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Akhter A, Alouffi S, Shahab U, Akasha R, Fazal-Ur-Rehman M, Ghoniem ME, Ahmad N, Kaur K, Pandey RP, Alshammari A, Akhter F, Ahmad S. Vitamin D supplementation modulates glycated hemoglobin (HBA1c) in diabetes mellitus. Arch Biochem Biophys 2024; 753:109911. [PMID: 38280562 DOI: 10.1016/j.abb.2024.109911] [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: 12/10/2023] [Revised: 01/20/2024] [Accepted: 01/23/2024] [Indexed: 01/29/2024]
Abstract
Diabetes is a metabolic illness that increases protein glycosylation in hyperglycemic conditions, which can have an impact on almost every organ system in the body. The role of vitamin D in the etiology of diabetes under RAGE (receptor for advanced glycation end products) stress has recently received some attention on a global scale. Vitamin D's other skeletal benefits have generated a great deal of research. Vitamin D's function in the development of type 1 and type 2 diabetes is supported by the discovery of 1,25 (OH)2D3 and 1-Alpha-Hydroylase expression in immune cells, pancreatic beta cells, and several other organs besides the bone system. A lower HBA1c level, metabolic syndrome, and diabetes mellitus all seems to be associated with vitamin D insufficiency. Most of the cross-sectional and prospective observational studies that were used to gather human evidence revealed an inverse relationship between vitamin D level and the prevalence or incidence of elevated HBA1c in type 2 diabetes. Several trials have reported on the impact of vitamin D supplementation for glycemia or incidence of type 2 diabetes, with varying degrees of success. The current paper examines the available data for a relationship between vitamin D supplementation and HBA1c level in diabetes and discusses the biological plausibility of such a relationship.
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Affiliation(s)
- Asma Akhter
- Department of Biomedical Engineering, Stony Brook University, Stony Brook, NY, 11790, United States.
| | - Sultan Alouffi
- Department of Medical Laboratory Sciences, College of Applied Medical Sciences, University of Hail, 2440, Saudi Arabia.
| | - Uzma Shahab
- Department of Biochemistry, King George Medical University, Lucknow, U.P., India.
| | - Rihab Akasha
- Department of Medical Laboratory Sciences, College of Applied Medical Sciences, University of Hail, 2440, Saudi Arabia.
| | | | - Mohamed E Ghoniem
- Department of Internal Medicine, College of Medicine, University of Hail, 2440, Saudi Arabia; Department of Internal Medicine, Faculty of Medicine, Zagazig University, Zagazig, 44519, Egypt.
| | - Naved Ahmad
- Department of Computer Science and Information System, College of Applied Sciences, AlMaarefa University, P.O.Box 71666, Riyadh, 13713, Saudi Arabia.
| | - Kirtanjot Kaur
- University Centre for Research and Development, Chandigarh University, Mohali, Punjab, India.
| | - Ramendra Pati Pandey
- School of Health Sciences and Technology (SOHST), UPES, Dehradun, 248007, Uttarakhand, India.
| | - Ahmed Alshammari
- Department of Internal Medicine, College of Medicine, University of Hail, Saudi Arabia.
| | - Firoz Akhter
- Department of Biomedical Engineering, Stony Brook University, Stony Brook, NY, 11790, United States.
| | - Saheem Ahmad
- Department of Medical Laboratory Sciences, College of Applied Medical Sciences, University of Hail, 2440, Saudi Arabia.
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AlSubai A, Baqai MH, Agha H, Shankarlal N, Javaid SS, Jesrani EK, Golani S, Akram A, Qureshi F, Ahmed S, Saran S. Vitamin D and preeclampsia: A systematic review and meta-analysis. SAGE Open Med 2023; 11:20503121231212093. [PMID: 38020794 PMCID: PMC10666722 DOI: 10.1177/20503121231212093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Accepted: 10/18/2023] [Indexed: 12/01/2023] Open
Abstract
Objectives Preeclampsia is one of the most frequent pregnancy disorders, with a global incidence of 2%-8%. Serum 25-hydroxyvitamin D is an essential mineral for human health; some studies suggest link between 25-hydroxyvitamin D deficiency and preeclampsia, while others offer contradictory findings. Thus, the goal of this study is to evaluate the relationships between maternal 25- hydroxyvitamin D concentrations and the risk of preeclampsia. In addition to this, our study also evaluates the effects of 25- hydroxyvitamin D supplementation on the incidence of preeclampsia. Therefore, assessing 25- hydroxyvitamin D's potential as a possible intervention to lower the risk of preeclampsia. Methods The Medline database was queried from inception until July 2021 for randomized controlled trials and observational studies without any restrictions. The studies assessing the association between 25-hydroxyvitamin D deficiency and preeclampsia and the impact of 25-hydroxyvitamin D supplementation on the incidence of preeclampsia were incorporated. The results were reported using a random-effects meta-analysis and the Mantel-Haenszel odds ratio. A p-value of <0.05 was considered significant for the analysis. Results This analysis includes 34 papers, including 10 randomized controlled trials and 24 observational studies. According to our pooled analysis, 25-hydroxyvitamin D supplementation was significantly associated with a lower risk of preeclampsia in pregnant women (OR: 0.50; 95% CI: 0.40-0.63; p = 0.00001), while 25-hydroxyvitamin D deficiency was significantly associated with an increased risk of preeclampsia (OR: 4.30; 95 % CI: 2.57-7.18; p < 0.00001, OR: 1.71; 95 % Cl: 1.27-2.32; p = 0.0005, OR 1.61; 95 % Cl: 1.21-2.16; p = 0.001). Conclusion Results suggest that 25-hydroxyvitamin D has a significant relationship with preeclampsia as confirmed by the findings that low maternal 25-hydroxyvitamin D concentrations cause increased risk of preeclampsia while 25-hydroxyvitamin D supplementation reduces the incidence of preeclampsia. Our findings indicate that 25-hydroxyvitamin D supplementation can be used as a possible intervention strategy in preventing one of the most common causes of maternal mortality around the world, preeclampsia.
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Affiliation(s)
| | | | - Hifza Agha
- Shaheed Mohtarma Benazir Bhutto Medical College Lyari, Karachi, Pakistan
| | | | | | | | - Shalni Golani
- The Aga Khan University Medical College Pakistan, Karachi, Sindh, Pakistan
| | | | - Faiza Qureshi
- The Aga Khan University Medical College Pakistan, Karachi, Sindh, Pakistan
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Motamed S, Anari R, Motamed S, Amani R. Vitamin D and biomarkers of inflammation and oxidative stress among pregnant women: a systematic review of observational studies. BMC Immunol 2023; 24:41. [PMID: 37891486 PMCID: PMC10612223 DOI: 10.1186/s12865-023-00577-w] [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: 09/06/2023] [Accepted: 10/16/2023] [Indexed: 10/29/2023] Open
Abstract
OBJECTIVE This systematic review aimed to map the evidence evaluated the relationship between vitamin D and redox and inflammatory status during gestation. METHODS Three databases (PubMed/MEDLINE, Scopus, and Web of Science (WoS)) and reference list of included documents were searched for related observational studies published until 2nd October 2023. To determine the quality of the selected observational studies, the Newcastle-Ottawa Scale (NOS) was used. RESULTS After a primary search of three databases, 19492records were appeared. When duplicates and irrelevant documents were removed, 14 articles were found to have eligible criteria. The design of the identified studies was cross-sectional, case-control and cohort. Evidence showed an adverse association between 25(OH)D and the biomarkers of inflammation, such as high-sensitivity C-reactive protein (hs-CRP), Interleukin-1beta (IL-1β), Interleukin-6 (IL-6), and tumor necrosis factor- alfa (TNF-α) during pregnancy. On the contrary, some studies represented that 25(OH)D positively correlated with hs-CRP in the cord blood. One study suggested a direct association between serum concentrations of 25(OH)D and Interleukin-8 (IL-8), macrophage inflammatory protein (MIP), and TNF-α levels in mothers with gestational diabetes mellitus (GDM). A case-control study showed that lower serum concentration of 25(OH)D positively correlated with total antioxidant capacity (TAC) levels in participants. CONCLUSIONS Evidence confirmed the supposition of the direct relationship between vitamin D levels and biomarkers with anti-inflammatory and anti-oxidative properties. However, the Existence of inconsistent evidence confirms the need for further studies in mothers with GDM and hypertensive disorders. PROSPERO REGISTRATION CODE CRD42020202600.
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Affiliation(s)
| | - Razieh Anari
- National Nutrition and Food Technology Research Institute, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Somayeh Motamed
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Reza Amani
- Department of Clinical Nutrition, School of Nutrition and Food Sciences, Isfahan University of Medical Sciences, Isfahan, Iran
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Karpova N, Dmitrenko O, Arshinova E, Nurbekov M. Review: Influence of 25(OH)D Blood Concentration and Supplementation during Pregnancy on Preeclampsia Development and Neonatal Outcomes. Int J Mol Sci 2022; 23:ijms232112935. [PMID: 36361738 PMCID: PMC9653937 DOI: 10.3390/ijms232112935] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 10/18/2022] [Accepted: 10/19/2022] [Indexed: 11/25/2022] Open
Abstract
Briefly, 25-hydroxyvitamin D (25(OH)D) plays an essential role in embryogenesis and the course of intra- and postnatal periods and is crucially involved in the functioning of the mother–placenta–fetus system. The low quantity of 25(OH)D during pregnancy can lead to an elevated risk for preeclampsia occurrence. Despite the numerous studies on the association of 25(OH)D deficiency and preeclampsia development, the current research on this theme is contradictory. In this review, we summarize and analyze study data on the effects of 25(OH)D deficiency and supplementation on pregnancy, labor, and fetal and neonatal outcomes.
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Dahma G, Neamtu R, Nitu R, Gluhovschi A, Bratosin F, Grigoras ML, Silaghi C, Citu C, Orlu IN, Bhattarai S, Mocanu AG, Craina M, Bernad E. The Influence of Maternal Vitamin D Supplementation in Pregnancies Associated with Preeclampsia: A Case-Control Study. Nutrients 2022; 14:nu14153008. [PMID: 35893862 PMCID: PMC9330723 DOI: 10.3390/nu14153008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 07/20/2022] [Accepted: 07/20/2022] [Indexed: 12/14/2022] Open
Abstract
Preeclampsia is a pregnancy-specific illness that is hypothesized to occur due to vitamin D deficiency during pregnancy. Therefore, vitamin D supplementation in early pregnancy should be explored for preventing preeclampsia and promoting neonatal well-being. The present study follows a case-control analysis that aims to determine the effect of vitamin D supplements on reducing the probability of recurrent preeclampsia. We identified 59 patients for the control group without vitamin D supplementation during pregnancy, while 139 patients were included in the cases group of pregnant women with a history of preeclampsia who confirmed taking daily vitamin D supplements in either 2000 UI or 4000 UI until the 36th week of pregnancy. There were 61 (80.3%) patients with a normal serum vitamin D level measured at 32 weeks in the pregnant women who took a daily dose of 4000 UI vitamin D and 43 (68.3%) in those who took a 2000 UI dose of vitamin D, compared to just 32 (54.2%) in those who did not take vitamin D at all. Regarding the blood pressure of pregnant women measured at 32 weeks, it was observed that 20.3% were hypertensive in the no supplementation group, compared to only 11.1% and 6.6% in those who were taking vitamin D during pregnancy (p-value = 0.049). Serum vitamin D levels at 32 weeks were measured at an average value of 23.9 ng/mL, compared with 28.4 ng/mL in the group taking a 2000 UI daily dose and 33.6 in those who supplemented with 4000 UI daily (p-value < 0.001). Proteinuria was identified more often in the group at risk for preeclampsia who did not take vitamin D supplements, while systolic blood pressure (p-value = 0.036) as well as diastolic blood pressure (p-value = 0.012), were all identified to have significantly higher values in the pregnant women with a history of preeclampsia that did not take vitamin D during the current pregnancy. The significant risk factors for preeclampsia development in pregnant patients at risk are: insufficient vitamin D serum levels (<20 ng/mL), OR = 2.52; no vitamin D supplementation, OR = 1.46; more than two pregnancies, OR = 1.89; gestational diabetes mellitus, OR = 1.66; and cardiovascular comorbidities, OR = 2.18. These findings imply that vitamin D has a role in the preservation of placental function and, therefore, in the prevention of the development of late preeclampsia. Pregnant mothers who supplemented their diets with vitamin D were protected against preeclampsia recurrence. Vitamin D supplementation during pregnancy may aid in the prevention of gestational hypertension and preeclampsia.
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Affiliation(s)
- George Dahma
- Department of Obstetrics and Gynecology, “Victor Babes” University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania; (G.D.); (R.N.); (A.G.); (C.S.); (C.C.); (A.G.M.); (M.C.); (E.B.)
| | - Radu Neamtu
- Department of Obstetrics and Gynecology, “Victor Babes” University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania; (G.D.); (R.N.); (A.G.); (C.S.); (C.C.); (A.G.M.); (M.C.); (E.B.)
| | - Razvan Nitu
- Department of Obstetrics and Gynecology, “Victor Babes” University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania; (G.D.); (R.N.); (A.G.); (C.S.); (C.C.); (A.G.M.); (M.C.); (E.B.)
- Correspondence: ; Tel.: +40-729-098-886
| | - Adrian Gluhovschi
- Department of Obstetrics and Gynecology, “Victor Babes” University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania; (G.D.); (R.N.); (A.G.); (C.S.); (C.C.); (A.G.M.); (M.C.); (E.B.)
| | - Felix Bratosin
- Methodological and Infectious Diseases Research Center, Department of Infectious Diseases, “Victor Babes” University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania; (F.B.); (M.L.G.)
| | - Mirela Loredana Grigoras
- Methodological and Infectious Diseases Research Center, Department of Infectious Diseases, “Victor Babes” University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania; (F.B.); (M.L.G.)
| | - Carmen Silaghi
- Department of Obstetrics and Gynecology, “Victor Babes” University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania; (G.D.); (R.N.); (A.G.); (C.S.); (C.C.); (A.G.M.); (M.C.); (E.B.)
| | - Cosmin Citu
- Department of Obstetrics and Gynecology, “Victor Babes” University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania; (G.D.); (R.N.); (A.G.); (C.S.); (C.C.); (A.G.M.); (M.C.); (E.B.)
| | - Igwe Nwobueze Orlu
- Faculty of General Medicine, University of Debrecen Medical School, Nagyerdei Street 94, 4032 Debrecen, Hungary;
| | | | - Adelina Geanina Mocanu
- Department of Obstetrics and Gynecology, “Victor Babes” University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania; (G.D.); (R.N.); (A.G.); (C.S.); (C.C.); (A.G.M.); (M.C.); (E.B.)
| | - Marius Craina
- Department of Obstetrics and Gynecology, “Victor Babes” University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania; (G.D.); (R.N.); (A.G.); (C.S.); (C.C.); (A.G.M.); (M.C.); (E.B.)
| | - Elena Bernad
- Department of Obstetrics and Gynecology, “Victor Babes” University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania; (G.D.); (R.N.); (A.G.); (C.S.); (C.C.); (A.G.M.); (M.C.); (E.B.)
