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Lin KC, Huang KJ, Lin MN, Wang CY, Tsai TY. Vitamin D Supplementation for Patients with Dysmenorrhoea: A Meta-Analysis with Trial Sequential Analysis of Randomised Controlled Trials. Nutrients 2024; 16:1089. [PMID: 38613122 PMCID: PMC11013696 DOI: 10.3390/nu16071089] [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: 03/05/2024] [Revised: 04/01/2024] [Accepted: 04/07/2024] [Indexed: 04/14/2024] Open
Abstract
Vitamin D reduces prostaglandin levels and inflammation, making it a promising treatment option for dysmenorrhoea. However, its effects on pain intensity in different types of dysmenorrhoea remain unclear. We examined whether vitamin D supplementation decreases pain intensity in patients with dysmenorrhoea. The Cochrane Library, Embase, Google Scholar, Medline, and Scopus databases were searched from inception to 30 December 2023. Randomised controlled trials (RCTs) evaluating vitamin D supplementation effects on such patients were included. The primary and secondary outcomes were measured by the changes in pain intensity and rescue analgesic use, respectively. Pooled mean differences and rate ratios were calculated using a random-effect model; trial sequential analysis (TSA) was also performed. Overall, 11 studies involving 687 participants were included. Vitamin D supplementation significantly decreased pain intensity in patients with dysmenorrhoea compared with controls (pooled mean difference, -1.64; 95% confidence interval, -2.27 to -1.00; p < 0.001; CoE, moderate; I2 statistic, 79.43%) and indicated substantial heterogeneity among the included studies. TSA revealed that the current RCTs provide sufficient information. In subgroup analyses, vitamin D supplement reduced primary dysmenorrhoea pain but not secondary dysmenorrhoea pain. In conclusion, although substantial heterogeneity persists, vitamin D supplementation decreased pain intensity in patients with dysmenorrhea, especially in those with primary dysmenorrhoea.
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Affiliation(s)
- Kan-Chu Lin
- Family Medicine Department, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi 62247, Taiwan; (K.-C.L.); (M.-N.L.)
| | - Kuan-Ju Huang
- Department of Obstetrics and Gynecology, National Taiwan University Hospital Yunlin Branch, Yunlin 640203, Taiwan;
| | - Ming-Nan Lin
- Family Medicine Department, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi 62247, Taiwan; (K.-C.L.); (M.-N.L.)
- School of Medicine, Tzu Chi University, Hualien 97004, Taiwan
| | - Cheng-Yu Wang
- Family Medicine Department, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi 62247, Taiwan; (K.-C.L.); (M.-N.L.)
| | - Tou-Yuan Tsai
- School of Medicine, Tzu Chi University, Hualien 97004, Taiwan
- Emergency Department, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi 62247, Taiwan
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei 106319, Taiwan
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Sörsjö Stevenazzi A, Pihl S, Blomberg M, Axelsson D. The association between maternal vitamin D deficiency and postpartum hemorrhage and uterine atony. Acta Obstet Gynecol Scand 2024; 103:286-293. [PMID: 37960966 PMCID: PMC10823403 DOI: 10.1111/aogs.14719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 10/18/2023] [Accepted: 10/24/2023] [Indexed: 11/15/2023]
Abstract
INTRODUCTION Postpartum hemorrhage is the leading cause of maternal morbidity and mortality worldwide. There are several known risk factors for postpartum hemorrhage related to pregnancy and delivery, but less evidence of predisposing factors. Recent research has shown that vitamin D deficiency may increase the risk of cesarean section due to dystocia, based on its effect on striated muscle as well as possible effect on the myometrium. Whether vitamin D deficiency increases the risk for postpartum hemorrhage and especially atonic hemorrhage is unknown. MATERIAL AND METHODS This was a retrospective translational study. The study population included 1367 women in Sweden and the main exposure was the serum concentration of 25-hydroxylated vitamin D at time of delivery. The LIASON® 25 OH vitamin D total assay method was used for analyzing 25-hydroxylated vitamin D. Vitamin D insufficiency was defined as serum concentration <50 nmol/L and vitamin D deficiency as serum concentrations <25 nmol/L. Primary outcomes were postpartum hemorrhage and severe postpartum hemorrhage defined as bleeding ≥500 mL and ≥ 1000 mL, respectively 2 h after delivery. Secondary outcome was atonic postpartum hemorrhage. Crude and adjusted odds ratios were calculated with 95% confidence intervals using univariable and multivariable logistic regression. Three different adjustment methods were used, adjusting for maternal, obstetrical and neonatal confounders. RESULTS Postpartum hemorrhage and severe postpartum hemorrhage afflicted 31.3% and 6.4% of the women, respectively. Rate of atonic postpartum hemorrhage was 21% in the whole population. Rate of vitamin D insufficiency and deficiency was 57%. Vitamin D insufficiency or deficiency was neither found to be associated with postpartum hemorrhage, nor with atonic postpartum hemorrhage. CONCLUSIONS In this study, the vitamin D status of women at the time of delivery was not a predictor of postpartum hemorrhage overall or atonic postpartum hemorrhage.
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Affiliation(s)
| | - Sofia Pihl
- Department of Obstetrics and Gynecology and Department of Biomedical and Clinical SciencesLinköping UniversityLinköpingSweden
| | - Marie Blomberg
- Department of Obstetrics and Gynecology and Department of Biomedical and Clinical SciencesLinköping UniversityLinköpingSweden
| | - Daniel Axelsson
- Department of Obstetrics and GynecologyRyhov County HospitalJönköpingSweden
- Department of Obstetrics and Gynecology and Department of Biomedical and Clinical SciencesLinköping UniversityLinköpingSweden
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Donayeva A, Amanzholkyzy A, Abdelazim I, Saparbayev S, Nurgaliyeva R, Kaldybayeva A, Zhexenova A, Gubasheva G, Ayaganov D, Samaha I. The effects of vitamin D and calcium on primary dysmenorrhea: a systematic review. J Med Life 2023; 16:1597-1605. [PMID: 38406773 PMCID: PMC10893561 DOI: 10.25122/jml-2023-0248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 09/06/2023] [Indexed: 02/27/2024] Open
Abstract
Dysmenorrhea, affecting approximately 80% of adolescents, significantly impairs quality of life, disrupts sleep patterns, and induces mood changes. Furthermore, its economic impact is substantial, accounting for an estimated $200 billion in the United States and $4.2 million in Japan annually. This review aimed to identify the effects of vitamin D and calcium on primary dysmenorrhea. We conducted a comprehensive literature search across Web of Science, PubMed, Scopus, and Science Direct, focusing on studies published from 2010 to 2020. Keywords included 'primary dysmenorrhea', 'vitamin D', '25-OH vitamin D3', 'cholecalciferol', and 'calcium'. The quality assessment of the articles was done using the Consolidated Standards of Reporting Trials (CONSORT) and the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklists, and the risk bias was assessed using the Cochrane assessment tool. Abnormal low Vit. D levels increased the severity of primary dysmenorrhea through increased prostaglandins and decreased calcium absorption. Vitamin D and calcium supplements could reduce the severity of primary dysmenorrhea and the need for analgesics. This systematic review found an inverse relation between the severity of dysmenorrhea and low serum Vit. D and calcium.. Vitamin D and calcium supplements could reduce the severity of primary dysmenorrhea and the need for analgesics.
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Affiliation(s)
- Ainur Donayeva
- Department of Normal Physiology, West Kazakhstan Marat Ospanov Medical University, Aktobe, Kazakhstan
| | - Ainur Amanzholkyzy
- Department of Normal Physiology, West Kazakhstan Marat Ospanov Medical University, Aktobe, Kazakhstan
| | - Ibrahim Abdelazim
- Department of Obstetrics and Gynecology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Samat Saparbayev
- Department of Normal Physiology, West Kazakhstan Marat Ospanov Medical University, Aktobe, Kazakhstan
| | - Roza Nurgaliyeva
- Department of Normal Physiology, West Kazakhstan Marat Ospanov Medical University, Aktobe, Kazakhstan
| | - Aiman Kaldybayeva
- Department of Normal Physiology, West Kazakhstan Marat Ospanov Medical University, Aktobe, Kazakhstan
| | - Azhar Zhexenova
- Department of Normal Physiology, West Kazakhstan Marat Ospanov Medical University, Aktobe, Kazakhstan
| | - Gulnara Gubasheva
- Department of Obstetrics and Gynecology №2, West Kazakhstan Marat Ospanov Medical University, Aktobe, Kazakhstan
| | - Dinmukhamed Ayaganov
- Department of Neurology, West Kazakhstan Marat Ospanov Medical University, Aktobe, Kazakhstan
| | - Ihab Samaha
- Department of Obstetrics and Gynecology, Faculty of Medicine, Helwan University, Cairo, Egypt
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Donayeva A, Amanzholkyzy A, Abdelazim I, Kurmangazin M, Khamidullina Z, Kurmanalina M, Sumanova A, Shabanbayeva Z, Baubekov Z, Bissaliyev B, Gubasheva G, Samaha I. The effect of vitamin D on adolescents' primary dysmenorrhea. J Med Life 2023; 16:1658-1662. [PMID: 38406787 PMCID: PMC10893579 DOI: 10.25122/jml-2023-0290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Accepted: 10/17/2023] [Indexed: 02/27/2024] Open
Abstract
Vitamin D receptor (VDR) expression in the female reproductive tract explains the regulatory role of vitamin D on inflammatory cytokine and prostaglandin (PGD) synthesis. This study aimed to evaluate the effect of vitamin D on adolescents' primary dysmenorrhea and the relationship between Vit. D and adolescents' primary dysmenorrhea. Eighty-five adolescents were included in the current study. After a detailed evaluation, pelvic sonography was performed for all participants to rule out any pelvic pathology. Blood samples were collected to measure thyroid stimulating hormone (TSH), prolactin, glycosylated hemoglobin (HbA1C), and 25-hydroxyvitamin D (25[OH]D). Participants were administered vitamin D (50,000 IU weekly for five months), and their dysmenorrhea symptoms were evaluated before and after this period using the Visual Analog Scale (VAS) and the Verbal Multidimensional Scoring (VMS). The mean VAS and VMS scores of dysmenorrhea statistically decreased from 8.7±0.91 and 2.65±0.93 to 4.8±0.75 and 0.80±0.75, respectively, after vitamin D intake (p=0.03 and 0.025, respectively). Significant negative associations between 25(OH)D and VAS (R = -0.886; p<0.00001) and VMS of dysmenorrhea (R = -0.885; p<0.00001) were detected in this study. Vit. D could be a useful therapeutic option to reduce the severity of primary dysmenorrhea and could limit the use of non-steroidal anti-inflammatory drugs.
