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Cameron BA, Anderson CW, Jensen ET, Dellon ES. Vitamin D Levels as a Potential Modifier of Eosinophilic Esophagitis Severity in Adults. Dig Dis Sci 2024; 69:1287-1292. [PMID: 38183560 DOI: 10.1007/s10620-023-08264-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Accepted: 11/27/2023] [Indexed: 01/08/2024]
Abstract
BACKGROUND Vitamin D deficiency is associated with atopic and immune-mediated diseases but has not been extensively assessed in eosinophilic esophagitis (EoE). We aimed to assess if vitamin D levels in newly diagnosed EoE patients were lower than in non-EoE controls and examine levels in relation to EoE clinical features. METHODS This secondary analysis of a prospective cohort study used data and biosamples from adults who underwent outpatient esophagogastroduodenoscopy. Before each procedure, blood was obtained and stored at -80oC. Serum 25-hydroxy-vitamin D3 (25(OH)D3) was measured by ELISA. Levels for cases and controls were compared at baseline. Within cases, 25(OH)D3 levels were compared for clinical, endoscopic, and histologic measures. RESULTS We analyzed 40 EoE and 40 non-EoE controls. Mean serum 25(OH)D3 level was slightly lower in EoE patients than controls (30.9 ± 15.3 ng/mL vs. 35.9 ± 15.4; p = 0.15). After controlling for age, sex, and race, adjusted levels were 10.8 ng/mL lower in EoE patients (95% CI: -19.0, -2.5), but 25(OH)D3 deficiency (< 20ng/mL) was similar in cases and controls (20% vs. 15%; p = 0.56). Levels of 25(OH)D3 were not associated with differences in clinical or endoscopic features of EoE, and EREFS and eosinophil counts did not significantly correlate with 25(OH)D3 levels (R of -0.28 [p = 0.08] and - 0.01 [p = 0.93], respectively). 25(OH)D3 levels were lower in EoE cases with lamina propria fibrosis (23.2 ± 9.6 vs. 45.0 ± 17.7; p = 0.03). CONCLUSIONS After adjusting for age, sex, and race, 25(OH)D3 levels were lower in EoE cases than controls, but deficiency was not common. 25(OH)D3 levels were generally similar across most EoE disease features.
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Affiliation(s)
- Brenderia A Cameron
- Center for Esophageal Diseases and Swallowing, University of North Carolina School of Medicine, CB#7080 Bioinformatics Building 130 Mason Farm Rd. UNC-CH, Chapel Hill, NC, 27599-7080, USA
| | - Carlton W Anderson
- Center for Gastrointestinal Biology and Disease, Division of Gastroenterology and Hepatology, Department of Medicine, University of North Carolina School of Medicine, Chapel Hill, NC, USA
| | - Elizabeth T Jensen
- Center for Esophageal Diseases and Swallowing, University of North Carolina School of Medicine, CB#7080 Bioinformatics Building 130 Mason Farm Rd. UNC-CH, Chapel Hill, NC, 27599-7080, USA
- Department of Epidemiology and Prevention, Wake Forest University School of Medicine, Winston-Salem, NC, USA
- Department of Internal Medicine, Gastroenterology Section, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Evan S Dellon
- Center for Esophageal Diseases and Swallowing, University of North Carolina School of Medicine, CB#7080 Bioinformatics Building 130 Mason Farm Rd. UNC-CH, Chapel Hill, NC, 27599-7080, USA.
- Center for Gastrointestinal Biology and Disease, Division of Gastroenterology and Hepatology, Department of Medicine, University of North Carolina School of Medicine, Chapel Hill, NC, USA.
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Qureshi G, Khemissa M, Amr G, Bhat R. The Non-conventional Effects of Hypovitaminosis D: A Pandemic Even in Sunlight-Rich Countries. Cureus 2024; 16:e59267. [PMID: 38813297 PMCID: PMC11135140 DOI: 10.7759/cureus.59267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/29/2024] [Indexed: 05/31/2024] Open
Abstract
The synthesis and absorption of Vitamin D play crucial roles in numerous bodily functions, yet deficiencies persist due to factors like insufficient sunlight exposure and dietary inadequacy. Research underscores the significance of lifestyle elements such as diet, sun exposure, and physical activity in maintaining optimal Vitamin D levels. Strategies aimed at tackling deficiencies emphasize supplementation alongside lifestyle adjustments, especially in regions with abundant sunlight like the Middle East and North Africa (MENA). Despite the abundance of sunshine in the Arab world, there remains a prevalent issue of Vitamin D deficiency. This problem arises from various factors, including cultural practices such as traditional clothing covering most skin areas, which limit sun exposure, and environmental factors like air pollution that reduce UV penetration. Dietary habits and lifestyle choices also contribute to this deficiency. Dealing with the ongoing pandemic requires a focused effort to enhance awareness. While some individuals may recognize common diseases caused by Vitamin D deficiency, such as rickets and osteomalacia, many remain unaware of the broader health risks associated with the condition, including non-skeletal manifestations. Additionally, there is a lack of understanding regarding the numerous hidden benefits of this hormone. Therefore, prioritizing educational initiatives that delve into these aspects is essential to effectively combat the current health crisis. This literature review aims to report both skeletal and extraskeletal consequences of hypovitaminosis and briefly discuss the cause of paradoxical vitamin D deficiency in sunny regions like the MENA. This was done by reviewing pertinent articles published between January 2000 and January 2024, sourced from databases such as PubMed, UpToDate, Scopus, and CINAHL, focusing exclusively on English language literature and using keywords such as "Vitamin D deficiency" and "Extraskeletal manifestations."
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Affiliation(s)
- Ghania Qureshi
- Internal Medicine, Ras al Khaimah Medical and Health Sciences University, Ras Al Khaimah, ARE
| | - Madjda Khemissa
- Internal Medicine, Ras al Khaimah Medical and Health Sciences University, Ras Al Khaimah, ARE
| | - Ganna Amr
- Internal Medicine, Ras al Khaimah Medical and Health Sciences University, Ras Al Khaimah, ARE
| | - Raghavendra Bhat
- Internal Medicine, Ras al Khaimah Medical and Health Sciences University, Ras Al Khaima, ARE
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3
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Wang Z, Yi SY, Zhang YY, Wang YD, Chen HL, Guo YJ, Wei XM, Yang DX. The role of vitamin D through SphK1/S1P in the regulation of MS progression. J Steroid Biochem Mol Biol 2024; 236:106425. [PMID: 37984747 DOI: 10.1016/j.jsbmb.2023.106425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 09/30/2023] [Accepted: 11/06/2023] [Indexed: 11/22/2023]
Abstract
Sphingosine-1-phosphate (S1P) is biologically active lipid, leading to neuroinflammation and macrophage invasion in central nervous system, plays an important role in the development of multiple sclerosis (MS) model in experimental allergic encephalomyelitis (EAE) rats. Vitamin D is observed to be a key factor in regulating cell S1P levels. We detected vitamin D can alleviate the symptoms of EAE rats, but the exact mechanism is unclear. In PC12 cells, vitamin D can reverse S1P-induced cell death, but the signaling pathway unclear. This study was aimed to investigate S1P regulation mechanism or signaling pathway mediated by vitamin D in EAE and PC12 model. In our experiments, S1P and Sphingosine kinase type 1 (SphK1) mRNA and protein expression in EAE rats group, control group, vitamin D feeding group were detected by HPLC, ELISA, RT-PCR and western blot. PC12 cell death was detected by Propidium (PI) staining. VDR plasmid overexpression and RNA interference, immunofluorescence, real-time cell analysis, protein immunoblotting was used to detect SphK1 transcriptional regulation, cell-substrate attachment quality, the signaling pathway of cell apoptosis and inflammation related gene expression (Bax/Bcl-2, Casepase-3, Il-6, TGF-β, TNF-α). Our study showed vitamin D can reverse the elevation of S1P level in EAE rats, reduce the severity and shorten the course of EAE. 1,25-(OH) 2D3 coupled with vitamin D receptor (VDR) inhibited SphK1 transcription. 1,25-(OH)2D3 significantly reduced PC12 cell death rate induced by S1P, in addition improved the cell substrate attachment quality. 1,25-(OH) 2D3 can block S1P-induced p-ERK activation and PI3K /Akt signaling pathway reduced Il-6, TGF-β, TNF-α cytokine release and Bax/Bcl-2, Casepase-3 apoptosis protein expression. On the other hand, immunofluorescence staining showed 1,25-(OH) 2D3 can increase the expression of neuronal perinuclear protein MAP2 in PC12 cells probably protect nerve cells further. In summary, the ameliorative effect of vitamin D was derived from its ability to reduce S1P levels, provides an idea for vitamin D as a combination therapy for disease.
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Affiliation(s)
- Zhen Wang
- Department of Human Anatomy, Shandong University School of Medicine, Jinan 250012, China
| | - Shu-Ying Yi
- School of Clinical and Basic Medicine, Shandong First Medical University, Jinan 250014, China
| | - Yuan-Ying Zhang
- School of Clinical and Basic Medicine, Shandong First Medical University, Jinan 250014, China
| | - Yu-di Wang
- School of Clinical and Basic Medicine, Shandong First Medical University, Jinan 250014, China
| | - Han-Lin Chen
- School of Clinical and Basic Medicine, Shandong First Medical University, Jinan 250014, China
| | - Yi-Jie Guo
- School of Clinical and Basic Medicine, Shandong First Medical University, Jinan 250014, China
| | - Xin-Ming Wei
- School of Clinical and Basic Medicine, Shandong First Medical University, Jinan 250014, China
| | - Du-Xiao Yang
- School of Clinical and Basic Medicine, Shandong First Medical University, Jinan 250014, China; Science and Technology Innovation Center, Shandong First Medical University, Jinan 250014, China.
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Sharifa M, Ghosh T, Daher OA, Bhusal P, Alaameri YA, Naz J, Ekhator C, Bellegarde SB, Bisharat P, Vaghani V, Hussain A. Unraveling the Gut-Brain Axis in Multiple Sclerosis: Exploring Dysbiosis, Oxidative Stress, and Therapeutic Insights. Cureus 2023; 15:e47058. [PMID: 38022314 PMCID: PMC10644699 DOI: 10.7759/cureus.47058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/15/2023] [Indexed: 12/01/2023] Open
Abstract
This comprehensive review delves into the intricate relationship between the gut microbiota and multiple sclerosis (MS), shedding light on the potential therapeutic avenues for this complex autoimmune disease. It emphasizes the multifactorial nature of MS, including genetic, environmental, and gender-related factors. Furthermore, the article highlights the emerging role of gut microbiota in MS pathophysiology, particularly in terms of gut dysbiosis, oxidative stress, and inflammasome activation within the gut-brain axis. This interplay raises intriguing questions about how the gut microbiota influences the onset and progression of MS. Environmental factors, such as diet and pollutants, add further layers of complexity to the connection between gut health and MS risk. This review also discusses promising therapeutic interventions, such as fecal microbiota transplantation, probiotics, dietary adjustments, and gut-derived metabolites that offer potential avenues for managing MS. It underscores the need for ongoing research to fully unravel the complexities of the role of the gut-brain axis in MS. Ultimately, this article provides a comprehensive exploration of the topic, offering hope for novel preventive and therapeutic strategies that could significantly improve the lives of individuals affected by this challenging autoimmune condition.
