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Abstract
Vitamin D, upon its discovery one century ago, was classified as a vitamin. This classification still greatly affects our perception about its biological role. 1,25(OH)2D (now known as the D hormone) is a pleiotropic steroid hormone that has multiple biologic effects. It is integral to the regulation of calcium homeostasis and bone turnover as well as having anti-proliferative, pro-differentiation, anti-bacterial, immunomodulatory and anti-inflammatory properties within the body in various cells and tissues. Vitamin D (cholecalciferol) should be considered a nutritional substrate that must be ingested or synthesized in sufficient amounts for the further synthesis of the very important regulatory steroid hormone (D hormone), especially in patients with pediatric rheumatic diseases (PRD). Vitamin D insufficiency or deficiency was shown to be pandemic and associated with numerous chronic inflammatory and malignant diseases and even with increased risk of mortality. Several studies have demonstrated that a high percentage of children with pediatric rheumatic diseases (PRD-e.g., JIA, jSLE) have a vitamin D deficiency or insufficiency which might correlate with disease outcome and flares. Glucocorticoids used to treat disease may have a regulatory effect on vitamin D metabolism which can additionally aggravate bone turnover in PRD. An effort to define the optimal serum 25(OH)D concentrations for healthy children and adults was launched in 2010 but as of now there are no guidelines about supplementation in PRD. In this review we have tried to summarize the strong evidence now suggesting that as the knowledge of the optimal approach to diagnosis and treatment PRD has evolved, there is also an emerging need for vitamin D supplementation as an adjunct to regular disease treatment. So in accordance with new vitamin D recommendations, we recommend that a child with rheumatic disease, especially if treated with steroids, needs at least 2-3 time higher doses of vitamin D than the dose recommended for age (approximately 2000 UI/day). Vitamin D supplementation has become an appealing and important adjunct treatment option in PRD.
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Affiliation(s)
- Jelena Vojinovic
- Clinic of Pediatrics, Clinical Center, Faculty of Medicine, University of Nis, Bul dr Zorana Djindjica 48, 18000, Nis, Serbia.
| | - Rolando Cimaz
- Dipartimento di Neuroscienze, Area del Farmaco e Salute del Bambino (NEUROFARBA), Viale Pieraccini, 24, 50139, Firenze, Italy.
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Cerhan JR, Kricker A, Paltiel O, Flowers CR, Wang SS, Monnereau A, Blair A, Dal Maso L, Kane EV, Nieters A, Foran JM, Miligi L, Clavel J, Bernstein L, Rothman N, Slager SL, Sampson JN, Morton LM, Skibola CF. Medical history, lifestyle, family history, and occupational risk factors for diffuse large B-cell lymphoma: the InterLymph Non-Hodgkin Lymphoma Subtypes Project. J Natl Cancer Inst Monogr 2015; 2014:15-25. [PMID: 25174023 DOI: 10.1093/jncimonographs/lgu010] [Citation(s) in RCA: 90] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Although risk factors for diffuse large B-cell lymphoma (DLBCL) have been suggested, their independent effects, modification by sex, and association with anatomical sites are largely unknown. METHODS In a pooled analysis of 4667 cases and 22639 controls from 19 studies, we used stepwise logistic regression to identify the most parsimonious multivariate models for DLBCL overall, by sex, and for selected anatomical sites. RESULTS DLBCL was associated with B-cell activating autoimmune diseases (odds ratio [OR] = 2.36, 95% confidence interval [CI] = 1.80 to 3.09), hepatitis C virus seropositivity (OR = 2.02, 95% CI = 1.47 to 2.76), family history of non-Hodgkin lymphoma (OR = 1.95, 95% CI = 1.54 to 2.47), higher young adult body mass index (OR = 1.58, 95% CI = 1.12 to 2.23, for 35+ vs 18.5 to 22.4 kg/m(2)), higher recreational sun exposure (OR = 0.78, 95% CI = 0.69 to 0.89), any atopic disorder (OR = 0.82, 95% CI = 0.76 to 0.89), and higher socioeconomic status (OR = 0.86, 95% CI = 0.79 to 0.94). Additional risk factors for women were occupation as field crop/vegetable farm worker (OR = 1.78, 95% CI = 1.22 to 2.60), hairdresser (OR = 1.65, 95% CI = 1.12 to 2.41), and seamstress/embroider (OR = 1.49, 95% CI = 1.13 to 1.97), low adult body mass index (OR = 0.46, 95% CI = 0.29 to 0.74, for <18.5 vs 18.5 to 22.4 kg/m(2)), hormone replacement therapy started age at least 50 years (OR = 0.68, 95% CI = 0.52 to 0.88), and oral contraceptive use before 1970 (OR = 0.78, 95% CI = 0.62 to 1.00); and for men were occupation as material handling equipment operator (OR = 1.58, 95% CI = 1.02 to 2.44), lifetime alcohol consumption (OR = 0.57, 95% CI = 0.44 to 0.75, for >400 kg vs nondrinker), and previous blood transfusion (OR = 0.69, 95% CI = 0.57 to 0.83). Autoimmune disease, atopy, and family history of non-Hodgkin lymphoma showed similar associations across selected anatomical sites, whereas smoking was associated with central nervous system, testicular and cutaneous DLBCLs; inflammatory bowel disease was associated with gastrointestinal DLBCL; and farming and hair dye use were associated with mediastinal DLBCL. CONCLUSION Our results support a complex and multifactorial etiology for DLBCL with some variation in risk observed by sex and anatomical site.
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Affiliation(s)
- James R Cerhan
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN (JRC, SLS); Sydney School of Public Health, The University of Sydney, Sydney, Australia (AK); Department of Entomology, The Robert H. Smith Faculty of Agriculture, Koret School of Veterinary Medicine Veterinary Teaching Hospital, Hebrew University of Jerusalem, Jerusalem, Israel (OP); Winship Cancer Institute, Emory University, Atlanta, GA (CRF); Department of Cancer Etiology, Beckman Research Institute of the City of Hope, Duarte, CA (SSW, LB); Inserm, Centre for Research in Epidemiology and Population Health (CESP), U1018, Environmental Epidemiology of Cancer Group, F-94805, and Univ Paris Sud, UMRS 1018, F-94805, Villejuif, France (AM, JC); Registry of Hematological Malignancies in Gironde, Bergonié Institute, Bordeaux, France (AM); Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD (AB, NR, JNS, LMM); Unit of Epidemiology and Biostatistics, Centro di Riferimento Oncologico, IRCCS, Aviano, Italy (LDM); Epidemiology and Cancer Statistics Group, Department of Health Sciences, University of York, York, UK (EVK); Center for Chronic Immunodeficiency (CCI), University Medical Center Freiburg, Freiburg, Germany (AN); Department of Cancer Biology, Mayo Clinic Cancer Center, Jacksonville, FL (JMF); Unit of Occupational and Environmental Epidemiology, Cancer Prevention and Research Institute ISPO Florence, Florence, Italy (LM); Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, AL (CFS).
| | - Anne Kricker
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN (JRC, SLS); Sydney School of Public Health, The University of Sydney, Sydney, Australia (AK); Department of Entomology, The Robert H. Smith Faculty of Agriculture, Koret School of Veterinary Medicine Veterinary Teaching Hospital, Hebrew University of Jerusalem, Jerusalem, Israel (OP); Winship Cancer Institute, Emory University, Atlanta, GA (CRF); Department of Cancer Etiology, Beckman Research Institute of the City of Hope, Duarte, CA (SSW, LB); Inserm, Centre for Research in Epidemiology and Population Health (CESP), U1018, Environmental Epidemiology of Cancer Group, F-94805, and Univ Paris Sud, UMRS 1018, F-94805, Villejuif, France (AM, JC); Registry of Hematological Malignancies in Gironde, Bergonié Institute, Bordeaux, France (AM); Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD (AB, NR, JNS, LMM); Unit of Epidemiology and Biostatistics, Centro di Riferimento Oncologico, IRCCS, Aviano, Italy (LDM); Epidemiology and Cancer Statistics Group, Department of Health Sciences, University of York, York, UK (EVK); Center for Chronic Immunodeficiency (CCI), University Medical Center Freiburg, Freiburg, Germany (AN); Department of Cancer Biology, Mayo Clinic Cancer Center, Jacksonville, FL (JMF); Unit of Occupational and Environmental Epidemiology, Cancer Prevention and Research Institute ISPO Florence, Florence, Italy (LM); Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, AL (CFS)
| | - Ora Paltiel
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN (JRC, SLS); Sydney School of Public Health, The University of Sydney, Sydney, Australia (AK); Department of Entomology, The Robert H. Smith Faculty of Agriculture, Koret School of Veterinary Medicine Veterinary Teaching Hospital, Hebrew University of Jerusalem, Jerusalem, Israel (OP); Winship Cancer Institute, Emory University, Atlanta, GA (CRF); Department of Cancer Etiology, Beckman Research Institute of the City of Hope, Duarte, CA (SSW, LB); Inserm, Centre for Research in Epidemiology and Population Health (CESP), U1018, Environmental Epidemiology of Cancer Group, F-94805, and Univ Paris Sud, UMRS 1018, F-94805, Villejuif, France (AM, JC); Registry of Hematological Malignancies in Gironde, Bergonié Institute, Bordeaux, France (AM); Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD (AB, NR, JNS, LMM); Unit of Epidemiology and Biostatistics, Centro di Riferimento Oncologico, IRCCS, Aviano, Italy (LDM); Epidemiology and Cancer Statistics Group, Department of Health Sciences, University of York, York, UK (EVK); Center for Chronic Immunodeficiency (CCI), University Medical Center Freiburg, Freiburg, Germany (AN); Department of Cancer Biology, Mayo Clinic Cancer Center, Jacksonville, FL (JMF); Unit of Occupational and Environmental Epidemiology, Cancer Prevention and Research Institute ISPO Florence, Florence, Italy (LM); Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, AL (CFS)
| | - Christopher R Flowers
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN (JRC, SLS); Sydney School of Public Health, The University of Sydney, Sydney, Australia (AK); Department of Entomology, The Robert H. Smith Faculty of Agriculture, Koret School of Veterinary Medicine Veterinary Teaching Hospital, Hebrew University of Jerusalem, Jerusalem, Israel (OP); Winship Cancer Institute, Emory University, Atlanta, GA (CRF); Department of Cancer Etiology, Beckman Research Institute of the City of Hope, Duarte, CA (SSW, LB); Inserm, Centre for Research in Epidemiology and Population Health (CESP), U1018, Environmental Epidemiology of Cancer Group, F-94805, and Univ Paris Sud, UMRS 1018, F-94805, Villejuif, France (AM, JC); Registry of Hematological Malignancies in Gironde, Bergonié Institute, Bordeaux, France (AM); Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD (AB, NR, JNS, LMM); Unit of Epidemiology and Biostatistics, Centro di Riferimento Oncologico, IRCCS, Aviano, Italy (LDM); Epidemiology and Cancer Statistics Group, Department of Health Sciences, University of York, York, UK (EVK); Center for Chronic Immunodeficiency (CCI), University Medical Center Freiburg, Freiburg, Germany (AN); Department of Cancer Biology, Mayo Clinic Cancer Center, Jacksonville, FL (JMF); Unit of Occupational and Environmental Epidemiology, Cancer Prevention and Research Institute ISPO Florence, Florence, Italy (LM); Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, AL (CFS)
| | - Sophia S Wang
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN (JRC, SLS); Sydney School of Public Health, The University of Sydney, Sydney, Australia (AK); Department of Entomology, The Robert H. Smith Faculty of Agriculture, Koret School of Veterinary Medicine Veterinary Teaching Hospital, Hebrew University of Jerusalem, Jerusalem, Israel (OP); Winship Cancer Institute, Emory University, Atlanta, GA (CRF); Department of Cancer Etiology, Beckman Research Institute of the City of Hope, Duarte, CA (SSW, LB); Inserm, Centre for Research in Epidemiology and Population Health (CESP), U1018, Environmental Epidemiology of Cancer Group, F-94805, and Univ Paris Sud, UMRS 1018, F-94805, Villejuif, France (AM, JC); Registry of Hematological Malignancies in Gironde, Bergonié Institute, Bordeaux, France (AM); Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD (AB, NR, JNS, LMM); Unit of Epidemiology and Biostatistics, Centro di Riferimento Oncologico, IRCCS, Aviano, Italy (LDM); Epidemiology and Cancer Statistics Group, Department of Health Sciences, University of York, York, UK (EVK); Center for Chronic Immunodeficiency (CCI), University Medical Center Freiburg, Freiburg, Germany (AN); Department of Cancer Biology, Mayo Clinic Cancer Center, Jacksonville, FL (JMF); Unit of Occupational and Environmental Epidemiology, Cancer Prevention and Research Institute ISPO Florence, Florence, Italy (LM); Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, AL (CFS)
| | - Alain Monnereau
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN (JRC, SLS); Sydney School of Public Health, The University of Sydney, Sydney, Australia (AK); Department of Entomology, The Robert H. Smith Faculty of Agriculture, Koret School of Veterinary Medicine Veterinary Teaching Hospital, Hebrew University of Jerusalem, Jerusalem, Israel (OP); Winship Cancer Institute, Emory University, Atlanta, GA (CRF); Department of Cancer Etiology, Beckman Research Institute of the City of Hope, Duarte, CA (SSW, LB); Inserm, Centre for Research in Epidemiology and Population Health (CESP), U1018, Environmental Epidemiology of Cancer Group, F-94805, and Univ Paris Sud, UMRS 1018, F-94805, Villejuif, France (AM, JC); Registry of Hematological Malignancies in Gironde, Bergonié Institute, Bordeaux, France (AM); Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD (AB, NR, JNS, LMM); Unit of Epidemiology and Biostatistics, Centro di Riferimento Oncologico, IRCCS, Aviano, Italy (LDM); Epidemiology and Cancer Statistics Group, Department of Health Sciences, University of York, York, UK (EVK); Center for Chronic Immunodeficiency (CCI), University Medical Center Freiburg, Freiburg, Germany (AN); Department of Cancer Biology, Mayo Clinic Cancer Center, Jacksonville, FL (JMF); Unit of Occupational and Environmental Epidemiology, Cancer Prevention and Research Institute ISPO Florence, Florence, Italy (LM); Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, AL (CFS)
| | - Aaron Blair
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN (JRC, SLS); Sydney School of Public Health, The University of Sydney, Sydney, Australia (AK); Department of Entomology, The Robert H. Smith Faculty of Agriculture, Koret School of Veterinary Medicine Veterinary Teaching Hospital, Hebrew University of Jerusalem, Jerusalem, Israel (OP); Winship Cancer Institute, Emory University, Atlanta, GA (CRF); Department of Cancer Etiology, Beckman Research Institute of the City of Hope, Duarte, CA (SSW, LB); Inserm, Centre for Research in Epidemiology and Population Health (CESP), U1018, Environmental Epidemiology of Cancer Group, F-94805, and Univ Paris Sud, UMRS 1018, F-94805, Villejuif, France (AM, JC); Registry of Hematological Malignancies in Gironde, Bergonié Institute, Bordeaux, France (AM); Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD (AB, NR, JNS, LMM); Unit of Epidemiology and Biostatistics, Centro di Riferimento Oncologico, IRCCS, Aviano, Italy (LDM); Epidemiology and Cancer Statistics Group, Department of Health Sciences, University of York, York, UK (EVK); Center for Chronic Immunodeficiency (CCI), University Medical Center Freiburg, Freiburg, Germany (AN); Department of Cancer Biology, Mayo Clinic Cancer Center, Jacksonville, FL (JMF); Unit of Occupational and Environmental Epidemiology, Cancer Prevention and Research Institute ISPO Florence, Florence, Italy (LM); Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, AL (CFS)
| | - Luigino Dal Maso
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN (JRC, SLS); Sydney School of Public Health, The University of Sydney, Sydney, Australia (AK); Department of Entomology, The Robert H. Smith Faculty of Agriculture, Koret School of Veterinary Medicine Veterinary Teaching Hospital, Hebrew University of Jerusalem, Jerusalem, Israel (OP); Winship Cancer Institute, Emory University, Atlanta, GA (CRF); Department of Cancer Etiology, Beckman Research Institute of the City of Hope, Duarte, CA (SSW, LB); Inserm, Centre for Research in Epidemiology and Population Health (CESP), U1018, Environmental Epidemiology of Cancer Group, F-94805, and Univ Paris Sud, UMRS 1018, F-94805, Villejuif, France (AM, JC); Registry of Hematological Malignancies in Gironde, Bergonié Institute, Bordeaux, France (AM); Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD (AB, NR, JNS, LMM); Unit of Epidemiology and Biostatistics, Centro di Riferimento Oncologico, IRCCS, Aviano, Italy (LDM); Epidemiology and Cancer Statistics Group, Department of Health Sciences, University of York, York, UK (EVK); Center for Chronic Immunodeficiency (CCI), University Medical Center Freiburg, Freiburg, Germany (AN); Department of Cancer Biology, Mayo Clinic Cancer Center, Jacksonville, FL (JMF); Unit of Occupational and Environmental Epidemiology, Cancer Prevention and Research Institute ISPO Florence, Florence, Italy (LM); Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, AL (CFS)
| | - Eleanor V Kane