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Affiliation(s)
- Ainur Donayeva
- Department of Normal Physiology, West Kazakhstan Marat Ospanov Medical University, Aktobe, Kazakhstan
| | - Ainur Amanzholkyzy
- Department of Normal Physiology, West Kazakhstan Marat Ospanov Medical University, Aktobe, Kazakhstan
| | - Ibrahim Abdelazim
- Department of Obstetrics and Gynecology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Meirambek Kurmangazin
- Department of Normal Physiology, West Kazakhstan Marat Ospanov Medical University, Aktobe, Kazakhstan
| | - Zaituna Khamidullina
- Department of Obstetrics and Gynecology №, Astana Medical University, Astana, Kazakhstan
| | - Madina Kurmanalina
- Department of Therapeutic and Orthopedic Dentistry, West Kazakhstan Marat Ospanov Medical University, Aktobe, Kazakhstan
| | - Aigul Sumanova
- Department of Therapeutic and Orthopedic Dentistry, West Kazakhstan Marat Ospanov Medical University, Aktobe, Kazakhstan
| | - Zhanara Shabanbayeva
- Department of Therapeutic and Orthopedic Dentistry, West Kazakhstan Marat Ospanov Medical University, Aktobe, Kazakhstan
| | - Zhenisbek Baubekov
- Department of Pediatric Surgery, West Kazakhstan Marat Ospanov Medical University, Aktobe, Kazakhstan
| | - Bauyrzhan Bissaliyev
- Department of Pediatric Surgery, West Kazakhstan Marat Ospanov Medical University, Aktobe, Kazakhstan
| | - Gulnara Gubasheva
- Department of Obstetrics and Gynecology №, West Kazakhstan Marat Ospanov Medical University, Aktobe, Kazakhstan
| | - Ihab Samaha
- Department of Obstetrics and Gynecology, Faculty of Medicine, Helwan University, Cairo, Egypt
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Alifu X, Si S, Qiu Y, Cheng H, Huang Y, Chi P, Zhuang Y, Zhou H, Zhang L, Ainiwan D, Peng Z, Liu H, Yu Y. The Association of Vitamin D during Pregnancy and mRNA Expression Levels of Inflammatory Factors with Preterm Birth and Prelabor Rupture of Membranes. Nutrients 2023; 15:3423. [PMID: 37571360 PMCID: PMC10421124 DOI: 10.3390/nu15153423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 07/26/2023] [Accepted: 07/31/2023] [Indexed: 08/13/2023] Open
Abstract
The aim of this study was to elucidate the association between vitamin D (VD) and the risk for preterm birth (PTB) and prelabor rupture of membranes (PROM). This study included two parts, with a cohort study and a case-control study. Plasma 25-hydroxyvitamin vitamin D [25(OH)D] levels in three trimesters in the cohort study and maternal 25(OH)D before delivery in the case-control study were measured. Quantitative real-time PCR was used to detect relative mRNA expression levels of the inflammatory factors associated with pyroptosis in peripheral blood mononuclear cell (PBMC), placenta and fetal membranes. Multinomial logistic regression and the Wilcoxon test were applied to analyze the associations. In the cohort study, 6381 pregnant women were included. We found that VD deficiency in T3 (PTB without PROM: OR = 1.90, 95% CI: 1.02-3.55, Term PROM (TPROM): OR = 0.76, 95% CI: 0.59-0.98) and less change of 25(OH)D between T1 and T3 (PTB without PROM: OR = 2.32, 95% CI: 1.07-5.06, TPROM: OR = 0.73, 95% CI: 0.56-0.96) were associated with the increased risk of PTB without PROM, while there was a decreased risk of TPROM. Neither VD, nor the increase of VD during pregnancy was associated with the premature rupture of membranes preterm delivery (PPROM). In the case-control study, there were no associations between VD during delivery and PTB or PROM (TPROM: OR = 1.33, 95% CI: 0.52-3.44); PTB without PROM: OR = 1.66, 95% CI: 0.33-8.19; PPROM: OR = 1.19, 95% CI: 0.42-3.40). The mRNA expression of NLRP1 (NOD-like receptor thermal protein domain associated protein 1) (p = 0.0165) in PBMC in the TPROM group was higher than that in the term group, and IL-18 (p = 0.0064) was lower than that in the term group. Plasma 25(OH)D in T3 and the increase of 25(OH)D between T1 and T3 were associated with a lower risk for PTB without PROM but a higher risk for TPROM. Further studies are warranted to clarify the association between VD and PTB and PROM and its mechanism.
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Affiliation(s)
- Xialidan Alifu
- Department of Public Health, and Department of Anesthesiology, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310009, China; (X.A.); (S.S.); (Y.Q.); (H.C.); (Y.H.); (P.C.); (Y.Z.); (H.Z.); (L.Z.); (D.A.); (Z.P.)
- Department of Epidemiology & Health Statistics, School of Public Health, School of Medicine, Zhejiang University, Hangzhou 310058, China
| | - Shuting Si
- Department of Public Health, and Department of Anesthesiology, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310009, China; (X.A.); (S.S.); (Y.Q.); (H.C.); (Y.H.); (P.C.); (Y.Z.); (H.Z.); (L.Z.); (D.A.); (Z.P.)
- Department of Epidemiology & Health Statistics, School of Public Health, School of Medicine, Zhejiang University, Hangzhou 310058, China
- Yiwu Maternity and Children Hospital, Yiwu 322000, China
| | - Yiwen Qiu
- Department of Public Health, and Department of Anesthesiology, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310009, China; (X.A.); (S.S.); (Y.Q.); (H.C.); (Y.H.); (P.C.); (Y.Z.); (H.Z.); (L.Z.); (D.A.); (Z.P.)
- Department of Epidemiology & Health Statistics, School of Public Health, School of Medicine, Zhejiang University, Hangzhou 310058, China
| | - Haoyue Cheng
- Department of Public Health, and Department of Anesthesiology, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310009, China; (X.A.); (S.S.); (Y.Q.); (H.C.); (Y.H.); (P.C.); (Y.Z.); (H.Z.); (L.Z.); (D.A.); (Z.P.)
- Department of Epidemiology & Health Statistics, School of Public Health, School of Medicine, Zhejiang University, Hangzhou 310058, China
| | - Ye Huang
- Department of Public Health, and Department of Anesthesiology, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310009, China; (X.A.); (S.S.); (Y.Q.); (H.C.); (Y.H.); (P.C.); (Y.Z.); (H.Z.); (L.Z.); (D.A.); (Z.P.)
- Department of Epidemiology & Health Statistics, School of Public Health, School of Medicine, Zhejiang University, Hangzhou 310058, China
| | - Peihan Chi
- Department of Public Health, and Department of Anesthesiology, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310009, China; (X.A.); (S.S.); (Y.Q.); (H.C.); (Y.H.); (P.C.); (Y.Z.); (H.Z.); (L.Z.); (D.A.); (Z.P.)
- Department of Epidemiology & Health Statistics, School of Public Health, School of Medicine, Zhejiang University, Hangzhou 310058, China
| | - Yan Zhuang
- Department of Public Health, and Department of Anesthesiology, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310009, China; (X.A.); (S.S.); (Y.Q.); (H.C.); (Y.H.); (P.C.); (Y.Z.); (H.Z.); (L.Z.); (D.A.); (Z.P.)
- Department of Epidemiology & Health Statistics, School of Public Health, School of Medicine, Zhejiang University, Hangzhou 310058, China
| | - Haibo Zhou
- Department of Public Health, and Department of Anesthesiology, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310009, China; (X.A.); (S.S.); (Y.Q.); (H.C.); (Y.H.); (P.C.); (Y.Z.); (H.Z.); (L.Z.); (D.A.); (Z.P.)