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Affiliation(s)
| | - Tanmay Ghosh
- Medical Education, Dinabandhu Andrews College, West Bengal, IND
| | - Omar A Daher
- Obstetrics and Gynaecology, Beirut Arab University, Tripoli, LBN
| | - Pramod Bhusal
- Internal Medicine, College Of Medical Sciences, Bharatpur, NPL
| | | | - Javeria Naz
- Internal Medicine, Jinnah Sindh Medical University, Karachi, PAK
| | - Chukwuyem Ekhator
- Neuro-Oncology, New York Institute of Technology, College of Osteopathic Medicine, Old Westbury, USA
| | - Sophia B Bellegarde
- Pathology and Laboratory Medicine, American University of Antigua, St. John's, ATG
| | | | - Viralkumar Vaghani
- Biomedical Informatics, The University of Texas Health Science Center, Houston, USA
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Lahoda Brodska H, Klempir J, Zavora J, Kohout P. The Role of Micronutrients in Neurological Disorders. Nutrients 2023; 15:4129. [PMID: 37836413 PMCID: PMC10574090 DOI: 10.3390/nu15194129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 09/09/2023] [Accepted: 09/11/2023] [Indexed: 10/15/2023] Open
Abstract
Trace elements and vitamins, collectively known as micronutrients, are essential for basic metabolic reactions in the human body. Their deficiency or, on the contrary, an increased amount can lead to serious disorders. Research in recent years has shown that long-term abnormal levels of micronutrients may be involved in the etiopathogenesis of some neurological diseases. Acute and chronic alterations in micronutrient levels may cause other serious complications in neurological diseases. Our aim was to summarize the knowledge about micronutrients in relation to selected neurological diseases and comment on their importance and the possibilities of therapeutic intervention in clinical practice.
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Affiliation(s)
- Helena Lahoda Brodska
- Institute of Medical Biochemistry and Laboratory Diagnostics, First Faculty of Medicine, Charles University and General University Hospital in Prague, U Nemocnice 499/2, 128 08 Prague, Czech Republic; (H.L.B.); (J.Z.)
| | - Jiri Klempir
- Department of Neurology and Centre of Clinical Neuroscience, First Faculty of Medicine, Charles University and General University Hospital in Prague, Katerinska 30, 120 00 Prague, Czech Republic
| | - Jan Zavora
- Institute of Medical Biochemistry and Laboratory Diagnostics, First Faculty of Medicine, Charles University and General University Hospital in Prague, U Nemocnice 499/2, 128 08 Prague, Czech Republic; (H.L.B.); (J.Z.)
- Department of Microbiology, Faculty of Medicine and Dentistry, Palacky University, Hnevotinska 3, 775 15 Olomouc, Czech Republic
| | - Pavel Kohout
- Clinic of Internal Medicine, 3rd Faculty Medicine, Charles University and Thomayer University Hospital, Videnska 800, 140 59 Prague, Czech Republic;
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de la Rubia Ortí JE, García MF, Drehmer E, Navarro-Illana E, Casani-Cubel J, Proaño B, Sanchis-Sanchis CE, Escrivá JD. Intake of Vitamin D in Patients with Multiple Sclerosis in the Valencian Region and Its Possible Relationship with the Pathogenesis of the Disease. Life (Basel) 2021; 11:1380. [PMID: 34947912 PMCID: PMC8708283 DOI: 10.3390/life11121380] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 12/08/2021] [Accepted: 12/08/2021] [Indexed: 11/16/2022] Open
Abstract
(1) Background: Multiple sclerosis (MS) is a neurodegenerative disease characterized by pronounced inflammation. Interleukin 6 (IL-6) is an accurate marker for the state of inflammation, due to the high levels of this cytokine linked to the pathogenesis of the disease. These IL-6 levels could be lowered with an adequate dietary intake of vitamin D. The objective of the study was to determine the level of vitamin D ingested in a sample of patients with MS in the Valencian region (Spain), to establish the vitamin sources, and the possible link between the intake of vitamin D and the pathogenesis of the disease through a relationship with the level of IL-6. (2) Materials and Methods: A descriptive pilot study was carried out with 39 patients with MS in the Valencian region. The dietary-nutritional anamnesis was gained through the food frequency questionnaire (FFQ) and a food diary. Diet and eating habits were analyzed through the Easy Diet (version: 2.0.1)-Consultation Management Program® software, and IL-6 levels in blood by ELISA technique. (3) Results: The results show a low intake of vitamin D, which is significantly and negatively related to the intake of proteins of vegetable origin, which are consumed in less quantity than proteins of animal origin, and significantly and negatively related with the high blood levels of IL-6, possibly as a consequence of the high intake of fats, mainly unsaturated. (4) Conclusions: MS patients in the Valencian region ingest little vitamin D related to low intake of vegetable protein, which would explain the high levels of IL-6 linked to the high intake of mainly saturated fats.
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Affiliation(s)
| | - María Faus García
- Department Nursing, Catholic University San Vicente Mártir, 46001 València, Spain; (M.F.G.); (E.N.-I.); (J.D.E.)
| | - Eraci Drehmer
- Department of Basic Sciences, Catholic University of Valencia San Vicente Mártir, 46900 Torrente, Spain;
| | - Esther Navarro-Illana
- Department Nursing, Catholic University San Vicente Mártir, 46001 València, Spain; (M.F.G.); (E.N.-I.); (J.D.E.)
| | - Julia Casani-Cubel
- Doctoral Degree School, Health Sciences, Catholic University of Valencia San Vicente Mártir, 46001 València, Spain; (J.C.-C.); (B.P.)
| | - Belén Proaño
- Doctoral Degree School, Health Sciences, Catholic University of Valencia San Vicente Mártir, 46001 València, Spain; (J.C.-C.); (B.P.)
| | | | - Juan Doménech Escrivá
- Department Nursing, Catholic University San Vicente Mártir, 46001 València, Spain; (M.F.G.); (E.N.-I.); (J.D.E.)
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7
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Mostafaee A, Rafiei S, Fazeli Z, Sayad A, Rahimi M, Rajabi S, Khamseh F, Shamshirgaran F, Rajabibazl M. The association analysis between rs1544410 and rs10735810 polymorphisms located at VDR gene and susceptibility to Multiple Sclerosis in Iranian population. GENE REPORTS 2019. [DOI: 10.1016/j.genrep.2019.100538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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8
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Feliciano LM, Sávio ALV, de Castro Marcondes JP, da Silva GN, Salvadori DMF. Genetic Alterations in Patients with Two Clinical Phenotypes of Multiple Sclerosis. J Mol Neurosci 2019; 70:120-130. [PMID: 31686392 DOI: 10.1007/s12031-019-01408-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2019] [Accepted: 09/26/2019] [Indexed: 11/26/2022]
Abstract
The etiology of multiple sclerosis (MS) is still not known, but the interaction of genetic, immunological, and environmental factors seem to be involved. This study aimed to investigate genetic alterations and the vitamin D status in patients with relapsing-remitting MS (RRMS) and secondary progressive MS (SPMS). A total of 53 patients (29 RRMS; 24 SPMS) and 25 healthy subjects were recruited to evaluate the micronucleated cell (MNC) frequency and nuclear abnormalities in the buccal mucosa, gene expression profiling in mononuclear cells, and plasmatic vitamin D concentration in the blood. Results showed a higher frequency of cells with karyorrhexis (SPMS) and lower frequencies of nuclear pyknosis (RRMS and SPMS) and karyolysis (SPMS) in patients with MS. Significant increase in the frequency of MNC was detected in the buccal mucosa of RRMS and SPMS patients. HIF1A, IL13, IL18, MYC, and TNF were differentially expressed in MS patients, and APP was overexpressed in cells of RRMS compared to SPMS patients. No relationship was observed between vitamin D level and the differentially expressed genes. In conclusion, the cytogenetic alterations in the buccal mucosa can be important indicators of genetic instability and degenerative processes in patients with MS. Furthermore, our data introduced novel biomarkers associated with the molecular pathogenesis of MS.
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9
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Doosti-Irani A, Tamtaji OR, Mansournia MA, Ghayour-Mobarhan M, Ferns G, Daneshvar Kakhaki R, Rezaei Shahmirzadi A, Asemi Z. The effects of vitamin D supplementation on expanded disability status scale in people with multiple sclerosis: A critical, systematic review and metaanalysis of randomized controlled trials. Clin Neurol Neurosurg 2019; 187:105564. [PMID: 31669929 DOI: 10.1016/j.clineuro.2019.105564] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Revised: 07/22/2019] [Accepted: 10/13/2019] [Indexed: 02/07/2023]
Abstract
In this meta-analysis of randomized controlled trials (RCTs), the effects of vitamin D supplementation on the scores for the expanded disability status scale (EDSS) in people with multiple sclerosis (MS) are assessed. The following databases were search up to January 2018: MEDLINE, EMBASE, Web of Science, and Cochrane Central Register of Controlled Trials. The quality of the relevant extracted data was assessed according to the Cochrane risk of bias tool. Data were pooled by the use of the inverse variance method and expressed as mean difference with 95% Confidence Intervals (95% CI). Six studies were included in this meta-analysis. The findings demonstrated that supplementation with vitamin D alone and vitamin D plus calcium did not affect the EDSS score (WMD -0.11 (-0.33, 0.11); P = 0.32). In addition, subgroup analysis showed that vitamin D supplementation alone, when compared to the use of a placebo, and vitamin D plus calcium supplementation compared with the control did not affect EDSS (WMD -0.13 (-0.30, 0.11); P = 0.29) and (WMD -0.08 (-0.57, 0.41); P = 0.29), respectively. Overall, this meta-analysis indicated that taking vitamin D in people with MS had no significant effect on EDSS.
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Affiliation(s)
- Amin Doosti-Irani
- Department of Epidemiology, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran; Modeling of Noncommunicable Diseases Research Center, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Omid Reza Tamtaji
- Research Center for Biochemistry and Nutrition in Metabolic Diseases, Kashan University of Medical Sciences, Kashan, Iran
| | - Mohammad Ali Mansournia
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Majid Ghayour-Mobarhan
- Metabolic Syndrome Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Gordon Ferns
- Brighton & Sussex Medical School, Division of Medical Education, Falmer, Brighton, Sussex BN1 9 PH, UK
| | - Reza Daneshvar Kakhaki
- Department of Neurology, School of Medicine, Kashan University of Medical Sciences, Kashan, Iran
| | | | - Zatollah Asemi
- Research Center for Biochemistry and Nutrition in Metabolic Diseases, Kashan University of Medical Sciences, Kashan, Iran.