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN (JRC, SLS); Sydney School of Public Health, The University of Sydney, Sydney, Australia (AK); Department of Entomology, The Robert H. Smith Faculty of Agriculture, Koret School of Veterinary Medicine Veterinary Teaching Hospital, Hebrew University of Jerusalem, Jerusalem, Israel (OP); Winship Cancer Institute, Emory University, Atlanta, GA (CRF); Department of Cancer Etiology, Beckman Research Institute of the City of Hope, Duarte, CA (SSW, LB); Inserm, Centre for Research in Epidemiology and Population Health (CESP), U1018, Environmental Epidemiology of Cancer Group, F-94805, and Univ Paris Sud, UMRS 1018, F-94805, Villejuif, France (AM, JC); Registry of Hematological Malignancies in Gironde, Bergonié Institute, Bordeaux, France (AM); Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD (AB, NR, JNS, LMM); Unit of Epidemiology and Biostatistics, Centro di Riferimento Oncologico, IRCCS, Aviano, Italy (LDM); Epidemiology and Cancer Statistics Group, Department of Health Sciences, University of York, York, UK (EVK); Center for Chronic Immunodeficiency (CCI), University Medical Center Freiburg, Freiburg, Germany (AN); Department of Cancer Biology, Mayo Clinic Cancer Center, Jacksonville, FL (JMF); Unit of Occupational and Environmental Epidemiology, Cancer Prevention and Research Institute ISPO Florence, Florence, Italy (LM); Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, AL (CFS)
| | - Alexandra Nieters
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN (JRC, SLS); Sydney School of Public Health, The University of Sydney, Sydney, Australia (AK); Department of Entomology, The Robert H. Smith Faculty of Agriculture, Koret School of Veterinary Medicine Veterinary Teaching Hospital, Hebrew University of Jerusalem, Jerusalem, Israel (OP); Winship Cancer Institute, Emory University, Atlanta, GA (CRF); Department of Cancer Etiology, Beckman Research Institute of the City of Hope, Duarte, CA (SSW, LB); Inserm, Centre for Research in Epidemiology and Population Health (CESP), U1018, Environmental Epidemiology of Cancer Group, F-94805, and Univ Paris Sud, UMRS 1018, F-94805, Villejuif, France (AM, JC); Registry of Hematological Malignancies in Gironde, Bergonié Institute, Bordeaux, France (AM); Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD (AB, NR, JNS, LMM); Unit of Epidemiology and Biostatistics, Centro di Riferimento Oncologico, IRCCS, Aviano, Italy (LDM); Epidemiology and Cancer Statistics Group, Department of Health Sciences, University of York, York, UK (EVK); Center for Chronic Immunodeficiency (CCI), University Medical Center Freiburg, Freiburg, Germany (AN); Department of Cancer Biology, Mayo Clinic Cancer Center, Jacksonville, FL (JMF); Unit of Occupational and Environmental Epidemiology, Cancer Prevention and Research Institute ISPO Florence, Florence, Italy (LM); Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, AL (CFS)
| | - James M Foran
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN (JRC, SLS); Sydney School of Public Health, The University of Sydney, Sydney, Australia (AK); Department of Entomology, The Robert H. Smith Faculty of Agriculture, Koret School of Veterinary Medicine Veterinary Teaching Hospital, Hebrew University of Jerusalem, Jerusalem, Israel (OP); Winship Cancer Institute, Emory University, Atlanta, GA (CRF); Department of Cancer Etiology, Beckman Research Institute of the City of Hope, Duarte, CA (SSW, LB); Inserm, Centre for Research in Epidemiology and Population Health (CESP), U1018, Environmental Epidemiology of Cancer Group, F-94805, and Univ Paris Sud, UMRS 1018, F-94805, Villejuif, France (AM, JC); Registry of Hematological Malignancies in Gironde, Bergonié Institute, Bordeaux, France (AM); Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD (AB, NR, JNS, LMM); Unit of Epidemiology and Biostatistics, Centro di Riferimento Oncologico, IRCCS, Aviano, Italy (LDM); Epidemiology and Cancer Statistics Group, Department of Health Sciences, University of York, York, UK (EVK); Center for Chronic Immunodeficiency (CCI), University Medical Center Freiburg, Freiburg, Germany (AN); Department of Cancer Biology, Mayo Clinic Cancer Center, Jacksonville, FL (JMF); Unit of Occupational and Environmental Epidemiology, Cancer Prevention and Research Institute ISPO Florence, Florence, Italy (LM); Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, AL (CFS)
| | - Lucia Miligi
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN (JRC, SLS); Sydney School of Public Health, The University of Sydney, Sydney, Australia (AK); Department of Entomology, The Robert H. Smith Faculty of Agriculture, Koret School of Veterinary Medicine Veterinary Teaching Hospital, Hebrew University of Jerusalem, Jerusalem, Israel (OP); Winship Cancer Institute, Emory University, Atlanta, GA (CRF); Department of Cancer Etiology, Beckman Research Institute of the City of Hope, Duarte, CA (SSW, LB); Inserm, Centre for Research in Epidemiology and Population Health (CESP), U1018, Environmental Epidemiology of Cancer Group, F-94805, and Univ Paris Sud, UMRS 1018, F-94805, Villejuif, France (AM, JC); Registry of Hematological Malignancies in Gironde, Bergonié Institute, Bordeaux, France (AM); Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD (AB, NR, JNS, LMM); Unit of Epidemiology and Biostatistics, Centro di Riferimento Oncologico, IRCCS, Aviano, Italy (LDM); Epidemiology and Cancer Statistics Group, Department of Health Sciences, University of York, York, UK (EVK); Center for Chronic Immunodeficiency (CCI), University Medical Center Freiburg, Freiburg, Germany (AN); Department of Cancer Biology, Mayo Clinic Cancer Center, Jacksonville, FL (JMF); Unit of Occupational and Environmental Epidemiology, Cancer Prevention and Research Institute ISPO Florence, Florence, Italy (LM); Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, AL (CFS)
| | - Jacqueline Clavel
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN (JRC, SLS); Sydney School of Public Health, The University of Sydney, Sydney, Australia (AK); Department of Entomology, The Robert H. Smith Faculty of Agriculture, Koret School of Veterinary Medicine Veterinary Teaching Hospital, Hebrew University of Jerusalem, Jerusalem, Israel (OP); Winship Cancer Institute, Emory University, Atlanta, GA (CRF); Department of Cancer Etiology, Beckman Research Institute of the City of Hope, Duarte, CA (SSW, LB); Inserm, Centre for Research in Epidemiology and Population Health (CESP), U1018, Environmental Epidemiology of Cancer Group, F-94805, and Univ Paris Sud, UMRS 1018, F-94805, Villejuif, France (AM, JC); Registry of Hematological Malignancies in Gironde, Bergonié Institute, Bordeaux, France (AM); Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD (AB, NR, JNS, LMM); Unit of Epidemiology and Biostatistics, Centro di Riferimento Oncologico, IRCCS, Aviano, Italy (LDM); Epidemiology and Cancer Statistics Group, Department of Health Sciences, University of York, York, UK (EVK); Center for Chronic Immunodeficiency (CCI), University Medical Center Freiburg, Freiburg, Germany (AN); Department of Cancer Biology, Mayo Clinic Cancer Center, Jacksonville, FL (JMF); Unit of Occupational and Environmental Epidemiology, Cancer Prevention and Research Institute ISPO Florence, Florence, Italy (LM); Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, AL (CFS)
| | - Leslie Bernstein
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN (JRC, SLS); Sydney School of Public Health, The University of Sydney, Sydney, Australia (AK); Department of Entomology, The Robert H. Smith Faculty of Agriculture, Koret School of Veterinary Medicine Veterinary Teaching Hospital, Hebrew University of Jerusalem, Jerusalem, Israel (OP); Winship Cancer Institute, Emory University, Atlanta, GA (CRF); Department of Cancer Etiology, Beckman Research Institute of the City of Hope, Duarte, CA (SSW, LB); Inserm, Centre for Research in Epidemiology and Population Health (CESP), U1018, Environmental Epidemiology of Cancer Group, F-94805, and Univ Paris Sud, UMRS 1018, F-94805, Villejuif, France (AM, JC); Registry of Hematological Malignancies in Gironde, Bergonié Institute, Bordeaux, France (AM); Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD (AB, NR, JNS, LMM); Unit of Epidemiology and Biostatistics, Centro di Riferimento Oncologico, IRCCS, Aviano, Italy (LDM); Epidemiology and Cancer Statistics Group, Department of Health Sciences, University of York, York, UK (EVK); Center for Chronic Immunodeficiency (CCI), University Medical Center Freiburg, Freiburg, Germany (AN); Department of Cancer Biology, Mayo Clinic Cancer Center, Jacksonville, FL (JMF); Unit of Occupational and Environmental Epidemiology, Cancer Prevention and Research Institute ISPO Florence, Florence, Italy (LM); Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, AL (CFS)
| | - Nathaniel Rothman
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN (JRC, SLS); Sydney School of Public Health, The University of Sydney, Sydney, Australia (AK); Department of Entomology, The Robert H. Smith Faculty of Agriculture, Koret School of Veterinary Medicine Veterinary Teaching Hospital, Hebrew University of Jerusalem, Jerusalem, Israel (OP); Winship Cancer Institute, Emory University, Atlanta, GA (CRF); Department of Cancer Etiology, Beckman Research Institute of the City of Hope, Duarte, CA (SSW, LB); Inserm, Centre for Research in Epidemiology and Population Health (CESP), U1018, Environmental Epidemiology of Cancer Group, F-94805, and Univ Paris Sud, UMRS 1018, F-94805, Villejuif, France (AM, JC); Registry of Hematological Malignancies in Gironde, Bergonié Institute, Bordeaux, France (AM); Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD (AB, NR, JNS, LMM); Unit of Epidemiology and Biostatistics, Centro di Riferimento Oncologico, IRCCS, Aviano, Italy (LDM); Epidemiology and Cancer Statistics Group, Department of Health Sciences, University of York, York, UK (EVK); Center for Chronic Immunodeficiency (CCI), University Medical Center Freiburg, Freiburg, Germany (AN); Department of Cancer Biology, Mayo Clinic Cancer Center, Jacksonville, FL (JMF); Unit of Occupational and Environmental Epidemiology, Cancer Prevention and Research Institute ISPO Florence, Florence, Italy (LM); Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, AL (CFS)
| | - Susan L Slager
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN (JRC, SLS); Sydney School of Public Health, The University of Sydney, Sydney, Australia (AK); Department of Entomology, The Robert H. Smith Faculty of Agriculture, Koret School of Veterinary Medicine Veterinary Teaching Hospital, Hebrew University of Jerusalem, Jerusalem, Israel (OP); Winship Cancer Institute, Emory University, Atlanta, GA (CRF); Department of Cancer Etiology, Beckman Research Institute of the City of Hope, Duarte, CA (SSW, LB); Inserm, Centre for Research in Epidemiology and Population Health (CESP), U1018, Environmental Epidemiology of Cancer Group, F-94805, and Univ Paris Sud, UMRS 1018, F-94805, Villejuif, France (AM, JC); Registry of Hematological Malignancies in Gironde, Bergonié Institute, Bordeaux, France (AM); Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD (AB, NR, JNS, LMM); Unit of Epidemiology and Biostatistics, Centro di Riferimento Oncologico, IRCCS, Aviano, Italy (LDM); Epidemiology and Cancer Statistics Group, Department of Health Sciences, University of York, York, UK (EVK); Center for Chronic Immunodeficiency (CCI), University Medical Center Freiburg, Freiburg, Germany (AN); Department of Cancer Biology, Mayo Clinic Cancer Center, Jacksonville, FL (JMF); Unit of Occupational and Environmental Epidemiology, Cancer Prevention and Research Institute ISPO Florence, Florence, Italy (LM); Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, AL (CFS)
| | - Joshua N Sampson
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN (JRC, SLS); Sydney School of Public Health, The University of Sydney, Sydney, Australia (AK); Department of Entomology, The Robert H. Smith Faculty of Agriculture, Koret School of Veterinary Medicine Veterinary Teaching Hospital, Hebrew University of Jerusalem, Jerusalem, Israel (OP); Winship Cancer Institute, Emory University, Atlanta, GA (CRF); Department of Cancer Etiology, Beckman Research Institute of the City of Hope, Duarte, CA (SSW, LB); Inserm, Centre for Research in Epidemiology and Population Health (CESP), U1018, Environmental Epidemiology of Cancer Group, F-94805, and Univ Paris Sud, UMRS 1018, F-94805, Villejuif, France (AM, JC); Registry of Hematological Malignancies in Gironde, Bergonié Institute, Bordeaux, France (AM); Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD (AB, NR, JNS, LMM); Unit of Epidemiology and Biostatistics, Centro di Riferimento Oncologico, IRCCS, Aviano, Italy (LDM); Epidemiology and Cancer Statistics Group, Department of Health Sciences, University of York, York, UK (EVK); Center for Chronic Immunodeficiency (CCI), University Medical Center Freiburg, Freiburg, Germany (AN); Department of Cancer Biology, Mayo Clinic Cancer Center, Jacksonville, FL (JMF); Unit of Occupational and Environmental Epidemiology, Cancer Prevention and Research Institute ISPO Florence, Florence, Italy (LM); Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, AL (CFS)
| | - Lindsay M Morton
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN (JRC, SLS); Sydney School of Public Health, The University of Sydney, Sydney, Australia (AK); Department of Entomology, The Robert H. Smith Faculty of Agriculture, Koret School of Veterinary Medicine Veterinary Teaching Hospital, Hebrew University of Jerusalem, Jerusalem, Israel (OP); Winship Cancer Institute, Emory University, Atlanta, GA (CRF); Department of Cancer Etiology, Beckman Research Institute of the City of Hope, Duarte, CA (SSW, LB); Inserm, Centre for Research in Epidemiology and Population Health (CESP), U1018, Environmental Epidemiology of Cancer Group, F-94805, and Univ Paris Sud, UMRS 1018, F-94805, Villejuif, France (AM, JC); Registry of Hematological Malignancies in Gironde, Bergonié Institute, Bordeaux, France (AM); Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD (AB, NR, JNS, LMM); Unit of Epidemiology and Biostatistics, Centro di Riferimento Oncologico, IRCCS, Aviano, Italy (LDM); Epidemiology and Cancer Statistics Group, Department of Health Sciences, University of York, York, UK (EVK); Center for Chronic Immunodeficiency (CCI), University Medical Center Freiburg, Freiburg, Germany (AN); Department of Cancer Biology, Mayo Clinic Cancer Center, Jacksonville, FL (JMF); Unit of Occupational and Environmental Epidemiology, Cancer Prevention and Research Institute ISPO Florence, Florence, Italy (LM); Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, AL (CFS)
| | - Christine F Skibola
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN (JRC, SLS); Sydney School of Public Health, The University of Sydney, Sydney, Australia (AK); Department of Entomology, The Robert H. Smith Faculty of Agriculture, Koret School of Veterinary Medicine Veterinary Teaching Hospital, Hebrew University of Jerusalem, Jerusalem, Israel (OP); Winship Cancer Institute, Emory University, Atlanta, GA (CRF); Department of Cancer Etiology, Beckman Research Institute of the City of Hope, Duarte, CA (SSW, LB); Inserm, Centre for Research in Epidemiology and Population Health (CESP), U1018, Environmental Epidemiology of Cancer Group, F-94805, and Univ Paris Sud, UMRS 1018, F-94805, Villejuif, France (AM, JC); Registry of Hematological Malignancies in Gironde, Bergonié Institute, Bordeaux, France (AM); Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD (AB, NR, JNS, LMM); Unit of Epidemiology and Biostatistics, Centro di Riferimento Oncologico, IRCCS, Aviano, Italy (LDM); Epidemiology and Cancer Statistics Group, Department of Health Sciences, University of York, York, UK (EVK); Center for Chronic Immunodeficiency (CCI), University Medical Center Freiburg, Freiburg, Germany (AN); Department of Cancer Biology, Mayo Clinic Cancer Center, Jacksonville, FL (JMF); Unit of Occupational and Environmental Epidemiology, Cancer Prevention and Research Institute ISPO Florence, Florence, Italy (LM); Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, AL (CFS)
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203
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Chiuso-Minicucci F, Ishikawa LLW, Mimura LAN, Fraga-Silva TFDC, França TGD, Zorzella-Pezavento SFG, Marques C, Ikoma MRV, Sartori A. Treatment with Vitamin D/MOG Association Suppresses Experimental Autoimmune Encephalomyelitis. PLoS One 2015; 10:e0125836. [PMID: 25965341 PMCID: PMC4428830 DOI: 10.1371/journal.pone.0125836] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2014] [Accepted: 03/25/2015] [Indexed: 11/18/2022] Open
Abstract
Experimental autoimmune encephalomyelitis (EAE) is an animal model to study multiple sclerosis (MS). Considering the tolerogenic effects of active vitamin D, we evaluated the therapeutic effect of myelin oligodendrocyte glycoprotein (MOG) associated with active vitamin D in EAE development. EAE was induced in female C57BL/6 mice by immunization with MOG emulsified with Complete Freund's Adjuvant plus Mycobacterium tuberculosis. Animals also received two intraperitoneal doses of Bordetella pertussis toxin. One day after immunization, mice were treated with 0,1 μg of 1α,25-dihydroxyvitamin D3 (1,25(OH)2D3) every other day during 15 days (on days 1, 3, 5, 7, 9, 11, 13 and 15). MOG (150 μg) was co-administered on days 3 and 11. The administration of 1,25(OH)2D3 or MOG determined significant reduction in EAE incidence and in clinical scores. When MOG was associated with 1,25(OH)2D3 the animals did not develop EAE. Spleen and central nervous system (CNS) cell cultures from this group produced less IL-6 and IL-17 upon stimulation with MOG in comparison to the EAE control group. In addition, this treatment inhibited dendritic cells maturation in the spleen and reduced inflammatory infiltration in the CNS. The association of MOG with 1,25(OH)2D3 was able to control EAE development.