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Hahn L, Meister S, Mannewitz M, Beyer S, Corradini S, Hasbargen U, Mahner S, Jeschke U, Kolben T, Burges A. Gal-2 Increases H3K4me3 and H3K9ac in Trophoblasts and Preeclampsia. Biomolecules 2022; 12:biom12050707. [PMID: 35625634 PMCID: PMC9139023 DOI: 10.3390/biom12050707] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2022] [Revised: 05/11/2022] [Accepted: 05/13/2022] [Indexed: 12/10/2022] Open
Abstract
Preeclampsia (PE) is a severe pregnancy disorder with a pathophysiology not yet completely understood and without curative therapy. The histone modifications H3K4me3 and H3K9ac, as well as galectin-2 (Gal-2), are known to be decreased in PE. To gain a better understanding of the development of PE, the influence of Gal-2 on histone modification in trophoblasts and in syncytialisation was investigated. Immunohistochemical stains of 13 PE and 13 control placentas were correlated, followed by cell culture experiments. An analysis of H3K4me3 and H3K9ac was conducted, as well as cell fusion staining with E-cadherin and β-catenin—both after incubation with Gal-2. The expression of H3K4me3 and H3K9ac correlated significantly with the expression of Gal-2. Furthermore, we detected an increase in H3K4me3 and H3K9ac after the addition of Gal-2 to BeWo/HVT cells. Moreover, there was increased fusion of HVT cells after incubation with Gal-2. Gal-2 is associated with the histone modifications H3K4me3 and H3K9ac in trophoblasts. Furthermore, syncytialisation increased after incubation with Gal-2. Therefore, we postulate that Gal-2 stimulates syncytialisation, possibly mediated by H3K4me3 and H3K9ac. Since Gal-2, as well as H3K4me3 and H3K9ac, are decreased in PE, the induction of Gal-2 might be a promising therapeutic target.
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Affiliation(s)
- Laura Hahn
- Department of Obsterics and Gynecology, University Hospital, Ludwig-Maximilians-Universität Munich, Marchioninistr. 15, 81337 Munich, Germany; (S.M.); (M.M.); (S.B.); (U.H.); (S.M.); (U.J.); (T.K.); (A.B.)
- Correspondence: ; Tel.: +49-89-440073800
| | - Sarah Meister
- Department of Obsterics and Gynecology, University Hospital, Ludwig-Maximilians-Universität Munich, Marchioninistr. 15, 81337 Munich, Germany; (S.M.); (M.M.); (S.B.); (U.H.); (S.M.); (U.J.); (T.K.); (A.B.)
| | - Mareike Mannewitz
- Department of Obsterics and Gynecology, University Hospital, Ludwig-Maximilians-Universität Munich, Marchioninistr. 15, 81337 Munich, Germany; (S.M.); (M.M.); (S.B.); (U.H.); (S.M.); (U.J.); (T.K.); (A.B.)
| | - Susanne Beyer
- Department of Obsterics and Gynecology, University Hospital, Ludwig-Maximilians-Universität Munich, Marchioninistr. 15, 81337 Munich, Germany; (S.M.); (M.M.); (S.B.); (U.H.); (S.M.); (U.J.); (T.K.); (A.B.)
| | - Stefanie Corradini
- Department of Radiation Oncology, University Hospital, Ludwig-Maximilians-Universität Munich, Marchioninistr. 15, 81337 Munich, Germany;
| | - Uwe Hasbargen
- Department of Obsterics and Gynecology, University Hospital, Ludwig-Maximilians-Universität Munich, Marchioninistr. 15, 81337 Munich, Germany; (S.M.); (M.M.); (S.B.); (U.H.); (S.M.); (U.J.); (T.K.); (A.B.)
| | - Sven Mahner
- Department of Obsterics and Gynecology, University Hospital, Ludwig-Maximilians-Universität Munich, Marchioninistr. 15, 81337 Munich, Germany; (S.M.); (M.M.); (S.B.); (U.H.); (S.M.); (U.J.); (T.K.); (A.B.)
| | - Udo Jeschke
- Department of Obsterics and Gynecology, University Hospital, Ludwig-Maximilians-Universität Munich, Marchioninistr. 15, 81337 Munich, Germany; (S.M.); (M.M.); (S.B.); (U.H.); (S.M.); (U.J.); (T.K.); (A.B.)
- Department of Gynecology and Obsterics, University Hospital Augsburg, 86156 Augsburg, Germany
| | - Thomas Kolben
- Department of Obsterics and Gynecology, University Hospital, Ludwig-Maximilians-Universität Munich, Marchioninistr. 15, 81337 Munich, Germany; (S.M.); (M.M.); (S.B.); (U.H.); (S.M.); (U.J.); (T.K.); (A.B.)
| | - Alexander Burges
- Department of Obsterics and Gynecology, University Hospital, Ludwig-Maximilians-Universität Munich, Marchioninistr. 15, 81337 Munich, Germany; (S.M.); (M.M.); (S.B.); (U.H.); (S.M.); (U.J.); (T.K.); (A.B.)
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Nunes PR, Romao-Veiga M, Ribeiro VR, de Oliveira LRC, de Carvalho Depra I, de Oliveira LG, Peracoli JC, Peracoli MTS. Inflammasomes in placental explants of women with preeclampsia cultured with monosodium urate may be modulated by vitamin D. Hypertens Pregnancy 2022; 41:139-148. [DOI: 10.1080/10641955.2022.2063330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
| | - Mariana Romao-Veiga
- Botucatu Medical School, Sao Paulo State University (Unesp), Sao Paulo, Brazil
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Aguilar-Cordero MJ, Pérez-Castillo IM. Response to the Letter to the Editor of Midwifery. Midwifery 2021; 105:103221. [PMID: 34895781 DOI: 10.1016/j.midw.2021.103221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- M J Aguilar-Cordero
- Development and Innovation Plan. CTS 367, University of Granada. Granada, Spain
| | - I M Pérez-Castillo
- Development and Innovation Plan. CTS 367, University of Granada. Granada, Spain
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Meister S, Hahn L, Beyer S, Paul C, Mitter S, Kuhn C, von Schönfeldt V, Corradini S, Sudan K, Schulz C, Kolben TM, Mahner S, Jeschke U, Kolben T. Regulation of Epigenetic Modifications in the Placenta during Preeclampsia: PPARγ Influences H3K4me3 and H3K9ac in Extravillous Trophoblast Cells. Int J Mol Sci 2021; 22:ijms222212469. [PMID: 34830351 PMCID: PMC8622744 DOI: 10.3390/ijms222212469] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 11/15/2021] [Accepted: 11/15/2021] [Indexed: 12/12/2022] Open
Abstract
The aim of this study was to analyze the expression of peroxisome proliferator-activated receptor γ (PPARγ) and retinoid X receptor α (RxRα), a binding heterodimer playing a pivotal role in the successful trophoblast invasion, in the placental tissue of preeclamptic patients. Furthermore, we aimed to characterize a possible interaction between PPARγ and H3K4me3 (trimethylated lysine 4 of the histone H3), respectively H3K9ac (acetylated lysine 9 of the histone H3), to illuminate the role of histone modifications in a defective trophoblast invasion in preeclampsia (PE). Therefore, the expression of PPARγ and RxRα was analyzed in 26 PE and 25 control placentas by immunohistochemical peroxidase staining, as well as the co-expression with H3K4me3 and H3K9ac by double immunofluorescence staining. Further, the effect of a specific PPARγ-agonist (Ciglitazone) and PPARγ-antagonist (T0070907) on the histone modifications H3K9ac and H3K4me3 was analyzed in vitro. In PE placentas, we found a reduced expression of PPARγ and RxRα and a reduced co-expression with H3K4me3 and H3K9ac in the extravillous trophoblast (EVT). Furthermore, with the PPARγ-antagonist treated human villous trophoblast (HVT) cells and primary isolated EVT cells showed higher levels of the histone modification proteins whereas treatment with the PPARγ-agonist reduced respective histone modifications. Our results show that the stimulation of PPARγ-activity leads to a reduction of H3K4me3 and H3K9ac in trophoblast cells, but paradoxically decreases the nuclear PPARγ expression. As the importance of PPARγ, being involved in a successful trophoblast invasion has already been investigated, our results reveal a pathophysiologic connection between PPARγ and the epigenetic modulation via H3K4me3 and H3K9ac in PE.
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Affiliation(s)
- Sarah Meister
- Department of Gynecology and Obstetrics, University Hospital, LMU Munich, Marchioninistr. 15, 81377 Munich, Germany; (L.H.); (S.B.); (C.P.); (S.M.); (V.v.S.); (T.M.K.); (S.M.); (T.K.)
- Correspondence: (S.M.); (U.J.); Tel.: +49-89-4400-54266 (S.M.); Fax: +49-89-4400-54916 (S.M.)
| | - Laura Hahn
- Department of Gynecology and Obstetrics, University Hospital, LMU Munich, Marchioninistr. 15, 81377 Munich, Germany; (L.H.); (S.B.); (C.P.); (S.M.); (V.v.S.); (T.M.K.); (S.M.); (T.K.)
| | - Susanne Beyer
- Department of Gynecology and Obstetrics, University Hospital, LMU Munich, Marchioninistr. 15, 81377 Munich, Germany; (L.H.); (S.B.); (C.P.); (S.M.); (V.v.S.); (T.M.K.); (S.M.); (T.K.)
| | - Corinna Paul
- Department of Gynecology and Obstetrics, University Hospital, LMU Munich, Marchioninistr. 15, 81377 Munich, Germany; (L.H.); (S.B.); (C.P.); (S.M.); (V.v.S.); (T.M.K.); (S.M.); (T.K.)
| | - Sophie Mitter
- Department of Gynecology and Obstetrics, University Hospital, LMU Munich, Marchioninistr. 15, 81377 Munich, Germany; (L.H.); (S.B.); (C.P.); (S.M.); (V.v.S.); (T.M.K.); (S.M.); (T.K.)
| | - Christina Kuhn
- Department of Gynecology and Obstetrics, University Hospital Augsburg, 86156 Augsburg, Germany;
| | - Viktoria von Schönfeldt
- Department of Gynecology and Obstetrics, University Hospital, LMU Munich, Marchioninistr. 15, 81377 Munich, Germany; (L.H.); (S.B.); (C.P.); (S.M.); (V.v.S.); (T.M.K.); (S.M.); (T.K.)
| | - Stefanie Corradini
- Department of Radiation Oncology, University Hospital, LMU Munich, Marchioninistr. 15, 81377 Munich, Germany;
| | - Kritika Sudan
- Medizinische Klinik und Poliklinik I, Klinikum der Universität München LMU Munich, Marchioninistr. 15, 81377 Munich, Germany; (K.S.); (C.S.)
| | - Christian Schulz
- Medizinische Klinik und Poliklinik I, Klinikum der Universität München LMU Munich, Marchioninistr. 15, 81377 Munich, Germany; (K.S.); (C.S.)
| | - Theresa Maria Kolben
- Department of Gynecology and Obstetrics, University Hospital, LMU Munich, Marchioninistr. 15, 81377 Munich, Germany; (L.H.); (S.B.); (C.P.); (S.M.); (V.v.S.); (T.M.K.); (S.M.); (T.K.)
| | - Sven Mahner
- Department of Gynecology and Obstetrics, University Hospital, LMU Munich, Marchioninistr. 15, 81377 Munich, Germany; (L.H.); (S.B.); (C.P.); (S.M.); (V.v.S.); (T.M.K.); (S.M.); (T.K.)
| | - Udo Jeschke
- Department of Gynecology and Obstetrics, University Hospital, LMU Munich, Marchioninistr. 15, 81377 Munich, Germany; (L.H.); (S.B.); (C.P.); (S.M.); (V.v.S.); (T.M.K.); (S.M.); (T.K.)
- Department of Gynecology and Obstetrics, University Hospital Augsburg, 86156 Augsburg, Germany;
- Correspondence: (S.M.); (U.J.); Tel.: +49-89-4400-54266 (S.M.); Fax: +49-89-4400-54916 (S.M.)
| | - Thomas Kolben
- Department of Gynecology and Obstetrics, University Hospital, LMU Munich, Marchioninistr. 15, 81377 Munich, Germany; (L.H.); (S.B.); (C.P.); (S.M.); (V.v.S.); (T.M.K.); (S.M.); (T.K.)
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Poniedziałek-Czajkowska E, Mierzyński R. Could Vitamin D Be Effective in Prevention of Preeclampsia? Nutrients 2021; 13:nu13113854. [PMID: 34836111 PMCID: PMC8621759 DOI: 10.3390/nu13113854] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 10/21/2021] [Accepted: 10/26/2021] [Indexed: 12/23/2022] Open
Abstract
Prevention of preeclampsia (PE) remains one of the most significant problems in perinatal medicine. Due to the possible unpredictable course of hypertension in pregnancy, primarily PE and the high complication rate for the mother and fetus/newborn, it is urgent to offer pregnant women in high-risk groups effective methods of preventing the PE development or delaying its appearance. In addition, due to the association of PE with an increased risk of developing cardiovascular diseases (CVD) in later life, effective preeclampsia prevention could also be important in reducing their incidence. Ideal PE prophylaxis should target the pathogenetic changes leading to the development of PE and be safe for the mother and fetus, inexpensive and freely available. Currently, the only recognized method of PE prevention recommended by many institutions around the world is the use of a small dose of acetylsalicylic acid in pregnant women with risk factors. Unfortunately, some cases of PE are diagnosed in women without recognized risk factors and in those in whom prophylaxis with acetylsalicylic acid is not adequate. Hence, new drugs which would target pathogenetic elements in the development of preeclampsia are studied. Vitamin D (Vit D) seems to be a promising agent due to its beneficial effect on placental implantation, the immune system, and angiogenic factors. Studies published so far emphasize the relationship of its deficiency with the development of PE, but the data on the benefits of its supplementation to reduce the risk of PE are inconclusive. In the light of current research, the key issue is determining the protective concentration of Vit D in a pregnant woman. The study aims to present the possibility of using Vit D to prevent PE, emphasizing its impact on the pathogenetic elements of preeclampsia development.
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11
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Nunes PR, Romao-Veiga M, Matias ML, Ribeiro VR, de Oliveira L, Peracoli JC, Terezinha S Peracoli M. Vitamin D decreases expression of NLRP1 and NLRP3 ninflammasomes in placental explants from women with preeclampsia cultured with hydrogen peroxide. Hum Immunol 2021; 83:74-80. [PMID: 34696918 DOI: 10.1016/j.humimm.2021.10.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 10/04/2021] [Accepted: 10/11/2021] [Indexed: 11/17/2022]
Abstract
This study aimed to evaluate the immunomodulatory effect of vitamin D (VD) on the NLRP1 and NLRP3 inflammasomes in placental explants from preeclamptic (PE) and normotensive (NT) pregnant women. Placental explants from eight PE and eight NT pregnant women were cultured with or without hydrogen peroxide (H2O2), VD or H2O2 + VD. Gene and protein expression of NLRP1, NLRP3, HMGB1, caspase-1, IL-1β, TNF-α and IL-18 were determined by qPCR and Western blotting/ELISA. Compared to NT pregnant women, the endogenous gene expression of NLRP1, NLRP3, HMGB1, IL-1β, TNF-α and IL-18 was significantly higher in explants from PE and became decreased after VD treatment. Similarly, VD decreased the protein expression of NLRP1, NLRP3, caspase-1, HMGB1, IL-1β, TNF-α and IL-18 in PE. Placental explants from NT cultured with H2O2 showed increased gene and protein expression of NLRP1, NLRP3, caspase-1, IL-1β, TNF-α and HMGB1, while H2O2 was also able to increase TNF-α and caspase-1 gene expression in PE. Treatment with H2O2 + VD decreased gene/protein expression of NLRP1, NLRP3, caspase-1, HMGB1, IL-1β, TNF-α and IL-18 in PE and NT explants with H2O2. NLRP1 and NLRP3 are upregulated in the PE. VD may play an immunomodulatory role in the placental inflammation and downregulates oxidative stress induced in vitro by H2O2.