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10
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Kotb MA, Kamal AM, Aldossary NM, Bedewi MA. Effect of vitamin D replacement on depression in multiple sclerosis patients. Mult Scler Relat Disord 2019; 29:111-117. [PMID: 30708308 DOI: 10.1016/j.msard.2019.01.029] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Revised: 01/18/2019] [Accepted: 01/22/2019] [Indexed: 11/29/2022]
Abstract
BACKGROUND Multiple sclerosis (MS) is a chronic demyelinating disease of the central nervous system. Depression is common among MS patients. In patients without MS, lower vitamin D levels were associated with higher depression scores and severity. Supplementation of vitamin D was associated with significant improvement of depressive symptoms. OBJECTIVE to evaluate the relation between vitamin D levels and depression scores, and the effect of vitamin D replacement on the depressive symptoms in patients with MS. METHODS The study included 35 patients with relapsing remitting multiple sclerosis. Neurological, psychiatric, and radiological evaluations were done. Participants received 10,000 IU of cholecalciferol daily for 12 months. RESULTS Vitamin D level was low at baseline. Depressive symptoms were high at baseline and improved with vitamin D replacement although, Expanded Disability Status Scale (EDSS) score was not improving. Vitamin D levels correlated negatively with depressive symptoms at baseline and follow up periods. CONCLUSION Lower vitamin D levels are associated with higher depressive scores, and vitamin D replacement could improve depressive symptoms in patients with relapsing remitting multiple sclerosis.
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Affiliation(s)
- Mamdouh Ali Kotb
- Neurology Department, College of Medicine, Prince Sattam bin Abdulaziz University, P.O.Box 173, Alkharj 11942, Saudi Arabia; Neurology Department, Faculty of Medicine, Minia University, Minia, Egypt.
| | - Ahmed M Kamal
- Psychiatry Department, College of Medicine, Prince Sattam bin Abdulaziz University, Alkharj, Saudi Arabia; Psychiatry Department, Faculty of Medicine, Minia University, Minia, Egypt
| | - Nasser M Aldossary
- Radiology Department, College of Medicine, Prince Sattam bin Abdulaziz University, Alkharj, Saudi Arabia
| | - Mohamed Abdelmohsen Bedewi
- Radiology Department, College of Medicine, Prince Sattam bin Abdulaziz University, Alkharj, Saudi Arabia
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11
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Labuschagne IL, Blaauw R. An anti-inflammatory approach to the dietary management of multiple sclerosis: a condensed review. SOUTH AFRICAN JOURNAL OF CLINICAL NUTRITION 2018. [DOI: 10.1080/16070658.2018.1465652] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Affiliation(s)
- IL Labuschagne
- Division of Human Nutrition, Stellenbosch University, Cape Town, South Africa
| | - R Blaauw
- Faculty of Medicine and Health Sciences, Stellenbosch University , Cape Town, South Africa
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12
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Skalli A, Ait Ben Haddou E, El Jaoudi R, Razine R, Mpandzou G, Tibar H, El Fahime E, Bouslam N, Alami A, Benomar A, Hajjout K, Yahyaoui M, Bouhouche A. Association of vitamin D status with multiple sclerosis in a case-control study from Morocco. Rev Neurol (Paris) 2018. [DOI: 10.1016/j.neurol.2017.06.030] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
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13
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Rivas Alonso V, Flores Rivera JDJ, Rito García Y, Corona T. The genetics of multiple sclerosis in Latin America. Mult Scler J Exp Transl Clin 2017; 3:2055217317727295. [PMID: 28979796 PMCID: PMC5617105 DOI: 10.1177/2055217317727295] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2017] [Accepted: 07/25/2017] [Indexed: 12/14/2022] Open
Abstract
Background In today’s globalised world, the heterogeneity of diseases such as multiple sclerosis has been studied since it has been suggested that ethnic differences, in conjunction with geographical and environmental factors, influence its incidence and prevalence. Aim Based on this, an attempt has been made to identify the genetic factors that may confer risk or protection, not only for developing multiple sclerosis but also for determining the course of its evolution. Results In Latin America we have some data about this, which have been replicated in different populations in the entire region, with very different results compared with other regions, which could explain not only the different frequencies in some populations, such as Caucasians, but also the course of the disease and the response to actual treatments. However, in addition to these findings, other associated epigenetic mechanisms have also been found in our populations, such as levels of vitamin D, parasitic diseases, and indigenous populations. Therefore, the study of epigenetics plays a crucial role in understanding the physiopathology of multiple sclerosis. It must be studied in each population, especially in Latin America, due to its broad heterogeneity. Conclusion It is very important to understand not only the genetic and external factors with these very specific effects in multiple sclerosis patients, but also the way they interact and are able to explain the frequency and some specific phenotypes of the disease in our populations besides the posibility to be a very specific treatment target.
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Affiliation(s)
- Verónica Rivas Alonso
- Clinical Laboratory of Neurodegenerative Diseases, National Institute of Neurology and Neurosurgery "Dr Manuel Velasco Suárez", México
| | - José de Jesús Flores Rivera
- Clinical Laboratory of Neurodegenerative Diseases, National Institute of Neurology and Neurosurgery "Dr Manuel Velasco Suárez", México
| | - Yamel Rito García
- Clinical Laboratory of Neurodegenerative Diseases, National Institute of Neurology and Neurosurgery "Dr Manuel Velasco Suárez", México
| | - Teresa Corona
- Clinical Laboratory of Neurodegenerative Diseases, National Institute of Neurology and Neurosurgery "Dr Manuel Velasco Suárez", México
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14
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Overexpression of GSN could decrease inflammation and apoptosis in EAE and may enhance vitamin D therapy on EAE/MS. Sci Rep 2017; 7:604. [PMID: 28377587 PMCID: PMC5428824 DOI: 10.1038/s41598-017-00684-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2016] [Accepted: 03/15/2017] [Indexed: 01/09/2023] Open
Abstract
The decrease of gelsolin (GSN) in the blood has been reported in multiple sclerosis (MS) patients and experimental allergic encephalomyelitis (EAE) animals, but the protective effect of GSN on EAE/MS lacks of evidence. In our study, we increased the GSN level in EAE by injecting GSN-overexpress lentivirus (LV-GSN) into the lateral ventricle and caudal vein and found that GSN administration can delay the onset and decrease the severity of EAE. Vitamin D is proven to have a therapeutic effect on MS/EAE; however, we previously found that vitamin D caused a downregulation of GSN, which might limit vitamin D efficacy. In our current research, we obtained a better symptom and a slowing down progression in EAE after combining vitamin D treatment with a proper increase of GSN. Furthermore, we discovered that the mediation of vitamin D on GSN might occur through the vitamin D receptor (VDR) by using gene interruption and overexpression to regulate the level of VDR in PC12 cells (a rat sympathetic nerve cell line). We also confirmed the anti-apoptotic function of GSN by GSN RNA interference in PC12. Collectively, these results support the therapeutic effect of GSN in EAE, which might enhance Vitamin D therapy in EAE/MS.
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Pierrot-Deseilligny C, Souberbielle JC. Vitamin D and multiple sclerosis: An update. Mult Scler Relat Disord 2017; 14:35-45. [PMID: 28619429 DOI: 10.1016/j.msard.2017.03.014] [Citation(s) in RCA: 131] [Impact Index Per Article: 18.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2017] [Revised: 03/23/2017] [Accepted: 03/27/2017] [Indexed: 12/12/2022]
Abstract
The most recent findings linking exposure to sun and vitamin D insufficiency to multiple sclerosis (MS) are reviewed. Due to insufficient sunshine and changing lifestyles, hypovitaminosis D is widespread in temperate countries. Numerous epidemiological studies have strongly suggested that sunshine and vitamin D insufficiency contributes to MS risk in these countries. Moreover, several large genetic studies in MS patients have recently stated unequivocally that diverse abnormalities involving vitamin D metabolism are related to the risk of the disease. The important implications of such results are discussed here. Then, the interactions of hypovitaminosis D with the other genetic and environmental protective and risk factors, such as the allele HLA DRB1*1501, Epstein-Barr virus infection, obesity, smoking and sexual hormones, are summarized. Vitamin D insufficiency and sufficiency could be a risk and a protective factor, respectively, among many other factors possibly continuously modulating the global MS risk from the mother's pregnancy to the triggering of MS in adulthood. However, many interactions between these different factors occur more particularly between conception and the end of adolescence, which corresponds to the period of maturation of the immune system and thymus and may be related to the dysimmune nature of the disease. The main mechanisms of action of vitamin D in MS appear to be immunomodulatory, involving the various categories of T and B lymphocytes in the general immune system, but neuroprotector and neurotrophic mechanisms could also be exerted at the central nervous system level. Furthermore, several controlled immunological studies performed in MS patients have recently confirmed that vitamin D supplementation has multiple beneficial immunomodulatory effects. However, there is still an enduring absence of major conclusive randomized clinical trials testing vitamin D supplementation in MS patients because of the quasi-insurmountable practical difficulties that exist nowadays in conducting and completing over several years such studies involving the use of a vitamin. Nevertheless, it should be noted that similar robust statistical models used in five different association studies have already predicted a favorable vitamin D effect reducing relapses by 50-70%. If there is now little doubt that vitamin D exerts a beneficial action on the inflammatory component of MS, the results are as yet much less clear for the progressive degenerative component. Lastly, until more information becomes available, vitamin D supplementation of MS patients, using a moderate physiological dose essentially correcting their vitamin insufficiency, is recommended.
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Affiliation(s)
- Charles Pierrot-Deseilligny
- Département de Neurologie, Hôpital de la Salpêtrière, Assistance Publique Hôpitaux de Paris, Université Pierre et Marie Curie (Paris VI), 47 bd de l'Hôpital, 75013 Paris, France.
| | - Jean-Claude Souberbielle
- Service d'explorations fonctionnelles, Hôpital Necker-Enfants Malades, Assistance Publique Hôpitaux de Paris, Université René Descartes (Paris V),149 rue de Sèvres, 75915 Paris, France.
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He R, Hu Y, Zeng H, Zhao J, Zhao J, Chai Y, Lu F, Liu F, Jia W. Vitamin D deficiency increases the risk of peripheral neuropathy in Chinese patients with type 2 diabetes. Diabetes Metab Res Rev 2017; 33. [PMID: 27155442 DOI: 10.1002/dmrr.2820] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2015] [Revised: 03/13/2016] [Accepted: 04/13/2016] [Indexed: 12/23/2022]
Abstract
BACKGROUND Vitamin D deficiency was reported to be associated with diabetic peripheral neuropathy. But the association in Chinese population and the screening value of vitamin D deficiency for diabetic peripheral neuropathy were unknown. METHODS A total of 861 patients with type 2 diabetes were recruited in this cross-sectional study. Vitamin D deficiency was defined as serum circulating 25-hydroxyvitamin D(25(OH)D) level < 20 ng/mL. Peripheral neuropathy was evaluated by neurological symptoms, neurological signs, neurothesiometer and electromyogram. RESULTS The patients with diabetic peripheral neuropathy had significantly lower serum 25(OH)D concentration (15.59 ± 7.68 ng/mL) and higher prevalence of vitamin D deficiency (80%) than patients with signs of diabetic peripheral neuropathy (17.66 ± 7.50 ng/mL; 64.5%) and non-DPN patients (18.35 ± 6.60; 61.7%) (all p < 0.01). Spearman's correlation analysis showed that serum circulating 25(OH)D level was closely associated with DPN (r = 0.121) and signs of DPN (r = 0.111) (both p < 0.01). After adjusting for all potential confounders, VDD was still linked with increased risk of DPN [odds ratio 2.59 (1.48-4.53)] (p < 0.01). Logistical regression analysis further revealed that VDD was an independent risk factor for DPN (β = 0.88) (p < 0.01). Receiver operating characteristic analysis indicated that serum 25(OH)D < 17.22 ng/mL hinted the signs of DPN and serum 25(OH)D < 16.01 ng/mL predicted the occurrence of DPN (both p < 0.01). CONCLUSIONS Vitamin D deficiency is an independent risk factor for diabetic peripheral neuropathy and may be a potential biomarker for peripheral neuropathy in Chinese patients with type 2 diabetes. Copyright © 2016 John Wiley & Sons, Ltd.