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Affiliation(s)
- Fernanda Chiuso-Minicucci
- Department of Microbiology and Immunology, Biosciences Institute, Universidade Estadual Paulista (UNESP), Botucatu, São Paulo, Brazil
| | - Larissa Lumi Watanabe Ishikawa
- Department of Microbiology and Immunology, Biosciences Institute, Universidade Estadual Paulista (UNESP), Botucatu, São Paulo, Brazil
| | - Luiza Ayumi Nishiyama Mimura
- Department of Microbiology and Immunology, Biosciences Institute, Universidade Estadual Paulista (UNESP), Botucatu, São Paulo, Brazil
| | | | - Thais Graziela Donegá França
- Department of Microbiology and Immunology, Biosciences Institute, Universidade Estadual Paulista (UNESP), Botucatu, São Paulo, Brazil
| | | | - Camila Marques
- Laboratório de Citometria de Fluxo—Fundação Dr. Amaral Carvalho, Jaú, São Paulo, Brazil
| | | | - Alexandrina Sartori
- Department of Microbiology and Immunology, Biosciences Institute, Universidade Estadual Paulista (UNESP), Botucatu, São Paulo, Brazil
- * E-mail:
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204
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Gorman S, Black LJ, Feelisch M, Hart PH, Weller R. Can skin exposure to sunlight prevent liver inflammation? Nutrients 2015; 7:3219-39. [PMID: 25951129 PMCID: PMC4446748 DOI: 10.3390/nu7053219] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2015] [Revised: 04/23/2015] [Accepted: 04/27/2015] [Indexed: 02/07/2023] Open
Abstract
Liver inflammation contributes towards the pathology of non-alcoholic fatty liver disease (NAFLD). Here we discuss how skin exposure to sunlight may suppress liver inflammation and the severity of NAFLD. Following exposure to sunlight-derived ultraviolet radiation (UVR), the skin releases anti-inflammatory mediators such as vitamin D and nitric oxide. Animal modeling studies suggest that exposure to UVR can prevent the development of NAFLD. Association studies also support a negative link between circulating 25-hydroxyvitamin D and NAFLD incidence or severity. Clinical trials are in their infancy and are yet to demonstrate a clear beneficial effect of vitamin D supplementation. There are a number of potentially interdependent mechanisms whereby vitamin D could dampen liver inflammation, by inhibiting hepatocyte apoptosis and liver fibrosis, modulating the gut microbiome and through altered production and transport of bile acids. While there has been a focus on vitamin D, other mediators induced by sun exposure, such as nitric oxide may also play important roles in curtailing liver inflammation.
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Affiliation(s)
- Shelley Gorman
- Telethon Kids Institute, University of Western Australia, 100 Roberts Rd, Subiaco, Western Australia 6008, Australia.
| | - Lucinda J Black
- Telethon Kids Institute, University of Western Australia, 100 Roberts Rd, Subiaco, Western Australia 6008, Australia.
| | - Martin Feelisch
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton General Hospital, Southampton, SO16 6YD, UK.
| | - Prue H Hart
- Telethon Kids Institute, University of Western Australia, 100 Roberts Rd, Subiaco, Western Australia 6008, Australia.
| | - Richard Weller
- University of Edinburgh, MRC Centre for Inflammation Research, Edinburgh, EH16 4TJ, UK.
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205
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Li YC, Chen Y, Du J. Critical roles of intestinal epithelial vitamin D receptor signaling in controlling gut mucosal inflammation. J Steroid Biochem Mol Biol 2015; 148:179-83. [PMID: 25603468 PMCID: PMC4361385 DOI: 10.1016/j.jsbmb.2015.01.011] [Citation(s) in RCA: 94] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2014] [Revised: 12/27/2014] [Accepted: 01/16/2015] [Indexed: 12/13/2022]
Abstract
Although vitamin D receptor (VDR) is highly expressed in the intestine, the role of VDR signaling in the gut is not fully understood. Our recent studies unveil a regulatory circuit that centers gut epithelial VDR as a key molecule in the control of mucosal inflammation and colitis development. On the one hand, intestinal epithelial VDR signaling protects the integrity of the mucosal barrier by inhibiting inflammation-induced epithelial cell apoptosis. This barrier-protecting, anti-colitic activity is independent of the non-epithelial immune VDR actions. A healthy and intact mucosal barrier prevents bacterial invasion and thus reduces mucosal inflammation. On the other hand, inflammation in turn down-regulates epithelial VDR expression by inducing VDR-targeting microRNA-346, thus compromising mucosal barrier functions. Consistently, colonic epithelial VDR levels are markedly reduced in patients with inflammatory bowel diseases or in experimental colitis models, whereas vitamin D analog therapy that ameliorates colitis up-regulates epithelial VDR. Thus, gut epithelial VDR signaling appears to play an essential role in controlling mucosal inflammation and thus could be a useful therapeutic target in the management of inflammatory bowel diseases. This article is part of a special issue entitled '17th Vitamin D Workshop' .
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Affiliation(s)
- Yan Chun Li
- Department of Medicine, Division of Biological Sciences, The University of Chicago, Chicago, IL 60637, USA.
| | - Yunzi Chen
- Department of Medicine, Division of Biological Sciences, The University of Chicago, Chicago, IL 60637, USA; Laboratory of Metabolic Disease Research and Drug Development, China Medical University, Shenyang, Liaoning 110001, China
| | - Jie Du
- Laboratory of Metabolic Disease Research and Drug Development, China Medical University, Shenyang, Liaoning 110001, China
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206
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Cherrie MPC, Wheeler BW, White MP, Sarran CE, Osborne NJ. Coastal climate is associated with elevated solar irradiance and higher 25(OH)D level. ENVIRONMENT INTERNATIONAL 2015; 77:76-84. [PMID: 25660687 DOI: 10.1016/j.envint.2015.01.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/09/2014] [Revised: 01/07/2015] [Accepted: 01/08/2015] [Indexed: 06/04/2023]
Abstract
INTRODUCTION There is evidence that populations living close to the coast have improved health and wellbeing. Coastal environments are linked to promotion of physical activity through provision of safe, opportune, aesthetic and accessible spaces for recreation. Exposure to coastal environments may also reduce stress and induce positive mood. We hypothesised that coastal climate may influence the vitamin D status of residents and thus partly explain benefits to health. MATERIALS AND METHODS Ecological and cross-sectional analyses were designed to elucidate the connection between coastal residence and vitamin D status. We divided residential data, from developed land use areas and the Lower Super Output Areas or Data Zones (Scotland) of the 1958 Birth Cohort participants, into the following coastal bands: <1 km, 1-5 km, 5-20 km, 20-50 km and over 50 km. In the ecological analysis we used a multiple regression model to describe the relationship between UV vitd and coastal proximity adjusted for latitude. Subsequently, using the residential information of the participants of the 1958 Birth Cohort we developed a multiple regression model to understand the relationship between serum 25(OH)D (a marker of vitamin D status) and coastal proximity adjusted for several factors related to vitamin D status (e.g. diet, outdoor activity). RESULTS We found that coastal proximity was associated with solar irradiance; on average a 99.6 (96.1-103.3)J/m(2)/day regression coefficient was recorded for settlements <1 km from the coast compared with those at >50 km. This relationship was modified by latitude with settlements at a lower latitude exhibiting a greater effect. Individuals living closer to the coast in England had higher vitamin D levels than those inland, particularly in autumn. CONCLUSION Geographic location may influence biochemistry and health outcomes due to environmental factors. This can provide benefits in terms of vitamin D status but may also pose a risk due to higher skin cancer risk. We provide further evidence in support of the claim that coastal environments can provide opportunities for health and wellbeing.
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Affiliation(s)
- M P C Cherrie
- European Centre for Environment and Human Health, University of Exeter Medical School, Knowledge Spa, Royal Cornwall Hospital, Truro TR1 3HD, United Kingdom
| | - B W Wheeler
- European Centre for Environment and Human Health, University of Exeter Medical School, Knowledge Spa, Royal Cornwall Hospital, Truro TR1 3HD, United Kingdom
| | - M P White
- European Centre for Environment and Human Health, University of Exeter Medical School, Knowledge Spa, Royal Cornwall Hospital, Truro TR1 3HD, United Kingdom
| | - C E Sarran
- Met Office, Fitzroy Road, Exeter, Devon, EX1 3PB, United Kingdom
| | - N J Osborne
- European Centre for Environment and Human Health, University of Exeter Medical School, Knowledge Spa, Royal Cornwall Hospital, Truro TR1 3HD, United Kingdom; Department of Paediatrics, University of Melbourne, Flemington Road, Parkville, Melbourne, Australia.
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207
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Simpson S, Taylor BV, van der Mei I. The role of epidemiology in MS research: Past successes, current challenges and future potential. Mult Scler 2015; 21:969-77. [DOI: 10.1177/1352458515574896] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2014] [Accepted: 01/04/2015] [Indexed: 12/26/2022]
Abstract
Multiple sclerosis (MS) is a multifaceted condition, with a range of environmental, behavioural and genetic factors implicated in its aetiology and clinical course. Successes in advancing our appreciation of the roles of Epstein-Barr virus, vitamin D/UV and the HLA-DRB1 locus; and our greater understanding of these and related factors’ modes of action in MS and other conditions, can be attributed in no small part to the work of generations of epidemiologists. Hardly content to rest on our laurels, however, there are yet a range of unsolved conundrums in MS, including some changes in epidemiological characteristics (e.g. increasing incidence and sex ratio), to say nothing of the unresolved parts regarding what underlies MS risk and its clinical course. There is evidence that epidemiology will continue to play a crucial role in unravelling the architecture of MS causation and clinical course. While classic epidemiological methods are ongoing, novel avenues for research include gene-environment interaction studies, the world of ‘-omic’ research, and the utilisation of mobile and social media tools to both access and track study populations, which means that the epidemiological discoveries of the past century may be but a glimpse of our understanding in the next few decades.
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Affiliation(s)
- Steve Simpson
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
| | - Bruce V Taylor
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
| | - Ingrid van der Mei
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
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208
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Berthon BS, Wood LG. Nutrition and respiratory health--feature review. Nutrients 2015; 7:1618-43. [PMID: 25751820 PMCID: PMC4377870 DOI: 10.3390/nu7031618] [Citation(s) in RCA: 68] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2015] [Revised: 02/15/2015] [Accepted: 02/15/2015] [Indexed: 01/08/2023] Open
Abstract
Diet and nutrition may be important modifiable risk factors for the development, progression and management of obstructive lung diseases such as asthma and chronic obstructive pulmonary disease (COPD). This review examines the relationship between dietary patterns, nutrient intake and weight status in obstructive lung diseases, at different life stages, from in-utero influences through childhood and into adulthood. In vitro and animal studies suggest important roles for various nutrients, some of which are supported by epidemiological studies. However, few well-designed human intervention trials are available to definitively assess the efficacy of different approaches to nutritional management of respiratory diseases. Evidence for the impact of higher intakes of fruit and vegetables is amongst the strongest, yet other dietary nutrients and dietary patterns require evidence from human clinical studies before conclusions can be made about their effectiveness.
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Affiliation(s)
- Bronwyn S Berthon
- Centre for Asthma and Respiratory Diseases, Level 2, Hunter Medical Research Institute, University of Newcastle, Lot 1 Kookaburra Circuit, New Lambton Heights, NSW 2305, Australia.
| | - Lisa G Wood
- Centre for Asthma and Respiratory Diseases, Level 2, Hunter Medical Research Institute, University of Newcastle, Lot 1 Kookaburra Circuit, New Lambton Heights, NSW 2305, Australia.
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209
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Abstract
Exposure of the skin to solar ultraviolet (UV) radiation has both risks and benefits for human health. Absorption of UV-B radiation by DNA results in mutations that underlie the development of skin cancers, as is apparent from genetic studies showing high occurrence of UV signature mutations within these tumors. UV-B radiation is also absorbed by 7-dehydrocholesterol to initiate vitamin D synthesis. In experimental studies vitamin D metabolites enhance apoptosis of malignant cells, inhibit angiogenesis and proliferation and increase differentiation, potentially reducing skin cancer development and improving prognosis after diagnosis. There are some supporting human data. We review the links between sun exposure, vitamin D and skin cancers.