- Department of Epidemiology & Health Statistics, School of Public Health, School of Medicine, Zhejiang University, Hangzhou 310058, China
| | - Libi Zhang
- Department of Public Health, and Department of Anesthesiology, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310009, China; (X.A.); (S.S.); (Y.Q.); (H.C.); (Y.H.); (P.C.); (Y.Z.); (H.Z.); (L.Z.); (D.A.); (Z.P.)
- Department of Epidemiology & Health Statistics, School of Public Health, School of Medicine, Zhejiang University, Hangzhou 310058, China
| | - Diliyaer Ainiwan
- Department of Public Health, and Department of Anesthesiology, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310009, China; (X.A.); (S.S.); (Y.Q.); (H.C.); (Y.H.); (P.C.); (Y.Z.); (H.Z.); (L.Z.); (D.A.); (Z.P.)
- Department of Epidemiology & Health Statistics, School of Public Health, School of Medicine, Zhejiang University, Hangzhou 310058, China
| | - Zhicheng Peng
- Department of Public Health, and Department of Anesthesiology, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310009, China; (X.A.); (S.S.); (Y.Q.); (H.C.); (Y.H.); (P.C.); (Y.Z.); (H.Z.); (L.Z.); (D.A.); (Z.P.)
- Department of Epidemiology & Health Statistics, School of Public Health, School of Medicine, Zhejiang University, Hangzhou 310058, China
| | - Hui Liu
- Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou 310058, China;
| | - Yunxian Yu
- Department of Public Health, and Department of Anesthesiology, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310009, China; (X.A.); (S.S.); (Y.Q.); (H.C.); (Y.H.); (P.C.); (Y.Z.); (H.Z.); (L.Z.); (D.A.); (Z.P.)
- Department of Epidemiology & Health Statistics, School of Public Health, School of Medicine, Zhejiang University, Hangzhou 310058, China
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Matsas A, Sachinidis A, Lamprinou M, Stamoula E, Christopoulos P. Vitamin Effects in Primary Dysmenorrhea. Life (Basel) 2023; 13:1308. [PMID: 37374091 DOI: 10.3390/life13061308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2023] [Revised: 05/10/2023] [Accepted: 05/31/2023] [Indexed: 06/29/2023] Open
Abstract
BACKGROUND Primary dysmenorrhea is considered to be one of the most common gynecological complaints, affecting women's daily activities and social life. The severity of dysmenorrhea varies among women, and its management is of high importance for them. Given that non-steroidal anti-inflammatory drugs (NSAIDs), the established treatment for dysmenorrhea, are associated with many adverse events, alternative therapeutic options are under evaluation. Emerging evidence correlates management of dysmenorrhea with micronutrients, especially vitamins. PURPOSE The aim of this narrative review is to highlight and provide evidence of the potential benefits of vitamins for the management of dysmenorrhea. METHODS The articles were searched on PubMed, Scopus and Google Scholar. The searching process was based on keywords, such as "primary dysmenorrhea", "vitamins", "supplementation", "vitamin D", "vitamin E" and others. Our search focused on data derived from clinical trials, published only during the last decade (older articles were excluded). RESULTS In this review, 13 clinical trials were investigated. Most of them supported the anti-inflammatory, antioxidant and analgesic properties of vitamins. Particularly, vitamins D and E revealed a desirable effect on dysmenorrhea relief Conclusion: Despite the scarcity and heterogeneity of related research, the studies indicate a role of vitamins for the management of primary dysmenorrhea, proposing that they should be considered as alternative therapeutic candidates for clinical use. Nevertheless, this correlation warrants further research.
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Affiliation(s)
- Alkis Matsas
- Second Department of Obstetrics and Gynaecology, Medical School, "Aretaieion'' University Hospital, National and Kapodistrian University of Athens, 115 27 Athens, Greece
| | - Athanasios Sachinidis
- Fourth Department of Internal Medicine, Hippokration General Hospital of Thessaloniki, School of Medicine, Aristotle University of Thessaloniki, 541 24 Thessaloniki, Greece
| | - Malamatenia Lamprinou
- Laboratory of Clinical Pharmacology, School of Medicine, Aristotle University of Thessaloniki, 541 24 Thessaloniki, Greece
| | - Eleni Stamoula
- Department of Biotechnology, Centre of Systems Biology, Biomedical Research Foundation of the Academy of Athens, 115 27 Athens, Greece
| | - Panagiotis Christopoulos
- Second Department of Obstetrics and Gynaecology, Medical School, "Aretaieion'' University Hospital, National and Kapodistrian University of Athens, 115 27 Athens, Greece
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Naraoka Y, Hosokawa M, Minato-Inokawa S, Sato Y. Severity of Menstrual Pain Is Associated with Nutritional Intake and Lifestyle Habits. Healthcare (Basel) 2023; 11:healthcare11091289. [PMID: 37174831 PMCID: PMC10178419 DOI: 10.3390/healthcare11091289] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 04/23/2023] [Accepted: 04/28/2023] [Indexed: 05/15/2023] Open
Abstract
Recently, the employment rate of women in Japan has steadily increased. Approximately 80% of women experience menstrual pain and premenstrual syndrome (PMS). These symptoms decrease a woman's quality of life and her work productivity, leading to an economic loss. This cross-sectional study of 321 healthy Japanese women aged 20-39 years aimed to clarify the lifestyle-related factors or nutrient intake that might cause menstrual pain. The participants underwent body composition measurements and completed meal survey sheets and lifestyle questionnaires, including menstrual status, exercise, sleep and breakfast consumption. Based on the questionnaire results, participants were divided into two groups according to the severity of menstrual pain, namely, heavy and light. Chi-square and Wilcoxon signed-rank sum tests were used to compare the severity of menstrual pain in the two groups. In the heavy group, the intake of animal proteins, including fish, vitamin D and vitamin B12, was significantly lower (p < 0.05), as was the frequency of breakfast consumption and bathing (p < 0.05). The rate of PMS symptoms was significantly higher in the heavy group (p < 0.05). This study suggests that a lack of animal protein, the accompanying vitamins and fatty acids, and the frequency of breakfast or bathing are associated with the severity of menstrual pain.
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Affiliation(s)
- Yuna Naraoka
- Intractable Disease Research Center, Graduate School of Medicine, Juntendo University, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan
- Japanese Center for Research on Woman in Sport, Juntendo University, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan
- General Incorporated Association Luvtelli, 3-2-14, Nihonbashi, Chou-ku, Tokyo 103-0027, Japan
| | - Momo Hosokawa
- General Incorporated Association Luvtelli, 3-2-14, Nihonbashi, Chou-ku, Tokyo 103-0027, Japan
| | - Satomi Minato-Inokawa
- General Incorporated Association Luvtelli, 3-2-14, Nihonbashi, Chou-ku, Tokyo 103-0027, Japan
- Laboratory of Community Health and Nutrition, Department of Bioscience, Graduate School of Agriculture, Ehime University, Matsuyama 790-8566, Japan
- Department of Pharmacoepidemiology, Graduate School of Medicine and Public Health, Kyoto University, Yoshida-Konoe-cho, Sakyo-ku, Kyoto 606-8501, Japan
| | - Yuichi Sato
- General Incorporated Association Luvtelli, 3-2-14, Nihonbashi, Chou-ku, Tokyo 103-0027, Japan
- Obstetrics and Gynecology, Tatedebari Sato Hospital, Takasaki 370-0836, Japan
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Chan SY, Yong HEJ, Chang HF, Barton SJ, Galani S, Zhang H, Wong JT, Ong J, Ebreo M, El-Heis S, Kenealy T, Nield H, Baker PN, Chong YS, Cutfield WS, Godfrey KM. Peripartum outcomes after combined myo-inositol, probiotics, and micronutrient supplementation from preconception: the NiPPeR randomized controlled trial. Am J Obstet Gynecol MFM 2022; 4:100714. [PMID: 35970494 DOI: 10.1016/j.ajogmf.2022.100714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Accepted: 08/08/2022] [Indexed: 10/31/2022]
Abstract
BACKGROUND Evidence that nutritional supplementation before and during pregnancy improves peripartum outcomes is sparse. In the Nutritional Intervention Preconception and During Pregnancy to Maintain Healthy Glucose Metabolism and Offspring Health (NiPPeR) trial, we previously reported that a combined myo-inositol, probiotics, and micronutrient supplement started at preconception showed no difference in the primary outcome of gestational glycemia, but did reduce the risk of preterm delivery, preterm prelabor rupture of membranes, and major postpartum hemorrhage. OBJECTIVE This study aimed to examine the hypothesis that a reduction in major postpartum hemorrhage following a combined nutritional (myo-inositol, probiotics, and micronutrients) intervention is linked with promotion of labor progress and reduced operative delivery. STUDY DESIGN This double-blind randomized controlled trial recruited 1729 women from the United Kingdom, Singapore, and New Zealand, aged 18 to 38 years, and planning conception between 2015 and 2017. The effects of the nutritional intervention compared with those of a standard micronutrient supplement (control), taken at preconception and throughout pregnancy, were examined for the secondary outcomes of peripartum events using multinomial, Poisson, and linear regression adjusting for site, ethnicity, and important covariates. RESULTS Of the women who conceived and progressed beyond 24 weeks' gestation with a singleton pregnancy (n=589), 583 (99%) provided peripartum data. Between women in the intervention (n=293) and control (n=290) groups, there were no differences in rates of labor induction, oxytocin augmentation during labor, instrumental delivery, perineal trauma, and intrapartum cesarean delivery. Although duration of the first stage of labor was similar, the second-stage duration was 20% shorter in the intervention than in the control group (adjusted mean difference, -12.0 [95% confidence interval, -22.2 to -1.2] minutes; P=.029), accompanied by a reduction in operative delivery for delayed second-stage progress (adjusted risk ratio, 0.61 [0.48-0.95]; P=.022). Estimated blood loss was 10% lower in the intervention than in the control group (adjusted mean difference, -35.0 [-70.0 to -3.5] mL; P=.047), consistent with previous findings of reduced postpartum hemorrhage. CONCLUSION Supplementation with a specific combination of myo-inositol, probiotics, and micronutrients started at preconception and continued in pregnancy reduced the duration of the second stage of labor, the risk of operative delivery for delay in the second stage, and blood loss at delivery.