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Affiliation(s)
- Rui He
- Department of Endocrinology and Metabolism, Shanghai Jiao-Tong University Affiliated Sixth People's Hospital, Shanghai Clinical Medical Centre of Diabetes, Diabetic Foot Collaboration Group, Shanghai Key Laboratory of Diabetes, Shanghai Key Clinical Centre of Metabolic Diseases, Shanghai Institute for Diabetes, Shanghai, 200233, People's Republic of China
| | - Yanyun Hu
- Department of Endocrinology and Metabolism, Shanghai Jiao-Tong University Affiliated Sixth People's Hospital, Shanghai Clinical Medical Centre of Diabetes, Diabetic Foot Collaboration Group, Shanghai Key Laboratory of Diabetes, Shanghai Key Clinical Centre of Metabolic Diseases, Shanghai Institute for Diabetes, Shanghai, 200233, People's Republic of China
| | - Hui Zeng
- Department of Endocrinology and Metabolism, Shanghai Jiao-Tong University Affiliated Sixth People's Hospital, Shanghai Clinical Medical Centre of Diabetes, Diabetic Foot Collaboration Group, Shanghai Key Laboratory of Diabetes, Shanghai Key Clinical Centre of Metabolic Diseases, Shanghai Institute for Diabetes, Shanghai, 200233, People's Republic of China
| | - Jun Zhao
- Department of Vascular Surgery, Shanghai Jiao-Tong University Affiliated Sixth People's Hospital, Diabetic Foot Collaboration Group, Shanghai, 200233, People's Republic of China
| | - Jungong Zhao
- Department of Interventional Radiology, Shanghai Jiao-Tong University Affiliated Sixth People's Hospital, Diabetic Foot Collaboration Group, Shanghai, 200233, People's Republic of China
| | - Yimin Chai
- Department of Osteology, Shanghai Jiao-Tong University Affiliated Sixth People's Hospital, Diabetic Foot Collaboration Group, Shanghai, 200233, People's Republic of China
| | - Fengdi Lu
- Department of Endocrinology and Metabolism, Shanghai Jiao-Tong University Affiliated Sixth People's Hospital, Shanghai Clinical Medical Centre of Diabetes, Diabetic Foot Collaboration Group, Shanghai Key Laboratory of Diabetes, Shanghai Key Clinical Centre of Metabolic Diseases, Shanghai Institute for Diabetes, Shanghai, 200233, People's Republic of China
| | - Fang Liu
- Department of Endocrinology and Metabolism, Shanghai Jiao-Tong University Affiliated Sixth People's Hospital, Shanghai Clinical Medical Centre of Diabetes, Diabetic Foot Collaboration Group, Shanghai Key Laboratory of Diabetes, Shanghai Key Clinical Centre of Metabolic Diseases, Shanghai Institute for Diabetes, Shanghai, 200233, People's Republic of China
| | - Weiping Jia
- Department of Endocrinology and Metabolism, Shanghai Jiao-Tong University Affiliated Sixth People's Hospital, Shanghai Clinical Medical Centre of Diabetes, Diabetic Foot Collaboration Group, Shanghai Key Laboratory of Diabetes, Shanghai Key Clinical Centre of Metabolic Diseases, Shanghai Institute for Diabetes, Shanghai, 200233, People's Republic of China
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Zostawa J, Adamczyk J, Sowa P, Adamczyk-Sowa M. The influence of sodium on pathophysiology of multiple sclerosis. Neurol Sci 2017; 38:389-398. [PMID: 28078565 PMCID: PMC5331099 DOI: 10.1007/s10072-016-2802-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2016] [Accepted: 12/19/2016] [Indexed: 01/06/2023]
Abstract
Multiple sclerosis (MS) is a chronic, inflammatory, autoimmune disease of the central nervous system, and is an important cause of disability in young adults. In genetically susceptible individuals, several environmental factors may play a partial role in the pathogenesis of MS. Some studies suggests that high-salt diet (>5 g/day) may contribute to the MS and other autoimmune disease development through the induction of pathogenic Th17 cells and pro-inflammatory cytokines in both humans and mice. However, the precise mechanisms of pro-inflammatory effect of sodium chloride intake are not yet explained. The purpose of this review was to discuss the present state of knowledge on the potential role of environmental and dietary factors, particularly sodium chloride on the development and course of MS.
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Affiliation(s)
- Jacek Zostawa
- Department of Neurology in Zabrze, Medical University of Silesia, ul. 3-go Maja 13-15, 41-800, Zabrze, Poland
| | - Jowita Adamczyk
- Department of Neurology in Zabrze, Medical University of Silesia, ul. 3-go Maja 13-15, 41-800, Zabrze, Poland.
| | - Paweł Sowa
- Department of Otorhinolaryngology and Oncological Laryngology, Medical University of Silesia, ul. C. Skłodowskiej 10, 41-800, Zabrze, Poland
| | - Monika Adamczyk-Sowa
- Department of Neurology in Zabrze, Medical University of Silesia, ul. 3-go Maja 13-15, 41-800, Zabrze, Poland
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Riccio P, Rossano R, Larocca M, Trotta V, Mennella I, Vitaglione P, Ettorre M, Graverini A, De Santis A, Di Monte E, Coniglio MG. Anti-inflammatory nutritional intervention in patients with relapsing-remitting and primary-progressive multiple sclerosis: A pilot study. Exp Biol Med (Maywood) 2016; 241:620-35. [PMID: 26785711 PMCID: PMC4950325 DOI: 10.1177/1535370215618462] [Citation(s) in RCA: 56] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2015] [Accepted: 10/29/2015] [Indexed: 01/06/2023] Open
Abstract
The aim of this work was to assess the influence of nutritional intervention on inflammatory status and wellness in people with multiple sclerosis. To this end, in a seven-month pilot study we investigated the effects of a calorie-restricted, semi-vegetarian diet and administration of vitamin D and other dietary supplements (fish oil, lipoic acid, omega-3 polyunsaturated fatty acids, resveratrol and multivitamin complex) in 33 patients with relapsing-remitting multiple sclerosis and 10 patients with primary-progressive multiple sclerosis. At 0/3/6 months, patients had neurological examination, filled questionnaires and underwent anthropometric measurements and biochemical analyses. Serum fatty acids and vitamin D levels were measured as markers of dietary compliance and nutritional efficacy of treatment, whereas serum gelatinase levels were analyzed as markers of inflammatory status. All patients had insufficient levels of vitamin D at baseline, but their values did not ameliorate following a weekly administration of 5000 IU, and rather decreased over time. Conversely, omega-3 polyunsaturated fatty acids increased already after three months, even under dietary restriction only. Co-treatment with interferon-beta in relapsing-remitting multiple sclerosis was irrelevant to vitamin D levels. After six months nutritional treatment, no significant changes in neurological signs were observed in any group. However, serum levels of the activated isoforms of gelatinase matrix metalloproteinase-9 decreased by 59% in primary-progressive multiple sclerosis and by 51% in relapsing-remitting multiple sclerosis patients under nutritional intervention, including dietary supplements. This study indicates that a healthy nutritional intervention is well accepted by people with multiple sclerosis and may ameliorate their physical and inflammatory status.
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Affiliation(s)
- Paolo Riccio
- Department of Sciences, University of Basilicata, 85100 Potenza, Italy
| | - Rocco Rossano
- Department of Sciences, University of Basilicata, 85100 Potenza, Italy
| | - Marilena Larocca
- Department of Sciences, University of Basilicata, 85100 Potenza, Italy
| | - Vincenzo Trotta
- Department of Sciences, University of Basilicata, 85100 Potenza, Italy
| | - Ilario Mennella
- Department of Agricultural and Food Science, University of Naples "Federico II", 80055 Portici, Napoli, Italy
| | - Paola Vitaglione
- Department of Agricultural and Food Science, University of Naples "Federico II", 80055 Portici, Napoli, Italy
| | | | - Antonio Graverini
- O.T.I. Officine Terapie Innovative S.r.l., 67061 Carsoli, Aquila, Italy
| | | | - Elisabetta Di Monte
- Center for Multiple Sclerosis, Hospital ASL 4 "Madonna Delle Grazie", 75100 Matera, Italy
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Khurrum H, AlGhamdi KM. The Relationship Between the Serum Level of Vitamin D and Vitiligo: A Controlled Study on 300 Subjects. J Cutan Med Surg 2015; 20:139-45. [PMID: 26458407 DOI: 10.1177/1203475415610071] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
BACKGROUND Low vitamin D levels have been associated with several autoimmune diseases. Vitiligo could be associated with low vitamin D levels. OBJECTIVE To determine the level of serum vitamin D in vitiligo patients compared to controls and reveal the possible association of vitamin levels with the pathogenesis of vitiligo. PATIENTS AND METHODS A case-controlled study was conducted. After excluding factors that may affect serum vitamin D levels, blood samples were taken from vitiligo patients and controls. The association between vitamin D levels and various vitiligo subgroups (duration of vitiligo, site of onset, age, etc) was measured and correlated. RESULTS A total of 150 vitiligo patients, 90 (60%) males with a mean age of 30.6 ± 11.4 years, were recruited. The study also had 150 age- and gender-matched vitiligo-free control subjects. There was no significant difference in median serum vitamin D levels between the cases and the controls (P = .25). The serum levels of vitamin D of the vitiligo patients were found to be lower in males (P = .01), the younger age group (P = .01), and patients not treated with ultraviolet (UV) treatment (P = .01). CONCLUSION There is no difference between the vitamin D levels of the vitiligo patients and the control subjects. However, deficiency of 25(OH)D levels within the vitiligo subgroups may be linked to younger age, male gender, short duration of vitiligo, and non-use of phototherapy.
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Affiliation(s)
- Huma Khurrum
- Vitiligo research chair, King Saud University, Riyadh, Saudi Arabia
| | - Khalid M AlGhamdi
- Dermatology Department, Director Vitiligo Research Chair, College of Medicine, King Saud University,Riyadh, Saudi Arabia
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20
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Nejati A, Shoja Z, Shahmahmoodi S, Tafakhori A, Mollaei-Kandelous Y, Rezaei F, Hamid KM, Mirshafiey A, Doosti R, Sahraian MA, Mahmoudi M, Shokri F, Emery V, Marashi SM. EBV and vitamin D status in relapsing-remitting multiple sclerosis patients with a unique cytokine signature. Med Microbiol Immunol 2015; 205:143-54. [PMID: 26365612 DOI: 10.1007/s00430-015-0437-7] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2015] [Accepted: 09/08/2015] [Indexed: 12/21/2022]
Abstract
Multiple sclerosis, a debilitating autoimmune and inflammatory disease of the central nervous system, is associated with both infectious and non-infectious factors. We investigated the role of EBV infection, vitamin D level, and cytokine signature in MS patients. Molecular and serological assays were used to investigate immune biomarkers, vitamin D level, and EBV status in 83 patients with relapsing-remitting multiple sclerosis and 62 healthy controls. In total, 98.8 % of MS patients showed a history of EBV exposure compared to 88.6 % in the healthy group (p = 0.005). EBV DNA load was significantly higher in MS patients than healthy subjects (p < 0.0001). Using a panel of biomarkers, we found a distinct transcriptional signature in MS patients compared to the healthy group with mRNA levels of CD73, IL-6, IL-23, IFN-γ, TNF-α, IL-15, IL-28, and IL-17 significantly elevated in MS patients (p < 0.0001). In contrast, the mRNA levels for TGF-β, IDO, S1PR1, IL-10, and CCL-3 were significantly lower in MS patients compared to healthy controls (p < 0.0001). No significant differences were found with the mRNA levels of IL-13, CCL-5, and FOXP3. Interestingly, in MS patients we found an inverse correlation between vitamin D concentration and EBV load, but not EBNA-1 IgG antibody levels. Our data highlight biomarker correlates in MS patients together with a complex interplay between EBV replication and vitamin D levels.