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Affiliation(s)
- Priscila R Nunes
- Botucatu Medical School, Sao Paulo State University (Unesp), Botucatu, Sao Paulo, Brazil.
| | - Mariana Romao-Veiga
- Botucatu Medical School, Sao Paulo State University (Unesp), Botucatu, Sao Paulo, Brazil
| | - Mariana L Matias
- Botucatu Medical School, Sao Paulo State University (Unesp), Botucatu, Sao Paulo, Brazil
| | - Vanessa R Ribeiro
- Botucatu Medical School, Sao Paulo State University (Unesp), Botucatu, Sao Paulo, Brazil
| | - Leandro de Oliveira
- Botucatu Medical School, Sao Paulo State University (Unesp), Botucatu, Sao Paulo, Brazil
| | - Jose Carlos Peracoli
- Botucatu Medical School, Sao Paulo State University (Unesp), Botucatu, Sao Paulo, Brazil
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12
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Santander Ballestín S, Giménez Campos MI, Ballestín Ballestín J, Luesma Bartolomé MJ. Is Supplementation with Micronutrients Still Necessary during Pregnancy? A Review. Nutrients 2021; 13:3134. [PMID: 34579011 PMCID: PMC8469293 DOI: 10.3390/nu13093134] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 08/26/2021] [Accepted: 09/06/2021] [Indexed: 02/06/2023] Open
Abstract
INTRODUCTION Proper nutrition during pregnancy is important to prevent nutritional imbalances that interfere with pregnancy. Micronutrients play critical roles in embryogenesis, fetal growth, and maternal health, as energy, protein, vitamin, and mineral needs can increase during pregnancy. Increased needs can be met by increasing the intake of dietary micronutrients. Severe micronutrient deficiency or excess during pregnancy can have negative effects on fetal growth (intrauterine growth retardation, low birth weight, or congenital malformations) and pregnancy development (pre-eclampsia or gestational diabetes). We investigate whether it is necessary to continue micronutrient supplementation during pregnancy to improve women's health in this stage and whether this supplementation could prevent and control pathologies associated with pregnancy. AIM The present review aims to summarize evidence on the effects of nutritional deficiencies on maternal and newborn morbidity. METHODS This aim is addressed by critically reviewing results from published studies on supplementation with different nutrients during pregnancy. For this, major scientific databases, scientific texts, and official webpages have been consulted. PubMed searches using the terms "pregnancy" OR "maternal-fetal health" AND "vitamins" OR "minerals" OR "supplementation" AND "requirement" OR "deficiency nutrients" were performed. RESULTS There are accepted interventions during pregnancy, such as folic acid supplementation to prevent congenital neural tube defects, potassium iodide supplementation to correct neurodevelopment, and oral iron supplementation during the second half of pregnancy to reduce the risk of maternal anemia and iron deficiency. A number of micronutrients have also been associated with pre-eclampsia, gestational diabetes mellitus, and nausea and vomiting in pregnancy. In general, experimental studies are necessary to demonstrate the benefits of supplementation with different micronutrients and to adjust the recommended daily doses and the recommended periconceptional nutrition for mothers. CONCLUSIONS Presently, there is evidence of the benefits of micronutrient supplementation in perinatal results, but indiscriminate use is discouraged due to the fact that the side effects of excessive doses are not known. Evidence supports the idea that micronutrient deficiencies negatively affect maternal health and the outcome of pregnancy. No single micronutrient is responsible for the adverse effects; thus, supplementing or correcting one deficiency will not be very effective while other deficiencies exist.
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Affiliation(s)
- Sonia Santander Ballestín
- Department of Pharmacology, Physiology and Legal and Forensic Medicine, Faculty of Medicine, University of Zaragoza, 50009 Zaragoza, Spain
| | | | | | - María José Luesma Bartolomé
- Department of Human Anatomy and Histology, Faculty of Science, University of Zaragoza, 50009 Zaragoza, Spain;
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13
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Nunes PR, Gomes VJ, Sandrim VC, Peraçoli JC, Peraçoli MTS, Carlström M. Effects of vitamin D-induced supernatant of placental explants from preeclamptic women on oxidative stress and nitric oxide bioavailability in human umbilical vein endothelial cells. ACTA ACUST UNITED AC 2021; 54:e11073. [PMID: 34037098 PMCID: PMC8148885 DOI: 10.1590/1414-431x2020e11073] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2020] [Accepted: 04/01/2021] [Indexed: 02/04/2023]
Abstract
The study evaluated the effect of the supernatant of placental explants from preeclamptic (PE) and normotensive (NT) pregnant women after tissue treatment with or without vitamin D (VD) on oxidative stress and nitric oxide (NO) bioavailability in human umbilical vein endothelial cells (HUVEC). Placental explants were prepared from eight NT and eight PE women, and supernatants were obtained after incubation with or without hydrogen peroxide (H2O2) and/or VD. HUVEC were cultured for 24 h with supernatants, and the following parameters were analyzed in HUVEC cultures: NO, nitrate (NO3-), and nitrite (NO2-) levels, lipid peroxidation, and intracellular reactive oxygen species (ROS). Results showed that the production of NO3-, NO2-, malondialdehyde (MDA), and ROS were significantly higher in HUVEC treated with explant supernatant from PE compared to NT pregnant women, while the supernatant of PE explants treated with VD led to a decrease in these parameters. A significantly high production of NO was detected in HUVEC cultured with control supernatant of NT group, and in cultures treated with supernatant of PE explants treated with VD. Taken together, these results demonstrated that cultures of placental explants from PE women with VD treatment generated a supernatant that decreased oxidative stress and increased the bioavailability of NO in endothelial cells.
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Affiliation(s)
- P R Nunes
- Departamento de Ginecologia e Obstetrícia, Faculdade de Medicina de Botucatu, Universidade Estadual Paulista "Júlio de Mesquita Filho", Botucatu, SP, Brasil
| | - V J Gomes
- Departamento de Ginecologia e Obstetrícia, Faculdade de Medicina de Botucatu, Universidade Estadual Paulista "Júlio de Mesquita Filho", Botucatu, SP, Brasil
| | - V C Sandrim
- Departamento de Biofísica e Farmacologia, Instituto de Biociências, Universidade Estadual Paulista "Júlio de Mesquita Filho", Botucatu, SP, Brasil
| | - J C Peraçoli
- Departamento de Ginecologia e Obstetrícia, Faculdade de Medicina de Botucatu, Universidade Estadual Paulista "Júlio de Mesquita Filho", Botucatu, SP, Brasil
| | - M T S Peraçoli
- Departamento de Ginecologia e Obstetrícia, Faculdade de Medicina de Botucatu, Universidade Estadual Paulista "Júlio de Mesquita Filho", Botucatu, SP, Brasil
| | - M Carlström
- Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
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14
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Matias ML, Romao-Veiga M, Ribeiro VR, Nunes PR, Gomes VJ, Devides AC, Borges VT, Romagnoli GG, Peracoli JC, Peracoli MT. Progesterone and vitamin D downregulate the activation of the NLRP1/NLRP3 inflammasomes and TLR4-MyD88-NF-κB pathway in monocytes from pregnant women with preeclampsia. J Reprod Immunol 2021; 144:103286. [PMID: 33578174 DOI: 10.1016/j.jri.2021.103286] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Revised: 01/07/2021] [Accepted: 01/31/2021] [Indexed: 12/13/2022]
Abstract
This study evaluated the in vitro modulatory effect of progesterone (PG) and vitamin D (VD) on NLRP1/NLRP3 inflammasomes and TLR4/NF-κB pathway in monocytes from pregnant women with preeclampsia (PE). Monocytes from 20 preeclamptic and 20 normotensive (NT) pregnant women, and THP-1 cells were cultured with/without hyaluronan (HA), PG, or VD to determine gene and protein expression of TLR4 receptor, phosphorylated NF-κB, IκBα, TLR4, MYD88, NF-κB, NLRP1, NLRP3, caspase-1, IL-1β, IL-18, TNF-α, and IL-10. Higher endogenous activation of inflammatory genes and higher protein expression of TLR4 and NF-κB was detected in monocytes of PE group and decreased after PG or VD treatment. Monocyte from PE stimulated with HA increased while treatment with PG or VD decreased the expression of genes and proteins related to the inflammasomes. THP-1 cells showed a similar immune response profile as monocytes from PE. These results demonstrate that PG and VD play an immunomodulatory role in monocyte activation.
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Affiliation(s)
- Mariana Leticia Matias
- Department of Gynaecology and Obstetrics, Botucatu Medical School, Sao Paulo State University (UNESP), Botucatu, Sao Paulo, Brazil
| | - Mariana Romao-Veiga
- Department of Gynaecology and Obstetrics, Botucatu Medical School, Sao Paulo State University (UNESP), Botucatu, Sao Paulo, Brazil
| | - Vanessa Rocha Ribeiro
- Department of Gynaecology and Obstetrics, Botucatu Medical School, Sao Paulo State University (UNESP), Botucatu, Sao Paulo, Brazil
| | - Priscila Rezeck Nunes
- Department of Gynaecology and Obstetrics, Botucatu Medical School, Sao Paulo State University (UNESP), Botucatu, Sao Paulo, Brazil
| | - Virginia Juliani Gomes
- Department of Gynaecology and Obstetrics, Botucatu Medical School, Sao Paulo State University (UNESP), Botucatu, Sao Paulo, Brazil
| | - Amanda Carreira Devides
- Department of Gynaecology and Obstetrics, Botucatu Medical School, Sao Paulo State University (UNESP), Botucatu, Sao Paulo, Brazil
| | - Vera Therezinha Borges
- Department of Gynaecology and Obstetrics, Botucatu Medical School, Sao Paulo State University (UNESP), Botucatu, Sao Paulo, Brazil
| | | | - Jose Carlos Peracoli
- Department of Gynaecology and Obstetrics, Botucatu Medical School, Sao Paulo State University (UNESP), Botucatu, Sao Paulo, Brazil
| | - Maria Terezinha Peracoli
- Department of Chemistry and Biological Sciences, Institute of Biosciences, Botucatu, Sao Paulo State University (UNESP), Botucatu, Sao Paulo, Brazil.
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15
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Zhang Y, Liu X, Yang L, Zou L. Current Researches, Rationale, Plausibility, and Evidence Gaps on Metformin for the Management of Hypertensive Disorders of Pregnancy. Front Pharmacol 2020; 11:596145. [PMID: 33381040 PMCID: PMC7768035 DOI: 10.3389/fphar.2020.596145] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Accepted: 10/22/2020] [Indexed: 12/16/2022] Open
Abstract
Hypertensive disorders of pregnancy (HDP) are a group of morbid pregnancy complications, with preeclampsia (PE) being the most common subclassification among them. PE affects 2%–8% of pregnancies globally and threatens maternal and fetal health seriously. However, the only effective treatment of PE to date is the timely termination of pregnancy, albeit with increased perinatal risks. Hence, more emerging therapies for PE management are in urgent need. Originally introduced as the first-line therapy for type 2 diabetes mellitus, metformin (MET) has now been found in clinical trials to significantly reduce the incidence of gestational hypertension and PE in pregnant women with PE-related risks, including but not limited to pregestational diabetes mellitus, gestational diabetes mellitus, polycystic ovary syndrome, or obesity. Additionally, existing clinical data have preliminarily ensured the safety of taking MET during human pregnancies. Relevant lab studies have indicated that the underlying mechanism includes angiogenesis promotion, endothelial protection, anti-inflammatory effects, and particularly protective effects on trophoblast cells against the risk factors, which are beneficial to placental development. Together with its global availability, easy administration, and low cost, MET is expected to be a promising option for the prevention and treatment of PE. Nevertheless, there are still some limitations in current studies, and the design of the relevant research scheme is supposed to be further improved in the future. Herein, we summarize the relevant clinical and experimental researches to discuss the rationale, safety, and feasibility of MET for the management of HDP. At the end of the article, gaps in current researches are proposed. Concretely, experimental MET concentration and PE models should be chosen cautiously. Besides, the clinical trial protocol should be further optimized to evaluate the reduction in the prevalence of PE as a primary endpoint. All of those evidence gaps may be of guiding significance to improve the design of relevant experiments and clinical trials in the future.
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Affiliation(s)
- Yang Zhang
- Department of Obstetrics and Gynecology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xiaoxia Liu
- Department of Obstetrics and Gynecology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Liu Yang
- Department of Obstetrics and Gynecology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Li Zou
- Department of Obstetrics and Gynecology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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16
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Veisian M, Javaheri A, Amjadi N, Tabatabaei RS, Zanbagh L, Hadadan A, Abbasi H, Salimi E, Dastgheib SA, Neamatzadeh H. Association of IL-6 -176G > C Polymorphism with Susceptibility to Preeclampsia: A Systematic Review and Meta-Analysis. Fetal Pediatr Pathol 2020; 39:491-502. [PMID: 31738646 DOI: 10.1080/15513815.2019.1675110] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Background: Many studies have described the influence of -176G > C polymorphism of the IL-6 gene on susceptibility to preeclampsia. However, the results have remained inconclusive and controversial. Therefore, we performed a meta-analysis to more precisely determine the association between the IL-6 -176G > C polymorphism and preeclampsia risk. Methods: Electronic databases including PubMed, Embase, Web of Science, and CNKI were searched up to August 15, 2019. The pooled odds ratios (ORs) and their corresponding 95% confidence intervals (CIs) were used to calculate the association. Results: A total of 12 studies with 1,821 preeclampsia cases and 3,339 controls were selected. Overall, no significant association was found between IL-6 -176G > C polymorphism and preeclampsia risk. In the stratified analyses by ethnicity, there was a significant association in Asians, but not in Caucasians and mixed populations. Conclusions: The results of meta-analysis indicated that IL-6 -176G > C polymorphism was not significantly associated with risk of preeclampsia in overall population.
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Affiliation(s)
- Mehrnaz Veisian
- Department of Gynecology and Obstetrics, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Atiyeh Javaheri
- Department of Gynecology and Obstetrics, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Nooshin Amjadi
- Department of Gynecology and Obstetrics, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Razieh Sadat Tabatabaei
- Department of Gynecology and Obstetrics, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Leila Zanbagh
- Department of Gynecology and Obstetrics, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.,Department of Gynecology and Obstetrics, Tehran University of Medical Sciences, Tehran, Iran
| | - Amaneh Hadadan
- Department of Gynecology and Obstetrics, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.,Department of Gynecology and Obstetrics, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hajar Abbasi
- Department of Gynecology and Obstetrics, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Erfaneh Salimi
- Department of Gynecology and Obstetrics, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Seyed Alireza Dastgheib
- Department of Medical Genetics, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Hossein Neamatzadeh
- Department of Medical Genetics, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.,Mother and Newborn Health Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
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17
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Prevention and Management of Gestational Diabetes Using Vitamin D Supplementation: An Overview and Appraisal of Clinical Trials. APPLIED SCIENCES-BASEL 2020. [DOI: 10.3390/app10228141] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
A number of studies have examined the role of vitamin D in reproductive processes and disorders of pregnancy such as gestational diabetes mellitus (GDM). Although observational studies have linked maternal vitamin D deficiency with a plethora of adverse pregnancy outcomes including GDM, intervention trials generally do not support the use of vitamin D supplementation for GDM prevention or management. This narrative review provides an up-to-date overview and critical appraisal of randomised controlled trials (RCTs) to describe the current state of knowledge regarding the efficacy of vitamin D supplementation for preventing and/or managing GDM. Overall, although RCT data indicates a potential benefit of vitamin D in maternal glycaemic control, results are highly disparate and the data published to date have not conclusively established the efficacy of vitamin D in GDM prevention. There are, however, several limitations within the existing literature, including some considerable challenges that are unique to vitamin D trials, which should be carefully considered in the interpretation of the evidence and design of future studies. For now, many unanswered questions remain, and there is still a need for adequately powered and well-designed trials before routine supplementation can be recommended in the context of GDM.