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Affiliation(s)
- Shiao-Yng Chan
- Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, National University Health System, Singapore (Drs Chan and Chong); Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore (Drs Chan, Yong, and Zhang, Mr Wong, and Dr Chong); Department of Obstetrics and Gynaecology, National University Hospital, Singapore (Dr Chan, Ms Chang, Drs Ong, Ebreo, and Chong).
| | - Hannah E J Yong
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore (Drs Chan, Yong, and Zhang, Mr Wong, and Dr Chong)
| | - Hsin Fang Chang
- Department of Obstetrics and Gynaecology, National University Hospital, Singapore (Dr Chan, Ms Chang, Drs Ong, Ebreo, and Chong)
| | - Sheila J Barton
- Medical Research Council Lifecourse Epidemiology Centre, University of Southampton, Southampton General Hospital, Southampton, United Kingdom (Dr Barton, Ms Galani, Dr El-Heis, Ms Nield, and Dr Godfrey)
| | - Sevasti Galani
- Medical Research Council Lifecourse Epidemiology Centre, University of Southampton, Southampton General Hospital, Southampton, United Kingdom (Dr Barton, Ms Galani, Dr El-Heis, Ms Nield, and Dr Godfrey)
| | - Han Zhang
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore (Drs Chan, Yong, and Zhang, Mr Wong, and Dr Chong)
| | - Jui-Tsung Wong
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore (Drs Chan, Yong, and Zhang, Mr Wong, and Dr Chong)
| | - Judith Ong
- Department of Obstetrics and Gynaecology, National University Hospital, Singapore (Dr Chan, Ms Chang, Drs Ong, Ebreo, and Chong)
| | - Marilou Ebreo
- Department of Obstetrics and Gynaecology, National University Hospital, Singapore (Dr Chan, Ms Chang, Drs Ong, Ebreo, and Chong)
| | - Sarah El-Heis
- Medical Research Council Lifecourse Epidemiology Centre, University of Southampton, Southampton General Hospital, Southampton, United Kingdom (Dr Barton, Ms Galani, Dr El-Heis, Ms Nield, and Dr Godfrey)
| | - Timothy Kenealy
- Liggins Institute, University of Auckland, Auckland, New Zealand (Drs Kenealy and Cutfield)
| | - Heidi Nield
- Medical Research Council Lifecourse Epidemiology Centre, University of Southampton, Southampton General Hospital, Southampton, United Kingdom (Dr Barton, Ms Galani, Dr El-Heis, Ms Nield, and Dr Godfrey)
| | - Philip N Baker
- College of Life Sciences, University of Leicester, Leicester, United Kingdom (Dr Baker)
| | - Yap Seng Chong
- Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, National University Health System, Singapore (Drs Chan and Chong); Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore (Drs Chan, Yong, and Zhang, Mr Wong, and Dr Chong); Department of Obstetrics and Gynaecology, National University Hospital, Singapore (Dr Chan, Ms Chang, Drs Ong, Ebreo, and Chong)
| | - Wayne S Cutfield
- Liggins Institute, University of Auckland, Auckland, New Zealand (Drs Kenealy and Cutfield); A Better Start, National Science Challenge, Auckland, New Zealand (Dr Cutfield); A Better Start, National Science Challenge, Auckland, New Zealand
| | - Keith M Godfrey
- Medical Research Council Lifecourse Epidemiology Centre, University of Southampton, Southampton General Hospital, Southampton, United Kingdom (Dr Barton, Ms Galani, Dr El-Heis, Ms Nield, and Dr Godfrey); National Institute for Health Research Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton, National Health Service (NHS) Foundation Trust, Southampton, United Kingdom (Dr Godfrey)
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Gangnat I, Kreuzer M. Effect of supplementing sows with <i>Solanum glaucophyllum</i>,
a natural source of calcitriol, on farrowing performance,
piglet survival and litter performance. JOURNAL OF ANIMAL AND FEED SCIENCES 2022. [DOI: 10.22358/jafs/146610/2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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10
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Li WJ, Chen KH, Huang LW, Tsai YL, Seow KM. Low Maternal Serum 25-Hydroxyvitamin D Concentration Is Associated With Postpartum Hemorrhage: A Retrospective Observational Study. Front Endocrinol (Lausanne) 2022; 13:816480. [PMID: 35370939 PMCID: PMC8968120 DOI: 10.3389/fendo.2022.816480] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Accepted: 02/22/2022] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE The primary aim of this study is to investigate the relationship between vitamin D serum level and the incidence of postpartum hemorrhage (PPH). The secondary objective is to determine the relative risk of low vitamin D associated with PPH. METHODS This was a retrospective observational study. A total of 600 women who had delivered their babies in a single tertiary teaching hospital were enrolled. Serum blood test for 25(OH)D was performed at 35 + 0 to 36 + 6 weeks of pregnancy to measure vitamin D. A 25(OH)D level < 20 ng/mL was defined as vitamin D deficient, and a level 21-29 ng/mL as insufficient. RESULTS Vitamin D levels were deficient in 145 (24.1%) and insufficient in 254 (42.3%) of the women tested. Women with deficient and insufficient vitamin D levels were significantly younger than those with sufficient vitamin D levels (p < 0.001). The overall rates of PPH in the deficient and insufficient groups were 6.9% (10/145) and 6.7% (17/254), respectively, and were significantly higher than the rate of the normal vitamin D group (1.5%, p = 0.009). Women with sufficient vitamin D levels had significantly higher hemoglobin levels than those with low vitamin D levels. Higher vitamin D levels were associated with a significantly low risk of PPH (AOR: 0.93, CI: 0.89-0.98, p = 0.006). CONCLUSION Our results suggest that a low vitamin D level is a risk factor for PPH. Low vitamin D also related to high risk of low hemoglobin before delivery. Thus, antepartum care should include vitamin D supplements for all women if possible.
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Affiliation(s)
- Wei-Jiun Li
- Department of Obstetrics and Gynecology, Shin-Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan
| | - Kuo-Hu Chen
- Department of Obstetrics and Gynecology, Taipei Tzu-Chi Hospital, The Buddhist Tzu-Chi Medical Foundation, Taipei, Taiwan
- School of Medicine, Buddhist Tzu-Chi University, Hualien, Taiwan
| | - Lee-Wen Huang
- Department of Obstetrics and Gynecology, Shin-Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan
- College of Medicine, Fu-Jen Catholic University, New Taipei City, Taiwan
| | - Yieh-Loong Tsai
- Department of Obstetrics and Gynecology, Shin-Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan
- College of Medicine, Fu-Jen Catholic University, New Taipei City, Taiwan
| | - Kok-Min Seow
- Department of Obstetrics and Gynecology, Shin-Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan
- Department of Obstetrics and Gynecology, National Yang Ming Chiao Tung University, Taipei, Taiwan
- *Correspondence: Kok-Min Seow,
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11
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Ashour H, Gamal SM, Sadek NB, Rashed LA, Hussein RE, Kamar SS, Ateyya H, Mehesen MN, ShamsEldeen AM. Vitamin D Supplementation Improves Uterine Receptivity in a Rat Model of Vitamin D Deficiency: A Possible Role of HOXA-10/FKBP52 Axis. Front Physiol 2021; 12:744548. [PMID: 34899377 PMCID: PMC8655728 DOI: 10.3389/fphys.2021.744548] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Accepted: 10/21/2021] [Indexed: 12/03/2022] Open
Abstract
Synchronized uterine receptivity with the time of implantation is crucial for pregnancy continuity. Vitamin D (VD) deficiency has been linked to the failure of implantation. Therefore, we tested the link between the Homeobox transcription factor-10/immunophilin FK506-binding protein 52 (HOXA-10/FKBP52) axis and the uterine receptivity in VD-deficient rats. The effect of VD supplementation at different doses was also investigated. Forty-eight pregnant rats were divided into six groups (eight/group); normal control rats fed with standard chow (control), control rats supplemented with VD (equivalent dose of 400 IU/day) (control-D400). VD-deficient group (DEF) and the three VD deficiency groups with VD supplementation were equivalent to 400, 4,000, and 10,000 IU/day (DEF-D400, DEF-D4000, and DEF-D10000, respectively). The expression levels of HOXA-10/FKBP52, progesterone level, and histological evaluation of decidualization using osteopontin (OSN) and progesterone receptor (PGR) were estimated. An assessment of the uterine contractility was conducted for all rats. This study showed the downregulation of HOXA-10/FKBP52 together with increased amplitude and frequency of the uterine contractility in the DEF group compared to control. VD dose-dependent supplementation restored progesterone/receptor competency, upregulated the expressional response of HOXA-10 and its downstream FKBP52, and improved uterine receptivity and endometrial decidualization at the time of implantation that was documented by increased area% of OSN and the number of implantation beads.