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Affiliation(s)
- Ahmad Nejati
- Virology Department, School of Public Health (SPH), Tehran University of Medical Sciences (TUMS), Tehran, 14155-6446, Iran
| | | | - Shohreh Shahmahmoodi
- Virology Department, School of Public Health (SPH), Tehran University of Medical Sciences (TUMS), Tehran, 14155-6446, Iran
| | - Abbas Tafakhori
- Iranian Centre of Neurological Research, Department of Neurology, School of Medicine, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | | | - Farhad Rezaei
- Virology Department, School of Public Health (SPH), Tehran University of Medical Sciences (TUMS), Tehran, 14155-6446, Iran
| | - Kabir Magaji Hamid
- Tehran University of Medical Sciences, International Campus (TUMS-IC), Tehran, Iran
| | - Abbas Mirshafiey
- Immunology Department, School of Public Health (SPH), Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Rozita Doosti
- MS Research Center, Neuroscience Institute, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Mohammad Ali Sahraian
- MS Research Center, Neuroscience Institute, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Mahmood Mahmoudi
- Department of Epidemiology and Biostatistics, School of Public Health (SPH), Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Fazel Shokri
- Immunology Department, School of Public Health (SPH), Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Vince Emery
- Department of Microbial and Cellular Sciences, University of Surrey, Guildford, Surrey, GU2 7XH, UK
| | - Sayed Mahdi Marashi
- Virology Department, School of Public Health (SPH), Tehran University of Medical Sciences (TUMS), Tehran, 14155-6446, Iran. .,Tehran University of Medical Sciences, International Campus (TUMS-IC), Tehran, Iran.
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Mayes T, Gottschlich MM, Khoury J, Kagan RJ. Investigation of Bone Health Subsequent to Vitamin D Supplementation in Children Following Burn Injury. Nutr Clin Pract 2015; 30:830-7. [PMID: 26024678 DOI: 10.1177/0884533615587720] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND The effect of supplemental vitamin D on fracture occurrence following burn injuries is unclear. The objective of this study was to evaluate postintervention incidence of fractures in children during the rehabilitative phase postburn (PB) following participation in a randomized clinical trial of vitamin D supplementation. MATERIALS AND METHODS Follow-up for fracture evaluation was obtained in 39 of 50 patients randomized to daily enteral vitamin D2, D3, or placebo throughout the acute burn course. Serum 25-hydroxyvitamin D, 1,25-dihydroxyvitamin D, D2, D3, calcitonin, and bone alkaline phosphatase (BAP) measurements were obtained PB day 7, midpoint, discharge, and 1-year PB. Urinary calcium was obtained PB day 7 and midpoint. Dual-energy x-ray absorptiometry (DXA) was performed at discharge and 1-year PB. RESULTS Fractures were reported in 6 of 39 respondents. Four fractures occurred in the placebo group, 2 in the D2 group, and none in the D3 group. Serum vitamin D, calcitonin, BAP, and urinary calcium were similar between fracture groups. The group with fracture morbidity had larger burn size (83.8% ± 4.9% vs 53.0% ± 2.9%, P < .0001), greater full-thickness burn (69.7% ± 9.4% vs 39.4% ± 4.1%, P = .02), and increased incidence of inhalation injury (33% vs 6%, P = .04). Decreased bone mineral density z score was noted at discharge in the placebo fracture compared with no-fracture group (P < .05). CONCLUSION This preliminary report suggests there may be benefit of vitamin D3 in reducing postdischarge fracture risk. Results reaffirm the importance of monitoring bone health in pediatric patients postburn.
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Affiliation(s)
- Theresa Mayes
- Department of Nutrition, Shriners Hospitals for Children, Cincinnati, Ohio Division of Nutrition Therapy, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Michele M Gottschlich
- Department of Nutrition, Shriners Hospitals for Children, Cincinnati, Ohio Department of Research, Shriners Hospitals for Children, Cincinnati, Ohio Department of Surgery, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Jane Khoury
- Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Richard J Kagan
- Department of Surgery, University of Cincinnati College of Medicine, Cincinnati, Ohio Department of Surgery, Shriners Hospitals for Children, Cincinnati, Ohio
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Moghimi E, Solomon JA, Gianforcaro A, Hamadeh MJ. Dietary Vitamin D3 Restriction Exacerbates Disease Pathophysiology in the Spinal Cord of the G93A Mouse Model of Amyotrophic Lateral Sclerosis. PLoS One 2015; 10:e0126355. [PMID: 26020962 PMCID: PMC4447353 DOI: 10.1371/journal.pone.0126355] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2015] [Accepted: 03/22/2015] [Indexed: 12/11/2022] Open
Abstract
Background Dietary vitamin D3 (D3) restriction reduces paw grip endurance and motor performance in G93A mice, and increases inflammation and apoptosis in the quadríceps of females. ALS, a neuromuscular disease, causes progressive degeneration of motor neurons in the brain and spinal cord. Objective We analyzed the spinal cords of G93A mice following dietary D3 restriction at 2.5% the adequate intake (AI) for oxidative damage (4-HNE, 3-NY), antioxidant enzymes (SOD2, catalase, GPx1), inflammation (TNF-α, IL-6, IL-10), apoptosis (bax/bcl-2 ratio, cleaved/pro-caspase 3 ratio), neurotrophic factor (GDNF) and neuron count (ChAT, SMI-36/SMI-32 ratio). Methods Beginning at age 25 d, 42 G93A mice were provided food ad libitum with either adequate (AI;1 IU D3/g feed; 12 M, 11 F) or deficient (DEF; 0.025 IU D3/g feed; 10 M, 9 F) D3. At age 113 d, the spinal cords were analyzed for protein content. Differences were considered significant at P ≤ 0.10, since this was a pilot study. Results DEF mice had 16% higher 4-HNE (P = 0.056), 12% higher GPx1 (P = 0.057) and 23% higher Bax/Bcl2 ratio (P = 0.076) vs. AI. DEF females had 29% higher GPx1 (P = 0.001) and 22% higher IL-6 (P = 0.077) vs. AI females. DEF males had 23% higher 4-HNE (P = 0.066) and 18% lower SOD2 (P = 0.034) vs. AI males. DEF males had 27% lower SOD2 (P = 0.004), 17% lower GPx1 (P = 0.070), 29% lower IL-6 (P = 0.023) and 22% lower ChAT (P = 0.082) vs. DEF females. Conclusion D3 deficiency exacerbates disease pathophysiology in the spinal cord of G93A mice, the exact mechanisms are sex-specific. This is in accord with our previous results in the quadriceps, as well as functional and disease outcomes.
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Affiliation(s)
- Elnaz Moghimi
- School of Kinesiology and Health Science, Faculty of Health, York University, Toronto, Ontario, Canada
- Muscle Health Research Centre, York University, Toronto, Ontario, Canada
| | - Jesse A. Solomon
- School of Kinesiology and Health Science, Faculty of Health, York University, Toronto, Ontario, Canada
- Muscle Health Research Centre, York University, Toronto, Ontario, Canada
| | - Alexandro Gianforcaro
- School of Kinesiology and Health Science, Faculty of Health, York University, Toronto, Ontario, Canada
- Muscle Health Research Centre, York University, Toronto, Ontario, Canada
| | - Mazen J. Hamadeh
- School of Kinesiology and Health Science, Faculty of Health, York University, Toronto, Ontario, Canada
- Muscle Health Research Centre, York University, Toronto, Ontario, Canada
- * E-mail:
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Comparison of serum vitamin D level in multiple sclerosis patients, their siblings, and healthy controls. IRANIAN JOURNAL OF NEUROLOGY 2015; 14:81-5. [PMID: 26056552 PMCID: PMC4449398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/27/2014] [Accepted: 01/10/2015] [Indexed: 10/28/2022]
Abstract
BACKGROUND Multiple sclerosis (MS) is an autoimmune, neuro-inflammatory disease of central nervous system affecting physical, emotional, and cognitive aspects of patients. Association of vitamin D deficiency and MS has been shown in previous studies. The aim of this study was to evaluate serum vitamin D level in MS cases and their sex-matched healthy siblings (who are genetically near similar) and non-relative sex-matched healthy controls. METHODS A total of 135 subjects enrolled in this case-control study. Group one (n = 45) consisted of patients with established MS. Group two (n = 45) included sex-matched healthy siblings of the group one and group three participants (n = 45) were non-relative sex-matched healthy controls. Demographic data (age, sex), level of education, daily sun exposure duration, and month of birth gathered for all. Serum sample of all participants was collected for 25-hydroxy vitamin D measurement. RESULTS There was no significant difference between vitamin D level, sun exposure duration, education level, and season of birth in three evaluated groups. Mean vitamin D level was 8.2 ± 10.1 (nmol/l) in women and 13.3 ± 7 (nmol/l) in men (P = 0.001). There was a significant positive correlation between daily sun exposure duration and vitamin D level in whole participants (r = 0.28, P < 0.001) as well as in MS patients (r = 0.32, P = 0.030). Mean vitamin D level was significantly lower in participants who have born in spring and summer. CONCLUSION Vitamin D deficiency is high among Iranian population as well as MS patients.
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Blood serum amino acids profile in patients with Multiple Sclerosis. CURRENT ISSUES IN PHARMACY AND MEDICAL SCIENCES 2015. [DOI: 10.12923/j.2084-980x/26.1/a.10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
Multiple sclerosis is the most common demyelinating disease of the central nervous system, affecting mostly young people. There were many risk factors for MS identified, however a direct cause of the disease is still unknown. Pathological changes in the SM lead to the myelin sheath damage around axons, what prevents proper transmission of nerve impulses in the central nervous system. The aim of this study was analyzing and comparing the amino acids profile in the blood serum of MS patients to control group of healthy individuals and evaluating the relationship between them. Significant (p<0.05) differences in the level of glutamate, aspartate and taurine in the blood serum of MS patients were revealed. A positive glutamate and aspartate level correlation in the serum has been demonstrated. Gender is significant only in the case of glutamate level in blood serum. The studies highlight the important role of neurotransmitters in MS and are the initial step in proteomic research.