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18
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Aguilar-Cordero MJ, Lasserrot-Cuadrado A, Mur-Villar N, León-Ríos XA, Rivero-Blanco T, Pérez-Castillo IM. Vitamin D, preeclampsia and prematurity: A systematic review and meta-analysis of observational and interventional studies. Midwifery 2020; 87:102707. [PMID: 32438283 DOI: 10.1016/j.midw.2020.102707] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Revised: 03/19/2020] [Accepted: 03/20/2020] [Indexed: 01/10/2023]
Abstract
BACKGROUND Vitamin D has important functions outside of bone metabolism. Deficiency has been associated with several adverse outcomes during pregnancy such as preeclampsia and prematurity. There is an increasing body of literature on this topic with studies performed to date having produced contradictory results. OBJECTIVE To synthesize the literature about vitamin D deficiency and its association with preeclampsia and prematurity in order to determine if maternal vitamin D insufficiency and/or deficiency during pregnancy is associated with the prevalence of preeclampsia and prematurity. DESIGN A systematic review and meta-analysis of observational and interventional studies. METHODS Two independent researchers reviewed the included studies according to PRISMA reporting guidelines. A protocol for this review was registered in PROSPERO with the registration number: "CRD42019136318". Three electronic databases (PubMed, ScienceDirect and Web of Science); were searched in order to identify eligible studies. Observational and interventional studies were selected which had been published in the last 6 years, and analysed the association between maternal vitamin D concentrations during pregnancy and the development of preeclampsia and/or preterm birth. Data were extracted and presented in tables and figures. Fixed and random-effects meta-analyses were performed on the studies which provided enough sample data to calculate odds ratios. Results from both statistical methods were compared. Meta-analysis cut-off points for vitamin D insufficiency and deficiency were defined as <75nmol/L and <50nmol/L, respectively. RESULTS Fifty-five studies met the inclusion criteria. Fixed-effects meta-analysis of the interventional studies indicated that vitamin D supplementation acts as a prevention factor for preeclampsia and prematurity. Fixed-effects meta-analysis of observational studies concluded that vitamin D insufficiency and deficiency are associated with a higher risk of developing preeclampsia. However, prematurity and vitamin D were only associated when maternal vitamin D concentrations was <75 nmol/L. Random-effects meta-analysis found no significant association between vitamin D, preeclampsia and prematurity in either observational or interventional studies. CONCLUSION Higher vitamin D concentrations during pregnancy could be associated with a decreased risk of preeclampsia and prematurity but statistical significance of associations depends on the study design used. Well-designed clinical trials with vitamin D supplementation are needed in order to better define associations.
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Affiliation(s)
- M J Aguilar-Cordero
- Department of Nursing, Faculty of Health Sciences, University of Granada, Granada, Spain; Andalusian Research, Development and Innovation Plan. CTS 367, University of Granada. Granada, Spain
| | - A Lasserrot-Cuadrado
- Andalusian Research, Development and Innovation Plan. CTS 367, University of Granada. Granada, Spain
| | - N Mur-Villar
- Andalusian Research, Development and Innovation Plan. CTS 367, University of Granada. Granada, Spain; University of Medical Sciences, Cienfuegos, Cuba
| | - X A León-Ríos
- Andalusian Research, Development and Innovation Plan. CTS 367, University of Granada. Granada, Spain
| | - T Rivero-Blanco
- Andalusian Research, Development and Innovation Plan. CTS 367, University of Granada. Granada, Spain
| | - I M Pérez-Castillo
- Andalusian Research, Development and Innovation Plan. CTS 367, University of Granada. Granada, Spain.
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Khalighi Sikaroudi M, Mokhtare M, Janani L, Faghihi Kashani AH, Masoodi M, Agah S, Abbaspour N, Dehnad A, Shidfar F. Vitamin D3 Supplementation in Diarrhea-Predominant Irritable Bowel Syndrome Patients: The Effects on Symptoms Improvement, Serum Corticotropin-Releasing Hormone, and Interleukin-6 - A Randomized Clinical Trial. Complement Med Res 2020; 27:302-309. [PMID: 32203968 DOI: 10.1159/000506149] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2019] [Accepted: 01/26/2020] [Indexed: 11/19/2022]
Abstract
OBJECTIVES This study aimed to evaluate whether vitamin D deficiency is associated with the severity of symptoms of irritable bowel syndrome (IBS) patients. Stress and gut inflammation can increase the serum level of corticotropin-releasing hormone (CRH) and interleukin-6 (IL-6), leading to a change in bowel movements. The aim of this study was to evaluate the anti-inflammatory and psychological effects of vitamin D3 supplementation on the symptom improvement of patients with a diarrhea-predominant form of IBS (IBS-D). METHODS Eighty-eight IBS-D patients (age: 18-65 years) based on Rome IV criteria who suffered from vitamin D deficiency and/or insufficiency were enrolled in this randomized, placebo-controlled trial from February 2017 to May 2018 at Rasoul-e-Akram Hospital, Tehran, Iran. Participants were randomly divided into two groups. The intervention group received 50,000 IU vitamin D3 weekly and the control group received a placebo for 9 weeks. All patients received Mebeverine 135 mg twice a day besides supplementation. The IBS Severity Score System (IBS-SSS), serum 25(OH) vitamin D3, CRH, and IL-6 were measured before and after interventions. RESULTS Seventy-four patients completed the study. The severity of IBS symptoms (p < 0.01) and IL-6 (p = 0.02) decreased significantly in the intervention group as compared to the control group, but there was no significant difference in the serum level of CRH. Also, in the treatment group, IBS-SSS and IL-6 were significantly reduced at the end of the study from baseline (p < 0.01 and p < 0.03, respectively). CONCLUSION Our findings indicate that vitamin D3 supplementation can modulate the serum level of CRH and IL-6 and can improve symptoms in IBS-D patients. Vitamin D3 supplementation should be considered in IBS-D patients who suffer from vitamin D deficiency and/or insufficiency.
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Affiliation(s)
| | - Marjan Mokhtare
- Colorectal Research Center, Rasoul-e-Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Leila Janani
- Department of Biostatistics, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | | | - Mohsen Masoodi
- Colorectal Research Center, Rasoul-e-Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Shahram Agah
- Colorectal Research Center, Rasoul-e-Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Narjes Abbaspour
- Department of Nutrition, Islamic Azad University, Science and Research Branch, Tehran, Iran
| | - Afsaneh Dehnad
- Department of English Language, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Farzad Shidfar
- Colorectal Research Center, Rasoul-e-Akram Hospital, Iran University of Medical Sciences, Tehran, Iran,
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20
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Motamed S, Nikooyeh B, Kashanian M, Hollis BW, Neyestani TR. Efficacy of two different doses of oral vitamin D supplementation on inflammatory biomarkers and maternal and neonatal outcomes. MATERNAL AND CHILD NUTRITION 2019; 15:e12867. [PMID: 31250540 DOI: 10.1111/mcn.12867] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/04/2018] [Revised: 02/25/2019] [Accepted: 03/19/2019] [Indexed: 12/14/2022]
Abstract
Hypovitaminosis D during pregnancy is suggested to have a link with complications in both mother and infant. We aimed to evaluate the efficacy of two doses of vitamin D3 supplementation during pregnancy on maternal and cord blood vitamin D status, inflammatory biomarkers, and maternal and neonatal outcomes. A total of 84 pregnant women (gestational age of <12 weeks) were randomly allocated to one of two groups: (a) 1,000-IU/d vitamin D and (b) 2,000 IU/d. Biochemical assessments (25-hydroxycalciferol (25(OH)D), hs-CRP, and cell-culture supernatant concentrations of IL-1β, IL-6, and TNF-α) of mothers were performed at the beginning and 34 weeks of gestation. Assessments of infants at delivery comprised cord blood serum concentrations of 25(OH)D, hs-CRP, IL-1β, IL-6, TNF-α, birth sizes, and Apgar score. Circulating concentrations of 25(OH)D increased in both intervention groups with more increment in 2,000 IU/d than in 1,000 IU/d (46.7 ± 30.7 vs. 24.0 ± 21.07 nmol L-1 , P = .001). Concentrations of TNF-α decreased significantly in group 2,000 (-913.1 ± 1261.3 ng L-1 , P = .01). The cord blood concentration of IL-6 in group 2,000 IU/d, compared with 1,000 IU/d, was significantly lower (25.9 ± 32.0 vs. 4.6 ± 1.4 ng L-1 , P = .03). The birth sizes including weight, length, and head circumference of the infants of group 2,000 IU/d were significantly higher than the infants' of group 1,000 IU/d. Supplementation with 2,000-IU/d vitamin D3 is more effective than 1,000 IU/d in pregnant women in terms of increasing circulating 25(OH)D, ameliorating pro-inflammatory markers notably TNF-α in mother and IL-6 in cord blood, and improving neonatal outcomes including the birth sizes.
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Affiliation(s)
- Soudabe Motamed
- Department of Nutrition, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Bahareh Nikooyeh
- Laboratory of Nutrition Research, National Nutrition and Food Technology Research Institute and Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Maryam Kashanian
- Department of Obstetrics and Gynecology, Akbarabadi Teaching Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Bruce W Hollis
- Division of Neonatology, Department of Pediatrics, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Tirang R Neyestani
- Laboratory of Nutrition Research, National Nutrition and Food Technology Research Institute and Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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21
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Muyayalo KP, Huang X, Qian Z, Li Z, Mor G, Liao A. Low circulating levels of vitamin D may contribute to the occurrence of preeclampsia through deregulation of Treg /Th17 cell ratio. Am J Reprod Immunol 2019; 82:e13168. [DOI: 10.1111/aji.13168] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2019] [Revised: 07/04/2019] [Accepted: 07/06/2019] [Indexed: 12/13/2022] Open
Affiliation(s)
- Kahindo P. Muyayalo
- Institute of Reproductive Health, Center for Reproductive Medicine, Tongji Medical College Huazhong University of Science and Technology Wuhan China
| | - Xiao‐Bo Huang
- Institute of Reproductive Health, Center for Reproductive Medicine, Tongji Medical College Huazhong University of Science and Technology Wuhan China
| | - Zhu Qian
- Institute of Reproductive Health, Center for Reproductive Medicine, Tongji Medical College Huazhong University of Science and Technology Wuhan China
| | - Zhi‐Hui Li
- Institute of Reproductive Health, Center for Reproductive Medicine, Tongji Medical College Huazhong University of Science and Technology Wuhan China
| | - Gil Mor
- Institute of Reproductive Health, Center for Reproductive Medicine, Tongji Medical College Huazhong University of Science and Technology Wuhan China
- C.S. Mott Center for Human Growth and Development Wayne State University School of Medicine Detroit MI USA
| | - Ai‐Hua Liao
- Institute of Reproductive Health, Center for Reproductive Medicine, Tongji Medical College Huazhong University of Science and Technology Wuhan China
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22
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Savard C, Gagnon C, Morisset AS. Disparities in the timing and measurement methods to assess vitamin D status during pregnancy: A Narrative Review. INT J VITAM NUTR RES 2019; 88:176-189. [PMID: 30747608 DOI: 10.1024/0300-9831/a000507] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Studies that examined associations between low circulating 25-hydroxyvitamin D (25(OH)D) and adverse pregnancy outcomes used various designs, assay methods and time points for measurement of 25(OH)D concentrations, which creates some confusion in the current literature. We aimed to investigate the variability in the timing and measurement methods used to evaluate vitamin D status during pregnancy. Analysis of 198 studies published between 1976 and 2017 showed an important variability in the choice of 1) threshold values for 25(OH)D insufficiency or deficiency, 2) 25(OH)D measurement methods, and 3) trimester in which 25(OH)D concentrations were measured. Blood samples were taken once during pregnancy in a large majority of studies, which may not be representative of vitamin D status throughout pregnancy. Most studies reported adjustment for confounding factors including season of blood sampling, but very few studies used the 25(OH)D gold standard assay, the LC-MS/MS. Prospective studies assessing maternal 25(OH)D concentrations 1) by standardized and validated methods, 2) at various time points during pregnancy, and 3) after considering potential confounding factors, are needed.
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Affiliation(s)
- Claudia Savard
- 1 School of Nutrition, Laval University.,2 Endocrinology and Nephrology Unit, CHU of Québec-Université Laval Research Center, Québec, Canada.,3 Institute of Nutrition and Functional Foods, Laval University Quebec City, Québec, Canada
| | - Claudia Gagnon
- 2 Endocrinology and Nephrology Unit, CHU of Québec-Université Laval Research Center, Québec, Canada.,3 Institute of Nutrition and Functional Foods, Laval University Quebec City, Québec, Canada.,4 Department of Medicine, Laval University, Quebec City, Québec, Canada
| | - Anne-Sophie Morisset
- 1 School of Nutrition, Laval University.,2 Endocrinology and Nephrology Unit, CHU of Québec-Université Laval Research Center, Québec, Canada.,3 Institute of Nutrition and Functional Foods, Laval University Quebec City, Québec, Canada
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23
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Dovnik A, Mujezinović F. The Association of Vitamin D Levels with Common Pregnancy Complications. Nutrients 2018; 10:nu10070867. [PMID: 29976852 PMCID: PMC6073751 DOI: 10.3390/nu10070867] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2018] [Revised: 06/30/2018] [Accepted: 07/03/2018] [Indexed: 12/18/2022] Open
Abstract
The association between vitamin D deficiency and various adverse pregnancy outcomes has been extensively investigated in recent years. The pregnant woman is the only source of vitamin D for the foetus. The main sources of vitamin D for pregnant women are sunlight, fortified dairy products, oily fish and dietary supplements. Vitamin D deficiency during pregnancy has been associated with some adverse neonatal outcomes as well as an increased risk of late pregnancy complications. The outcomes of the published studies investigating preeclampsia and gestational diabetes mellitus vary with some large trials suggesting a potential positive effect of vitamin D supplementation during pregnancy on the decreased risk of these complications. Research also suggests a possible connection between lower vitamin D concentrations and increased risk of preterm labour. In our manuscript, we aim to review the existing literature regarding the prevalence of vitamin D deficiency during pregnancy, the factors associated with vitamin D deficiency, and possible pregnancy complications arising from it.
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Affiliation(s)
- Andraž Dovnik
- University Clinic for Gynaecology and Perinatology, Maribor University Medical Centre, Ljubljanska 5, SI-2000 Maribor, Slovenia.
| | - Faris Mujezinović
- University Clinic for Gynaecology and Perinatology, Maribor University Medical Centre, Ljubljanska 5, SI-2000 Maribor, Slovenia.
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24
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Curtis EM, Moon RJ, Harvey NC, Cooper C. Maternal vitamin D supplementation during pregnancy. Br Med Bull 2018; 126:57-77. [PMID: 29684104 PMCID: PMC6003599 DOI: 10.1093/bmb/ldy010] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2017] [Accepted: 03/26/2018] [Indexed: 12/19/2022]
Abstract
Introduction Maternal vitamin D status in pregnancy has been linked to many health outcomes in mother and offspring. A wealth of observational studies have reported on both obstetric outcomes and complications, including pre-eclampsia, gestational diabetes, mode and timing of delivery. Many foetal and childhood outcomes are also linked to vitamin D status, including measures of foetal size, body composition and skeletal mineralization, in addition to later childhood outcomes, such as asthma. Sources of data Synthesis of systematic and narrative reviews. Areas of agreement and controversy The findings are generally inconsistent in most areas, and, at present, there is a lack of data from high-quality intervention studies to confirm a causal role for vitamin D in these outcomes. In most areas, the evidence tends towards maternal vitamin D being of overall benefit, but often does not reach statistical significance in meta-analyses. Growing points and areas timely for developing research The most conclusive evidence is in the role of maternal vitamin D supplementation in the prevention of neonatal hypocalcaemia; as a consequence the UK department of health recommends that pregnant women take 400 IU vitamin D daily. High-quality randomized placebo-controlled trials, such as the UK-based MAVIDOS trial, will inform the potential efficacy and safety of vitamin D supplementation in pregnancy across a variety of outcomes.