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Affiliation(s)
- Hend Ashour
- Department of Physiology, Faculty of Medicine, King Khalid University, Abha, Saudi Arabia
- Department of Physiology, Kasralainy Faculty of Medicine, Cairo University, Giza, Egypt
| | - Sara Mahmoud Gamal
- Department of Physiology, Kasralainy Faculty of Medicine, Cairo University, Giza, Egypt
| | - Nermeen Bakr Sadek
- Department of Physiology, Kasralainy Faculty of Medicine, Cairo University, Giza, Egypt
| | - Laila Ahmed Rashed
- Department of Biochemistry and Molecular Biology, Kasralainy Faculty of Medicine, Cairo University, Giza, Egypt
| | - Rania Elsayed Hussein
- Department of Biochemistry and Molecular Biology, Kasralainy Faculty of Medicine, Cairo University, Giza, Egypt
| | - Samaa Samir Kamar
- Department of Histology and Cell Biology, Kasralainy Faculty of Medicine, Cairo University, Giza, Egypt
- Armed Forces College of Medicine, Cairo, Egypt
| | - Hayam Ateyya
- Department of Pharmacy Practice and Clinical Pharmacy, Faculty of Pharmacy, Future University in Egypt, Cairo, Egypt
- Department of Medical Pharmacology, Faculty of Medicine, Cairo University, Giza, Egypt
| | - Marwa Nagi Mehesen
- Department of Medical Pharmacology, Faculty of Medicine, Cairo University, Giza, Egypt
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12
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Late Pregnancy Vitamin D Deficiency is Associated with Doubled Odds of Birth Asphyxia and Emergency Caesarean Section: A Prospective Cohort Study. Matern Child Health J 2021; 24:1412-1418. [PMID: 32844359 PMCID: PMC7560912 DOI: 10.1007/s10995-020-02999-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Objectives The aim of this prospective cohort study was to investigate the associations between maternal vitamin D status in late pregnancy and emergency caesarean section (EMCS) and birth asphyxia, in a population based sample of women in Sweden. Methods Pregnant women were recruited at the antenatal care in Sweden and 1832 women were included after exclusion of miscarriages, terminated pregnancies and missing data on vitamin D status. Mode of delivery was retrieved from medical records. EMCS was defined as caesarean section after onset of labour. Birth asphyxia was defined as either 5 min Apgar score < 7 or arterial umbilical cord pH < 7.1. Serum was sampled in the third trimester of pregnancy (T3) and 25-hydroxyvitamin D (25OHD) was analysed by liquid chromatography tandem mass spectrometry. Vitamin D deficiency was defined as 25OHD < 30 nmol/L, and associations were studied using logistic regression analysis and expressed as adjusted odds ratios (AOR). Results In total, 141 (7.7%) women had an EMCS and 58 (3.2%) children were born with birth asphyxia. Vitamin D deficiency was only associated with higher odds of EMCS in women without epidural anaesthesia (AOR = 2.01, p = 0.044). Vitamin D deficiency was also associated with higher odds of birth asphyxia (AOR = 2.22, p = 0.044). Conclusions for Practice In this Swedish prospective population-based cohort study, vitamin D deficiency in late pregnancy was associated with doubled odds of birth asphyxia and with EMCS in deliveries not aided by epidural anaesthesia. Prevention of vitamin D deficiency among pregnant women may reduce the incidence of EMCS and birth asphyxia. The mechanism behind the findings require further investigation.
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13
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Vitamin D supplementation for primary dysmenorrhea: a double-blind, randomized, placebo-controlled trial. Obstet Gynecol Sci 2021; 64:353-363. [PMID: 34010550 PMCID: PMC8290151 DOI: 10.5468/ogs.20316] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Accepted: 04/26/2021] [Indexed: 11/29/2022] Open
Abstract
Objective Recent studies have shown a possible association between vitamin D deficiency and the severity of primary dysmenorrhea. The present study aimed to investigate the effect of vitamin D supplementation on pain and systemic symptoms in patients with primary dysmenorrhea. Methods This double-blind, randomized, placebo-controlled trial was conducted on female students aged 18 to 32 years with primary dysmenorrhea and vitamin D deficiency (25 [OH]D <30 ng/mL). The participants (n=116) received either 50,000 IU of vitamin D3 (cholecalciferol) or placebo capsules on a weekly basis for eight consecutive weeks. The outcomes were pain intensity (scored 0 to 10), number of days with pain, number of consumed pain-relief medications (per day), and severity of systemic symptoms (fatigue, headache, nausea/vomiting, and diarrhea; total score of 0 to 12). Results Compared with baseline, our participants who received vitamin D experienced significant reductions in pain intensity (−1.0 and −1.5 score at weeks 4 and 8, P<0.001), the number of days with pain (−1.0 day at weeks 4 and 8, P<0.001), the number of consumed pain-relief medications (−1.0 at weeks 4 and 8, P<0.001), and systemic symptoms severity (−1.0 score at weeks 4 and 8, P<0.001). No significant improvements were observed in the placebo group in terms of these outcomes. Conclusion Vitamin D supplementation in women with primary dysmenorrhea and vitamin D deficiency could improve systemic symptoms and reduce pain intensity, the number of days with pain, and the need for consuming pain-relief medications.
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14
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Vitamin D: Mechanism of Action and Biological Effects in Uterine Fibroids. Nutrients 2021; 13:nu13020597. [PMID: 33670322 PMCID: PMC7917888 DOI: 10.3390/nu13020597] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2021] [Revised: 02/07/2021] [Accepted: 02/08/2021] [Indexed: 12/15/2022] Open
Abstract
Uterine fibroids (UFs) are the most common benign gynecological tumors. It was estimated that fifty percent of women presenting with UFs has symptomatology that negatively influences their quality of life. Pharmacological and/or surgical treatments are frequently required, depending on the woman's desire to preserve fertility, with a high impact on healthcare costs. Generally, the use of currently available pharmacological treatments may lead to side effects. Therefore, there is a growing interest in a natural and safe approach for UFs. In recent years, epidemiological studies reported a vitamin D deficiency in patients with UFs raised interest in the potential biological effects of vitamin D supplementation. In vitro studies proved vitamin D efficacy in inhibiting UFs growth by targeting pathways involved in the regulation of various biological processes, including proliferation, extracellular matrix (ECM) remodeling, DNA repair, signaling and apoptosis. However, clinical studies supported only in part the beneficial effects of vitamin D supplementation in reducing UFs growth and tumor volume. Randomized controlled trials and large population studies are mandatory as the potential clinical benefits are likely to be substantial.
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15
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Gilani S, Janssen P. Maternal Vitamin D Levels During Pregnancy and Their Effects on Maternal-Fetal Outcomes: A Systematic Review. JOURNAL OF OBSTETRICS AND GYNAECOLOGY CANADA 2019; 42:1129-1137. [PMID: 31874818 DOI: 10.1016/j.jogc.2019.09.013] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Revised: 09/11/2019] [Accepted: 09/16/2019] [Indexed: 01/01/2023]
Abstract
To synthesize and critically review the current evidence available on maternal vitamin D deficiency and its effects on maternal-fetal outcomes, this study reviewed the maternal-fetal outcomes, including prolonged labour or cesarean delivery, preeclampsia, gestational diabetes, low birth weight and small for gestational age, and preterm birth. An extensive systematic searched was performed in Medline and EMBASE, where a medical subject heading (MeSH) was used with terms "Vitamin D/25(OH)D" and "pregnancy/fetal outcomes"; these terms were combined with "and." In Web of Science and Google Scholar, a key word search was used. Nineteen articles were included for full review. This review found that the current state of the evidence is equivocal for maternal-fetal outcomes such as the risk of prolonged labour and cesarean delivery, gestational diabetes, low birth weight and small for gestational age, and preterm birth. Although some previous studies have found improvement in pregnancy outcomes with sufficient vitamin D levels, others have not shown any association with the aforementioned outcomes. This systematic review also highlights an association between the risk of preeclampsia and maternal vitamin D levels that is found to be consistent among studies.