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Celikbilek A, Gocmen AY, Tanik N, Borekci E, Adam M, Celikbilek M, Suher M, Delibas N. Decreased serum vitamin D levels are associated with diabetic peripheral neuropathy in a rural area of Turkey. Acta Neurol Belg 2015; 115:47-52. [PMID: 24841640 DOI: 10.1007/s13760-014-0304-0] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2013] [Accepted: 04/25/2014] [Indexed: 01/04/2023]
Abstract
Data examining the association between vitamin D and diabetic peripheral neuropathy are limited. This study investigated the serum levels of vitamin D, vitamin D-binding protein (VDBP), and vitamin D receptor (VDR) in diabetics in the Yozgat region of Turkey, and assessed their relationships with diabetic peripheral neuropathy. 69 diabetic patients and 49 age- and sex-matched control subjects were enrolled in this clinical prospective study. All the diabetics underwent conventional sensory and motor nerve conduction studies, and diabetic peripheral neuropathy was confirmed or ruled out according to the electromyography findings and Douleur Neuropathique 4 questions. Serum vitamin D, VDBP and VDR levels were measured using commercial enzyme-linked immunosorbent assay kits. The serum vitamin D levels (p = 0.001) were significantly lower, while the VDR levels (p = 0.003) were higher, in diabetics than in controls. The serum VDBP levels were similar in both groups (p > 0.05). The serum vitamin D levels were significantly lower in diabetics with diabetic peripheral neuropathy than in those without (p = 0.032), whereas the serum VDBP and VDR levels were similar in these two groups (p > 0.05). The lower serum vitamin D levels in diabetics, especially in those with peripheral neuropathy, may suggest a neurotrophic effect of vitamin D.
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Abstract
The question whether dietary habits and lifestyle have influence on the course of multiple sclerosis (MS) is still a matter of debate, and at present, MS therapy is not associated with any information on diet and lifestyle. Here we show that dietary factors and lifestyle may exacerbate or ameliorate MS symptoms by modulating the inflammatory status of the disease both in relapsing-remitting MS and in primary-progressive MS. This is achieved by controlling both the metabolic and inflammatory pathways in the human cell and the composition of commensal gut microbiota. What increases inflammation are hypercaloric Western-style diets, characterized by high salt, animal fat, red meat, sugar-sweetened drinks, fried food, low fiber, and lack of physical exercise. The persistence of this type of diet upregulates the metabolism of human cells toward biosynthetic pathways including those of proinflammatory molecules and also leads to a dysbiotic gut microbiota, alteration of intestinal immunity, and low-grade systemic inflammation. Conversely, exercise and low-calorie diets based on the assumption of vegetables, fruit, legumes, fish, prebiotics, and probiotics act on nuclear receptors and enzymes that upregulate oxidative metabolism, downregulate the synthesis of proinflammatory molecules, and restore or maintain a healthy symbiotic gut microbiota. Now that we know the molecular mechanisms by which dietary factors and exercise affect the inflammatory status in MS, we can expect that a nutritional intervention with anti-inflammatory food and dietary supplements can alleviate possible side effects of immune-modulatory drugs and the symptoms of chronic fatigue syndrome and thus favor patient wellness.
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Affiliation(s)
- Paolo Riccio
- Department of Sciences, University of Basilicata, Potenza, Italy
| | - Rocco Rossano
- Department of Sciences, University of Basilicata, Potenza, Italy
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Moghtaderi A, Tamadon GH, Haghighi F. 25-hydroxyvitamin D3 Concentration in Serum and Cerebrospinal Fluid of Patients with Remitting-relapse Multiple Sclerosis. Prague Med Rep 2014; 114:162-71. [DOI: 10.14712/23362936.2014.18] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Abstract
There is epidemiological, geographical and immunological evidence suggesting that low environmental supplies of vitamin D3 may act as a risk factor for developing multiple sclerosis (MS), possibly due to dysfunction in the immunomodulatory properties of 25-hydroxyvitamin D3 (25-OH-D3) in the brain. The objective of this study is to measure the serum and cerebrospinal fluid (CSF) concentrations of 25-OH-D3 in MS patients during their relapsing phase. 52 patients with remitting-relapse and 58 patients with other non-inflammatory diseases of central and peripheral nervous system were entered into the study. Patients in both groups were admitted for the first time to do diagnostic procedures and they were not on any other treatment for neurological disorders. The means and medians for serum levels of 25-OH-D3 in MS patients and control group were 10.64 ± 9.2 ng/ml (median: 9.6 ng/ml) and 13.23 ± 17.56 ng/ml (median: 11.90 ng/ml), respectively (p=0.328). CSF concentrations for the same values were 2.02 ± 1.94 ng/ml (median: 0.23 ng/ml) and 3.28 ± 2.96 (median: 0.29 ng/ml), respectively (p=0.242). The differences between calculated numbers of serum/CSF ratios were not statistically significant too. The serum and CSF concentrations of 25-OH-D3 in MS group were lower than the control counterpart without any statistical difference and the authors did not find any influence of serum 25-OH-D3 concentration on the CSF concentration based on the non-significant statistical difference between the serum/CSF ratios in two study groups of MS patients and control cases.
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Delvin E, Souberbielle JC, Viard JP, Salle B. Role of vitamin D in acquired immune and autoimmune diseases. Crit Rev Clin Lab Sci 2014; 51:232-47. [DOI: 10.3109/10408363.2014.901291] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Harandi AA, Harandi AA, Pakdaman H, Sahraian MA. Vitamin D and multiple sclerosis. IRANIAN JOURNAL OF NEUROLOGY 2014; 13:1-6. [PMID: 24800040 PMCID: PMC3968350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 08/19/2013] [Accepted: 11/22/2013] [Indexed: 06/03/2023]
Abstract
Multiple sclerosis (MS) is a chronic demyelinating disease and also is one of the most common disabling neurological disorders in young and middle-aged adults. The main pathogenesis of MS has long been thought to be an immune mediated disorder of the central nervous system. The function of the immune system is under the influence of vitamin D which as a modulator of immune response could play a role in autoimmune diseases including MS. Deficiency of vitamin D or variations in DNA sequence (polymorphism) of vitamin D receptor gene diminishes its optimal function on immune system that consequently could lead to increasing risk of MS. However, its role in development and modulating the course of MS is still under investigation. In this review we aimed to discuss the role of vitamin D in body, immune system and consequently altering the risk of MS.
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Affiliation(s)
- Asghar Amini Harandi
- Department of Biochemistry, School of Medicine, Jahrom University of Medical Sciences, Jahrom, Iran
| | - Ali Amini Harandi
- Department of Neurology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hossein Pakdaman
- Department of Neurology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammad Ali Sahraian
- MS Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
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Makris A, Piperopoulos A, Karmaniolou I. Multiple sclerosis: basic knowledge and new insights in perioperative management. J Anesth 2013; 28:267-78. [DOI: 10.1007/s00540-013-1697-2] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2013] [Accepted: 08/06/2013] [Indexed: 01/24/2023]
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Martinelli V, Dalla Costa G, Colombo B, Dalla Libera D, Rubinacci A, Filippi M, Furlan R, Comi G. Vitamin D levels and risk of multiple sclerosis in patients with clinically isolated syndromes. Mult Scler 2013; 20:147-55. [DOI: 10.1177/1352458513494959] [Citation(s) in RCA: 76] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background: Growing evidence suggests that vitamin D deficiency may be one of the most important environmental factors for the development of multiple sclerosis (MS). Objectives: The objectives of this paper are to evaluate serum 25-hydroxyvitamin D (25(OH)D) levels in patients with clinically isolated syndromes (CIS) and to examine whether they are related to MS risk. Methods: This is a retrospective study of 100 CIS patients hospitalized from 2000 to 2009 at San Raffaele Hospital, Milan, Italy. We evaluated baseline 25(OH)D level as well as clinical, brain magnetic resonance imaging (MRI) and cerebrospinal fluid (CSF) data. Results: A total of 52% of CIS patients had vitamin D deficiency (25(OH)D < 50 nmol/l). During follow-up (median: 7.17 years), 55 patients developed clinically definite MS (CDMS). Patients with very low (< 10th percentile) and low (< 25th percentile) 25(OH)D levels were particularly at risk of CDMS (HRs (95% CIs): 2.12 (0.91–4.96) and 1.61 (0.85–3.03), respectively), while no further reduction in the HRs of disease was observed at high levels of 25(OH)D. This association was even stronger after adjustment for additional risk factors for CDMS development (HRs (95% CIs) for 25(OH)D levels < 10th and 25th percentiles: 3.34 (1.32–8.45) and 2.04 (0.96–4.36), respectively). Conclusion: Low serum vitamin D is associated with increased MS risk in patients with CIS.
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Affiliation(s)
| | | | - Bruno Colombo
- Department of Neurology, San Raffaele Hospital, Milan, Italy
| | | | | | - Massimo Filippi
- Neuroimaging Research Unit, San Raffaele Hospital, Milan, Italy
| | - Roberto Furlan
- Institute of Experimental Neurology, San Raffaele Scientific Institute, Milan, Italy
| | - Giancarlo Comi
- Department of Neurology, San Raffaele Hospital, Milan, Italy
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Dudani SJ, Kalhan S, Sharma SP. Vitamin D and multiple sclerosis: Potential pathophysiological role and clinical implications. Int J Appl Basic Med Res 2013; 1:71-4. [PMID: 23776780 PMCID: PMC3657971 DOI: 10.4103/2229-516x.91146] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
Multiple sclerosis (MS) is thought to arise due to an interplay of genetic and environmental risk factors. Vitamin D, besides maintaining bone health and calcium metabolism, is thought to play an immunomodulatory role in the central nervous system. Studies have shown that patients with the highest level of Vitamin D (99–152 nmol/l) had a significantly lower risk of MS than the subgroup with the lowest levels (15–63 nmol/l). Furthermore, populations having a high oral intake of vitamin D had a decreased risk of MS. Hypovitaminosis D is one of the environmental risk factors for MS based on numerous physiological, experimental and epidemiologic data, which can be corrected to provide an effective therapeutic option for this debilitating disease.