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Affiliation(s)
- Elizabeth M Curtis
- MRC Lifecourse Epidemiology Unit, University of Southampton,
Southampton, SO16 6YD, UK
| | - Rebecca J Moon
- MRC Lifecourse Epidemiology Unit, University of Southampton,
Southampton, SO16 6YD, UK
- Paediatric Endocrinology, Southampton University Hospitals NHS
Foundation Trust, Southampton, SO16 6YD, UK
| | - Nicholas C Harvey
- MRC Lifecourse Epidemiology Unit, University of Southampton,
Southampton, SO16 6YD, UK
- NIHR Southampton Biomedical Research Centre, University of
Southampton and University Hospital Southampton NHS Foundation Trust, Tremona Road,
Southampton, SO16 6YD, UK
| | - Cyrus Cooper
- MRC Lifecourse Epidemiology Unit, University of Southampton,
Southampton, SO16 6YD, UK
- NIHR Southampton Biomedical Research Centre, University of
Southampton and University Hospital Southampton NHS Foundation Trust, Tremona Road,
Southampton, SO16 6YD, UK
- NIHR Oxford Biomedical Research Centre, University of Oxford,
Oxford, OX3 7LD, UK
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25
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Serrano-Díaz NC, Gamboa-Delgado EM, Domínguez-Urrego CL, Vesga-Varela AL, Serrano-Gómez SE, Quintero-Lesmes DC. Vitamin D and risk of preeclampsia: A systematic review and meta-analysis. BIOMEDICA : REVISTA DEL INSTITUTO NACIONAL DE SALUD 2018; 38 Suppl 1:43-53. [PMID: 29874709 DOI: 10.7705/biomedica.v38i0.3683] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/17/2016] [Revised: 05/02/2017] [Accepted: 05/23/2017] [Indexed: 01/23/2023]
Abstract
Introduction Human vitamin D levels have been increasingly related to a wide range of clinical outcomes. There is a large amount of reports on its associations, especially with obstetric complications, including preeclampsia and gestational diabetes. These results are scarcely consistent and there is still a lack of quality intervention studies to confirm the role of vitamin D in those outcomes. Objective: To review the available scientific evidence on the role of maternal vitamin D in the development of preeclampsia. Materials and methods The methodology used followed the recommendations of the Cochrane guide for the preparation of systematic reviews, and for metaanalysis, the Guide of the Metaanalysis of Observational Studies in Epidemiology group (MOOSE). The search included both observational studies and controlled clinical trials. Results Low vitamin D levels, measured by the 25-hydroxyvitamin D test, are common in pregnancy. The results of this systematic review and metaanalysis suggest an inverse ratio between vitamin D levels and the development of preeclampsia. There was heterogeneity among the studies with regard to the design, population, geographic location, definitions of exposure, and the outcome. We excluded randomized controlled trials from this meta-analysis. Conclusion The inverse association we found suggests that the higher the levels of vitamin D the lesser the probability of developing preeclampsia, in spite of the heterogeneity of the global measurement in this type of analysis.
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Affiliation(s)
- Norma Cecilia Serrano-Díaz
- Grupo de Investigación Biomédica Traslacional, Fundación Cardiovascular de Colombia, Bucaramanga, Colombia.
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26
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Serrano NC, Guío E, Quintero-Lesmes DC, Becerra-Bayona S, Luna-Gonzalez ML, Herrera VM, Prada CE. Vitamin D deficiency and pre-eclampsia in Colombia: PREVitD study. Pregnancy Hypertens 2018; 14:240-244. [PMID: 29588145 DOI: 10.1016/j.preghy.2018.03.006] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2018] [Revised: 03/10/2018] [Accepted: 03/12/2018] [Indexed: 01/09/2023]
Abstract
PURPOSE Pre-eclampsia is a multisystem disorder characterized by new-onset hypertension and proteinuria during pregnancy. Pre-eclampsia remains a major cause of maternal death in low-income countries. Vitamin D has a very diverse biological role in cardiovascular diseases. This study will evaluate the association of vitamin D levels and relevance to pre-eclampsia. METHODS We conducted a case-control study of women recruited from the GenPE (Genetics and Pre-eclampsia) Colombian registry. This is a multicenter case-control study conducted in eight Colombian cities. 25-Hydroxyvitamin D (25(OH)D) concentration was measured using liquid-chromatography-tandem mass spectrometry from 1013 women with pre-eclampsia and 1015 mothers without pre-eclampsia (controls). RESULTS Fifty-two percent of women with pre-eclampsia were vitamin D deficient. The 25(OH)D concentrations were significantly lower in the pre-eclampsia (mean 29.99 ng/mL; 95% CI: 29.40-30.58 ng/mL) group compared to controls (mean 33.7 ng/mL; 95% CI: 33.20-34.30 ng/mL). In the unadjusted model, maternal vitamin D deficiency, defined by maternal 25(OH)D concentration <30 ng/mL, was associated with an increased probability of suffering from pre-eclampsia (OR 2.10; 95% CI, 1.75-2.51). After adjusting for covariates, a similarly increased probability of having pre-eclampsia was observed (OR 2.18; 95% CI, 1.80-2.64) among women with vitamin D deficiency, relative to controls. CONCLUSION Although the results suggest that low maternal concentrations of 25(OH)D increase pre-eclampsia risk, this evidence may not be indicative of a causal association. Future studies are needed to confirm a definite causal relationship between concentrations of vitamin D and the risk of pre-eclampsia, by means of powered clinical trials.
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Affiliation(s)
- Norma C Serrano
- Fundación Cardiovascular de Colombia FCV, Colombia; Fundación Universitaria FCV, Colombia.
| | | | | | | | | | | | - Carlos E Prada
- Fundación Cardiovascular de Colombia FCV, Colombia; Fundación Universitaria FCV, Colombia; Department of Pediatrics, University of Cincinnati, College of Medicine, Cincinnati, OH, United States; Division of Genetics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States.
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27
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Ali AM, Alobaid A, Malhis TN, Khattab AF. Effect of vitamin D3 supplementation in pregnancy on risk of pre-eclampsia - Randomized controlled trial. Clin Nutr 2018; 38:557-563. [PMID: 29550150 DOI: 10.1016/j.clnu.2018.02.023] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2017] [Revised: 01/07/2018] [Accepted: 02/16/2018] [Indexed: 11/25/2022]
Abstract
BACKGROUND Vitamin D plays pivotal role in decidualization and implantation of the placenta. Recent researches have shown that low level of vitamin D3 "25-hydroxyvitamin D (25[OH]D)" in serum is a risk factor for pre-eclampsia. Latest evidence supports role of vitamin D3 deficiency treatment in reducing the risk of pre-eclampsia. The aim of this study is to determine the effect of antenatal supplementation of vitamin D3 on the risk of pre-eclampsia and to explore the dose effect in attaining the vitamin D3 normal level. METHOD An open labelled randomized controlled study was conducted on 179 pregnant women presenting in King Fahad Medical City antenatal clinic from Oct 2012-Oct 2015. Patients with age less than 20 years or more than 40 years, pregnancy with fetal anomalies, history of hypertension, pre-eclampsia, recurrent miscarriage, chronic renal or hepatic disease and malignancy were excluded from the study. Serum 25[OH]D was analysed during the first trimester (between 6 and 12 weeks of pregnancy). Patients with vitamin D3 deficiency (serum levels <25 nmol/L) were included in the study and randomized for vitamin D3 supplementation 400 IU (Group 1) versus 4000 IU (Group 2). Both groups were compared for the prevalence of pre-eclampsia and dose effect on vitamin D level. RESULTS Of 179 gravidae enrolled, 164 completed the trial. Mean maternal 25[OH]D was significantly increased in group 2 from 16.3 ± 5 nmol/mL to 72.3 ± 30.9 nmol/mL compared with group 1 from 17.5 ± 6.7 nmol/mL to 35.3 ± 20.7 nmol/mL (p > 0.0001). The relative risk reduction (RRR) for attaining ≥75 nmol/L before delivery was significantly higher (RRR 93.2 [CI 79-98] when treated with 4000 IU. The total incidence of pre-eclampsia in the study population was 4.3%. In comparison to group 1, the group 2 reported fewer pre-eclampsia events during the study period (8.6% versus 1.2%; p < 0.05). The total number of IUGRs was lesser in the group 2 (9.6%) versus group 1 (22.2%); p = 0.027. However, other obstetric outcomes were comparable between both groups. CONCLUSION Vitamin D supplementation in the deficient group reduces the risk of pre-eclampsia and IUGR in a dose dependant manner. However larger clinical trials are essential to investigate optimum dosage of vitamin D3 in this group.
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Affiliation(s)
- Aisha Mansoor Ali
- Women Specialized Hospital, King Fahad Medical City, P.O. Box 59046, Riyadh, 11525, Saudi Arabia
| | - Abdulaziz Alobaid
- Women Specialized Hospital, King Fahad Medical City, P.O. Box 59046, Riyadh, 11525, Saudi Arabia
| | - Tasnim Nidal Malhis
- Women Specialized Hospital, King Fahad Medical City, P.O. Box 59046, Riyadh, 11525, Saudi Arabia
| | - Ahmad Fawzi Khattab
- Women Specialized Hospital, King Fahad Medical City, P.O. Box 59046, Riyadh, 11525, Saudi Arabia.
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O'Callaghan KM, Kiely M. Systematic Review of Vitamin D and Hypertensive Disorders of Pregnancy. Nutrients 2018; 10:nu10030294. [PMID: 29494538 PMCID: PMC5872712 DOI: 10.3390/nu10030294] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Revised: 02/19/2018] [Accepted: 02/27/2018] [Indexed: 01/07/2023] Open
Abstract
This narrative systematic review evaluates growing evidence of an association between low maternal vitamin D status and increased risk of hypertensive disorders. The inclusion of interventional, observational, and dietary studies on vitamin D and all hypertensive disorders of pregnancy is a novel aspect of this review, providing a unique contribution to an intensively-researched area that still lacks a definitive conclusion. To date, trial evidence supports a protective effect of combined vitamin D and calcium supplementation against preeclampsia. Conflicting data for an association of vitamin D with gestational hypertensive disorders in observational studies arises from a number of sources, including large heterogeneity between study designs, lack of adherence to standardized perinatal outcome definitions, variable quality of analytical data for 25-hydroxyvitamin D (25(OH)D), and inconsistent data reporting of vitamin D status. While evidence does appear to lean towards an increased risk of gestational hypertensive disorders at 25(OH)D concentrations <50 nmol/L, caution should be exercised with dosing in trials, given the lack of data on long-term safety. The possibility that a fairly narrow target range for circulating 25(OH)D for achievement of clinically-relevant improvements requires further exploration. As hypertension alone, and not preeclampsia specifically, limits intrauterine growth, evaluation of the relationship between vitamin D status and all terms of hypertension in pregnancy is a clinically relevant area for research and should be prioritised in future randomised trials.
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Affiliation(s)
- Karen M O'Callaghan
- Cork Centre for Vitamin D and Nutrition Research, School of Food and Nutritional Sciences, University College Cork, Cork T12 Y337, Ireland.
- Irish Centre for Fetal and Neonatal Translational Research (INFANT), University College Cork, Cork T12 DFK4, Ireland.
| | - Mairead Kiely
- Cork Centre for Vitamin D and Nutrition Research, School of Food and Nutritional Sciences, University College Cork, Cork T12 Y337, Ireland.
- Irish Centre for Fetal and Neonatal Translational Research (INFANT), University College Cork, Cork T12 DFK4, Ireland.
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29
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Ribeiro VR, Romao‐Veiga M, Romagnoli GG, Matias ML, Nunes PR, Borges VTM, Peracoli JC, Peracoli MTS. Association between cytokine profile and transcription factors produced by T-cell subsets in early- and late-onset pre-eclampsia. Immunology 2017; 152:163-173. [PMID: 28502089 PMCID: PMC5543493 DOI: 10.1111/imm.12757] [Citation(s) in RCA: 65] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2017] [Revised: 04/18/2017] [Accepted: 05/06/2017] [Indexed: 01/04/2023] Open
Abstract
Pre-eclampsia (PE) is an obstetric pathology characterized by abnormal activation of the innate and adaptive immune systems dependent on the imbalance of T helper subsets. The present study aimed to evaluate the gene and protein expression of T helper type 1 (Th1)/Th2/Th17/regulatory T (Treg) cell transcription factors in peripheral blood lymphocytes from pregnant women with PE employing quantitative RT-PCR and flow cytometry techniques, as well as the cytokine profile produced by these CD4+ T-cell subsets in the plasma of pregnant women with PE, classified as early-onset PE (n = 20), late-onset PE (n = 20) and normotensive pregnant women (n = 20). Results showed a higher percentage of CD4+ T cells expressing the RORc transcription factor (Th17) and a lower percentage of cells expressing FoxP3 (Treg) in women with early-onset PE compared with late-onset PE and normotensive groups. A lower gene expression of GATA-3 transcription factor was detected in cells of women with early-onset PE compared with the late-onset PE group. Endogenous plasma levels of interleukin-6 (IL-6), IL-17 and tumour necrosis factor-α were significantly higher in the early-onset PE group than in the late-onset PE and normotensive groups, whereas IL-4 (Th2 profile) and IL-22 (Th17 profile), were not significantly different between the studied groups. The endogenous levels of transforming growth factor-β and IL-10 were significantly lower in the pre-eclamptic than in the normotensive groups of the same gestational age, with a significant difference between early- and late-onset PE. The results show that in women with PE there is an imbalance between inflammatory and anti-inflammatory profiles in CD4+ T-cell subsets, with polarization to Th17 profiles in the early-onset PE, considered as the severe form of PE.
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MESH Headings
- Adaptive Immunity
- Adolescent
- Adult
- Biomarkers/blood
- Case-Control Studies
- Cytokines/blood
- Cytokines/genetics
- Cytokines/immunology
- Female
- Forkhead Transcription Factors/blood
- Forkhead Transcription Factors/genetics
- Forkhead Transcription Factors/immunology
- GATA3 Transcription Factor/blood
- GATA3 Transcription Factor/genetics
- GATA3 Transcription Factor/immunology
- Gene Expression Regulation
- Humans
- Inflammation Mediators/blood
- Inflammation Mediators/immunology
- Nuclear Receptor Subfamily 1, Group F, Member 3/blood
- Nuclear Receptor Subfamily 1, Group F, Member 3/genetics
- Nuclear Receptor Subfamily 1, Group F, Member 3/immunology
- Phenotype
- Pre-Eclampsia/blood
- Pre-Eclampsia/diagnosis
- Pre-Eclampsia/genetics
- Pre-Eclampsia/immunology
- Pregnancy
- RNA, Messenger/blood
- RNA, Messenger/genetics
- Severity of Illness Index
- T-Lymphocytes, Regulatory/immunology
- T-Lymphocytes, Regulatory/metabolism
- Th1 Cells/immunology
- Th1 Cells/metabolism
- Th17 Cells/immunology
- Th17 Cells/metabolism
- Th2 Cells/immunology
- Th2 Cells/metabolism
- Transcription Factors/blood
- Transcription Factors/genetics
- Transcription Factors/immunology
- Young Adult
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Affiliation(s)
- Vanessa R. Ribeiro
- Department of Gynaecology and ObstetricsMedical SchoolBotucatu Sao Paulo State University (UNESP)BotucatuSao PauloBrazil
| | - Mariana Romao‐Veiga
- Department of Microbiology and ImmunologyInstitute of BiosciencesBotucatu Sao Paulo State University (UNESP)BotucatuSao PauloBrazil
| | - Graziela G. Romagnoli
- Department of Microbiology and ImmunologyInstitute of BiosciencesBotucatu Sao Paulo State University (UNESP)BotucatuSao PauloBrazil
| | - Mariana L. Matias
- Department of Gynaecology and ObstetricsMedical SchoolBotucatu Sao Paulo State University (UNESP)BotucatuSao PauloBrazil
| | - Priscila R. Nunes
- Department of Gynaecology and ObstetricsMedical SchoolBotucatu Sao Paulo State University (UNESP)BotucatuSao PauloBrazil
| | - Vera Therezinha M. Borges
- Department of Gynaecology and ObstetricsMedical SchoolBotucatu Sao Paulo State University (UNESP)BotucatuSao PauloBrazil
| | - Jose C. Peracoli
- Department of Gynaecology and ObstetricsMedical SchoolBotucatu Sao Paulo State University (UNESP)BotucatuSao PauloBrazil
| | - Maria Terezinha S. Peracoli
- Department of Microbiology and ImmunologyInstitute of BiosciencesBotucatu Sao Paulo State University (UNESP)BotucatuSao PauloBrazil
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Mousa A, Abell SK, Shorakae S, Harrison CL, Naderpoor N, Hiam D, Moreno-Asso A, Stepto NK, Teede HJ, de Courten B. Relationship between vitamin D and gestational diabetes in overweight or obese pregnant women may be mediated by adiponectin. Mol Nutr Food Res 2017; 61. [PMID: 28741856 DOI: 10.1002/mnfr.201700488] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2017] [Revised: 07/13/2017] [Accepted: 07/17/2017] [Indexed: 12/15/2022]
Abstract
SCOPE Maternal vitamin D deficiency has been implicated in adverse pregnancy outcomes. However, the association between vitamin D and inflammation, particularly adipokines, remains unexplored in pregnancy. METHODS AND RESULTS In 102 overweight or obese pregnant women at high-risk of gestational diabetes mellitus (GDM), we investigated relationships between maternal 25-hydroxyvitamin D (25(OH)D) concentrations at 12-15 wk gestation (baseline) and serum lipids, inflammatory markers, novel adipokines (omentin-1, visfatin, high molecular weight (HMW) adiponectin), and subsequent pregnancy outcomes (GDM, preeclampsia, preterm birth [PTB]). After adjustment for maternal factors (age, BMI, parity, ethnicity, and smoking status), baseline 25(OH)D concentrations were inversely associated with total cholesterol and triglycerides, and positively associated with HMW-adiponectin. Higher baseline 25(OH)D concentrations were associated with decreased fasting and 1-h post-OGTT glucose and reduced risk of GDM at 26-28 wk, as well as with longer gestation and reduced risk of PTB upon additional adjustment for caesarean section. Adding HMW-adiponectin to the multivariable models attenuated most associations, and HMW-adiponectin was a significant predictor in the models. CONCLUSION Our findings suggest that lower maternal 25(OH)D concentrations in overweight/obese pregnant women at high-risk of GDM are associated with increased cardiometabolic risks during pregnancy and adverse pregnancy outcomes, and that these associations may be mediated by HMW-adiponectin.