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Affiliation(s)
- Candy Wyatt
- National Centre for Epidemiology & Population Health, Australian National University, Canberra, Australia.,Telethon Kids Institute, University of Western Australia, Perth, Australia.,National Centre for Epidemiology & Population Health, Australian National University, Canberra, Australia.,Telethon Kids Institute, University of Western Australia, Perth, Australia
| | - Rachel E Neale
- QIMR Berghofer Institute of Medical Research, Brisbane, Australia.,QIMR Berghofer Institute of Medical Research, Brisbane, Australia
| | - Robyn M Lucas
- National Centre for Epidemiology & Population Health, Australian National University, Canberra, Australia.,Telethon Kids Institute, University of Western Australia, Perth, Australia.,National Centre for Epidemiology & Population Health, Australian National University, Canberra, Australia.,Telethon Kids Institute, University of Western Australia, Perth, Australia
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210
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Hartley M, Hoare S, Lithander FE, Neale RE, Hart PH, Gorman S, Gies P, Sherriff J, Swaminathan A, Beilin LJ, Mori TA, King L, Black LJ, Marshall K, Xiang F, Wyatt C, King K, Slevin T, Pandeya N, Lucas RM. Comparing the effects of sun exposure and vitamin D supplementation on vitamin D insufficiency, and immune and cardio-metabolic function: the Sun Exposure and Vitamin D Supplementation (SEDS) Study. BMC Public Health 2015; 15:115. [PMID: 25884724 PMCID: PMC4391331 DOI: 10.1186/s12889-015-1461-7] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2015] [Accepted: 01/23/2015] [Indexed: 12/22/2022] Open
Abstract
Background Adults living in the sunny Australian climate are at high risk of skin cancer, but vitamin D deficiency (defined here as a serum 25-hydroxyvitamin D (25(OH)D) concentration of less than 50 nmol/L) is also common. Vitamin D deficiency may be a risk factor for a range of diseases. However, the optimal strategies to achieve and maintain vitamin D adequacy (sun exposure, vitamin D supplementation or both), and whether sun exposure itself has benefits over and above initiating synthesis of vitamin D, remain unclear. The Sun Exposure and Vitamin D Supplementation (SEDS) Study aims to compare the effectiveness of sun exposure and vitamin D supplementation for the management of vitamin D insufficiency, and to test whether these management strategies differentially affect markers of immune and cardio-metabolic function. Methods/Design The SEDS Study is a multi-centre, randomised controlled trial of two different daily doses of vitamin D supplementation, and placebo, in conjunction with guidance on two different patterns of sun exposure. Participants recruited from across Australia are aged 18–64 years and have a recent vitamin D test result showing a serum 25(OH)D level of 40–60 nmol/L. Discussion This paper discusses the rationale behind the study design, and considers the challenges but necessity of data collection within a non-institutionalised adult population, in order to address the study aims. We also discuss the challenges of participant recruitment and retention, ongoing engagement of referring medical practitioners and address issues of compliance and participant retention. Trial registration Australia New Zealand Clinical Trials Registry: ACTRN12613000290796 Registered 14 March 2013.
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Affiliation(s)
- Mica Hartley
- National Centre for Epidemiology and Population Health, The Australian National University, Canberra, Australian Capital Territory, 2600, Australia.
| | - Samuel Hoare
- National Centre for Epidemiology and Population Health, The Australian National University, Canberra, Australian Capital Territory, 2600, Australia. .,Department of Health and Human Services, Hobart, Tasmania, Australia.
| | - Fiona E Lithander
- University of Canberra, Canberra, Australian Capital Territory, Australia.
| | - Rachel E Neale
- QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia.
| | - Prue H Hart
- Telethon Kids Institute, The University of Western Australia, Perth, Western Australia, Australia.
| | - Shelley Gorman
- Telethon Kids Institute, The University of Western Australia, Perth, Western Australia, Australia.
| | - Peter Gies
- Australian Radiation Protection and Nuclear Safety Agency, Melbourne, Victoria, Australia.
| | - Jill Sherriff
- Curtin University, Perth, Western Australia, Australia.
| | - Ashwin Swaminathan
- The Canberra Hospital, Canberra, Australian Capital Territory, Australia.
| | - Lawrence J Beilin
- School of Medicine and Pharmacology, Royal Perth Hospital Unit, University of Western Australia, Perth, Western Australia, Australia.
| | - Trevor A Mori
- School of Medicine and Pharmacology, Royal Perth Hospital Unit, University of Western Australia, Perth, Western Australia, Australia.
| | - Laura King
- National Centre for Epidemiology and Population Health, The Australian National University, Canberra, Australian Capital Territory, 2600, Australia.
| | - Lucinda J Black
- Telethon Kids Institute, The University of Western Australia, Perth, Western Australia, Australia.
| | - Kushani Marshall
- National Centre for Epidemiology and Population Health, The Australian National University, Canberra, Australian Capital Territory, 2600, Australia.
| | - Fan Xiang
- National Centre for Epidemiology and Population Health, The Australian National University, Canberra, Australian Capital Territory, 2600, Australia.
| | - Candy Wyatt
- National Centre for Epidemiology and Population Health, The Australian National University, Canberra, Australian Capital Territory, 2600, Australia. .,Telethon Kids Institute, The University of Western Australia, Perth, Western Australia, Australia.
| | - Kerryn King
- Australian Radiation Protection and Nuclear Safety Agency, Melbourne, Victoria, Australia.
| | - Terry Slevin
- Cancer Council of Western Australia, Perth, Western Australia, Australia.
| | | | - Robyn M Lucas
- National Centre for Epidemiology and Population Health, The Australian National University, Canberra, Australian Capital Territory, 2600, Australia. .,Telethon Kids Institute, The University of Western Australia, Perth, Western Australia, Australia.
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211
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Gruber-Wackernagel A, Byrne SN, Wolf P. Polymorphous light eruption: clinic aspects and pathogenesis. Dermatol Clin 2015; 32:315-34, viii. [PMID: 24891054 DOI: 10.1016/j.det.2014.03.012] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Polymorphous light eruption is an immunologically mediated photodermatosis with high prevalence, particularly among young women in temperate climates, characterized by pruritic skin lesions of variable morphology, occurring in spring or early summer on sun-exposed body sites. A resistance to ultraviolet radiation (UVR)-induced immunosuppression and a subsequent delayed-type hypersensitivity response to a photoantigen have been suggested as key factors in the disease. Molecular and immunologic disturbances associated with disease pathogenesis include a failure of skin infiltration by neutrophils and other regulatory immune cells on UVR exposure linked to a disturbed cytokine microenvironment. Standard management is based on prevention.
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Affiliation(s)
- Alexandra Gruber-Wackernagel
- Research Unit for Photodermatology, Department of Dermatology, Medical University of Graz, Auenbruggerplatz 8, Graz A-8036, Austria
| | - Scott N Byrne
- Cellular Photoimmunology Group, Infectious Diseases and Immunology, Department of Dermatology, Sydney Medical School, Royal Prince Alfred Hospital, The University of Sydney, 676, Blackburn Building D06, Darlington, New South Wales 2006, Australia
| | - Peter Wolf
- Research Unit for Photodermatology, Department of Dermatology, Medical University of Graz, Auenbruggerplatz 8, Graz A-8036, Austria.
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212
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Menezes AC, Raposo S, Simões S, Ribeiro H, Oliveira H, Ascenso A. Prevention of Photocarcinogenesis by Agonists of 5-HT1A and Antagonists of 5-HT2A Receptors. Mol Neurobiol 2015; 53:1145-1164. [DOI: 10.1007/s12035-014-9068-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2014] [Accepted: 12/29/2014] [Indexed: 12/13/2022]
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213
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Lucas RM, Norval M, Neale RE, Young AR, de Gruijl FR, Takizawa Y, van der Leun JC. The consequences for human health of stratospheric ozone depletion in association with other environmental factors. Photochem Photobiol Sci 2015; 14:53-87. [DOI: 10.1039/c4pp90033b] [Citation(s) in RCA: 101] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Ozone depletion, climate and human health.
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Affiliation(s)
- R. M. Lucas
- National Centre for Epidemiology and Population Health
- The Australian National University
- Canberra 2601
- Australia
- Telethon Kids Institute
| | - M. Norval
- Biomedical Sciences
- University of Edinburgh Medical School
- Edinburgh EH8 9AG
- UK
| | - R. E. Neale
- QIMR Berghofer Medical Research Institute
- Brisbane 4029
- Australia
| | - A. R. Young
- King's College London (KCL)
- St John's Institute of Dermatology
- London SE1 9RT
- UK
| | - F. R. de Gruijl
- Department of Dermatology
- Leiden University Medical Centre
- NL-2300 RC Leiden
- The Netherlands
| | - Y. Takizawa
- Akita University Graduate School of Medicine
- Akita Prefecture
- Japan
- National Institute for Minamata Diseases
- Kumamoto Prefecture
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214
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Abstract
The ultraviolet (UV) radiation contained in sunlight is a powerful immune suppressant. While exposure to UV is best known for its ability to cause skin cancer, it is also associated with protection against a range of autoimmune diseases, particularly multiple sclerosis (MS). Although the precise mechanism by which sunlight affords protection from MS remains to be determined, some have hypothesised that UV immunosuppression explains the "latitude-gradient effect" associated with MS. By stimulating the release of soluble factors in exposed skin, UV activates immune suppressive pathways that culminate in the induction of regulatory cells in distant tissues. Each and every one of the immune suppressive cells and molecules activated by UV exposure are potential targets for treating and preventing MS. A thorough understanding of the mechanisms involved is therefore required if we are to realise the therapeutic potential of photoimmunology.
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Affiliation(s)
- Felix Marsh-Wakefield
- Cellular Photoimmunology Group, Discipline of Infectious Diseases and Immunology, Sydney Medical School, University of Sydney, Camperdown, Australia.,Department of Dermatology, Royal Prince Alfred Hospital, Camperdown, NSW, Australia.,Discipline of Dermatology, Bosch Institute, Sydney Medical School, University of Sydney, Camperdown, Australia
| | - Scott N Byrne
- Cellular Photoimmunology Group, Discipline of Infectious Diseases and Immunology, Sydney Medical School, University of Sydney, Camperdown, Australia. .,Department of Dermatology, Royal Prince Alfred Hospital, Camperdown, NSW, Australia. .,Discipline of Dermatology, Bosch Institute, Sydney Medical School, University of Sydney, Camperdown, Australia. .,Infectious Diseases and Immunology, Level 5 (East), The Charles Perkins Centre Hub (D17), University of Sydney, Camperdown, NSW, 2006, Australia.
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215
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Hart PH, Lucas RM, Walsh JP, Zosky GR, Whitehouse AJO, Zhu K, Allen KL, Kusel MM, Anderson D, Mountain JA. Vitamin D in fetal development: findings from a birth cohort study. Pediatrics 2015; 135:e167-73. [PMID: 25511121 DOI: 10.1542/peds.2014-1860] [Citation(s) in RCA: 76] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Birth cohort studies provide an invaluable resource for studies of the influence of the fetal environment on health in later life. It is uncertain to what extent maternal vitamin D status influences fetal development. Using an unselected community-based cohort of 901 mother-offspring pairs (the Western Australian Pregnancy Cohort [Raine] Study), we examined the relationship between maternal vitamin D deficiency at 18 weeks' pregnancy and long-term health outcomes of offspring who were born in Perth, Western Australia (32° South), in 1989-1991. Vitamin D deficiency (serum 25-hydroxyvitamin D [25(OH)D] <50 nmol/L) was present in 36% (323 of 901) of the pregnant women. After adjusting for relevant covariates, maternal vitamin D deficiency during pregnancy was associated with impaired lung development in 6-year-old offspring, neurocognitive difficulties at age 10, increased risk of eating disorders in adolescence, and lower peak bone mass at 20 years. In summary, vitamin D may have an important, multifaceted role in the development of fetal lungs, brain, and bone. Experimental animal studies support an active contribution of vitamin D to organ development. Randomized controlled trials of vitamin D supplementation in pregnant women with long-term follow-up of offspring are urgently required to examine whether the correction of vitamin D deficiency in pregnant women is beneficial for their offspring and to determine the optimal level of maternal serum 25(OH)D for fetal development.
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Affiliation(s)
| | - Robyn M Lucas
- Telethon Kids Institute, College of Medicine, Biology and Environment, Australian National University, Canberra, Australia
| | - John P Walsh
- Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Nedlands, Australia; and School of Medicine and Pharmacology, and
| | - Graeme R Zosky
- Telethon Kids Institute, School of Medicine, Faculty of Health, University of Tasmania, Hobart, Australia
| | | | - Kun Zhu
- Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Nedlands, Australia; and School of Medicine and Pharmacology, and
| | - Karina L Allen
- Telethon Kids Institute, School of Psychology, University of Western Australia, Perth, Australia
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216
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Jones A, D'Vaz N, Meldrum S, Palmer D, Zhang G, Prescott S. 25-hydroxyvitamin D3 status is associated with developing adaptive and innate immune responses in the first 6 months of life. Clin Exp Allergy 2014; 45:220-31. [DOI: 10.1111/cea.12449] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2014] [Revised: 10/27/2014] [Accepted: 10/31/2014] [Indexed: 12/23/2022]
Affiliation(s)
- A.P. Jones
- School of Paediatrics and Child Health; University of Western Australia; Perth WA Australia
- Telethon Kids Institute; University of Western Australia; Perth WA Australia
| | - N. D'Vaz
- School of Paediatrics and Child Health; University of Western Australia; Perth WA Australia
- Telethon Kids Institute; University of Western Australia; Perth WA Australia
| | - S. Meldrum
- School of Paediatrics and Child Health; University of Western Australia; Perth WA Australia
- Telethon Kids Institute; University of Western Australia; Perth WA Australia
| | - D.J. Palmer
- School of Paediatrics and Child Health; University of Western Australia; Perth WA Australia
- Telethon Kids Institute; University of Western Australia; Perth WA Australia
- ‘In-FLAME’ the International Inflammation Network; Worldwide Universities Network (WUN); Perth WA Australia
| | - G. Zhang
- School of Paediatrics and Child Health; University of Western Australia; Perth WA Australia
- School of Public Health; Curtin University of Technology; Perth WA Australia
| | - S.L. Prescott
- School of Paediatrics and Child Health; University of Western Australia; Perth WA Australia
- Telethon Kids Institute; University of Western Australia; Perth WA Australia
- ‘In-FLAME’ the International Inflammation Network; Worldwide Universities Network (WUN); Perth WA Australia
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217
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Wang Y, Marling SJ, Beaver EF, Severson KS, Deluca HF. UV light selectively inhibits spinal cord inflammation and demyelination in experimental autoimmune encephalomyelitis. Arch Biochem Biophys 2014; 567:75-82. [PMID: 25541149 DOI: 10.1016/j.abb.2014.12.017] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2014] [Revised: 12/03/2014] [Accepted: 12/13/2014] [Indexed: 12/25/2022]
Abstract
Multiple sclerosis (MS) is a chronic demyelinating disease of the central nervous system (CNS). The incidence of MS is inversely related to sun light exposure or ultraviolet radiation (UVR). UVR was found to suppress experimental autoimmune encephalomyelitis (EAE), an animal model of MS, independent of vitamin D production. The mechanism of this suppression remains to be elucidated. To this end, several elements of an immune response in the spinal cord, spleen and skin during development of EAE were studied. As expected, UVR (10kJ/m(2)) inhibits inflammation and demyelination of the spinal cord. Most significant, UVR dramatically reduced spinal cord chemokine CCL5 mRNA and protein levels. UVR also suppressed IL-10 in skin and spleen but not the spinal cord. As expected from the UVR action on skin, macrophage population and IFN-γ levels are increased in that organ. UVR had no effect on lymphocyte proliferation and IFN-γ in spleen. From these measurements, we suggest that UVR suppression of EAE prevents the migration of inflammatory cells into the CNS by a focal inhibition of chemokine CCL-5 in the CNS and a systemic elevation of immunosuppressive IL-10.