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Affiliation(s)
- Sharmila J Dudani
- Department of Pathology, Army College of Medical Sciences, Delhi Cantt., New Delhi, India
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Fereidan-Esfahani M, Ramagopalan SV, Etemadifar M, Sadri S, Abtahi SH. Vitamin d: shining a light on clinical and sex specific effects in multiple sclerosis? Int J Prev Med 2013; 4:499-500. [PMID: 23930158 PMCID: PMC3733178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2013] [Accepted: 04/12/2013] [Indexed: 10/27/2022] Open
Affiliation(s)
- Mahboobeh Fereidan-Esfahani
- Isfahan Research Committee of Multiple Sclerosis, Isfahan University of Medical Sciences, Isfahan, Iran,Medical Students’ Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Sreeram V Ramagopalan
- Department of Physiology, Anatomy and Genetics, University of Oxford, John Radcliffe Hospital, Oxford, UK
| | - Masoud Etemadifar
- Isfahan Research Committee of Multiple Sclerosis, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Soroush Sadri
- Medical Students’ Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Seyed-Hossein Abtahi
- Isfahan Research Committee of Multiple Sclerosis, Isfahan University of Medical Sciences, Isfahan, Iran,Medical Students’ Research Center, Isfahan University of Medical Sciences, Isfahan, Iran,Correspondence to: Dr. Seyed-Hossein Abtahi, S.H.A. Official Research Center of Neurological-Ophthalmological Sciences, No. 9, Boroomand, Seyed-Alikhan, Chaharbagh Abbasi, Isfahan 81448-14581, Iran. E-mail:
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Shaygannejad V, Tolou-Ghamari Z. What is the Real Fate of Vitamin D in Multiple Sclerosis? Int J Prev Med 2013; 4:S159-64. [PMID: 23776718 PMCID: PMC3678212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2013] [Accepted: 03/23/2013] [Indexed: 10/25/2022] Open
Abstract
Multiple sclerosis (MS) is a multifactorial disease (caused by both environmental and genetic features) that could results from a demyelination of the myelin sheath. Subsequently, it leads to many scars or lesions in different places within the central nervous system. The symptoms that occur depend on the site and rigorousness of the lesions and this is why people with MS experience different symptoms. Although, it is not clearly known that why people develop MS, research suggests that vitamin D plays a key role in preventing or repairing the damaged myelin. Previous studies have shown that vitamin D is a potent natural immune-regulator and has an anti-inflammatory action. Increased exposure to vitamin D may result in changed immunologic profiles or commotion that donates to MS risk. Vitamin D deficiency is caused by insufficient sunlight exposure or low dietary vitamin D3 intake. Recent studies have also indicated that, there are several polymorphisms for vitamin D receptor (VDR) gene, but the effect of VDR gene polymorphisms on protein function of VDR and how exerts second signaling pathways in cells is still unknown. Therefore, this review focuses on vitamin D metabolism and genetic polymorphisms related to VDR and MS to better understand of discrepancies among patients.
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Affiliation(s)
- Vahid Shaygannejad
- Department of Neurology, Isfahan Neurosciences Research Centre, Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Zahra Tolou-Ghamari
- Isfahan Neurosciences Research Centre, Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran,Correspondence to: Dr. Zahra Tolou-Ghamari, Isfahan Neurosciences Research Centre, Faculty of Medicine, Isfahan University of Medical Sciences, Iran E-mail:
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Pierrot-Deseilligny C, Souberbielle JC. Contribution of vitamin D insufficiency to the pathogenesis of multiple sclerosis. Ther Adv Neurol Disord 2013; 6:81-116. [PMID: 23483715 PMCID: PMC3582312 DOI: 10.1177/1756285612473513] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
The contribution of vitamin D insufficiency to the pathogenesis of multiple sclerosis (MS) is reviewed. Among the multiple recently discovered actions of vitamin D, an immunomodulatory role has been documented in experimental autoimmune encephalomyelitis and in humans. This action in the peripheral immune system is currently the main known mechanism through which vitamin D might influence MS, but other types of actions could be involved within the central nervous system. Furthermore, vitamin D insufficiency is widespread in temperate countries and in patients with MS at the earliest stages of the disease, suggesting that the deleterious effects related to vitamin D insufficiency may be exerted in these patients. In fact, many genetic and environmental risk factors appear to interact and contribute to MS. In genetics, several human leukocyte antigen (HLA) alleles (more particularly HLA-DRB1*1501) could favour the disease whereas some others could be protective. Some of the genes involved in vitamin D metabolism (e.g. CYP27B1) also play a significant role. Furthermore, three environmental risk factors have been identified: past Epstein-Barr virus infection, vitamin D insufficiency and cigarette smoking. Interactions between genetic and environmental risk or protective factors may occur during the mother's pregnancy and could continue during childhood and adolescence and until the disease is triggered in adulthood, therefore possibly modulating the MS risk throughout the first decades of life. Furthermore, some clinical findings already strongly suggest that vitamin D status influences the relapse rate and radiological lesions in patients with MS, although the results of adequately powered randomized clinical trials using vitamin D supplementation have not yet been reported. While awaiting these incontrovertible results, which might be long in coming, patients with MS who are currently in vitamin D insufficiency should be supplemented, at least for their general health status, using moderate doses of the vitamin.
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Affiliation(s)
- Charles Pierrot-Deseilligny
- Service de Neurologie 1, Hôpital de la Salpêtrière, Assistance Publique-Hôpitaux de Paris, Université Pierre et Marie Curie (Paris VI), Paris, France
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Ashtari F, Jamshidi F, Shoormasti RS, Pourpak Z, Akbari M. Cow's milk allergy in multiple sclerosis patients. JOURNAL OF RESEARCH IN MEDICAL SCIENCES : THE OFFICIAL JOURNAL OF ISFAHAN UNIVERSITY OF MEDICAL SCIENCES 2013; 18:S62-5. [PMID: 23961290 PMCID: PMC3743324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/20/2012] [Revised: 01/15/2013] [Accepted: 02/04/2013] [Indexed: 11/15/2022]
Abstract
BACKGROUND Exposure to some environmental agent such as different nutrition and contact with allergens may have a role in developing multiple sclerosis (MS). The present study was aimed to evaluate the cow's milk allergy (CMA) in MS patients compared to healthy controls. MATERIALS AND METHODS Between March 2012 and July 2012, 48 MS patients were selected and compared with 48 healthy subjectsto assess the frequency of CMA in MS patients compared to healthy control. Cow's milk specific immunoglobin E (IgE) was determined by Immuno CAP. Sex and the frequency of CMA were compared between study groups by Chi-square test. RESULTS Total of 96 subjects were assessed (22% male and 78% female). The mean age of the study subjects was 30.8 ± 6.6 years. Mean age of case and control groups was 30.7 (±6.9) versus 30.9 ± 6.3, respectively (P value = 0.83). There were no detection of cow's milk specific IgE in serum of MS patients and healthy subjects. CONCLUSION There was no difference between MS and healthy subjects regarding CMA.
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Affiliation(s)
- Fereshteh Ashtari
- Department of Neurology, Isfahan Neuroscience Research Center, Isfahan University of Medical Sciences, Isfahan, Iran,Address for correspondence: Dr. Fereshteh Ashtari, Professor of Neurology Department of Neurology, Isfahan Neuroscience Research Centre, Isfahan University of Medical Sciences, Isfahan, Iran. E-mail:
| | - Fatemeh Jamshidi
- Department of Neurology, Isfahan Neuroscience Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Raheleh Shokouhi Shoormasti
- Department of Immunology, Asthma and Allergy Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Zahra Pourpak
- Department of Immunology, Asthma and Allergy Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mojtaba Akbari
- Department of Neurology, Isfahan Neuroscience Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
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Sternberg Z. Autonomic dysfunction: A unifying multiple sclerosis theory, linking chronic cerebrospinal venous insufficiency, vitamin D3, and Epstein-Barr virus. Autoimmun Rev 2012; 12:250-9. [DOI: 10.1016/j.autrev.2012.04.004] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2012] [Accepted: 04/22/2012] [Indexed: 12/18/2022]
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Faridar A, Eskandari G, Sahraian MA, Minagar A, Azimi A. Vitamin D and multiple sclerosis: a critical review and recommendations on treatment. Acta Neurol Belg 2012; 112:327-33. [PMID: 22767049 DOI: 10.1007/s13760-012-0108-z] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2012] [Accepted: 06/19/2012] [Indexed: 11/26/2022]
Abstract
Multiple sclerosis (MS) is an immune-mediated and degenerative disease of nervous system, which affects mostly young adults. Vitamin D deficiency is a well-known environmental risk factor for MS and is considerable in terms of immediate clinical implications. In addition to its classical action on regulation of bone homeostasis, vitamin D may have a potent impact on cytokine profiles and neuro-inflammation. Given the immunomodulatory effects of vitamin D and its high rate of deficiency in MS patients, prescribing vitamin D is a remarkable issue in MS. The results from several experimental and clinical studies indicate that vitamin D supplementation may ameliorate the inflammation during the relapse phase and attenuate disease progression. We present the experimental and clinical studies, which assessed the effects of vitamin D on the pathophysiology, prevalence and management of MS. The authors also discuss current recommendations on prescription of this vitamin to MS patients.
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Affiliation(s)
- Alireza Faridar
- Department of Neurology, University of California, San Francisco, USA
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40
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Aftab SAS, Fouda MA. Attitude and awareness of health care providers towards the therapeutic and prophylactic roles of Vitamin D. MEDITERRANEAN JOURNAL OF NUTRITION AND METABOLISM 2012. [DOI: 10.1007/s12349-011-0085-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Rahn K, Slusher B, Kaplin A. Cognitive impairment in multiple sclerosis: a forgotten disability remembered. CEREBRUM : THE DANA FORUM ON BRAIN SCIENCE 2012; 2012:14. [PMID: 23447800 PMCID: PMC3574761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Physicians first noted the presence of cognitive impairment in patients with multiple sclerosis (MS) more than 160 years ago, yet it took clinicians until 2001 to codify a standard test to measure cognitive function. We now know that cognitive impairment occurs in up to 65 percent of people with MS and usually lessens their ability to remember previously learned information. So far, trials of drugs formulated to treat cognitive impairment have failed, but the authors remain optimistic that new approaches to diagnosis and drug development could lead to effective therapies in the future.
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Pierrot-Deseilligny C, Rivaud-Péchoux S, Clerson P, de Paz R, Souberbielle JC. Relationship between 25-OH-D serum level and relapse rate in multiple sclerosis patients before and after vitamin D supplementation. Ther Adv Neurol Disord 2012; 5:187-98. [PMID: 22783368 DOI: 10.1177/1756285612447090] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Vitamin D could play a protective role in multiple sclerosis. METHODS In an observational, uncontrolled study, vitamin D3 supplementation (3010 IU/day on average) was given to 156 consecutive patients with relapsing-remitting multiple sclerosis, under first-line immunomodulatory therapy and with initial 25-OH-D serum level lower than 100 nmol/l (40 ng/ml). Relapses were determined for 29.1 ± 8.4 months during vitamin D and 29.8 ± 10.1 months before supplementation. The 25-OH-D level was measured before supplementation and several times during supplementation. The incidence rate of relapses before and during supplementation was estimated using negative binomial regression models with follow-up durations as offset terms. The incidence rate and incidence rate ratio of relapses at various 25-OH-D levels were also calculated using negative binomial regression models. RESULTS In 76 patients, immunomodulatory therapy preceded vitamin D supplementation (by 4.2 ± 2.7 years) and in 80 patients both treatments were started simultaneously. Under supplementation, the 25-OH-D level increased from 49 ± 22 nmol/l to 110 ± 26 nmol/l on average. Pooling data collected before and during supplementation, we found a significant strong inverse relationship between the relapse incidence rate and the 25-OH-D level (p < 0.0001), suggesting that vitamin D did indeed influence the relapse rate. Results of univariate, bivariate and multivariate analyses were analogous: in the multivariate model adjusted for age, disease duration and previous use of immunomodulatory therapy, every 10 nmol increase in 25-OH-D level was associated with a reduction in the relapse incidence rate of 13.7%. Dividing iteratively the population made up of pooled periods into two subgroups according to the 25-OH-D levels, the relapse incidence rate ratio decreased as the 25-OH-D level increased up to 110 nmol/l, but a plateau effect was observed beyond this limit. CONCLUSION Further studies are warranted for accurate quantification of the vitamin D effect.
