PMID: 23723170 DOI: 10.1002/bdrc.21031] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2013] [Accepted: 03/13/2013] [Indexed: 02/06/2023]
Abstract
The essentiality of vitamin D for normal growth and development has been recognized for over 80 years, and vitamin D fortification programs have been in place in the United States for more than 70 years. Despite the above, vitamin D deficiency continues to be a common finding in certain population groups. Vitamin D deficiency has been suggested as a potential risk factor for the development of preeclampsia, and vitamin D deficiency during infancy and early childhood is associated with an increased risk for numerous skeletal disorders, as well as immunological and vascular abnormalities. Vitamin D deficiency can occur through multiple mechanisms including the consumption of diets low in this vitamin and inadequate exposure to environmental ultraviolet B rays. The potential value of vitamin D supplementation in high-risk pregnancies and during infancy and early childhood is discussed. Currently, there is vigorous debate concerning what constitutes appropriate vitamin D intakes during early development as exemplified by differing recommendations from the Institute of Medicine Dietary Reference Intake report and recent recommendations by the Endocrine Society. As is discussed, a major issue that needs to be resolved is what key biological endpoint should be used when making vitamin D recommendations for the pregnant woman and her offspring.
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Affiliation(s)
- Janet Y Uriu-Adams
- Department of Nutrition, University of California, Davis, Davis, California 95616, USA
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99
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Liu NQ, Ouyang Y, Bulut Y, Lagishetty V, Chan SY, Hollis BW, Wagner C, Equils O, Hewison M. Dietary vitamin D restriction in pregnant female mice is associated with maternal hypertension and altered placental and fetal development. Endocrinology 2013; 154:2270-80. [PMID: 23677931 DOI: 10.1210/en.2012-2270] [Citation(s) in RCA: 60] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Epidemiology has linked vitamin D deficiency with preeclampsia in humans. We hypothesized that low vitamin D status in pregnant mice may lead to symptoms of preeclampsia. Female BL6 mice were raised on vitamin D-sufficient or -deficient diets from weeks 4 of age and then mated with vitamin D-sufficient BL6 males at week 8. The resulting pregnant mice were either allowed to deliver pups and monitored for blood pressure (BP) and weight of offspring or euthanized at day 14 or 18 of gestation (E14 or E18) for analysis of serum, placental/kidney tissues, and fetuses. At E14 serum concentrations of 25-hydroxyvitamin D (30.1 ± 5.0 vs 1.8 ± 0.6 ng/mL, P < .001) and 1,25-dihydroxyvitamin D (119.5 ± 18.7 vs 37.4 ± 5.1 pg/mL, P < .01) were higher in sufficient vs deficient pregnant mice. At E14 BP was significantly elevated in vitamin D-deficient pregnant mice relative to vitamin D-sufficient mice for both systolic BP (124.89 ± 2.28 vs 105.34 ± 3.61 mm Hg, P < .001) and mean arterial pressure (115.33 ± 1.93 vs 89.33 ± 5.02 mm Hg, P < .001). This elevation continued through pregnancy until 7 days postpartum (PP7) but returned to baseline by PP14. Analysis of maternal kidneys showed increased expression of mRNA for renin and the angiotensin II receptor (3- and 4-fold, respectively) in vitamin D-deficient vs -sufficient mice at E14. Histological analysis of E14 placentas from vitamin D-deficient mice showed decreased vascular diameter within the labyrinth region. E14 and E18 fetuses from vitamin D-deficient mice were larger than those from vitamin D-sufficient mothers. However, by PP14 pups from vitamin D-deficient mothers weighed significantly less than those from vitamin D-sufficient mothers. Resupplementation of vitamin D periconceptually partially reversed the effects of vitamin D deficiency. These data provide further evidence that low vitamin D status may predispose pregnant women to dysregulated placental development and elevated blood pressure.
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Affiliation(s)
- Nancy Q Liu
- Orthopaedic Hospital Research Center, University of California, Los Angeles, Los Angeles, CA 90095, USA
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100
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Guo L, Tsai SQ, Hardison NE, James AH, Motsinger-Reif AA, Thames B, Stone EA, Deng C, Piedrahita JA. Differentially expressed microRNAs and affected biological pathways revealed by modulated modularity clustering (MMC) analysis of human preeclamptic and IUGR placentas. Placenta 2013; 34:599-605. [PMID: 23639576 DOI: 10.1016/j.placenta.2013.04.007] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2012] [Revised: 03/25/2013] [Accepted: 04/05/2013] [Indexed: 01/12/2023]
Abstract
INTRODUCTION This study focuses on the implementation of modulated modularity clustering (MMC) a new cluster algorithm for the identification of molecular signatures of preeclampsia and intrauterine growth restriction (IUGR), and the identification of affected microRNAs METHODS Eighty-six human placentas from normal (40), growth-restricted (27), and preeclamptic (19) term pregnancies were profiled using Illumina Human-6 Beadarrays. MMC was utilized to generate modules based on similarities in placental transcriptome. Gene Set Enrichment Analysis (GSEA) was used to predict affected microRNAs. Expression levels of these candidate microRNAs were investigated in seventy-one human term placentas as follows: control (29); IUGR (26); and preeclampsia (16). RESULTS MMC identified two modules, one representing IUGR placentas and one representing preeclamptic placentas. 326 differentially expressed genes in the module representing IUGR and 889 differentially expressed genes in a module representing preeclampsia were identified. Functional analysis of molecular signatures associated with IUGR identified P13K/AKT, mTOR, p70S6K, apoptosis and IGF-1 signaling as being affected. Analysis of variance of GSEA-predicted microRNAs indicated that miR-194 was significantly down-regulated both in preeclampsia (p = 0.0001) and IUGR (p = 0.0304), and miR-149 was significantly down-regulated in preeclampsia (p = 0.0168). DISCUSSION Implementation of MMC, allowed identification of genes disregulated in IUGR and preeclampsia. The reliability of MMC was validated by comparing to previous linear modeling analysis of preeclamptic placentas. CONCLUSION MMC allowed the elucidation of a molecular signature associated with preeclampsia and a subset of IUGR samples. This allowed the identification of genes, pathways, and microRNAs affected in these diseases.
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Affiliation(s)
- L Guo
- Department of Molecular Biomedical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, USA
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