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Affiliation(s)
- Yanping Wang
- Department of Biochemistry, University of Wisconsin-Madison, 433 Babcock Drive, Madison, WI 53706, United States
| | - Steven J Marling
- Department of Biochemistry, University of Wisconsin-Madison, 433 Babcock Drive, Madison, WI 53706, United States
| | - Emily F Beaver
- Department of Biochemistry, University of Wisconsin-Madison, 433 Babcock Drive, Madison, WI 53706, United States
| | - Kyle S Severson
- Department of Biochemistry, University of Wisconsin-Madison, 433 Babcock Drive, Madison, WI 53706, United States
| | - Hector F Deluca
- Department of Biochemistry, University of Wisconsin-Madison, 433 Babcock Drive, Madison, WI 53706, United States.
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218
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Noda S, Krueger JG, Guttman-Yassky E. The translational revolution and use of biologics in patients with inflammatory skin diseases. J Allergy Clin Immunol 2014; 135:324-36. [PMID: 25541257 DOI: 10.1016/j.jaci.2014.11.015] [Citation(s) in RCA: 135] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2014] [Revised: 11/12/2014] [Accepted: 11/17/2014] [Indexed: 12/28/2022]
Abstract
Psoriasis and atopic dermatitis (AD) are common inflammatory skin diseases characterized by immune-mediated inflammation and abnormal keratinocyte differentiation. Although T-cell infiltration characterizes both diseases, T-cell polarization differs. Psoriasis is currently the best model for translational medicine because many targeted therapeutics have been developed and testing of targeted therapeutics has cemented psoriasis as IL-23/TH17 polarized. In patients with AD, although therapeutic development is approximately a decade behind that in patients with psoriasis, there is now active development and testing of targeted therapeutics against various immune axes (TH2, TH22, and IL-23/TH17). These clinical trials and subsequent molecular analyses using human samples will be able to clarify the relative roles of polar cytokines in patients with AD.
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Affiliation(s)
- Shinji Noda
- Laboratory for Investigative Dermatology, Rockefeller University, New York, NY
| | - James G Krueger
- Laboratory for Investigative Dermatology, Rockefeller University, New York, NY
| | - Emma Guttman-Yassky
- Laboratory for Investigative Dermatology, Rockefeller University, New York, NY; Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY.
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219
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Della Giustina A, Landi M, Bellini F, Bosoni M, Ferrante G, Onorari M, Travaglini A, Pingitore G, Passalacqua G, Tripodi S. Vitamin D, allergies and asthma: focus on pediatric patients. World Allergy Organ J 2014; 7:27. [PMID: 25829979 PMCID: PMC4363348 DOI: 10.1186/1939-4551-7-27] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2014] [Accepted: 09/11/2014] [Indexed: 11/10/2022] Open
Abstract
In recent years, the interest of the scientific world towards vitamin D gradually increased, and several studies have been conducted to dissect its possible role in modulating the development/course of allergic diseases. Also, Vitamin D supplementation has been assessed as a beneficial approach for treating allergies in some, but not all studies. We reviewed herein the available and relevant literature concerning the possible links between Vitamin D, its supplementation and allergic diseases. A literature search was made independently by the Authors, identifying articles for a narrative review. As per literature, Vitamin D plays a key role in calcium and phosphate metabolism, and it is essential for bone health in infants, children and adolescents. However, there is presently insufficient evidence to support vitamin D supplementation for prevention or treatment of allergic diseases in infants, children and adolescents, concerning allergic rhinitis, asthma, food allergy and atopic dermatitis.
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Affiliation(s)
| | - Massimo Landi
- Department of Pediatrics, National Healthcare System ASL TO1, Turin, Italy
| | - Federica Bellini
- Pediatric Unit Department of Gynecologic, Obstetric and Pediatric Sciences, University of Bologna, Bologna, Italy
| | | | - Giuliana Ferrante
- Department of Sciences for Health Promotion and mother and child, University of Palermo, Palermo, Italy
| | - Marzia Onorari
- Department of Prato, Environmental Protection Agency of Tuscany (ARPAT), Prato, Italy
| | | | | | - Giovanni Passalacqua
- Allergy and Respiratory Diseases, IRCCS San Martino-Ist-University of Genoa, Pad. Maragliano, L.go R Benzi 10, 16133 Genoa, Italy
| | - Salvatore Tripodi
- Department of Pediatrics and Allergy Unit Sandro Pertini Hospital, Rome, Italy
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220
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Shore-Lorenti C, Brennan SL, Sanders KM, Neale RE, Lucas RM, Ebeling PR. Shining the light on Sunshine: a systematic review of the influence of sun exposure on type 2 diabetes mellitus-related outcomes. Clin Endocrinol (Oxf) 2014; 81:799-811. [PMID: 25066830 DOI: 10.1111/cen.12567] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2014] [Revised: 05/16/2014] [Accepted: 07/17/2014] [Indexed: 01/21/2023]
Abstract
Prospective observational studies uniformly link vitamin D deficiency with the incidence of type 2 diabetes mellitus (T2DM), yet trials supplementing participants at risk of T2DM with vitamin D to reduce progression to T2DM have yielded inconsistent results. Inconsistencies between supplementation trials may be due to insufficient dosing or small sample sizes. Observational studies may also have reported spurious associations due to uncontrolled confounding by lifestyle or genetic factors. Alternatively, observational and intervention studies may not be entirely comparable. Observational studies show an association between higher vitamin D status, which is predominantly derived from sun exposure, and decreased incidence of T2DM. Trials intervene with vitamin D supplementation, and therefore may be missing alternate causes of the effect of sun exposure, as seen in observational studies. We propose that sun exposure may be the driving force behind the associations seen in observational studies; sun exposure may have additional benefits beyond increasing serum 25-hydroxyvitamin D (25OHD) levels. We performed an electronic literature search to identify articles that examined associations between sun exposure and T2DM and/or glucose metabolism. A best evidence synthesis was then conducted using outcomes from analyses deemed to have high methodological quality. Ten eligible full-text articles were identified, yielding 19 T2DM-related outcomes. The best evidence analysis considered 11 outcomes which were grouped into six outcome types: T2DM, fasting glucose, glucose tolerance, fasting insulin, insulin secretion and insulin sensitivity. There was moderate evidence to support a role of recreational sun exposure in reducing odds of T2DM incidence. High-level evidence was lacking; evidence presented for other outcomes was of low or insufficient level. This review highlights significant gaps in research pertaining to sun exposure and T2DM-related outcomes. Further research is encouraged as we aim to identify novel preventative strategies for T2DM.
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Affiliation(s)
- Catherine Shore-Lorenti
- NorthWest Academic Centre, Department of Medicine, Western Health, The University of Melbourne, Melbourne, Vic., Australia
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221
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Hawken S, Potter BK, Benchimol EI, Little J, Ducharme R, Wilson K. Seasonal variation in rates of emergency room visits and acute admissions following recommended infant vaccinations in Ontario, Canada: A self-controlled case series analysis. Vaccine 2014; 32:7148-53. [DOI: 10.1016/j.vaccine.2014.09.059] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2014] [Revised: 09/19/2014] [Accepted: 09/29/2014] [Indexed: 11/25/2022]
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222
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Abstract
Vitamin D deficiency has been linked to an increased risk of a wide range of adverse health outcomes. The active form of vitamin D has an important role in calcium metabolism and in bone mineralisation, but the evidence for other health outcomes is mixed, with the strongest effects seen in the weakest epidemiological study designs. There are plausible pathways whereby vitamin D deficiency can impair immune function, resulting in both overactivity and increased risk of autoimmune disease, as well as immune suppression with poorer resistance to infection. Vitamin D status may influence the bacterial flora that constitute the microbiome and affect immune function through this route. Exposure of the skin to ultraviolet radiation causes the production of a range of chemicals, including vitamin D, and new research is exploring possible vitamin D-independent immunomodulatory pathways.
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Affiliation(s)
- Robyn M. Lucas
- Telethon Kids Institute, University of Western Australia100 Roberts Road, Subiaco, PerthAustralia 6008
- National Centre for Epidemiology and Population Health, The Australian National UniversityCanberraAustralia 0200
| | - Shelley Gorman
- Telethon Kids Institute, University of Western Australia100 Roberts Road, Subiaco, PerthAustralia 6008
| | - Sian Geldenhuys
- Telethon Kids Institute, University of Western Australia100 Roberts Road, Subiaco, PerthAustralia 6008
| | - Prue H. Hart
- Telethon Kids Institute, University of Western Australia100 Roberts Road, Subiaco, PerthAustralia 6008
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223
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Swaminathan A, Lucas RM, Harley D, McMichael AJ. Will Global Climate Change Alter Fundamental Human Immune Reactivity: Implications for Child Health? CHILDREN (BASEL, SWITZERLAND) 2014; 1:403-23. [PMID: 27417487 PMCID: PMC4928742 DOI: 10.3390/children1030403] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/10/2014] [Revised: 10/07/2014] [Accepted: 10/12/2014] [Indexed: 12/31/2022]
Abstract
The human immune system is an interface across which many climate change sensitive exposures can affect health outcomes. Gaining an understanding of the range of potential effects that climate change could have on immune function will be of considerable importance, particularly for child health, but has, as yet, received minimal research attention. We postulate several mechanisms whereby climate change sensitive exposures and conditions will subtly impair aspects of the human immune response, thereby altering the distribution of vulnerability within populations-particularly for children-to infection and disease. Key climate change-sensitive pathways include under-nutrition, psychological stress and exposure to ambient ultraviolet radiation, with effects on susceptibility to infection, allergy and autoimmune diseases. Other climate change sensitive exposures may also be important and interact, either additively or synergistically, to alter health risks. Conducting directed research in this area is imperative as the potential public health implications of climate change-induced weakening of the immune system at both individual and population levels are profound. This is particularly relevant for the already vulnerable children of the developing world, who will bear a disproportionate burden of future adverse environmental and geopolitical consequences of climate change.
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Affiliation(s)
- Ashwin Swaminathan
- National Centre for Epidemiology and Population Health, Australian National University, Corner of Mills and Eggleston Roads, Canberra, Australian Capital Territory 2601, Australia; E-Mails: ;
- Departments of General Medicine and Infectious Diseases, Canberra Hospital, Yamba Drive, Garran, Canberra, Australian Capital Territory 2605, Australia
- Australian National University Medical School, Australian National University, Canberra, Australian Capital Territory 0200, Australia
| | - Robyn M. Lucas
- National Centre for Epidemiology and Population Health, Australian National University, Corner of Mills and Eggleston Roads, Canberra, Australian Capital Territory 2601, Australia; E-Mails: ;
- Telethon Kids Institute, University of Western Australia, 100 Roberts Road, Subiaco, Perth, Western Australia 6008, Australia
| | - David Harley
- National Centre for Epidemiology and Population Health, Australian National University, Corner of Mills and Eggleston Roads, Canberra, Australian Capital Territory 2601, Australia; E-Mails: ;
| | - Anthony J. McMichael
- National Centre for Epidemiology and Population Health, Australian National University, Corner of Mills and Eggleston Roads, Canberra, Australian Capital Territory 2601, Australia; E-Mails: ;
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224
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Abstract
The emerging role of vitamin D as a regulator of both innate and adaptive immune responses has encouraged the investigation of its role in the pathogenesis of a variety of autoimmune conditions including the inflammatory bowel diseases (IBD), Crohn's disease and ulcerative colitis. Animal models consistently demonstrate that vitamin D significantly impacts on the modulation of astrointestinal inflammation, while epidemiological and observational data show an inverse relationship between vitamin D status and the onset/progression of Crohn's disease as well as the development of colorectal cancer. As vitamin D supplementation is readily available, at low cost, it is a very attractive potential therapeutic option. The biological plausibility for a role for vitamin D in inflammation modulation, the potential genetic links associated with vitamin D metabolism and the clinical aspects for it in IBD will be discussed.