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Affiliation(s)
- Charles Pierrot-Deseilligny
- Service de Neurologie 1, Hôpital de la Salpêtrière, Assistance Publique-Hôpitaux de Paris, Université Pierre et Marie Curie (Paris VI), Paris, France
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Loma I, Heyman R. Multiple sclerosis: pathogenesis and treatment. Curr Neuropharmacol 2012; 9:409-16. [PMID: 22379455 PMCID: PMC3151595 DOI: 10.2174/157015911796557911] [Citation(s) in RCA: 206] [Impact Index Per Article: 17.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2010] [Revised: 10/02/2010] [Accepted: 10/05/2010] [Indexed: 12/20/2022] Open
Abstract
Multiple sclerosis (MS) is a chronic inflammatory autoimmune demyelinating disease of the central nervous system. It affects approximately 400,000 people in the United States and onset is usually during young adulthood. There are four clinical forms of MS, of which relapsing remitting type is the most common. As the etiology of MS is unknown, finding a cure will remain challenging. The main mechanism of injury appears to be inflammation and 8 agents are now FDA approved to help control MS. These agents for relapsing forms of MS target different parts of the immune system, with the end goal of decreasing and avoiding further inflammation. No agents are FDA approved for the primary progressive version of MS. FDA approved agents include four preparations of interferon β (Avonex, Rebif, Betaseron and Extavia), glatiramer acetate (Copaxone), mitoxantrone (Novantrone), natalizumab (Tysabri) and fingolimod (Gilenya). There are several drug undergoing phase II and III trials. The heterogeneity of the MS disease process, individual patient response, and medication toxicities continue to challenge the treating physician.
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Affiliation(s)
- Ingrid Loma
- Department of Neurology, University of Pittsburgh Medical Center, Pittsburgh, PA 15213, USA
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What is needed to keep persons with multiple sclerosis vitamin D-sufficient throughout the year? J Neurol 2012; 260:182-8. [DOI: 10.1007/s00415-012-6611-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2012] [Revised: 06/27/2012] [Accepted: 07/05/2012] [Indexed: 12/16/2022]
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Summerday NM, Brown SJ, Allington DR, Rivey MP. Vitamin D and multiple sclerosis: review of a possible association. J Pharm Pract 2012; 25:75-84. [PMID: 21987526 DOI: 10.1177/0897190011421839] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
There has been growing interest in determining environmental risk factors that may play a role in the development or progression of multiple sclerosis (MS). Epidemiological evidence and data from human and animal studies have shown an association between low serum vitamin D levels and an increased incidence of MS and that supplementation with vitamin D may protect against MS development and/or disease relapses. The most appropriate vitamin D dosage for patients with MS is unclear, but investigator shave proposed that serum vitamin D concentrations between 75 and 100 nmol/L (30-40 ng/mL) are optimal to achieve favor able clinical outcomes. Vitamin D supplemented in doses up to 3000 International Units (IU) daily may be necessary to achieve these levels in many patients, and doses of 500 to 800 IU daily appear to be necessary to maintain desired serum vitamin D levels.Short-term supplementation with doses up to 40 000 IU daily has been found to be safe. However, larger and longer clinical studies are needed to assess whether a true relationship exists between serum vitamin D concentrations and MS and to determine a safe and effective amount of vitamin D supplementation.
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Body JJ, Bergmann P, Boonen S, Devogelaer JP, Gielen E, Goemaere S, Kaufman JM, Rozenberg S, Reginster JY. Extraskeletal benefits and risks of calcium, vitamin D and anti-osteoporosis medications. Osteoporos Int 2012; 23 Suppl 1:S1-23. [PMID: 22311111 PMCID: PMC3273686 DOI: 10.1007/s00198-011-1891-8] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2011] [Accepted: 12/19/2011] [Indexed: 12/11/2022]
Abstract
UNLABELLED Drugs used for the prevention and the treatment of osteoporosis exert various favourable and unfavourable extra-skeletal effects whose importance is increasingly recognized notably for treatment selection. INTRODUCTION The therapeutic armamentarium for the prevention and the treatment of osteoporosis is increasingly large, and possible extra-skeletal effects of available drugs could influence the choice of a particular compound. METHODS The present document is the result of a national consensus, based on a systematic and critical review of the literature. RESULTS Observational research has suggested an inverse relationship between calcium intake and cardiovascular diseases, notably through an effect on blood pressure, but recent data suggest a possible deleterious effect of calcium supplements on cardiovascular risk. Many diverse studies have implicated vitamin D in the pathogenesis of clinically important non-skeletal functions or diseases, especially muscle function, cardiovascular disease, autoimmune diseases and common cancers. The possible effects of oral or intravenous bisphosphonates are well-known. They have been associated with an increased risk of oesophageal cancer or atrial fibrillation, but large-scale studies have not found any association with bisphosphonate use. Selective oestrogen receptor modulators have demonstrated favourable or unfavourable extra-skeletal effects that vary between compounds. Strontium ranelate has a limited number of non-skeletal effects. A reported increase in the risk of venous thromboembolism is not found in observational studies, and very rare cases of cutaneous hypersensitivity reactions have been reported. Denosumab has been introduced recently, and its extra-skeletal effects still have to be assessed. CONCLUSION Several non-skeletal effects of bone drugs are well demonstrated and influence treatment choices.
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Affiliation(s)
- J.-J. Body
- Department of Medicine, CHU Brugmann, Université Libre de Bruxelles, Brussels, Belgium
| | - P. Bergmann
- Department of Radioisotopes, CHU Brugmann, Université Libre de Bruxelles, Brussels, Belgium
| | - S. Boonen
- Center for Metabolic Bone Diseases, Katholieke University Leuven, Leuven, Belgium
| | - J.-P. Devogelaer
- Department of Rheumatology, Saint Luc University Hospital, Université Catholique de Louvain, Brussels, Belgium
| | - E. Gielen
- Gerontology and Geriatrics Section, Department of Experimental Medicine, K.U.Leuven, Leuven, Belgium
| | - S. Goemaere
- Department of Rheumatology and Endocrinology, State University of Gent, Gent, Belgium
| | - J.-M. Kaufman
- Department of Endocrinology, State University of Gent, Gent, Belgium
| | - S. Rozenberg
- Department of Gynaecology–Obstetrics, Université Libre de Bruxelles, Brussels, Belgium
| | - J.-Y. Reginster
- Department of Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium
- Bone and Cartilage Metabolism Research Unit, CHU Centre-Ville, Policliniques L. BRULL, Quai Godefroid Kurth 45 (9ème étage), 4020 Liege, Belgium
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Abstract
Multiple sclerosis (MS) is a chronic, complex neurological disease with a variable clinical course in which several pathophysiological mechanisms such as axonal/ neuronal damage, demyelination, inflammation, gliosis, remyelination and repair, oxidative injury and excitotoxicity, alteration of the immune system as well as biochemical disturbances and disruption of blood-brain barrier are involved.(1,2) Exacerbations of MS symptoms reflect inflammatory episodes, while the neurodegenerative aspects of gliosis and axonal loss result in the progression of disability. The precise aetiology of MS is not yet known, although epidemiological data indicate that it arises from a complex interactions between genetic susceptibility and environmental factors.(3) In this chapter the brain structures and processes involved in immunopathogenesis of MS are presented. Additionally, clinical phenotypes and biomarkers of MS are showed.
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Jankosky C, Deussing E, Gibson RL, Haverkos HW. Viruses and vitamin D in the etiology of type 1 diabetes mellitus and multiple sclerosis. Virus Res 2011; 163:424-30. [PMID: 22119899 DOI: 10.1016/j.virusres.2011.11.010] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2011] [Revised: 11/11/2011] [Accepted: 11/13/2011] [Indexed: 12/28/2022]
Abstract
Although specific viruses have been associated with autoimmune diseases, none fulfill Koch's criteria of causation. The etiologies of such diseases appear to be complex and multifactorial. For example, one might propose that the etiology of type 1 diabetes mellitus results from a toxic metabolite of nitrosamines during an enteroviral infection. Multiple sclerosis might result from a cascade of events involving several herpes virus infections activated during periods of vitamin D deficiency. We encourage investigators to consider Rotman's sufficient-component causal model when developing hypotheses for testing for the etiology of chronic diseases. Delineating the web of causation may lead to additional strategies for prevention and treatment of several autoimmune diseases.
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Affiliation(s)
- Christopher Jankosky
- Division of Preventive Medicine and Biometrics, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
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Hoffjan S, Epplen JT. Acute demyelination in children: predicting pediatric multiple sclerosis manifestation. FUTURE NEUROLOGY 2011. [DOI: 10.2217/fnl.11.41] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Evaluation of: Banwell B, Bar-Or A, Arnold DL et al. Clinical, environmental, and genetic determinants of multiple sclerosis in children with acute demyelination: a prospective national cohort study. Lancet Neurol. 10(5), 436–445 (2011). This study represents a prospective Canadian cohort study investigating risk of multiple sclerosis (MS) development in children presenting with an acute demyelination event. Out of 302 children followed for a median of 3.14 years, 63 (21%) were diagnosed with MS during this period of time. HLA-DRB1*15 alleles, remote Epstein–Barr virus infection and reduced vitamin D levels were each independently associated with increased MS risk but did not show interacting effects. Based on MRI findings, age of onset and clinical presentation, the authors developed a decision tree, suggesting the highest risk for children with T2 lesions in baseline MRI that were >11.85 years of age at onset (60.6%). While this seems a helpful preliminary tool for clinicians, longer follow-up time as well as integration of additional genetic and environmental variables may allow an even more thorough risk estimation in future studies.
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Affiliation(s)
- Sabine Hoffjan
- Department of Human Genetics, Ruhr-University Bochum, Universitätsstrasse 150, 44801 Bochum, Germany
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Riccio P. The molecular basis of nutritional intervention in multiple sclerosis: a narrative review. Complement Ther Med 2011; 19:228-37. [PMID: 21827937 DOI: 10.1016/j.ctim.2011.06.006] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2010] [Revised: 06/03/2011] [Accepted: 06/29/2011] [Indexed: 11/28/2022] Open
Abstract
It is commonly accepted that nutrition is one of the possible environmental factors involved in the pathogenesis of multiple sclerosis (MS), but its role as complementary MS treatment is unclear and largely disregarded. At present, MS therapy is not associated to a particular diet, probably due to lack of information on the effects of nutrition on the disease. To overcome the distrust of the usefulness of dietary control in MS and to encourage nutritional interventions in the course of the disease, it is necessary to assess the nature and the role of bioactive dietary molecules and their targets, and establish how a dietary control can influence cell metabolism and improve the wellness of MS patients. The aim of this review is to provide a rationale for a nutritional intervention in MS by evaluating at the molecular level the effects of dietary molecules on the inflammatory and autoimmune processes involved in the disease. Present data reveal that healthy dietary molecules have a pleiotropic role and are able to change cell metabolism from anabolism to catabolism and down-regulate inflammation by interacting with enzymes, nuclear receptors and transcriptional factors. The control of gut dysbiosis and the combination of hypo-caloric, low-fat diets with specific vitamins, oligoelements and dietary integrators, including fish oil and polyphenols, may slow-down the progression of the disease and ameliorate the wellness of MS patients.
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Affiliation(s)
- P Riccio
- Dipartimento di Biologia D.B.A.F., University of Basilicata, Potenza, Italy.
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