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Affiliation(s)
- Samreen Gilani
- School of Population and Public Health, Faculty of Medicine, University of British Columbia, Vancouver, BC.
| | - Patricia Janssen
- School of Population and Public Health, Faculty of Medicine, University of British Columbia, Vancouver, BC
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16
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Elhusseini H, Elkafas H, Abdelaziz M, Halder S, Atabiekov I, Eziba N, Ismail N, El Andaloussi A, Al-Hendy A. Diet-induced vitamin D deficiency triggers inflammation and DNA damage profile in murine myometrium. Int J Womens Health 2018; 10:503-514. [PMID: 30214319 PMCID: PMC6120572 DOI: 10.2147/ijwh.s163961] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Background Previously, we reported a significantly higher prevalence of uterine fibroids (UFs) in African American women. This minority group also commonly suffers from vitamin D deficiency. We have demonstrated that 1,25(OH)2D3 attains a fibroid growth inhibitory impact through its ability to block the G1/S (gap 1/synthesis) phase of the cell cycle. Vitamin D is involved in DNA damage as well as in immune response regulation, anti-inflammation, autoimmunity and cancer. Since most of the prior data on vitamin D and UF were generated in vitro via established cell lines, it was necessary to verify and validate this observation in vivo using a diet-induced vitamin D-deficient mouse model. Materials and Methods Our model of vitamin D lacking function was established using 8-week exposure of C57/BL6 mice to vitamin D-deficient diet provides evidence of different functions accomplished by vitamin D in the regulation of myometrium homeostasis disrupted in the context of uterine fibroid. Results We found that vitamin D deficiency was associated with increased expression of sex steroid receptors in murine myometrium, increased expression of proliferation related genes, the promotion of fibrosis and enhanced inflammation, and promoted immunosuppression through Tregs expansion in murine myometrium. We also showed that a vitamin D deficient diet enhanced DNA damage in murine myometrium. Conclusion Our model mimics the effects in humans that a lack of vitamin D has and propels the study of in vivo interaction between inflammation, genomic instability and cell proliferation in the myometrium.
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Affiliation(s)
- Heba Elhusseini
- Department of Obstetrics and Gynecology, University of Illinois of Chicago, Chicago, IL, USA, ;
| | - Hoda Elkafas
- Department of Obstetrics and Gynecology, University of Illinois of Chicago, Chicago, IL, USA, ; .,Pharmacology and Toxicology Department, National Organization for Drug Control and Research, Cairo, Egypt
| | - Mohamed Abdelaziz
- Department of Obstetrics and Gynecology, Mansoura University Hospital, Mansoura Faculty of Medicine, Mansoura, Egypt
| | - Sunil Halder
- Department of Obstetrics and Gynecology, University of Illinois of Chicago, Chicago, IL, USA, ;
| | - Ihor Atabiekov
- Department of Obstetrics and Gynecology, University of Illinois of Chicago, Chicago, IL, USA, ;
| | - Noura Eziba
- Department of Obstetrics and Gynecology, University of Illinois of Chicago, Chicago, IL, USA, ;
| | - Nahed Ismail
- Clinical Microbiology Division, University of Illinois of Chicago, Chicago, IL, USA
| | | | - Ayman Al-Hendy
- Department of Obstetrics and Gynecology, University of Illinois of Chicago, Chicago, IL, USA, ;
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Sayem ASM, Giribabu N, Karim K, Si LK, Muniandy S, Salleh N. Differential expression of the receptors for thyroid hormone, thyroid stimulating hormone, vitamin D and retinoic acid and extracellular signal-regulated kinase in uterus of rats under influence of sex-steroids. Biomed Pharmacother 2018; 100:132-141. [DOI: 10.1016/j.biopha.2018.02.008] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2017] [Revised: 02/01/2018] [Accepted: 02/02/2018] [Indexed: 01/19/2023] Open
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The PPI network analysis of mRNA expression profile of uterus from primary dysmenorrheal rats. Sci Rep 2018; 8:351. [PMID: 29321498 PMCID: PMC5762641 DOI: 10.1038/s41598-017-18748-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2017] [Accepted: 12/15/2017] [Indexed: 11/08/2022] Open
Abstract
To elucidate the mechanisms of molecular regulations underlying primary dysmenorrhea (PD), we used our previously published mRNA expression profile of uterus from PD syndrome rats to construct protein-protein interactions (PPI) network via STRING Interactome. Consequently, 34 subnetworks, including a "continent" (Subnetwork 1) and 33 "islands" (Subnetwork 2-34) were generated. The nodes, with relative expression ratios, were visualized in the PPI networks and their connections were identified. Through path and module exploring in the network, the bridges were found from pathways of cellular response to calcium ion, SMAD protein signal transduction, regulation of transcription from RNA polymerase II promoter in response to stress and muscle stretch that were significantly enriched by the up-regulated mRNAs, to the cascades of cAMP metabolic processes and positive regulation of cyclase activities by the down-regulated ones. This link is mainly dependent on Fos/Jun - Vip connection. Our data, for the first time, report the PPI network analysis of differentially expressed mRNAs in the uterus of PD syndrome rats, to give insight into screening drugs and find new therapeutic strategies to relieve PD.
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Varlamova EG, Cheremushkina IV. Contribution of mammalian selenocysteine-containing proteins to carcinogenesis. J Trace Elem Med Biol 2017; 39:76-85. [PMID: 27908428 DOI: 10.1016/j.jtemb.2016.08.004] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2016] [Revised: 07/28/2016] [Accepted: 08/09/2016] [Indexed: 12/17/2022]
Abstract
Oxidative stress caused by a sharp growth of free radicals in the organism is a major cause underlying the occurrence of all kinds of malignant formations. Selenium is an important essential trace element found in selenoproteins in the form of selenocysteine, an amino acid differing from cysteine for the presence of selenium instead of sulfur and making such proteins highly active. To date the role of selenium has been extensively investigated through studying the functions of selenoproteins in carcinogenesis. Analysis of the obtained results clearly demonstrates that selenoproteins can act as oncosuppressors, but can also, on the contrary, favor the formation of malignant tumors.
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Affiliation(s)
- Elena Gennadyevna Varlamova
- Federal State Institution of Science Institute of Cell Biophysics, Russian Academy of Sciences, Moscow Region, Institutskaya st. 3, 142290, Pushchino, Russia.
| | - Irina Valentinovna Cheremushkina
- Federal State Educational Institution of Higher Education Voronezh State University of Engineering Technology, Prospect revolution st. 19, 394000, Voronezh, Russia.
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Characterisation of vitamin D-related molecules and calcium-sensing receptor in human Fallopian tube during the menstrual cycle and in ectopic pregnancy. Cell Tissue Res 2016; 368:201-213. [DOI: 10.1007/s00441-016-2519-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2016] [Accepted: 09/22/2016] [Indexed: 12/26/2022]
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Opinions and Practice of US-Based Obstetrician-Gynecologists regarding Vitamin D Screening and Supplementation of Pregnant Women. J Pregnancy 2016; 2016:1454707. [PMID: 27648304 PMCID: PMC5014971 DOI: 10.1155/2016/1454707] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2016] [Revised: 07/22/2016] [Accepted: 07/31/2016] [Indexed: 12/15/2022] Open
Abstract
Vitamin D deficiency/insufficiency is prevalent among pregnant women. Recommendations for adequate levels of circulating 25-hydroxyvitamin D and appropriate vitamin D supplementation during pregnancy differ between the Institute of Medicine and the Endocrine Society. Obstetrician-gynecologists must make clinical decisions in this environment of uncertain guidance. An online questionnaire regarding physician practice patterns for screening and supplementing pregnant women was administered to 225 randomly selected practicing obstetrician-gynecologists of whom 101 (45%) completed the questionnaire. A majority indicated that vitamin D insufficiency was a problem in their patient population (68.4%) and that most of their pregnant patients would benefit from vitamin D supplementation (66.3%). Half (52.5%) would recommend vitamin D supplementation during pregnancy to some patients, but only 16.8% to all. Only one in four (25.8%) routinely screen their pregnant patients for vitamin D status. Physicians who indicated that vitamin D status was a problem in their patient population were more likely to screen routinely (32.8% versus 9.7%, P = 0.002) and believe their patients would benefit from supplementation (91.2% versus 16.1%, P = 0.001). Opinion regarding supplementation levels and indicators of adequacy were split between the two competing recommendations, suggesting that clinical practice will likely remain variable across physicians, with uncertain public health consequences.