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Affiliation(s)
- Simon Ghaly
- Centre for Inflammatory Bowel Diseases, Fremantle Hospital and School of Medicine and Pharmacology, University of Western Australia, Level 5, T Block, Alma St, Fremanlte, Western Australia 6159, Australia
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225
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Brøndum-Jacobsen P, Nordestgaard BG, Nielsen SF, Benn M. Authors' response to: skin cancer as a marker of sun exposure. Int J Epidemiol 2014; 43:1992-3. [PMID: 25335502 DOI: 10.1093/ije/dyu211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Peter Brøndum-Jacobsen
- Department of Clinical Biochemistry, Herlev Hospital, Copenhagen University Hospital and Faculty of Health and Medical Sciences, University of Copenhagen and Department of Clinical Biochemistry, Gentofte Hospital, Denmark Department of Clinical Biochemistry, Herlev Hospital, Copenhagen University Hospital and Faculty of Health and Medical Sciences, University of Copenhagen and Department of Clinical Biochemistry, Gentofte Hospital, Denmark
| | - Børge G Nordestgaard
- Department of Clinical Biochemistry, Herlev Hospital, Copenhagen University Hospital and Faculty of Health and Medical Sciences, University of Copenhagen and Department of Clinical Biochemistry, Gentofte Hospital, Denmark Department of Clinical Biochemistry, Herlev Hospital, Copenhagen University Hospital and Faculty of Health and Medical Sciences, University of Copenhagen and Department of Clinical Biochemistry, Gentofte Hospital, Denmark
| | - Sune F Nielsen
- Department of Clinical Biochemistry, Herlev Hospital, Copenhagen University Hospital and Faculty of Health and Medical Sciences, University of Copenhagen and Department of Clinical Biochemistry, Gentofte Hospital, Denmark
| | - Marianne Benn
- Department of Clinical Biochemistry, Herlev Hospital, Copenhagen University Hospital and Faculty of Health and Medical Sciences, University of Copenhagen and Department of Clinical Biochemistry, Gentofte Hospital, Denmark Department of Clinical Biochemistry, Herlev Hospital, Copenhagen University Hospital and Faculty of Health and Medical Sciences, University of Copenhagen and Department of Clinical Biochemistry, Gentofte Hospital, Denmark
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226
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Spelman T, Gray O, Trojano M, Petersen T, Izquierdo G, Lugaresi A, Hupperts R, Bergamaschi R, Duquette P, Grammond P, Giuliani G, Boz C, Verheul F, Oreja-Guevara C, Barnett M, Grand'Maison F, Edite Rio M, Lechner-Scott J, Van Pesch V, Fernandez Bolanos R, Flechter S, Den Braber-Moerland L, Iuliano G, Amato MP, Slee M, Cristiano E, Saladino ML, Paine M, Vella N, Kasa K, Deri N, Herbert J, Moore F, Petkovska-Boskova T, Alroughani R, Savino A, Shaw C, Vucic S, Santiago V, Bacile EA, Skromne E, Poehlau D, Cabrera-Gomez JA, Lucas R, Butzkueven H. Seasonal variation of relapse rate in multiple sclerosis is latitude dependent. Ann Neurol 2014; 76:880-90. [DOI: 10.1002/ana.24287] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2014] [Revised: 09/14/2014] [Accepted: 09/22/2014] [Indexed: 12/15/2022]
Affiliation(s)
- Tim Spelman
- Department of Neurology; Royal Melbourne Hospital; Parkville Australia
| | - Orla Gray
- Craigavon Area Hospital; Portadown Northern Ireland
| | - Maria Trojano
- Department of Basic Medical Sciences, Neuroscience, and Sense Organs; University of Bari; Bari Italy
| | | | | | - Alessandra Lugaresi
- Multiple Sclerosis Center, Department of Neuroscience and Imaging, University “G. d'Annunzio”; Chieti Italy
| | | | - Roberto Bergamaschi
- Neurological lnstitute of Scientific Research and Treatment Mondino; Pavia Italy
| | | | - Pierre Grammond
- Chaudière-Appalache Physical Disability Rehabilitation Center; Lévis Quebec Canada
| | | | - Cavit Boz
- Karadeniz Technical University; Trabzon Turkey
| | | | | | | | | | | | | | | | | | | | | | | | - Maria Pia Amato
- Department of Neurology; University of Florence; Florence Italy
| | - Mark Slee
- Flinders University and Medical Center; Adelaide Australia
| | | | | | - Mark Paine
- St Vincent's Hospital; Fitzroy Australia
| | | | | | - Norma Deri
- Fernandez Hospital; Buenos Aires Argentina
| | - Joseph Herbert
- New York University Hospital for Joint Diseases; New York NY
| | - Fraser Moore
- Jewish General Hospital, Montreal; Quebec Canada
| | | | | | | | | | | | - Vetere Santiago
- Hospital International General Acute Gral San Martin; La Plata Argentina
| | | | - Eli Skromne
- Hospital Angeles Mexico City; Mexico City Mexico
| | - Dieter Poehlau
- Multiple Sclerosis Center, Camillus Hospital; Asbach Germany
| | | | - Robyn Lucas
- National Center for Epidemiology and Population Health, Australian National University; Canberra Australia
| | - Helmut Butzkueven
- Department of Neurology; Royal Melbourne Hospital; Parkville Australia
- Department of Medicine, Royal Melbourne Hospital; University of Melbourne; Parkville Australia
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227
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Li H, Prasad R, Katiyar SK, Yusuf N, Elmets CA, Xu H. Interleukin-17 mediated inflammatory responses are required for ultraviolet radiation-induced immune suppression. Photochem Photobiol 2014; 91:235-41. [PMID: 25250896 DOI: 10.1111/php.12351] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2014] [Accepted: 09/15/2014] [Indexed: 12/21/2022]
Abstract
Ultraviolet radiation (UVR) induces immunosuppression and is a major factor for development of skin cancer. Numerous efforts have been made to determine mechanisms for UVR-induced immunosuppression and to develop strategies for prevention and treatment of UVR-induced cancers. In the current study, we use IL-17 receptor (IL-17R) deficient mice to examine whether IL-17 mediated responses have a role in UVB (290-320)-induced immunosuppression of contact hypersensitivity responses. Results demonstrate that IL-17 mediated responses are required for UVB-induced immunosuppression of contact hypersensitivity responses. The systemic immune suppression and development of regulatory T cells are inhibited in UVB-treated IL-17R deficient mice compared to wild-type animals. The deficiency in IL-17R inhibits the infiltration and development of a tolerogenic myeloid cell population in UVB-treated skin, which expresses CD11b and Gr-1 and produces reactive oxygen species. We speculate that the development of the tolerogenic myeloid cells is dependent on IL-17-induced chemokines and inflammatory mediators in UVB-treated skin. The inhibition of the tolerogenic myeloid cells may be attributed to the suppression of regulatory T cells in UVR-treated IL-17R(-/-) mice. The findings may be exploited to new strategies for prevention and treatment of UVR-induced skin diseases and cancers.
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Affiliation(s)
- Hui Li
- Department of Dermatology, University of Alabama at Birmingham, Birmingham, AL
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228
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Li YC, Chen Y, Liu W, Thadhani R. MicroRNA-mediated mechanism of vitamin D regulation of innate immune response. J Steroid Biochem Mol Biol 2014; 144 Pt A:81-6. [PMID: 24103701 PMCID: PMC3976893 DOI: 10.1016/j.jsbmb.2013.09.014] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2013] [Revised: 09/13/2013] [Accepted: 09/26/2013] [Indexed: 12/14/2022]
Abstract
Macrophages play a critical role in innate immune response to protect the host from pathogenic microorganisms. Inflammatory response is regulated by negative feedback mechanisms to prevent detrimental effects. The SOCS family of proteins is key component of the negative feedback loop that regulates the intensity, duration and quality of cytokine signaling, whereas miR-155 is a key regulator of Toll-like receptor (TLR) signaling that targets SOCS1 in activated macrophages to block the negative feedback loop. Recently we showed that 1,25-dihydroxyvitamin D (1,25(OH)2D3) modulates innate immune response by targeting the miR-155-SOCS1 axis. We found that Vdr deletion leads to hyper inflammatory response in mice and macrophage cultures when challenged with lipopolysaccharide (LPS), due to miR-155 overproduction to excessively suppress SOCS1. Using mice with bic/miR-155 deletion we confirmed that 1,25(OH)2D3 suppresses inflammation and stimulates SOCS1 by down-regulating miR-155. Mechanistically 1,25(OH)2D3 down-regulates bic transcription by blocking NF-κB activation, which is mediated by a κB cis-DNA element identified within the first intron of the bic gene. At the molecular level, we demonstrated that VDR inhibits NF-κB activation by directly interacting with IKKβ protein. Our studies identified a novel mechanism whereby VDR signaling attenuates TLR-mediated inflammation by enhancing the negative feedback regulation. This article is part of a Special Issue entitled '16th Vitamin D Workshop'.
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Affiliation(s)
- Yan Chun Li
- Department of Medicine, Division of Biological Sciences, The University of Chicago, Chicago, IL 60637, USA.
| | - Yunzi Chen
- Department of Medicine, Division of Biological Sciences, The University of Chicago, Chicago, IL 60637, USA
| | - Weicheng Liu
- Department of Medicine, Division of Biological Sciences, The University of Chicago, Chicago, IL 60637, USA
| | - Ravi Thadhani
- Division of Nephrology, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA
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229
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Rueter K, Siafarikas A, Prescott SL, Palmer DJ. In uteroand postnatal vitamin D exposure and allergy risk. Expert Opin Drug Saf 2014; 13:1601-11. [DOI: 10.1517/14740338.2014.961913] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
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230
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Abstract
Living on a sun-drenched planet has necessitated adaption to and protection from the harmful effects of solar ultraviolet (UV) radiation, particularly skin cancer. However, convincing epidemiological and recent empirical evidence also supports a protective effect of UV against a range of diseases including multiple sclerosis, asthma and cardiovascular disease. Despite years of research attention into the biological effects of sunlight exposure, we are still far from being able to fully answer the question: How much sunlight is enough? This is probably because the answer is dependent on many complex and interacting variables. Many talented researchers are focused on exploring whether UV-induced vitamin D explains some of these effects. This perspectives article proposes an alternative hypothesis, namely that targeting UV-induced immune suppression by affecting the activation of regulatory cells and molecules will be of therapeutic benefit.
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Affiliation(s)
- Scott N Byrne
- Cellular Photoimmunology Group, Discipline of Infectious Diseases and Immunology, Sydney Medical School, University of Sydney, Australia.
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231
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Abstract
The active form of vitamin D has effects on both innate and adaptive immune responses that may influence the outcome in many infectious diseases. Observational studies conclusively show that a low vitamin D status is associated with an increased occurrence of respiratory viral infections, which globally represent significant health and financial burdens. However, no consistent protective effects are evident in prospective clinical trials carried out to date where vitamin D was provided as a dietary supplement, except possibly in cases where the starting vitamin D status of the individual was considered deficient. Thus far, vitamin D has not been found to enhance the immune response to vaccines. The design of future prospective clinical trials assessing a role for vitamin D in respiratory viral infections requires very careful planning to avoid the uncertainties associated with the data available currently.
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An unexpected role: UVA-induced release of nitric oxide from skin may have unexpected health benefits. J Invest Dermatol 2014; 134:1791-1794. [PMID: 24924758 DOI: 10.1038/jid.2014.33] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
UVR has deleterious and beneficial effects on human health. In this issue, Liu et al. (2014) show that UVA decreases blood pressure and increases blood flow and heart rate in humans, which is beneficial to the cardiovascular system. This is likely mediated by UVA causing release of nitric oxide (NO) from skin stores. This mediator may have additional effects on human health.
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Abstract
Psoriasis is a common chronic inflammatory skin disease with a spectrum of clinical phenotypes and results from the interplay of genetic, environmental, and immunological factors. Four decades of clinical and basic research on psoriasis have elucidated many of the pathogenic mechanisms underlying disease and paved the way to effective targeted therapies. Here, we review this progress and identify future directions of study that are supported by a more integrative research approach and aim at further improving the patients' life.
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Affiliation(s)
- Paola Di Meglio
- Molecular Immunology, Medical Research Council National Institute for Medical Research, London NW7 1AA, United Kingdom
| | - Federica Villanova
- St. John's Institute of Dermatology, King's College London, London SE1 9RT, United Kingdom National Institute for Health Research GSTT/KCL Comprehensive Biomedical Research Centre, Guy's and St. Thomas' National Health Service Foundation Trust, London SE1 9RT, United Kingdom
| | - Frank O Nestle
- St. John's Institute of Dermatology, King's College London, London SE1 9RT, United Kingdom National Institute for Health Research GSTT/KCL Comprehensive Biomedical Research Centre, Guy's and St. Thomas' National Health Service Foundation Trust, London SE1 9RT, United Kingdom
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Guidi M, Foletti G, McLaren P, Cavassini M, Rauch A, Tarr PE, Lamy O, Panchaud A, Telenti A, Csajka C, Rotger M. Vitamin D time profile based on the contribution of non-genetic and genetic factors in HIV-infected individuals of European ancestry. Antivir Ther 2014; 20:261-9. [PMID: 25032819 DOI: 10.3851/imp2823] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/29/2014] [Indexed: 10/25/2022]
Abstract
BACKGROUND Vitamin D deficiency is prevalent in HIV-infected individuals and vitamin D supplementation is proposed according to standard care. This study aimed at characterizing the kinetics of 25(OH)D in a cohort of HIV-infected individuals of European ancestry to better define the influence of genetic and non-genetic factors on 25(OH)D levels. These data were used for the optimization of vitamin D supplementation in order to reach therapeutic targets. METHODS 1,397 25(OH)D plasma levels and relevant clinical information were collected in 664 participants during medical routine follow-up visits. They were genotyped for 7 SNPs in 4 genes known to be associated with 25(OH)D levels. 25(OH)D concentrations were analysed using a population pharmacokinetic approach. The percentage of individuals with 25(OH)D concentrations within the recommended range of 20-40 ng/ml during 12 months of follow-up and several dosage regimens were evaluated by simulation. RESULTS A one-compartment model with linear absorption and elimination was used to describe 25(OH)D pharmacokinetics, while integrating endogenous baseline plasma concentrations. Covariate analyses confirmed the effect of seasonality, body mass index, smoking habits, the analytical method, darunavir/ritonavir and the genetic variant in GC (rs2282679) on 25(OH)D concentrations. 11% of the inter-individual variability in 25(OH)D levels was explained by seasonality and other non-genetic covariates, and 1% by genetics. The optimal supplementation for severe vitamin D deficient patients was 300,000 IU two times per year. CONCLUSIONS This analysis allowed identifying factors associated with 25(OH)D plasma levels in HIV-infected individuals. Improvement of dosage regimen and timing of vitamin D supplementation is proposed based on those results.
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Affiliation(s)
- Monia Guidi
- School of Pharmaceutical Sciences, University of Lausanne and University of Geneva, Geneva, Switzerland
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Ionizing radiation selectively reduces skin regulatory T cells and alters immune function. PLoS One 2014; 9:e100800. [PMID: 24959865 PMCID: PMC4069168 DOI: 10.1371/journal.pone.0100800] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2014] [Accepted: 05/28/2014] [Indexed: 12/28/2022] Open
Abstract
The skin serves multiple functions that are critical for life. The protection from pathogens is achieved by a complicated interaction between aggressive effectors and controlling functions that limit damage. Inhomogeneous radiation with limited penetration is used in certain types of therapeutics and is experienced with exposure to solar particle events outside the protection of the Earth’s magnetic field. This study explores the effect of ionizing radiation on skin immune function. We demonstrate that radiation, both homogeneous and inhomogeneous, induces inflammation with resultant specific loss of regulatory T cells from the skin. This results in a hyper-responsive state with increased delayed type hypersensitivity in vivo and CD4+ T cell proliferation in vitro. The effects of inhomogeneous radiation to the skin of astronauts or as part of a therapeutic approach could result in an unexpected enhancement in skin immune function. The effects of this need to be considered in the design of radiation therapy protocols and in the development of countermeasures for extended space travel.
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Bjelakovic G, Gluud LL, Nikolova D, Whitfield K, Krstic G, Wetterslev J, Gluud C. Vitamin D supplementation for prevention of cancer in adults. Cochrane Database Syst Rev 2014; 2014:CD007469. [PMID: 24953955 PMCID: PMC11285304 DOI: 10.1002/14651858.cd007469.pub2] [Citation(s) in RCA: 91] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND The evidence on whether vitamin D supplementation is effective in decreasing cancers is contradictory. OBJECTIVES To assess the beneficial and harmful effects of vitamin D supplementation for prevention of cancer in adults. SEARCH METHODS We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, LILACS, Science Citation Index Expanded, and the Conference Proceedings Citation Index-Science to February 2014. We scanned bibliographies of relevant publications and asked experts and pharmaceutical companies for additional trials. SELECTION CRITERIA We included randomised trials that compared vitamin D at any dose, duration, and route of administration versus placebo or no intervention in adults who were healthy or were recruited among the general population, or diagnosed with a specific disease. Vitamin D could have been administered as supplemental vitamin D (vitamin D₃ (cholecalciferol) or vitamin D₂ (ergocalciferol)), or an active form of vitamin D (1α-hydroxyvitamin D (alfacalcidol), or 1,25-dihydroxyvitamin D (calcitriol)). DATA COLLECTION AND ANALYSIS Two review authors extracted data independently. We conducted random-effects and fixed-effect model meta-analyses. For dichotomous outcomes, we calculated the risk ratios (RRs). We considered risk of bias in order to assess the risk of systematic errors. We conducted trial sequential analyses to assess the risk of random errors. MAIN RESULTS Eighteen randomised trials with 50,623 participants provided data for the analyses. All trials came from high-income countries. Most of the trials had a high risk of bias, mainly for-profit bias. Most trials included elderly community-dwelling women (aged 47 to 97 years). Vitamin D was administered for a weighted mean of six years. Fourteen trials tested vitamin D₃, one trial tested vitamin D₂, and three trials tested calcitriol supplementation. Cancer occurrence was observed in 1927/25,275 (7.6%) recipients of vitamin D versus 1943/25,348 (7.7%) recipients of control interventions (RR 1.00 (95% confidence interval (CI) 0.94 to 1.06); P = 0.88; I² = 0%; 18 trials; 50,623 participants; moderate quality evidence according to the GRADE instrument). Trial sequential analysis (TSA) of the 18 vitamin D trials shows that the futility area is reached after the 10th trial, allowing us to conclude that a possible intervention effect, if any, is lower than a 5% relative risk reduction. We did not observe substantial differences in the effect of vitamin D on cancer in subgroup analyses of trials at low risk of bias compared to trials at high risk of bias; of trials with no risk of for-profit bias compared to trials with risk of for-profit bias; of trials assessing primary prevention compared to trials assessing secondary prevention; of trials including participants with vitamin D levels below 20 ng/mL at entry compared to trials including participants with vitamin D levels of 20 ng/mL or more at entry; or of trials using concomitant calcium supplementation compared to trials without calcium. Vitamin D decreased all-cause mortality (1854/24,846 (7.5%) versus 2007/25,020 (8.0%); RR 0.93 (95% CI 0.88 to 0.98); P = 0.009; I² = 0%; 15 trials; 49,866 participants; moderate quality evidence), but TSA indicates that this finding could be due to random errors. Cancer occurrence was observed in 1918/24,908 (7.7%) recipients of vitamin D₃ versus 1933/24,983 (7.7%) in recipients of control interventions (RR 1.00 (95% CI 0.94 to 1.06); P = 0.88; I² = 0%; 14 trials; 49,891 participants; moderate quality evidence). TSA of the vitamin D₃ trials shows that the futility area is reached after the 10th trial, allowing us to conclude that a possible intervention effect, if any, is lower than a 5% relative risk reduction. Vitamin D₃ decreased cancer mortality (558/22,286 (2.5%) versus 634/22,206 (2.8%); RR 0.88 (95% CI 0.78 to 0.98); P = 0.02; I² = 0%; 4 trials; 44,492 participants; low quality evidence), but TSA indicates that this finding could be due to random errors. Vitamin D₃ combined with calcium increased nephrolithiasis (RR 1.17 (95% CI 1.03 to 1.34); P = 0.02; I² = 0%; 3 trials; 42,753 participants; moderate quality evidence). TSA, however, indicates that this finding could be due to random errors. We did not find any data on health-related quality of life or health economics in the randomised trials included in this review. AUTHORS' CONCLUSIONS There is currently no firm evidence that vitamin D supplementation decreases or increases cancer occurrence in predominantly elderly community-dwelling women. Vitamin D₃ supplementation decreased cancer mortality and vitamin D supplementation decreased all-cause mortality, but these estimates are at risk of type I errors due to the fact that too few participants were examined, and to risks of attrition bias originating from substantial dropout of participants. Combined vitamin D₃ and calcium supplements increased nephrolithiasis, whereas it remains unclear from the included trials whether vitamin D₃, calcium, or both were responsible for this effect. We need more trials on vitamin D supplementation, assessing the benefits and harms among younger participants, men, and people with low vitamin D status, and assessing longer duration of treatments as well as higher dosages of vitamin D. Follow-up of all participants is necessary to reduce attrition bias.