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Affiliation(s)
- Aya Mousa
- Monash Centre for Health Research and Implementation (MCHRI), School of Public Health and Preventive Medicine, Monash University, Clayton, Melbourne, Victoria, Australia
| | - Sally K Abell
- Monash Centre for Health Research and Implementation (MCHRI), School of Public Health and Preventive Medicine, Monash University, Clayton, Melbourne, Victoria, Australia
| | - Soulmaz Shorakae
- Monash Centre for Health Research and Implementation (MCHRI), School of Public Health and Preventive Medicine, Monash University, Clayton, Melbourne, Victoria, Australia
| | - Cheryce L Harrison
- Monash Centre for Health Research and Implementation (MCHRI), School of Public Health and Preventive Medicine, Monash University, Clayton, Melbourne, Victoria, Australia
| | - Negar Naderpoor
- Monash Centre for Health Research and Implementation (MCHRI), School of Public Health and Preventive Medicine, Monash University, Clayton, Melbourne, Victoria, Australia
| | - Danielle Hiam
- Institute of Sport, Exercise and Active Living, Victoria University, Melbourne, Victoria, Australia
| | - Alba Moreno-Asso
- Institute of Sport, Exercise and Active Living, Victoria University, Melbourne, Victoria, Australia
| | - Nigel K Stepto
- Monash Centre for Health Research and Implementation (MCHRI), School of Public Health and Preventive Medicine, Monash University, Clayton, Melbourne, Victoria, Australia.,Institute of Sport, Exercise and Active Living, Victoria University, Melbourne, Victoria, Australia
| | - Helena J Teede
- Monash Centre for Health Research and Implementation (MCHRI), School of Public Health and Preventive Medicine, Monash University, Clayton, Melbourne, Victoria, Australia
| | - Barbora de Courten
- Monash Centre for Health Research and Implementation (MCHRI), School of Public Health and Preventive Medicine, Monash University, Clayton, Melbourne, Victoria, Australia
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The Effects of Vitamin D Supplement on Prevention of Recurrence of Preeclampsia in Pregnant Women with a History of Preeclampsia. Obstet Gynecol Int 2017; 2017:8249264. [PMID: 28912817 PMCID: PMC5585545 DOI: 10.1155/2017/8249264] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2017] [Revised: 06/12/2017] [Accepted: 07/04/2017] [Indexed: 11/30/2022] Open
Abstract
Introduction Preeclampsia is a pregnancy-specific syndrome. One of the hypotheses concerning the etiology of preeclampsia is vitamin D deficiency during pregnancy. Method and Materials The present study is a randomized controlled clinical trial which aims to determine the effect of vitamin D supplement on reducing the probability of recurrent preeclampsia. 72 patients were placed in control group while 70 patients were randomized to the intervention group. The intervention group received a 50000 IU pearl vitamin D3 once every two weeks. The control group was administered placebo. Vitamin D or placebo was given until the 36th week of pregnancy. Results The patients in intervention group have significantly lower (P value = 0.036) probability of preeclampsia than patients in the control group. The risk of preeclampsia for the control group was 1.94 times higher than that for the intervention group (95% CI 1.02, 3.71). Conclusion The intended intervention (i.e., prescription of vitamin D) has a protective effect against recurrent preeclampsia. Vitamin D supplementation therapy in pregnancy could help in reducing the incidence of gestational hypertension/preeclampsia. Registration This study has been registered in Iranian Registry of Clinical Trials (IRCT) site with ID number IRCT2017010131695N1.
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Purswani JM, Gala P, Dwarkanath P, Larkin HM, Kurpad A, Mehta S. The role of vitamin D in pre-eclampsia: a systematic review. BMC Pregnancy Childbirth 2017; 17:231. [PMID: 28709403 PMCID: PMC5513133 DOI: 10.1186/s12884-017-1408-3] [Citation(s) in RCA: 54] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2015] [Accepted: 07/03/2017] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND The etiology of pre-eclampsia (PE) is not yet fully understood, though current literature indicates an upregulation of inflammatory mediators produced by the placenta as a potential causal mechanism. Vitamin D is known to have anti-inflammatory properties and there is evidence of an inverse relationship between dietary calcium intake and the incidence of PE. Evidence of the role of vitamin D status and supplementation in the etiology and prevention of PE is reviewed in this article along with identification of research gaps to inform future studies. METHODS We conducted a structured literature search using MEDLINE electronic databases to identify published studies until February 2015. These sources were retrieved, collected, indexed, and assessed for availability of pregnancy-related data on PE and vitamin D. RESULTS Several case-control studies and cross-sectional studies have shown an association between vitamin D status and PE, although evidence has been inconsistent. Clinical trials to date have been unable to show an independent effect of vitamin D supplementation in preventing PE. CONCLUSIONS The included clinical trials do not show an independent effect of vitamin D supplementation in preventing PE; however, issues with dose, timing, and duration of supplementation have not been completely addressed.
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Affiliation(s)
- Juhi M. Purswani
- Division of Nutritional Sciences, Cornell University, 314 Savage Hall, Ithaca, NY 14853 USA
| | - Pooja Gala
- Weill-Cornell Medical College, New York, NY USA
| | | | - Heather M. Larkin
- Division of Nutritional Sciences, Cornell University, 314 Savage Hall, Ithaca, NY 14853 USA
| | - Anura Kurpad
- St. John’s Research Institute, Bangalore, Karnataka India
| | - Saurabh Mehta
- Division of Nutritional Sciences, Cornell University, 314 Savage Hall, Ithaca, NY 14853 USA
- St. John’s Research Institute, Bangalore, Karnataka India
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Lambert JA, Carlisle MA, Lam A, Aggarwal S, Doran S, Ren C, Bradley WE, Dell'Italia L, Ambalavanan N, Ford DA, Patel RP, Jilling T, Matalon S. Mechanisms and Treatment of Halogen Inhalation-Induced Pulmonary and Systemic Injuries in Pregnant Mice. Hypertension 2017; 70:390-400. [PMID: 28607126 DOI: 10.1161/hypertensionaha.117.09466] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2017] [Revised: 04/05/2017] [Accepted: 05/10/2017] [Indexed: 11/16/2022]
Abstract
Inhalation of oxidant gases has been implicated in adverse outcomes in pregnancy, but animal models to address mechanisms and studies to identify potential pregnancy-specific therapies are lacking. Herein, we show that inhalation of bromine at 600 parts per million for 30 minutes by pregnant mice on the 15th day of embryonic development results in significantly lower survival after 96 hours than an identical level of exposure in nonpregnant mice. On the 19th embryonic day, bromine-exposed pregnant mice have increased systemic blood pressure, abnormal placental development, severe fetal growth restriction, systemic inflammation, increased levels of circulating antiangiogenic short fms-like tyrosine kinase-1, and evidence of pulmonary and cardiac injury. Treatment with tadalafil, an inhibitor of type 5 phosphodiesterase, by oral gavage 1 hour post-exposure and then once daily thereafter, attenuated systemic blood pressures, decreased inflammation, ameliorated pulmonary and cardiac injury, and improved maternal survival (from 36% to 80%) and fetal growth. These pathological changes resemble those seen in preeclampsia. Nonpregnant mice did not exhibit any of these pathological changes and were not affected by tadalafil. These findings suggest that pregnant women exposed to bromine may require particular attention and monitoring for signs of preeclampsia-like symptoms.
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Affiliation(s)
- James A Lambert
- From the Biochemistry, Structural and Stem Cell Biology, Graduate Biomedical Sciences (J.A.L.), Division of Molecular and Translational Biomedicine, Department of Anesthesiology and Perioperative Medicine (J.A.L., M.A.C., A.L., S.A., S.D., S.M.), Division of Neonatology, Department of Pediatrics (C.R., N.A., T.J.), Division of Cardiovascular Disease, Department of Medicine (W.E.B., L.D.), and Cellular and Molecular Pathology, Department of Pathology (R.P.P.), University of Alabama at Birmingham; and Department of Biochemistry and Molecular Biology and Center for Cardiovascular Research, Saint Louis University, MO (D.A.F.)
| | - Matthew A Carlisle
- From the Biochemistry, Structural and Stem Cell Biology, Graduate Biomedical Sciences (J.A.L.), Division of Molecular and Translational Biomedicine, Department of Anesthesiology and Perioperative Medicine (J.A.L., M.A.C., A.L., S.A., S.D., S.M.), Division of Neonatology, Department of Pediatrics (C.R., N.A., T.J.), Division of Cardiovascular Disease, Department of Medicine (W.E.B., L.D.), and Cellular and Molecular Pathology, Department of Pathology (R.P.P.), University of Alabama at Birmingham; and Department of Biochemistry and Molecular Biology and Center for Cardiovascular Research, Saint Louis University, MO (D.A.F.)
| | - Adam Lam
- From the Biochemistry, Structural and Stem Cell Biology, Graduate Biomedical Sciences (J.A.L.), Division of Molecular and Translational Biomedicine, Department of Anesthesiology and Perioperative Medicine (J.A.L., M.A.C., A.L., S.A., S.D., S.M.), Division of Neonatology, Department of Pediatrics (C.R., N.A., T.J.), Division of Cardiovascular Disease, Department of Medicine (W.E.B., L.D.), and Cellular and Molecular Pathology, Department of Pathology (R.P.P.), University of Alabama at Birmingham; and Department of Biochemistry and Molecular Biology and Center for Cardiovascular Research, Saint Louis University, MO (D.A.F.)
| | - Saurabh Aggarwal
- From the Biochemistry, Structural and Stem Cell Biology, Graduate Biomedical Sciences (J.A.L.), Division of Molecular and Translational Biomedicine, Department of Anesthesiology and Perioperative Medicine (J.A.L., M.A.C., A.L., S.A., S.D., S.M.), Division of Neonatology, Department of Pediatrics (C.R., N.A., T.J.), Division of Cardiovascular Disease, Department of Medicine (W.E.B., L.D.), and Cellular and Molecular Pathology, Department of Pathology (R.P.P.), University of Alabama at Birmingham; and Department of Biochemistry and Molecular Biology and Center for Cardiovascular Research, Saint Louis University, MO (D.A.F.)
| | - Stephen Doran
- From the Biochemistry, Structural and Stem Cell Biology, Graduate Biomedical Sciences (J.A.L.), Division of Molecular and Translational Biomedicine, Department of Anesthesiology and Perioperative Medicine (J.A.L., M.A.C., A.L., S.A., S.D., S.M.), Division of Neonatology, Department of Pediatrics (C.R., N.A., T.J.), Division of Cardiovascular Disease, Department of Medicine (W.E.B., L.D.), and Cellular and Molecular Pathology, Department of Pathology (R.P.P.), University of Alabama at Birmingham; and Department of Biochemistry and Molecular Biology and Center for Cardiovascular Research, Saint Louis University, MO (D.A.F.)
| | - Changchun Ren
- From the Biochemistry, Structural and Stem Cell Biology, Graduate Biomedical Sciences (J.A.L.), Division of Molecular and Translational Biomedicine, Department of Anesthesiology and Perioperative Medicine (J.A.L., M.A.C., A.L., S.A., S.D., S.M.), Division of Neonatology, Department of Pediatrics (C.R., N.A., T.J.), Division of Cardiovascular Disease, Department of Medicine (W.E.B., L.D.), and Cellular and Molecular Pathology, Department of Pathology (R.P.P.), University of Alabama at Birmingham; and Department of Biochemistry and Molecular Biology and Center for Cardiovascular Research, Saint Louis University, MO (D.A.F.)
| | - Wayne E Bradley
- From the Biochemistry, Structural and Stem Cell Biology, Graduate Biomedical Sciences (J.A.L.), Division of Molecular and Translational Biomedicine, Department of Anesthesiology and Perioperative Medicine (J.A.L., M.A.C., A.L., S.A., S.D., S.M.), Division of Neonatology, Department of Pediatrics (C.R., N.A., T.J.), Division of Cardiovascular Disease, Department of Medicine (W.E.B., L.D.), and Cellular and Molecular Pathology, Department of Pathology (R.P.P.), University of Alabama at Birmingham; and Department of Biochemistry and Molecular Biology and Center for Cardiovascular Research, Saint Louis University, MO (D.A.F.)
| | - Louis Dell'Italia
- From the Biochemistry, Structural and Stem Cell Biology, Graduate Biomedical Sciences (J.A.L.), Division of Molecular and Translational Biomedicine, Department of Anesthesiology and Perioperative Medicine (J.A.L., M.A.C., A.L., S.A., S.D., S.M.), Division of Neonatology, Department of Pediatrics (C.R., N.A., T.J.), Division of Cardiovascular Disease, Department of Medicine (W.E.B., L.D.), and Cellular and Molecular Pathology, Department of Pathology (R.P.P.), University of Alabama at Birmingham; and Department of Biochemistry and Molecular Biology and Center for Cardiovascular Research, Saint Louis University, MO (D.A.F.)
| | - Namasivayam Ambalavanan
- From the Biochemistry, Structural and Stem Cell Biology, Graduate Biomedical Sciences (J.A.L.), Division of Molecular and Translational Biomedicine, Department of Anesthesiology and Perioperative Medicine (J.A.L., M.A.C., A.L., S.A., S.D., S.M.), Division of Neonatology, Department of Pediatrics (C.R., N.A., T.J.), Division of Cardiovascular Disease, Department of Medicine (W.E.B., L.D.), and Cellular and Molecular Pathology, Department of Pathology (R.P.P.), University of Alabama at Birmingham; and Department of Biochemistry and Molecular Biology and Center for Cardiovascular Research, Saint Louis University, MO (D.A.F.)