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Miyashita M, Koga K, Izumi G, Sue F, Makabe T, Taguchi A, Nagai M, Urata Y, Takamura M, Harada M, Hirata T, Hirota Y, Wada-Hiraike O, Fujii T, Osuga Y. Effects of 1,25-Dihydroxy Vitamin D3 on Endometriosis. J Clin Endocrinol Metab 2016; 101:2371-9. [PMID: 27035829 DOI: 10.1210/jc.2016-1515] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
CONTEXT Endometriosis is an estrogen-dependent, chronic inflammatory disease. Recent studies have shown that vitamin D (VD) is an effective modulator of the immune system and plays an important role in controlling many inflammatory diseases. OBJECTIVE The objective of the study was to clarify the in vitro effects of 1,25-dihydroxy vitamin D3 (1,25[OH]2D3) on human endometriotic stromal cells (ESCs) and to determine the serum levels of VD in endometriosis patients. DESIGN, PATIENTS, AND MAIN OUTCOME MEASURES ESCs were isolated from ovarian endometrioma and cultured with 1,25(OH)2D3. Gene expression of IL-8, cyclooxygenase-2, microsomal prostaglandin E synthase-1, microsomal prostaglandin E synthase-2, cytosolic prostaglandin E synthase, 15-hydroxyprostaglandin dehydrogenase, matrix metalloproteinase (MMP)-2, and MMP-9 was examined using quantitative RT-PCR. The production of IL-8 and prostaglandin E2 was measured using an ELISA and an enzyme immunoassay. Viable cell number was assessed using a cell-counting assay, and DNA synthesis was assessed using the bromodeoxyuridine incorporation assay. Apoptosis was assessed using flow cytometry. The expression of inhibitory-κBα protein was detected using Western blotting. The serum levels of 25-hydroxyvitamin D3 and 1,25(OH)2D3 were measured by a RIA. RESULTS In vitro studies showed that 1,25(OH)2D3 significantly reduced IL-1β- or TNF-α-induced inflammatory responses, such as IL-8 expression and prostaglandin activity. 1,25(OH)2D3 also reduced viable ESC numbers and DNA synthesis but did not affect apoptosis. MMP-2 and MMP-9 expressions were reduced by 1,25(OH)2D3. 1,25(OH)2D3 inhibited nuclear factor-κB activation. The serum 25-hydroxyvitamin D3 levels were significantly lower in women with severe endometriosis than in the controls and women with mild endometriosis. Serum 1,25(OH)2D3 levels were not different between groups. CONCLUSIONS VD modulates inflammation and proliferation in endometriotic cells, and a lower VD status is associated with endometriosis. Taken together, VD supplementation could be a novel therapeutic strategy for managing endometriosis.
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Affiliation(s)
- Mariko Miyashita
- Department of Obstetrics and Gynecology, University of Tokyo, Tokyo 113-8655, Japan
| | - Kaori Koga
- Department of Obstetrics and Gynecology, University of Tokyo, Tokyo 113-8655, Japan
| | - Gentaro Izumi
- Department of Obstetrics and Gynecology, University of Tokyo, Tokyo 113-8655, Japan
| | - Fusako Sue
- Department of Obstetrics and Gynecology, University of Tokyo, Tokyo 113-8655, Japan
| | - Tomoko Makabe
- Department of Obstetrics and Gynecology, University of Tokyo, Tokyo 113-8655, Japan
| | - Ayumi Taguchi
- Department of Obstetrics and Gynecology, University of Tokyo, Tokyo 113-8655, Japan
| | - Miwako Nagai
- Department of Obstetrics and Gynecology, University of Tokyo, Tokyo 113-8655, Japan
| | - Yoko Urata
- Department of Obstetrics and Gynecology, University of Tokyo, Tokyo 113-8655, Japan
| | - Masashi Takamura
- Department of Obstetrics and Gynecology, University of Tokyo, Tokyo 113-8655, Japan
| | - Miyuki Harada
- Department of Obstetrics and Gynecology, University of Tokyo, Tokyo 113-8655, Japan
| | - Tetsuya Hirata
- Department of Obstetrics and Gynecology, University of Tokyo, Tokyo 113-8655, Japan
| | - Yasushi Hirota
- Department of Obstetrics and Gynecology, University of Tokyo, Tokyo 113-8655, Japan
| | - Osamu Wada-Hiraike
- Department of Obstetrics and Gynecology, University of Tokyo, Tokyo 113-8655, Japan
| | - Tomoyuki Fujii
- Department of Obstetrics and Gynecology, University of Tokyo, Tokyo 113-8655, Japan
| | - Yutaka Osuga
- Department of Obstetrics and Gynecology, University of Tokyo, Tokyo 113-8655, Japan
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Li H, Yu Y, Shi Y, Fazli L, Slater D, Lye S, Dong X. HoxA13 Stimulates Myometrial Cells to Secrete IL-1β and Enhance the Expression of Contraction-Associated Proteins. Endocrinology 2016; 157:2129-39. [PMID: 26982635 DOI: 10.1210/en.2015-2005] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Bipedalism in humans requires regionalization of myometrial function with a contracted lower uterine segment and a relaxed fundus during pregnancy to prevent fetal pressure on the cervix and reversal of this phenotype during labor. The HoxA13 gene is highly expressed in the lower uterine segment before term labor and regulates the regionalization of myometrium contractility. However, how HoxA13 regulates signal pathways to exert its functions remains unclear. Using a gene microarray technique, we profiled HoxA13 transcriptome in myometrial cells containing immune response genes (eg, IL-1β, IL-6, and IL-8) and contraction-associated proteins (CAPs) such as cyclooxygenase-2 (Cox-2) and connexin-43. IL-1β is responsible for mediating HoxA13 actions in up-regulating IL-6, IL-8, Cox-2, and connexin-43 expression. Blocking IL-1β with its inhibitor abolishes these HoxA13 actions. HoxA13-induced IL-1β stimulates the recruitment of activated THP-1 monocytes to myometrial cells, which in turn amplify the secretion of IL-1β, IL-6, and IL-8 through a mutual feed-forward loop between these cell types. As a result, Cox-2 expression is dramatically enhanced. These findings lead us to conclude that HoxA13 increases myometrial cell contractility by enhancing the secretion of IL-1β, resulting in an up-regulation of CAP and other proinflammatory cytokine expression. HoxA13-induced IL-1β in myometrial cells also prompts leukocyte recruitment and further amplifies CAP expression.
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Affiliation(s)
- Haolong Li
- Vancouver Prostate Centre (H.L., Y.Y., Y.S., L.F., X.D.), Department of Urologic Sciences, University of British Columbia, Vancouver, Canada V6H 3Z6; Department of Physiology and Pharmacology (D.S.), University of Calgary, Calgary, Canada T2N 4N1; and Department of Obstetrics and Gynaecology (S.L., X.D.), University of Toronto, Toronto, Canada M5G 1E2
| | - Yue Yu
- Vancouver Prostate Centre (H.L., Y.Y., Y.S., L.F., X.D.), Department of Urologic Sciences, University of British Columbia, Vancouver, Canada V6H 3Z6; Department of Physiology and Pharmacology (D.S.), University of Calgary, Calgary, Canada T2N 4N1; and Department of Obstetrics and Gynaecology (S.L., X.D.), University of Toronto, Toronto, Canada M5G 1E2
| | - Yao Shi
- Vancouver Prostate Centre (H.L., Y.Y., Y.S., L.F., X.D.), Department of Urologic Sciences, University of British Columbia, Vancouver, Canada V6H 3Z6; Department of Physiology and Pharmacology (D.S.), University of Calgary, Calgary, Canada T2N 4N1; and Department of Obstetrics and Gynaecology (S.L., X.D.), University of Toronto, Toronto, Canada M5G 1E2
| | - Ladan Fazli
- Vancouver Prostate Centre (H.L., Y.Y., Y.S., L.F., X.D.), Department of Urologic Sciences, University of British Columbia, Vancouver, Canada V6H 3Z6; Department of Physiology and Pharmacology (D.S.), University of Calgary, Calgary, Canada T2N 4N1; and Department of Obstetrics and Gynaecology (S.L., X.D.), University of Toronto, Toronto, Canada M5G 1E2
| | - Donna Slater
- Vancouver Prostate Centre (H.L., Y.Y., Y.S., L.F., X.D.), Department of Urologic Sciences, University of British Columbia, Vancouver, Canada V6H 3Z6; Department of Physiology and Pharmacology (D.S.), University of Calgary, Calgary, Canada T2N 4N1; and Department of Obstetrics and Gynaecology (S.L., X.D.), University of Toronto, Toronto, Canada M5G 1E2
| | - Stephen Lye
- Vancouver Prostate Centre (H.L., Y.Y., Y.S., L.F., X.D.), Department of Urologic Sciences, University of British Columbia, Vancouver, Canada V6H 3Z6; Department of Physiology and Pharmacology (D.S.), University of Calgary, Calgary, Canada T2N 4N1; and Department of Obstetrics and Gynaecology (S.L., X.D.), University of Toronto, Toronto, Canada M5G 1E2
| | - Xuesen Dong
- Vancouver Prostate Centre (H.L., Y.Y., Y.S., L.F., X.D.), Department of Urologic Sciences, University of British Columbia, Vancouver, Canada V6H 3Z6; Department of Physiology and Pharmacology (D.S.), University of Calgary, Calgary, Canada T2N 4N1; and Department of Obstetrics and Gynaecology (S.L., X.D.), University of Toronto, Toronto, Canada M5G 1E2
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1,25-Dihydroxyvitamin D3 alleviates salivary adenoid cystic carcinoma progression by suppressing GPX1 expression through the NF-κB pathway. Int J Oncol 2016; 48:1271-9. [DOI: 10.3892/ijo.2016.3341] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2015] [Accepted: 12/31/2015] [Indexed: 11/05/2022] Open
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Chittoor G, Pajewski NM, Voruganti VS, Comuzzie AG, Clarkson TB, Nudy M, Schnatz PF, Kaplan JR, Jorgensen MJ. Vitamin D heritability and effect of pregnancy status in Vervet monkeys (Chlorocebus aethiops sabaeus) under conditions of modest and high dietary supplementation. AMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY 2015; 159:639-45. [PMID: 26708407 DOI: 10.1002/ajpa.22923] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/01/2015] [Revised: 11/05/2015] [Accepted: 12/03/2015] [Indexed: 12/19/2022]
Abstract
OBJECTIVES The two objectives of the current study were to: 1) investigate the genetic contributions to variations in serum vitamin D concentrations under two dietary conditions (a standard monkey biscuit diet vs. a diet designed to model typical American consumption); and 2) explore the interaction of vitamin D with pregnancy status using a cohort of pedigreed female vervet/African green monkeys. METHODS This study includes 185 female (≥3.5 years) vervet/African green monkeys (Chlorocebus aethiops sabaeus) from a multi-generational, pedigreed breeding colony. The 25(OH)D3 concentrations were first measured seven to eight weeks after consuming a "typical American" diet (TAD), deriving 37, 18, and 45% of calories from fat, protein sources, and carbohydrates, and supplemented with vitamin D to a human equivalent of 1,000 IU/day. Vitamin D concentrations were assessed again when animals were switched to a low-fat, standard biscuit diet (LabDiet 5038) for 8 months, which provided a human equivalent of approximately 4,000 IU/day of vitamin D. All statistical analyses were implemented in SOLAR. RESULTS Pregnancy was associated with reduced 25(OH)D3 concentrations. Heritability analyses indicated a significant genetic contribution to 25(OH)D3 concentrations in the same monkeys consuming the biscuit diet (h(2) =0.66, P=0.0004) and TAD (h(2) =0.67, P=0.0078) diets, with higher 25(OH)D3 concentrations in animals consuming the biscuit diet. Additionally, there was a significant genotype-by-pregnancy status interaction on 25(OH)D3 concentrations (P<0.05) only among animals consuming the TAD diet. DISCUSSION These results support the existence of a genetic contribution to differences in serum 25(OH)D3 concentrations by pregnancy status and emphasize the role of diet (including vitamin D supplementation) in modifying genetic signals as well as vitamin D concentrations.