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Affiliation(s)
- Goran Bjelakovic
- Medical Faculty, University of NisDepartment of Internal MedicineZorana Djindjica 81NisSerbia18000
- Copenhagen Trial Unit, Centre for Clinical Intervention Research, Department 7812, Rigshospitalet, Copenhagen University HospitalThe Cochrane Hepato‐Biliary GroupBlegdamsvej 9CopenhagenDenmarkDK‐2100
| | - Lise Lotte Gluud
- Copenhagen University Hospital HvidovreGastrounit, Medical DivisionKettegaards AlleHvidovreDenmark2650
| | - Dimitrinka Nikolova
- Copenhagen Trial Unit, Centre for Clinical Intervention Research, Department 7812, Rigshospitalet, Copenhagen University HospitalThe Cochrane Hepato‐Biliary GroupBlegdamsvej 9CopenhagenDenmarkDK‐2100
| | - Kate Whitfield
- Rigshospitalet, Copenhagen University HospitalCopenhagen Trial Unit, Centre for Clinical Intervention Research, Department 7812CopenhagenDenmark
| | - Goran Krstic
- Environmental Health ServicesFraser Health Authority#218 ‐ 610 Sixth StreetNew WestminsterBCCanadaV3L 3C2
| | - Jørn Wetterslev
- Rigshospitalet, Copenhagen University HospitalCopenhagen Trial Unit, Centre for Clinical Intervention Research, Department 7812CopenhagenDenmark
| | - Christian Gluud
- Copenhagen Trial Unit, Centre for Clinical Intervention Research, Department 7812, Rigshospitalet, Copenhagen University HospitalThe Cochrane Hepato‐Biliary GroupBlegdamsvej 9CopenhagenDenmarkDK‐2100
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Natarajan VT, Ganju P, Ramkumar A, Grover R, Gokhale RS. Multifaceted pathways protect human skin from UV radiation. Nat Chem Biol 2014; 10:542-51. [DOI: 10.1038/nchembio.1548] [Citation(s) in RCA: 144] [Impact Index Per Article: 14.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2014] [Accepted: 05/02/2014] [Indexed: 02/07/2023]
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Breuer J, Schwab N, Schneider-Hohendorf T, Marziniak M, Mohan H, Bhatia U, Gross CC, Clausen BE, Weishaupt C, Luger TA, Meuth SG, Loser K, Wiendl H. Ultraviolet B light attenuates the systemic immune response in central nervous system autoimmunity. Ann Neurol 2014; 75:739-58. [DOI: 10.1002/ana.24165] [Citation(s) in RCA: 92] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2014] [Revised: 04/17/2014] [Accepted: 04/21/2014] [Indexed: 12/22/2022]
Affiliation(s)
| | | | | | | | - Hema Mohan
- Department of Neurology; University of Münster; Münster
| | | | | | - Björn E. Clausen
- Institute for Molecular Medicine, Johannes Gutenberg-University Mainz; Mainz
| | | | - Thomas A. Luger
- Department of Dermatology; University of Münster; Münster
- Interdisciplinary Center of Clinical Research; Münster
- Cluster of Excellence EXC 1003, Cells in Motion; Münster Germany
| | - Sven G. Meuth
- Department of Neurology; University of Münster; Münster
- Interdisciplinary Center of Clinical Research; Münster
- Cluster of Excellence EXC 1003, Cells in Motion; Münster Germany
| | - Karin Loser
- Department of Dermatology; University of Münster; Münster
- Interdisciplinary Center of Clinical Research; Münster
- Cluster of Excellence EXC 1003, Cells in Motion; Münster Germany
| | - Heinz Wiendl
- Department of Neurology; University of Münster; Münster
- Interdisciplinary Center of Clinical Research; Münster
- Cluster of Excellence EXC 1003, Cells in Motion; Münster Germany
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Yip KH, Kolesnikoff N, Yu C, Hauschild N, Taing H, Biggs L, Goltzman D, Gregory PA, Anderson PH, Samuel MS, Galli SJ, Lopez AF, Grimbaldeston MA. Mechanisms of vitamin D₃ metabolite repression of IgE-dependent mast cell activation. J Allergy Clin Immunol 2014; 133:1356-64, 1364.e1-14. [PMID: 24461581 PMCID: PMC4154631 DOI: 10.1016/j.jaci.2013.11.030] [Citation(s) in RCA: 84] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2013] [Revised: 10/15/2013] [Accepted: 11/15/2013] [Indexed: 01/11/2023]
Abstract
BACKGROUND Mast cells have gained notoriety based on their detrimental contributions to IgE-mediated allergic disorders. Although mast cells express the vitamin D receptor (VDR), it is not clear to what extent 1α,25-dihydroxyvitamin D3 (1α,25[OH]2D3) or its predominant inactive precursor metabolite in the circulation, 25-hydroxyvitamin D3 (25OHD3), can influence IgE-mediated mast cell activation and passive cutaneous anaphylaxis (PCA) in vivo. OBJECTIVE We sought to assess whether the vitamin D3 metabolites 25OHD3 and 1α,25(OH)2D3 can repress IgE-dependent mast cell activation through mast cell-25-hydroxyvitamin D-1α-hydroxylase (CYP27B1) and mast cell-VDR activity. METHODS We measured the extent of vitamin D3 suppression of IgE-mediated mast cell degranulation and mediator production in vitro, as well as the vitamin D3-induced curtailment of PCA responses in WBB6F1-Kit(W/W-v) or C57BL/6J-Kit(W-sh/W-sh) mice engrafted with mast cells that did or did not express VDR or CYP27B1. RESULTS Here we show that mouse and human mast cells can convert 25OHD3 to 1α,25(OH)2D3 through CYP27B1 activity and that both of these vitamin D3 metabolites suppressed IgE-induced mast cell-derived proinflammatory and vasodilatory mediator production in a VDR-dependent manner in vitro. Furthermore, epicutaneously applied vitamin D3 metabolites significantly reduced the magnitude of skin swelling associated with IgE-mediated PCA reactions in vivo; a response that required functional mast cell-VDRs and mast cell-CYP27B1. CONCLUSION Taken together, our findings provide a mechanistic explanation for the anti-inflammatory effects of vitamin D3 on mast cell function by demonstrating that mast cells can actively metabolize 25OHD3 to dampen IgE-mediated mast cell activation in vitro and in vivo.
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Affiliation(s)
- Kwok-Ho Yip
- Division of Human Immunology, Centre for Cancer Biology, SA Pathology, Adelaide, Australia
| | - Natasha Kolesnikoff
- Division of Human Immunology, Centre for Cancer Biology, SA Pathology, Adelaide, Australia
| | - Chunping Yu
- Division of Human Immunology, Centre for Cancer Biology, SA Pathology, Adelaide, Australia; University of Adelaide, Adelaide, Australia
| | - Nicholas Hauschild
- Division of Human Immunology, Centre for Cancer Biology, SA Pathology, Adelaide, Australia
| | - Houng Taing
- Division of Human Immunology, Centre for Cancer Biology, SA Pathology, Adelaide, Australia; University of Adelaide, Adelaide, Australia
| | - Lisa Biggs
- Division of Human Immunology, Centre for Cancer Biology, SA Pathology, Adelaide, Australia
| | - David Goltzman
- Departments of Medicine and Physiology, McGill University, Montreal, Quebec, Canada
| | - Philip A Gregory
- Division of Human Immunology, Centre for Cancer Biology, SA Pathology, Adelaide, Australia
| | | | - Michael S Samuel
- Division of Human Immunology, Centre for Cancer Biology, SA Pathology, Adelaide, Australia; University of Adelaide, Adelaide, Australia; University of South Australia, Adelaide, Australia
| | - Stephen J Galli
- Departments of Pathology and of Microbiology and Immunology, Stanford University School of Medicine, Stanford, Calif
| | - Angel F Lopez
- Division of Human Immunology, Centre for Cancer Biology, SA Pathology, Adelaide, Australia; University of Adelaide, Adelaide, Australia; University of South Australia, Adelaide, Australia
| | - Michele A Grimbaldeston
- Division of Human Immunology, Centre for Cancer Biology, SA Pathology, Adelaide, Australia; University of Adelaide, Adelaide, Australia; University of South Australia, Adelaide, Australia.
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Duan S, Lv Z, Fan X, Wang L, Han F, Wang H, Bi S. Vitamin D status and the risk of multiple sclerosis: a systematic review and meta-analysis. Neurosci Lett 2014; 570:108-13. [PMID: 24769422 DOI: 10.1016/j.neulet.2014.04.021] [Citation(s) in RCA: 84] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2014] [Revised: 04/10/2014] [Accepted: 04/16/2014] [Indexed: 12/21/2022]
Abstract
To estimate the associations between vitamin D status and multiple sclerosis (MS). We searched electronic databases of the human literature in PubMed, EMBASE and the Cochrane Library up to February, 2014 using the following keywords: 'vitamin D' or '25(OH)D' and 'status' or 'deficiency' or 'insufficiency' and 'multiple sclerosis'. A systematic review and meta-analysis were conducted on observational studies that reported the association between blood vitamin D levels and MS. Eleven studies met the inclusion criteria. 1007 patients and 829 controls were included. Results of our meta-analysis show that MS patients had lower mean levels of 25-hydroxyvitamin D [25(OH)D] than healthy controls (weighted mean difference[MD], -14.52, 95% confidence interval [CI], -23.83 to -5.22). There were statistically significant heterogeneity (P<0.00001; I(2)=92%). The significant heterogeneity may be due to the differences in ethnicity, country, season of blood sampling and age of the participants studied. To sum up, low vitamin D levels are associated with an increased risk of MS.
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Affiliation(s)
- Shurong Duan
- Department of Neurology, The First Affiliated Hospital, Harbin Medical University, Harbin 150001, China
| | - Zheng Lv
- Department of Rehabilitation, The First Affiliated Hospital, Harbin Medical University, Harbin 150001, China
| | - Xiaoxue Fan
- Department of Neurology, The First Affiliated Hospital, Harbin Medical University, Harbin 150001, China
| | - Le Wang
- Department of Neurology, The First Affiliated Hospital, Harbin Medical University, Harbin 150001, China
| | - Fei Han
- Department of Neurology, The First Affiliated Hospital, Harbin Medical University, Harbin 150001, China
| | - Hong Wang
- Department of Neurology, The First Affiliated Hospital, Harbin Medical University, Harbin 150001, China
| | - Sheng Bi
- Department of Neurology, The First Affiliated Hospital, Harbin Medical University, Harbin 150001, China.
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Ng RLX, Scott NM, Bisley JL, Lambert MJ, Gorman S, Norval M, Hart PH. Characterization of regulatory dendritic cells differentiated from the bone marrow of UV-irradiated mice. Immunology 2014; 140:399-412. [PMID: 23826713 DOI: 10.1111/imm.12145] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2013] [Revised: 06/28/2013] [Accepted: 07/01/2013] [Indexed: 12/14/2022] Open
Abstract
When antigen-loaded dendritic cells (DCs) differentiated from the bone marrow (BM) of UV-irradiated mice (UV-BMDCs) were adoptively transferred into naive mice or mice pre-sensitized with that antigen, the recipients exhibited a reduced immune response following antigen challenge. Hence, UV-BMDCs are poorly immunogenic and can suppress pre-existing immunity. The UV-induced effect on BM-derived DCs was rapid (observed 1 day after UV radiation), long-lasting (observed 10 days after UV radiation) and UV dose-dependent. The mechanism by which UV-BMDCs could regulate immunity was investigated. The CD11c(+) cells, differentiated using granulocyte-macrophage colony-stimulating factor + interleukin-4, were confirmed to be DCs because they did not express the myeloid-derived suppressor cell marker, Gr1. UV-BMDCs did not display altered antigen uptake, processing or ability to activate T cells in vitro. When gene expression in UV-BMDCs and DCs differentiated from the BM of non-irradiated mice (control-BMDCs) was examined, Ccl7, Ccl8 and CSF1R (CD115) mRNA transcripts were up-regulated in UV-BMDCs compared with control-BMDCs. However, neutralizing antibodies for Ccl7 and Ccl8 did not abrogate the reduced immunogenicity of UV-BMDCs in vivo. Moreover, the up-regulation of CSF1R transcript did not correspond with increased receptor expression on UV-BMDCs. The phenotypes of UV-BMDCs and control-BMDCs were similar, with no difference in the expression of CD4, CD8α, CD103, B220 or F4/80, or the regulatory molecules CCR7 (CD197), FasL (CD95L), B7H3 (CD276) and B7H4. However, PDL1 (CD274) expression was reduced in UV-BMDCs compared with control-BMDCs following lipopolysaccharide stimulation. In summary, UV-BMDCs do not express the classical phenotypic or gene expression properties of DCs reported by others as 'regulatory' or 'tolerogenic'.