| | - David A Ford
- From the Biochemistry, Structural and Stem Cell Biology, Graduate Biomedical Sciences (J.A.L.), Division of Molecular and Translational Biomedicine, Department of Anesthesiology and Perioperative Medicine (J.A.L., M.A.C., A.L., S.A., S.D., S.M.), Division of Neonatology, Department of Pediatrics (C.R., N.A., T.J.), Division of Cardiovascular Disease, Department of Medicine (W.E.B., L.D.), and Cellular and Molecular Pathology, Department of Pathology (R.P.P.), University of Alabama at Birmingham; and Department of Biochemistry and Molecular Biology and Center for Cardiovascular Research, Saint Louis University, MO (D.A.F.)
| | - Rakesh P Patel
- From the Biochemistry, Structural and Stem Cell Biology, Graduate Biomedical Sciences (J.A.L.), Division of Molecular and Translational Biomedicine, Department of Anesthesiology and Perioperative Medicine (J.A.L., M.A.C., A.L., S.A., S.D., S.M.), Division of Neonatology, Department of Pediatrics (C.R., N.A., T.J.), Division of Cardiovascular Disease, Department of Medicine (W.E.B., L.D.), and Cellular and Molecular Pathology, Department of Pathology (R.P.P.), University of Alabama at Birmingham; and Department of Biochemistry and Molecular Biology and Center for Cardiovascular Research, Saint Louis University, MO (D.A.F.)
| | - Tamas Jilling
- From the Biochemistry, Structural and Stem Cell Biology, Graduate Biomedical Sciences (J.A.L.), Division of Molecular and Translational Biomedicine, Department of Anesthesiology and Perioperative Medicine (J.A.L., M.A.C., A.L., S.A., S.D., S.M.), Division of Neonatology, Department of Pediatrics (C.R., N.A., T.J.), Division of Cardiovascular Disease, Department of Medicine (W.E.B., L.D.), and Cellular and Molecular Pathology, Department of Pathology (R.P.P.), University of Alabama at Birmingham; and Department of Biochemistry and Molecular Biology and Center for Cardiovascular Research, Saint Louis University, MO (D.A.F.)
| | - Sadis Matalon
- From the Biochemistry, Structural and Stem Cell Biology, Graduate Biomedical Sciences (J.A.L.), Division of Molecular and Translational Biomedicine, Department of Anesthesiology and Perioperative Medicine (J.A.L., M.A.C., A.L., S.A., S.D., S.M.), Division of Neonatology, Department of Pediatrics (C.R., N.A., T.J.), Division of Cardiovascular Disease, Department of Medicine (W.E.B., L.D.), and Cellular and Molecular Pathology, Department of Pathology (R.P.P.), University of Alabama at Birmingham; and Department of Biochemistry and Molecular Biology and Center for Cardiovascular Research, Saint Louis University, MO (D.A.F.).
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Adela R, Borkar RM, Mishra N, Bhandi MM, Vishwakarma G, Varma BA, Ragampeta S, Banerjee SK. Lower Serum Vitamin D Metabolite Levels in Relation to Circulating Cytokines/Chemokines and Metabolic Hormones in Pregnant Women with Hypertensive Disorders. Front Immunol 2017; 8:273. [PMID: 28348564 PMCID: PMC5346572 DOI: 10.3389/fimmu.2017.00273] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2016] [Accepted: 02/24/2017] [Indexed: 12/31/2022] Open
Abstract
The aim of this study was to investigate whether lower serum vitamin D metabolite levels were associated with altered cytokine/chemokine and metabolic hormone levels in three different hypertensive disorders in pregnancy (HDP). Healthy pregnancy (n = 30) and hypertensive disorders in pregnancy (HDP) (n = 30), i.e., gestational hypertension (GH), preeclampsia (PE), and eclampsia (EC) subjects were enrolled. Vitamin D metabolites were measured by UPLC/APCI/HRMS method. Circulatory 27 cytokines/chemokines and 10 metabolic hormones were measured. Significantly decreased 25(OH)D and 1,25(OH)2D levels were observed in HDP. The levels of 25(OH)D were significantly lower in PE and EC, whereas the serum levels of 1,25(OH)2D significantly decreased only in EC subjects. Serum 25(OH)D and 1,25(OH)2D levels were negatively correlated with systolic- and diastolic blood pressure, creatinine, and uric acid levels. Serum interleukin (IL)-6 and IL-13 decreased, and GIP levels were increased in gestational hypertensive subjects. Platelet-derived growth factor-BB and IL-8 levels were increased and macrophage inflammatory protein-1beta levels were decreased in EC subjects. IL-8 and IL-10 increased, and rantes and GIP levels decreased in the EC group as compared with the GH group. Multivariate logistic regression analysis showed that eotaxin, monocyte chemotactic protein-1, 25(OH)D, and 1,25(OH)2D were predictors of HDP. Our analyses suggest that lower vitamin D metabolites are associated with altered cytokines/chemokines and metabolic hormones in HDP.
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Affiliation(s)
- Ramu Adela
- Drug Discovery Research Center, Translational Health Science and Technology Institute (THSTI) , Faridabad, Haryana , India
| | - Roshan M Borkar
- National Center for Mass Spectrometry, Indian Institute of Chemical Technology (CSIR-IICT) , Hyderabad , India
| | - Navneeta Mishra
- Department of Biochemistry, Mediciti Institute of Medical Sciences , Ghanpur, Medchal , India
| | - Murali Mohan Bhandi
- National Center for Mass Spectrometry, Indian Institute of Chemical Technology (CSIR-IICT) , Hyderabad , India
| | - Gayatri Vishwakarma
- Clinical Development Service Agency (CDSA), Translational Health Science and Technology Institute (THSTI) , Faridabad, Haryana , India
| | - B Aparna Varma
- Department of Biochemistry, Mediciti Institute of Medical Sciences , Ghanpur, Medchal , India
| | - Srinivas Ragampeta
- National Center for Mass Spectrometry, Indian Institute of Chemical Technology (CSIR-IICT) , Hyderabad , India
| | - Sanjay K Banerjee
- Drug Discovery Research Center, Translational Health Science and Technology Institute (THSTI) , Faridabad, Haryana , India
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Abstract
Preeclampsia is a common complication of pregnancy that is associated with an increased risk of maternal and neonatal morbidity and mortality. Currently, delivery is the only cure for preeclampsia; therefore, effective prevention and treatment options for this condition are sorely needed. In the current issue of the JCI, Mirzakhani et al. report the findings of the Vitamin D Antenatal Asthma Reduction Trial (VDAART), a well-conducted large, randomized, double-blind, placebo-controlled trial of vitamin D supplementation for the prevention of preeclampsia. Though vitamin D supplementation had no effect on the risk of preeclampsia, reduced maternal serum vitamin D levels did correlate with preeclampsia risk. Mirzakhani and colleagues identified a number of gene pathways that are differentially regulated among women with low serum vitamin D levels who develop preeclampsia. These results indicate that further research on the role of vitamin D in preeclampsia is warranted.
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Baca KM, Simhan HN, Platt RW, Bodnar LM. Low maternal 25-hydroxyvitamin D concentration increases the risk of severe and mild preeclampsia. Ann Epidemiol 2016; 26:853-857.e1. [PMID: 27818017 DOI: 10.1016/j.annepidem.2016.09.015] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2015] [Revised: 09/06/2016] [Accepted: 09/26/2016] [Indexed: 12/29/2022]
Abstract
PURPOSE The objective of this case-cohort study was to evaluate the relationship between maternal 25-hydroxyvitamin D (25(OH)D) concentration and preeclampsia overall and by severity. METHODS From an eligible cohort of 12,861 women who had serum banked from aneuploidy screening in Pittsburgh, Pennsylvania from 1999 to 2010, we randomly sampled a subcohort of 2327 pregnancies and all remaining preeclampsia cases (n = 650 cases). Preeclampsia (defined as new-onset hypertension and proteinuria) and its mild and severe forms were identified using ICD-9 codes. Maternal serum collected at 20 weeks or less gestation was measured for 25(OH)D. We used log-binomial regression with restricted cubic splines to estimate the association between 25(OH)D and preeclampsia after adjusting for confounders. RESULTS Approximately 21% of the randomly selected sample had 25(OH)D less than 50 nmol per L. We found that the adjusted risk of preeclampsia declined as serum 25(OH)D increased to 50 nmol per L and then plateaued (test of nonlinearity P < .05). The adjusted preeclampsia risk ratios (95% confidence intervals) for 25(OH)D less than 25 nmol per L, 25 to 49.9 nmol per L, and 50 to 74.9 nmol per L were 2.4 (1.2-4.8), 1.1 (0.69-1.7), and 1.3 (0.89-1.8), respectively, compared with those with 25(OH)D 75 nmol per L and over. Similar associations were observed with severe and mild preeclampsia. CONCLUSIONS Vitamin D deficiency increases risks of severe and mild forms of preeclampsia.
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Affiliation(s)
- Katharyn M Baca
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA
| | - Hyagriv N Simhan
- Department of Obstetrics, Gynecology, and Reproductive Sciences, School of Medicine, University of Pittsburgh, Pittsburgh, PA; Magee-Womens Research Institute, Pittsburgh, PA
| | - Robert W Platt
- Department of Pediatrics, McGill University, Montreal, QC, Canada; Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, QC, Canada
| | - Lisa M Bodnar
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA; Department of Obstetrics, Gynecology, and Reproductive Sciences, School of Medicine, University of Pittsburgh, Pittsburgh, PA; Magee-Womens Research Institute, Pittsburgh, PA.
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37
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Nobles CJ, Markenson G, Chasan-Taber L. Early pregnancy vitamin D status and risk for adverse maternal and infant outcomes in a bi-ethnic cohort: the Behaviors Affecting Baby and You (B.A.B.Y.) Study. Br J Nutr 2015; 114:2116-28. [PMID: 26507186 PMCID: PMC5653966 DOI: 10.1017/s0007114515003980] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Vitamin D deficiency is common during pregnancy and higher in Hispanic as compared with non-Hispanic white women. However, the association between vitamin D deficiency and adverse pregnancy outcomes remains unclear and may vary across ethnic groups, in part because of genetic variation in the metabolism of vitamin D. Few studies have included Hispanic women. Therefore, we investigated this association among 237 participants in the Behaviors Affecting Baby and You Study, a randomised trial of an exercise intervention among ethnically diverse prenatal care patients in Massachusetts. Baseline serum 25-hydroxyvitamin D (25(OH)D) was measured at 15·2 (sd 4·7) weeks' gestation. Information on adverse pregnancy outcomes was abstracted from medical records. Mean 25(OH)D was 30·4 (sd 12·0) ng/ml; 53·2 % of participants had insufficient (<30 ng/ml) and 20·7 % had deficient (<20 ng/ml) 25(OH)D levels. After adjusting for month of blood draw, gestational age at blood draw, gestational age at delivery, age, BMI and Hispanic ethnicity, women with insufficient and deficient vitamin D had infants with birth weights 139·74 (se 69·16) g (P=0·045) and 175·52 (se 89·45) g (P=0·051) lower compared with women with sufficient vitamin D levels (≥30 ng/ml). Each 1 ng/ml increase in 25(OH)D was associated with an increased risk for gestational diabetes mellitus among Hispanic women only (relative risk 1·07; 95 % CI 1·03, 1·11) in multivariable analysis. We did not observe statistically significant associations between maternal vitamin D status and other pregnancy outcomes. Our findings provide further support for an adverse impact of vitamin D deficiency on birth weight in Hispanic women.
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Affiliation(s)
- Carrie J. Nobles
- Department of Biostatistics and Epidemiology, School of Public Health & Health Sciences, Division of Biostatistics & Epidemiology, University of Massachusetts, Amherst, MA 01003-9304, USA
| | - Glenn Markenson
- Baystate Medical Center, Division of Maternal-Fetal Medicine, Springfield, MA 01199, USA
| | - Lisa Chasan-Taber
- Department of Biostatistics and Epidemiology, School of Public Health & Health Sciences, Division of Biostatistics & Epidemiology, University of Massachusetts, Amherst, MA 01003-9304, USA
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Chiswick C, Reynolds RM, Denison F, Drake AJ, Forbes S, Newby DE, Walker BR, Quenby S, Wray S, Weeks A, Lashen H, Rodriguez A, Murray G, Whyte S, Norman JE. Effect of metformin on maternal and fetal outcomes in obese pregnant women (EMPOWaR): a randomised, double-blind, placebo-controlled trial. Lancet Diabetes Endocrinol 2015; 3:778-86. [PMID: 26165398 PMCID: PMC4673088 DOI: 10.1016/s2213-8587(15)00219-3] [Citation(s) in RCA: 168] [Impact Index Per Article: 18.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2015] [Revised: 05/26/2015] [Accepted: 05/28/2015] [Indexed: 02/02/2023]
Abstract
BACKGROUND Maternal obesity is associated with increased birthweight, and obesity and premature mortality in adult offspring. The mechanism by which maternal obesity leads to these outcomes is not well understood, but maternal hyperglycaemia and insulin resistance are both implicated. We aimed to establish whether the insulin sensitising drug metformin improves maternal and fetal outcomes in obese pregnant women without diabetes. METHODS We did this randomised, double-blind, placebo-controlled trial in antenatal clinics at 15 National Health Service hospitals in the UK. Pregnant women (aged ≥16 years) between 12 and 16 weeks' gestation who had a BMI of 30 kg/m(2) or more and normal glucose tolerance were randomly assigned (1:1), via a web-based computer-generated block randomisation procedure (block size of two to four), to receive oral metformin 500 mg (increasing to a maximum of 2500 mg) or matched placebo daily from between 12 and 16 weeks' gestation until delivery of the baby. Randomisation was stratified by study site and BMI band (30-39 vs ≥40 kg/m(2)). Participants, caregivers, and study personnel were masked to treatment assignment. The primary outcome was Z score corresponding to the gestational age, parity, and sex-standardised birthweight percentile of liveborn babies delivered at 24 weeks or more of gestation. We did analysis by modified intention to treat. This trial is registered, ISRCTN number 51279843. FINDINGS Between Feb 3, 2011, and Jan 16, 2014, inclusive, we randomly assigned 449 women to either placebo (n=223) or metformin (n=226), of whom 434 (97%) were included in the final modified intention-to-treat analysis. Mean birthweight at delivery was 3463 g (SD 660) in the placebo group and 3462 g (548) in the metformin group. The estimated effect size of metformin on the primary outcome was non-significant (adjusted mean difference -0·029, 95% CI -0·217 to 0·158; p=0·7597). The difference in the number of women reporting the combined adverse outcome of miscarriage, termination of pregnancy, stillbirth, or neonatal death in the metformin group (n=7) versus the placebo group (n=2) was not significant (odds ratio 3·60, 95% CI 0·74-17·50; p=0·11). INTERPRETATION Metformin has no significant effect on birthweight percentile in obese pregnant women. Further follow-up of babies born to mothers in the EMPOWaR study will identify longer-term outcomes of metformin in this population; in the meantime, metformin should not be used to improve pregnancy outcomes in obese women without diabetes. FUNDING The Efficacy and Mechanism Evaluation (EME) Programme, a Medical Research Council and National Institute for Health Research partnership.
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Affiliation(s)
- Carolyn Chiswick
- Tommy's Centre for Maternal and Fetal Health, Medical Research Council (MRC) Centre for Reproductive Health, Queen's Medical Research Institute, Edinburgh, UK
| | - Rebecca M Reynolds
- British Heart Foundation Centre for Cardiovascular Science, Queen's Medical Research Institute, Edinburgh, UK
| | - Fiona Denison
- Tommy's Centre for Maternal and Fetal Health, Medical Research Council (MRC) Centre for Reproductive Health, Queen's Medical Research Institute, Edinburgh, UK
| | - Amanda J Drake
- British Heart Foundation Centre for Cardiovascular Science, Queen's Medical Research Institute, Edinburgh, UK
| | - Shareen Forbes
- British Heart Foundation Centre for Cardiovascular Science, Queen's Medical Research Institute, Edinburgh, UK
| | - David E Newby
- Chancellor's Building, Royal Infirmary of Edinburgh, Edinburgh, UK
| | - Brian R Walker
- British Heart Foundation Centre for Cardiovascular Science, Queen's Medical Research Institute, Edinburgh, UK
| | - Siobhan Quenby
- Division of Reproductive Health, Warwick Medical School, University of Warwick, Coventry, UK
| | - Susan Wray
- Faculty of Health and Life Sciences, First Floor, Liverpool Women's Hospital, Liverpool, UK
| | - Andrew Weeks
- Faculty of Health and Life Sciences, First Floor, Liverpool Women's Hospital, Liverpool, UK
| | - Hany Lashen
- Academic Unit of Reproductive and Developmental Medicine, The Jessop Wing, Sheffield, UK
| | | | - Gordon Murray
- Centre for Population Health Sciences, Teviot Place, Edinburgh, UK
| | - Sonia Whyte
- Tommy's Centre for Maternal and Fetal Health, Medical Research Council (MRC) Centre for Reproductive Health, Queen's Medical Research Institute, Edinburgh, UK
| | - Jane E Norman
- Tommy's Centre for Maternal and Fetal Health, Medical Research Council (MRC) Centre for Reproductive Health, Queen's Medical Research Institute, Edinburgh, UK.
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Bakacak M, Serin S, Ercan O, Köstü B, Avci F, Kılınç M, Kıran H, Kiran G. Comparison of Vitamin D levels in cases with preeclampsia, eclampsia and healthy pregnant women. Int J Clin Exp Med 2015; 8:16280-16286. [PMID: 26629145 PMCID: PMC4659033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2015] [Accepted: 08/05/2015] [Indexed: 06/05/2023]
Abstract
The aim of this study is to assess vitamin D levels in eclampsia, preeclampsia and healthy pregnant women and the role of vitamin D deficiency in the etiology of preeclampsia (PE). Forty healthy pregnant women, 83 preeclamptic and 32 eclamptic pregnant women were included. Maternal and infant medical records were reviewed. Blood samples were obtained from all groups. Demographics and serum vitamin D levels were compared between the groups. No statistical differences were observed in age, gravidity, parity, weight, height and BMI between the three groups. Week of pregnancy and weight at birth in eclamptic and preeclamptic patients were lower compared to the healthy patients (P<0.001 and P<0.001, respectively). Systolic and diastolic blood pressures were higher in eclamptic (P<0.001) and preeclamptic patients (P<0.001) compared to the healthy pregnant group. The rate of cesarean section was found to be higher in preeclamptic and eclamptic patients (P<0.001). Vitamin D levels were lower in both preeclamptic and eclamptic patients compared to healthy normotensive pregnant women (P<0.001). Preeclamptic and eclamptic women were similar in terms of the data compared. Vitamin D supplementation is considered to decrease the risk of both preeclampsia and eclampsia in the patient population at risk for vitamin D deficiency.
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Affiliation(s)
- Murat Bakacak
- Department of Obstetrics and Gynecology, School of Medicine, Kahramanmaras Sutcu Imam UniversityKahramanmaraş, Turkey
| | - Salih Serin
- Department of Obstetrics and Gynecology, School of Medicine, Kahramanmaras Sutcu Imam UniversityKahramanmaraş, Turkey
| | - Onder Ercan
- Department of Obstetrics and Gynecology, School of Medicine, Kahramanmaras Sutcu Imam UniversityKahramanmaraş, Turkey
| | - Bülent Köstü
- Department of Obstetrics and Gynecology, School of Medicine, Kahramanmaras Sutcu Imam UniversityKahramanmaraş, Turkey
| | - Fazıl Avci
- Department of Obstetrics and Gynecology, School of Medicine, Kahramanmaras Sutcu Imam UniversityKahramanmaraş, Turkey
| | - Metin Kılınç
- Department of Biochemistry, School of Medicine, Kahramanmaras Sutcu Imam UniversityKahramanmaraş, Turkey
| | - Hakan Kıran
- Department of Obstetrics and Gynecology, School of Medicine, Kahramanmaras Sutcu Imam UniversityKahramanmaraş, Turkey
| | - Gürkan Kiran
- Department of Obstetrics and Gynecology, School of Medicine, Kahramanmaras Sutcu Imam UniversityKahramanmaraş, Turkey
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Barrera D, Díaz L, Noyola-Martínez N, Halhali A. Vitamin D and Inflammatory Cytokines in Healthy and Preeclamptic Pregnancies. Nutrients 2015; 7:6465-90. [PMID: 26247971 PMCID: PMC4555132 DOI: 10.3390/nu7085293] [Citation(s) in RCA: 57] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2015] [Revised: 04/28/2015] [Accepted: 07/29/2015] [Indexed: 01/08/2023] Open
Abstract
Preeclampsia is a pregnancy disease characterized by hypertension and proteinuria. Among several disorders, the imbalance of inflammatory cytokines and the alteration of vitamin D metabolism have been reported in preeclampsia. The effects of calcitriol upon inflammatory cytokines has been demonstrated. In healthy pregnant women there is a shift toward a Th2 cytokine profile, which is necessary for an adequate pregnancy outcome. As compared with normal pregnancy, high pro-inflammatory and low anti-inflammatory cytokine levels have been observed in preeclamptic women. Preeclampsia has been associated with low calcitriol levels and vitamin D deficiency is correlated with a higher risk of the development of this disease. It has been demonstrated that placenta is a source as well as the target of calcitriol and cytokines and placental dysfunction has been associated with preeclampsia. Therefore, the present manuscript includes a review about serum calcitriol levels in non-pregnant, pregnant, and preeclamptic women as well as a review on the fetoplacental vitamin D metabolism in healthy and preeclamptic pregnancies. In addition, circulating and fetoplacental inflammatory cytokines in healthy and preeclamptic pregnancies are reviewed. Finally, the effects of calcitriol upon placental pro-inflammatory cytokines are also explored. In conclusion, maternal and placental calcitriol levels are low in preeclampsia which may explain, at least in part, high pro-inflammatory cytokine levels in this disease.
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Affiliation(s)
- David Barrera
- Department of Reproductive Biology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Vasco de Quiroga No. 15, Tlalpan, México D.F. 14000, México.
| | - Lorenza Díaz
- Department of Reproductive Biology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Vasco de Quiroga No. 15, Tlalpan, México D.F. 14000, México.
| | - Nancy Noyola-Martínez
- Department of Reproductive Biology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Vasco de Quiroga No. 15, Tlalpan, México D.F. 14000, México.
| | - Ali Halhali
- Department of Reproductive Biology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Vasco de Quiroga No. 15, Tlalpan, México D.F. 14000, México.
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Moon RJ, Harvey NC, Cooper C. ENDOCRINOLOGY IN PREGNANCY: Influence of maternal vitamin D status on obstetric outcomes and the fetal skeleton. Eur J Endocrinol 2015; 173:R69-83. [PMID: 25862787 PMCID: PMC4968635 DOI: 10.1530/eje-14-0826] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2014] [Accepted: 04/10/2015] [Indexed: 12/28/2022]
Abstract
Vitamin D status has been increasingly associated with wide-ranging clinical outcomes. There is now a wealth of observational studies reporting on its associations with obstetric complications, including pre-eclampsia, gestational diabetes and the mode and timing of delivery. The findings are inconsistent, and currently there is a lack of data from high-quality intervention studies to confirm a causal role for vitamin D in these outcomes. This is similarly true with regards to fetal development, including measures of fetal size and skeletal mineralisation. Overall, there is an indication of possible benefits of vitamin D supplementation during pregnancy for offspring birthweight, calcium concentrations and bone mass as well as for reduced maternal pre-eclampsia. However, for none of these outcomes is the current evidence base conclusive, and the available data justify the instatement of high-quality randomised placebo controlled trials in a range of populations and health care settings to establish the potential efficacy and safety of vitamin D supplementation to improve particular outcomes.
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Affiliation(s)
- Rebecca J Moon
- MRC Lifecourse Epidemiology UnitSouthampton General Hospital, University of Southampton, Tremona Road, Southampton SO16 6YD, UKPaediatric EndocrinologyUniversity Hospitals Southampton NHS Foundation Trust, Tremona Road, Southampton SO16 6YD, UKNIHR Southampton Biomedical Research CentreUniversity of Southampton and University Hospital Southampton NHS Foundation Trust, Tremona Road, Southampton SO16 6YD, UKNIHR Musculoskeletal Biomedical Research UnitUniversity of Oxford, Oxford OX3 7LD, UK MRC Lifecourse Epidemiology UnitSouthampton General Hospital, University of Southampton, Tremona Road, Southampton SO16 6YD, UKPaediatric EndocrinologyUniversity Hospitals Southampton NHS Foundation Trust, Tremona Road, Southampton SO16 6YD, UKNIHR Southampton Biomedical Research CentreUniversity of Southampton and University Hospital Southampton NHS Foundation Trust, Tremona Road, Southampton SO16 6YD, UKNIHR Musculoskeletal Biomedical Research UnitUniversity of Oxford, Oxford OX3 7LD, UK
| | - Nicholas C Harvey
- MRC Lifecourse Epidemiology UnitSouthampton General Hospital, University of Southampton, Tremona Road, Southampton SO16 6YD, UKPaediatric EndocrinologyUniversity Hospitals Southampton NHS Foundation Trust, Tremona Road, Southampton SO16 6YD, UKNIHR Southampton Biomedical Research CentreUniversity of Southampton and University Hospital Southampton NHS Foundation Trust, Tremona Road, Southampton SO16 6YD, UKNIHR Musculoskeletal Biomedical Research UnitUniversity of Oxford, Oxford OX3 7LD, UK MRC Lifecourse Epidemiology UnitSouthampton General Hospital, University of Southampton, Tremona Road, Southampton SO16 6YD, UKPaediatric EndocrinologyUniversity Hospitals Southampton NHS Foundation Trust, Tremona Road, Southampton SO16 6YD, UKNIHR Southampton Biomedical Research CentreUniversity of Southampton and University Hospital Southampton NHS Foundation Trust, Tremona Road, Southampton SO16 6YD, UKNIHR Musculoskeletal Biomedical Research UnitUniversity of Oxford, Oxford OX3 7LD, UK
| | - Cyrus Cooper
- MRC Lifecourse Epidemiology UnitSouthampton General Hospital, University of Southampton, Tremona Road, Southampton SO16 6YD, UKPaediatric EndocrinologyUniversity Hospitals Southampton NHS Foundation Trust, Tremona Road, Southampton SO16 6YD, UKNIHR Southampton Biomedical Research CentreUniversity of Southampton and University Hospital Southampton NHS Foundation Trust, Tremona Road, Southampton SO16 6YD, UKNIHR Musculoskeletal Biomedical Research UnitUniversity of Oxford, Oxford OX3 7LD, UK MRC Lifecourse Epidemiology UnitSouthampton General Hospital, University of Southampton, Tremona Road, Southampton SO16 6YD, UKPaediatric EndocrinologyUniversity Hospitals Southampton NHS Foundation Trust, Tremona Road, Southampton SO16 6YD, UKNIHR Southampton Biomedical Research CentreUniversity of Southampton and University Hospital Southampton NHS Foundation Trust, Tremona Road, Southampton SO16 6YD, UKNIHR Musculoskeletal Biomedical Research UnitUniversity of Oxford, Oxford OX3 7LD, UK MRC Lifecourse Epidemiology UnitSouthampton General Hospital, University of Southampton, Tremona Road, Southampton SO16 6YD, UKPaediatric EndocrinologyUniversity Hospitals Southampton NHS Foundation Trust, Tremona Road, Southampton SO16 6YD, UKNIHR Southampton Biomedical Research CentreUniversity of Southampton and University Hospital Southampton NHS Foundation Trust, Tremona Road, Southampton SO16 6YD, UKNIHR Musculoskeletal Biomedical Research UnitUniversity of Oxford, Oxford OX3 7LD, UK
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Smith TA, Kirkpatrick DR, Kovilam O, Agrawal DK. Immunomodulatory role of vitamin D in the pathogenesis of preeclampsia. Expert Rev Clin Immunol 2015; 11:1055-63. [PMID: 26098965 DOI: 10.1586/1744666x.2015.1056780] [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: 12/31/2022]
Abstract
Worldwide, preeclampsia is a significant health risk to both pregnant women and their unborn children. Despite scientific advances, the exact pathogenesis of preeclampsia is not yet fully understood. Meanwhile, the incidence of preeclampsia is expected to increase. A series of potential etiologies for preeclampsia has been identified, including endothelial dysfunction, immunological dysregulation and trophoblastic invasion. In this literature review, we have critically reviewed existing literature regarding the research findings that link the role of vitamin D to the pathogenesis and immunoregulation of preeclampsia. The relationship of vitamin D with the suspected etiologies of preeclampsia underscores its clinical potential in the diagnosis and treatment of preeclampsia.
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Affiliation(s)
- Tyler A Smith
- Center for Clinical & Translational Science, Creighton University School of Medicine, Omaha, NE, USA
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Olmos-Ortiz A, Avila E, Durand-Carbajal M, Díaz L. Regulation of calcitriol biosynthesis and activity: focus on gestational vitamin D deficiency and adverse pregnancy outcomes. Nutrients 2015; 7:443-80. [PMID: 25584965 PMCID: PMC4303849 DOI: 10.3390/nu7010443] [Citation(s) in RCA: 72] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2014] [Accepted: 12/16/2014] [Indexed: 02/07/2023] Open
Abstract
Vitamin D has garnered a great deal of attention in recent years due to a global prevalence of vitamin D deficiency associated with an increased risk of a variety of human diseases. Specifically, hypovitaminosis D in pregnant women is highly common and has important implications for the mother and lifelong health of the child, since it has been linked to maternal and child infections, small-for-gestational age, preterm delivery, preeclampsia, gestational diabetes, as well as imprinting on the infant for life chronic diseases. Therefore, factors that regulate vitamin D metabolism are of main importance, especially during pregnancy. The hormonal form and most active metabolite of vitamin D is calcitriol. This hormone mediates its biological effects through a specific nuclear receptor, which is found in many tissues including the placenta. Calcitriol synthesis and degradation depend on the expression and activity of CYP27B1 and CYP24A1 cytochromes, respectively, for which regulation is tissue specific. Among the factors that modify these cytochromes expression and/or activity are calcitriol itself, parathyroid hormone, fibroblast growth factor 23, cytokines, calcium and phosphate. This review provides a current overview on the regulation of vitamin D metabolism, focusing on vitamin D deficiency during gestation and its impact on pregnancy outcomes.
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Affiliation(s)
- Andrea Olmos-Ortiz
- Department of Reproductive Biology, National Institute of Medical Sciences and Nutrition Salvador Zubirán, Vasco de Quiroga No. 15, Tlalpan 14000, Mexico City, Mexico.
| | - Euclides Avila
- Department of Reproductive Biology, National Institute of Medical Sciences and Nutrition Salvador Zubirán, Vasco de Quiroga No. 15, Tlalpan 14000, Mexico City, Mexico.
| | - Marta Durand-Carbajal
- Department of Reproductive Biology, National Institute of Medical Sciences and Nutrition Salvador Zubirán, Vasco de Quiroga No. 15, Tlalpan 14000, Mexico City, Mexico.
| | - Lorenza Díaz
- Department of Reproductive Biology, National Institute of Medical Sciences and Nutrition Salvador Zubirán, Vasco de Quiroga No. 15, Tlalpan 14000, Mexico City, Mexico.
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