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Affiliation(s)
- Royce L X Ng
- Telethon Institute for Child Health Research, Centre for Child Health Research, University of Western Australia, Perth, WA, Australia
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242
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Foong RE, Shaw NC, Berry LJ, Hart PH, Gorman S, Zosky GR. Vitamin D deficiency causes airway hyperresponsiveness, increases airway smooth muscle mass, and reduces TGF-β expression in the lungs of female BALB/c mice. Physiol Rep 2014; 2:e00276. [PMID: 24760528 PMCID: PMC4002254 DOI: 10.1002/phy2.276] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Vitamin D deficiency is associated with disease severity in asthma. We tested whether there is a causal association between vitamin D deficiency, airway smooth muscle (ASM) mass, and the development of airway hyperresponsiveness (AHR). A physiologically relevant mouse model of vitamin D deficiency was developed by raising BALB/c mice on vitamin D‐deficient or ‐replete diets. AHR was assessed by measuring lung function responses to increasing doses of inhaled methacholine. Five‐micron sections from formalin‐fixed lungs were used for ASM measurement and assessment of lung structure using stereological methods. Transforming growth factor (TGF)‐β levels were measured in bronchoalveolar lavage fluid (BALF). Lungs were dissected from embryonic day (E) 17.5 vitamin D‐deficient and ‐replete fetal mice for quantification of ASM density and relative gene expression of TGF‐β signaling pathway molecules. Eight‐week‐old adult vitamin D‐deficient female mice had significantly increased airway resistance and ASM in the large airways compared with controls. Vitamin D‐deficient female mice had a smaller lung volume, volume of parenchyma, and alveolar septa. Both vitamin D‐deficient male and female mice had reduced TGF‐β levels in BALF. Vitamin D deficiency did not have an effect on ASM density in E17.5 mice, however, expression of TGF‐β1 and TGF‐β receptor I was downregulated in vitamin D‐deficient female fetal mice. Decreased expression of TGF‐β1 and TGF‐β receptor I during early lung development in vitamin D‐deficient mice may contribute to airway remodeling and AHR in vitamin D‐deficient adult female mice. This study provides a link between vitamin D deficiency and respiratory symptoms in chronic lung disease. Vitamin D deficiency caused airway hyperresponsiveness and increased airway smooth muscle mass in the airways of adult female mice. Vitamin D deficiency also reduced transforming growth factor (TGF)‐β1 protein levels in both male and female mice, as well as reduced gene expression of TGF‐β1 and TGF‐β receptor I in female E17.5 fetal pups. These observations may provide a link between vitamin D deficiency and respiratory symptoms in chronic lung disease.
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Affiliation(s)
- Rachel E Foong
- Telethon Institute for Child Health Research, The University of Western Australia, Subiaco, Western Australia, Australia
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Loss of epidermal p38α signaling prevents UVR-induced inflammation via acute and chronic mechanisms. J Invest Dermatol 2014; 134:2231-2240. [PMID: 24662766 PMCID: PMC4102657 DOI: 10.1038/jid.2014.153] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2013] [Revised: 03/06/2014] [Accepted: 03/13/2014] [Indexed: 11/21/2022]
Abstract
Ultraviolet B radiation (UVB) is a component of solar radiation primarily responsible for causing damage and cancer in irradiated skin, and disrupting immune homeostasis. The immediate harm and long-term health risks of excessive sunlight exposure are impacting the lives of nearly all people worldwide. Inflammation is a key mechanism underlying UVB’s various detrimental effects. Here we show that activation of the protein kinase p38α is restricted to the epidermis in UVB-exposed skin, and p38α ablation targeted to the epithelial compartment is sufficient to suppress UVB-induced inflammation. Mechanistically, loss of epithelial p38α signaling attenuates the expression of genes required to induce vascular leakage and edema, and also increases the steady-state abundance of epidermal γδ T cells, which are known to promote the repair of damaged epidermis. These effects of p38α deficiency delineate a molecular network operating at the organism-environment interface, and reveal conditions crucial to preventing the pathology resulting from sun-damaged skin.
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244
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Tamari M, Hirota T. Genome-wide association studies of atopic dermatitis. J Dermatol 2014; 41:213-20. [DOI: 10.1111/1346-8138.12321] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2013] [Accepted: 09/19/2013] [Indexed: 12/23/2022]
Affiliation(s)
- Mayumi Tamari
- Laboratory for Respiratory and Allergic Diseases; Center for Integrative Medical Sciences; The Institute of Physical and Chemical Research (RIKEN); Kanagawa Japan
| | - Tomomitsu Hirota
- Laboratory for Respiratory and Allergic Diseases; Center for Integrative Medical Sciences; The Institute of Physical and Chemical Research (RIKEN); Kanagawa Japan
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Abstract
Autoimmune disease manifests in numerous forms, but as a disease group is relatively common in the population. It is complex in aetiology, with genetic and environmental determinants. The involvement of gene variants in autoimmune disease is well established, and evidence for significant involvement of the environment in various disease forms is growing. These factors may act independently, or they may interact, with the effect of one factor influenced by the presence of another. Identifying combinations of genetic and environmental factors that interact in autoimmune disease has the capacity to more fully explain disease risk profile, and to uncover underlying molecular mechanisms contributing to disease pathogenesis. In turn, such knowledge is likely to contribute significantly to the development of personalised medicine, and targeted preventative approaches. In this review, we consider the current evidence for gene-environment (G-E) interaction in autoimmune disease. Large-scale G-E interaction research efforts, while well-justified, face significant practical and methodological challenges. However, it is clear from the evidence that has already been generated that knowledge on how genes and environment interact at a biological level will be crucial in fully understanding the processes that manifest as autoimmunity.
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Knippenberg S, Damoiseaux J, Bol Y, Hupperts R, Taylor BV, Ponsonby AL, Dwyer T, Simpson S, van der Mei IAF. Higher levels of reported sun exposure, and not vitamin D status, are associated with less depressive symptoms and fatigue in multiple sclerosis. Acta Neurol Scand 2014; 129:123-31. [PMID: 23763464 DOI: 10.1111/ane.12155] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/30/2013] [Indexed: 12/28/2022]
Abstract
OBJECTIVE Insufficient sun exposure and vitamin D deficiency have both been associated with increased risk of multiple sclerosis (MS). Depressi on, anxiety, fatigue and cognitive impairment are prevalent and disabling symptoms in MS. Our objective was to examine the associations between personal sun exposure and serum 25-hydroxyvitamin D (25(OH)D), and depression, anxiety, fatigue and cognition. METHODS A total of 198 participants with multiple sclerosis were followed prospectively for an average of 2.3 years. Assessments of serum 25(OH)D, sun exposure, depression, anxiety and fatigue were carried out biannually; cognition was assessed annually. RESULTS Personal reported sun exposure was inversely associated with depression scores (β -0.26 (95%CI -0.40, -0.12);P ≤ 0.001) and fatigue scores (β -0.65 (95%CI -1.23, -0.07); P = 0.028). Only high levels of 25(OH)D (>80 nm) were inversely associated depression scores (β -0.64 (95%CI -1.15, -0.13); P = 0.015), but this was not significant after adjustment for reported sun exposure. No associations were seen between reported sun exposure or serum 25(OH)D levels and anxiety or cognition scores. CONCLUSION We found that higher levels reported sun exposure, rather than 25(OH)D levels, were associated with less depressive symptoms and levels of fatigue. The role of UV or light therapy will need to be evaluated in randomized controlled trials to confirm an effect on these symptoms in MS.
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Affiliation(s)
- S. Knippenberg
- School for Mental Health and Neuroscience; Maastricht University Medical Center; Maastricht The Netherlands
- Academic MS Center Limburg; Orbis Medical Center; Sittard The Netherlands
- Department of Internal Medicine; Division of Clinical and Experimental Immunology; Maastricht University Medical Center; Maastricht The Netherlands
| | - J. Damoiseaux
- Central Diagnostic Laboratory; Maastricht University Medical Center; Maastricht The Netherlands
| | - Y. Bol
- Academic MS Center Limburg; Orbis Medical Center; Sittard The Netherlands
- Department of Medical Psychology and Psychiatry; Orbis Medical Center; Sittard The Netherlands
| | - R. Hupperts
- School for Mental Health and Neuroscience; Maastricht University Medical Center; Maastricht The Netherlands
- Academic MS Center Limburg; Orbis Medical Center; Sittard The Netherlands
| | - B. V. Taylor
- Menzies Research Institute Tasmania; University of Tasmania; Hobart Tasmania Australia
| | - A.-L. Ponsonby
- Murdoch Childrens Research Institute; The University of Melbourne; Melbourne Victoria Australia
| | - T. Dwyer
- Murdoch Childrens Research Institute; The University of Melbourne; Melbourne Victoria Australia
| | - S. Simpson
- Menzies Research Institute Tasmania; University of Tasmania; Hobart Tasmania Australia
| | - I. A. F. van der Mei
- Menzies Research Institute Tasmania; University of Tasmania; Hobart Tasmania Australia
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Espinosa-Ramírez G, Ordoñez G, Flores-Rivera J, Sotelo J. Sunlight exposure and multiple sclerosis in a tropical country. Neurol Res 2014; 36:647-50. [PMID: 24620971 DOI: 10.1179/1743132813y.0000000307] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
OBJECTIVE We analysed past and current sun exposure in multiple sclerosis (MS) patients as compared with matched controls in Mexico, a country with tropical climate. METHODS In a case-controlled study that include 83 MS patients and 166 matched controls, we inquired about sunlight exposure in two different periods: during adolescence and during the immediate past 5 years. Indicators were: exposure on quotidian and weekend outdoor activities with direct sunlight contact as expressed on frequency by mean number of days, daytime (morning, noon, afternoon), number of hours, visits to sunny places, and use of sunblocking agents. Additional elements were socioeconomic status, skin colour, and antecedent of varicella infection during childhood. RESULTS MS patients showed a larger proportion of white skin. MS patients had more sunlight exposure during adolescence (80% versus 60%, P = 0·002); this tendency prevailed on current indicators (46% versus 30%, P = 0·02). However, current exposure on weekends (10% versus 22%, P = 0·02) and visits to the beach (64% versus 98%, P = 0·002) were lower in MS than in controls. DISCUSSION Mexico gets more sunlight through the year than areas with high incidence of MS; nevertheless, its prevalence has greatly increased over the last decades, making it a relevant emerging disease. Our results indicate that in a tropical country, there is no association between sunlight exposure and the risk to develop MS, given the immunological effects of sunlight exposure either through UV radiation or vitamin D metabolism.
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Mukhopadhyay D, Dalton JE, Kaye PM, Chatterjee M. Post kala-azar dermal leishmaniasis: an unresolved mystery. Trends Parasitol 2014; 30:65-74. [PMID: 24388776 PMCID: PMC3919212 DOI: 10.1016/j.pt.2013.12.004] [Citation(s) in RCA: 86] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2013] [Revised: 11/29/2013] [Accepted: 12/05/2013] [Indexed: 12/31/2022]
Abstract
Sodium antimony gluconate contributes towards the pathogenesis of PKDL. UV light plays a pivotal role in the development of PKDL. Development of PKDL can be viewed as a reinfection or activation of latent Leishmania parasites. PKDL can be resolved by mounting an effective tissue-specific memory T cell response. Host genetic factors play a contributory role.
Post kala-azar dermal leishmaniasis (PKDL), a cutaneous sequela of visceral leishmaniasis (VL), develops in some patients alongside but more commonly after apparent cure from VL. In view of the pivotal role of PKDL patients in the transmission of VL, here we review clinical, epidemiological, parasitological, and immunological perspectives of this disease, focusing on five hypotheses to explain the development of PKDL: (i) the role of antimonial drugs; (ii) UV-induced skin damage; (iii) reinfection; (iv) organ specific failure of memory T cell responses; and (v) genetic susceptibility of the host. This review will enable researchers and clinicians to explore the unresolved mystery of PKDL and provide a framework for future application of ‘omic’ approaches for the control and eventual elimination of VL.
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Affiliation(s)
- Debanjan Mukhopadhyay
- Department of Pharmacology, Institute of Postgraduate Medical Education and Research, 244 B, Acharya JC Bose Road, Kolkata 700 020, India
| | - Jane E Dalton
- Centre for Immunology and Infection, Hull York Medical School and Department of Biology, University of York, Wentworth Way, York, YO10 5DD, UK
| | - Paul M Kaye
- Centre for Immunology and Infection, Hull York Medical School and Department of Biology, University of York, Wentworth Way, York, YO10 5DD, UK.
| | - Mitali Chatterjee
- Department of Pharmacology, Institute of Postgraduate Medical Education and Research, 244 B, Acharya JC Bose Road, Kolkata 700 020, India.
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Salzer J, Biström M, Sundström P. Vitamin D and multiple sclerosis: where do we go from here? Expert Rev Neurother 2013; 14:9-18. [PMID: 24320602 DOI: 10.1586/14737175.2014.864952] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
This article briefly introduces the basics of multiple sclerosis' (MS) clinical hallmarks and pathophysiology. Vitamin D is presented, including its metabolism and effects on the immune system. The epidemiological observations linking vitamin D to MS range from a half century old findings of latitude gradients and migrational risk patterns to modern, nested, case-control biobank studies. These observations show an association without doubt although causation has yet to be proven. Vitamin D as a treatment for MS is an emerging concept and both current and anticipated data will be covered. Lastly, we discuss future challenges, ideas on how to move from association to causation, and the prospect of primary prevention of this disabling disease.
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Affiliation(s)
- Jonatan Salzer
- Department of Pharmacology and Clinical Neuroscience, Section of Neurology, Umeå University, SE-90187, Umeå, Sweden
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Kane L, Moore K, Lütjohann D, Bikle D, Schwartz JB. Vitamin D3 effects on lipids differ in statin and non-statin-treated humans: superiority of free 25-OH D levels in detecting relationships. J Clin Endocrinol Metab 2013; 98:4400-9. [PMID: 24030939 PMCID: PMC3816263 DOI: 10.1210/jc.2013-1922] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
CONTEXT Inverse associations between 25-OH vitamin D levels and cardiovascular morbidity and mortality have been reported. OBJECTIVES Our goals were to 1) investigate effects of correcting inadequate D status on lipids, 2) determine whether free 25-OH D is better correlated with lipids than total 25-OH D. DESIGN A randomized, double-blind placebo-controlled trial was performed. SETTING Participants resided in the general community. PARTICIPANTS Adults with inadequate D status were randomized to D3: 14 men, 12 women, age 60 ± 8 years (mean ± SD) or placebo: 12 men, 11 women: 59 ±12 years. INTERVENTION Responses to 12-week oral vitamin D3 titrated (1000-3000 IU/d) to achieve 25-OH D levels ≥25 ng/mL were compared to placebo. MAIN OUTCOME MEASURES Measurements were 25-OH D (tandem mass spectometry), free 25-OH D (direct immunoassay), lipids (directly measured triglyceride, cholesterol, and subfractions; plant sterols and cholesterol synthesis precursors), and safety labs before and after 6 and 12 weeks D3 or placebo. Data were analyzed by repeated measures ANOVA and linear regression. RESULTS Vitamin D3 was titrated to 1000 IU/d in 15/26 (58%), to 2000 IU/d in 10, and 3000 IU/d in one patient. D3 had no effect on cholesterol or cholesterol subfractions except for trends for decreases in atorvastatin-treated patients (cholesterol, P = .08; low-density lipoprotein [LDL] cholesterol, P = .05). Decreased campesterol concentrations (P = .05) were seen with D3 but not placebo in statin-treated patients. Relationships between total 25-OH D and lipids were not detected, but inverse linear relationships were detected between free 25-OH D and triglycerides (P = .03 for all participants [n = 49], P = .03 in all statin-treated [n = 19], and P = .0009 in atorvastatin-treated [n = 11]), and between free 25-OH D and LDL cholesterol (P = .08 overall, P = .02 in all statin-treated, and P = .03 for atorvastatin-treated), and total cholesterol (P = .09 overall; P = .04 for all statin-treated, and P = .05 for atorvastatin-treated). CONCLUSIONS Vitamin D lipid-lowering effects appear limited to statin-treated patients and are likely due to decreased cholesterol absorption. Relationships between lipids and D metabolites were only detected when free 25-OH D was measured, suggesting the superiority of determining free 25-OH D levels compared to total 25-OH vitamin D levels when analyzing biologic responses.
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Affiliation(s)
- Lynn Kane
- MD, 302 Silver Avenue, San Francisco, CA 94112.
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