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Affiliation(s)
- Geetha Chittoor
- Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, Kannapolis, NC.,UNC Nutrition Research Institute, University of North Carolina at Chapel Hill, Chapel Hill, Kannapolis, NC
| | - Nicholas M Pajewski
- Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, NC
| | - V Saroja Voruganti
- Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, Kannapolis, NC.,UNC Nutrition Research Institute, University of North Carolina at Chapel Hill, Chapel Hill, Kannapolis, NC
| | - Anthony G Comuzzie
- Department of Genetics, Texas Biomedical Research Institute, San Antonio, TX.,Southwest National Primate Research Center, Texas Biomedical Research Institute, San Antonio, TX
| | - Thomas B Clarkson
- Department of Pathology, Section of Comparative Medicine, Wake Forest School of Medicine, Winston-Salem, NC
| | - Matthew Nudy
- Department of Obstetrics and Gynecology, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA.,Department of Internal Medicine, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA
| | - Peter F Schnatz
- Department of Obstetrics and Gynecology, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA.,Department of Internal Medicine, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA.,Department of Obstetrics and Gynecology, Reading Hospital, Reading, PA.,Department of Internal Medicine, Reading Hospital, Reading, PA
| | - Jay R Kaplan
- Department of Pathology, Section of Comparative Medicine, Wake Forest School of Medicine, Winston-Salem, NC
| | - Matthew J Jorgensen
- Department of Pathology, Section of Comparative Medicine, Wake Forest School of Medicine, Winston-Salem, NC
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26
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Loy SL, Lek N, Yap F, Soh SE, Padmapriya N, Tan KH, Biswas A, Yeo GSH, Kwek K, Gluckman PD, Godfrey KM, Saw SM, Müller-Riemenschneider F, Chong YS, Chong MFF, Chan JKY. Association of Maternal Vitamin D Status with Glucose Tolerance and Caesarean Section in a Multi-Ethnic Asian Cohort: The Growing Up in Singapore Towards Healthy Outcomes Study. PLoS One 2015; 10:e0142239. [PMID: 26571128 PMCID: PMC4646602 DOI: 10.1371/journal.pone.0142239] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2015] [Accepted: 10/18/2015] [Indexed: 01/03/2023] Open
Abstract
OBJECTIVE Epidemiological studies relating maternal 25-hydroxyvitamin D (25OHD) with gestational diabetes mellitus (GDM) and mode of delivery have shown controversial results. We examined if maternal 25OHD status was associated with plasma glucose concentrations, risks of GDM and caesarean section in the Growing Up in Singapore Towards healthy Outcomes (GUSTO) study. METHODS Plasma 25OHD concentrations, fasting glucose (FG) and 2-hour postprandial glucose (2HPPG) concentrations were measured in 940 women from a Singapore mother-offspring cohort study at 26-28 weeks' gestation. 25OHD inadequacy and adequacy were defined based on concentrations of 25OHD ≤75nmol/l and >75nmol/l respectively. Mode of delivery was obtained from hospital records. Multiple linear regression was performed to examine the association between 25OHD status and glucose concentrations, while multiple logistic regression was performed to examine the association of 25OHD status with risks of GDM and caesarean section. RESULTS In total, 388 (41.3%) women had 25OHD inadequacy. Of these, 131 (33.8%), 155 (39.9%) and 102 (26.3%) were Chinese, Malay and Indian respectively. After adjustment for confounders, maternal 25OHD inadequacy was associated with higher FG concentrations (β = 0.08mmol/l, 95% Confidence Interval (CI) = 0.01, 0.14), but not 2HPPG concentrations and risk of GDM. A trend between 25OHD inadequacy and higher likelihood of emergency caesarean section (Odds Ratio (OR) = 1.39, 95% CI = 0.95, 2.05) was observed. On stratification by ethnicity, the association with higher FG concentrations was significant in Malay women (β = 0.19mmol/l, 95% CI = 0.04, 0.33), while risk of emergency caesarean section was greater in Chinese (OR = 1.90, 95% CI = 1.06, 3.43) and Indian women (OR = 2.41, 95% CI = 1.01, 5.73). CONCLUSIONS 25OHD inadequacy is prevalent in pregnant Singaporean women, particularly among the Malay and Indian women. This is associated with higher FG concentrations in Malay women, and increased risk of emergency caesarean section in Chinese and Indian women.
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Affiliation(s)
- See Ling Loy
- KK Research Centre, KK Women’s and Children’s Hospital, Singapore
| | - Ngee Lek
- Duke-NUS Graduate Medical School, Singapore
- Department of Paediatrics, KK Women’s and Children’s Hospital, Singapore
| | - Fabian Yap
- Duke-NUS Graduate Medical School, Singapore
- Department of Paediatrics, KK Women’s and Children’s Hospital, Singapore
| | - Shu E. Soh
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, (A*STAR), Singapore
| | - Natarajan Padmapriya
- Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, National University Health Systems, Singapore
| | - Kok Hian Tan
- Division of Obstetrics and Gynaecology, KK Women’s and Children’s Hospital, Singapore
| | - Arijit Biswas
- Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, National University Health Systems, Singapore
| | - George Seow Heong Yeo
- Department of Maternal Fetal Medicine, KK Women’s and Children’s Hospital, Singapore
| | - Kenneth Kwek
- Department of Maternal Fetal Medicine, KK Women’s and Children’s Hospital, Singapore
| | - Peter D. Gluckman
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, (A*STAR), Singapore
- Liggins Institute, University of Auckland, Auckland, New Zealand
| | - Keith M. Godfrey
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, United Kingdom
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom
| | - Seang Mei Saw
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Falk Müller-Riemenschneider
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
- Institute for Social Medicine, Epidemiology and Health Economics, Charite University Medical Centre, Berlin, Germany
| | - Yap-Seng Chong
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, (A*STAR), Singapore
- Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, National University Health Systems, Singapore
| | - Mary Foong-Fong Chong
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, (A*STAR), Singapore
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore
- Clinical Nutrition Research Centre, Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore
| | - Jerry Kok Yen Chan
- KK Research Centre, KK Women’s and Children’s Hospital, Singapore
- Duke-NUS Graduate Medical School, Singapore
- Department of Reproductive Medicine, KK Women’s and Children’s Hospital, Singapore
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Laknaur A, Foster TL, Bobb LE, Ramesh A, Ladson GM, Hood DB, Al-Hendy A, Thota C. Altered expression of histone deacetylases, inflammatory cytokines and contractile-associated factors in uterine myometrium of Long Evans rats gestationally exposed to benzo[a]pyrene. J Appl Toxicol 2015; 36:827-35. [PMID: 26358852 DOI: 10.1002/jat.3216] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2015] [Revised: 06/17/2015] [Accepted: 06/19/2015] [Indexed: 11/05/2022]
Abstract
Etiology of preterm birth (PTB) is multifactorial; therefore, decreasing the incidence of PTB is a major challenge in the field of obstetrics. Epidemiological studies have reported an association between toxicants and PTB. However, there are no studies on the role of benzo[a]pyrene (BaP), an environmental toxicant, in the incidence of PTB. We first assessed the effects of BaP (150 and 300 µg kg(-1) body weight) dosed via gavage from day 14 to 17 of pregnancy on gestation length in Long Evans rats. We further assessed the histopathology of the uterus, expression of inflammatory cytokines, contractile-associated factors, histone deacetylases (HDACs) and NFқB-p65 in myometrium collected on day 22 postpartum versus vehicle-treated controls. In our study, rats exposed to BaP delivered prematurely (P < 0.05) compared to control. Hematoxylin and eosin staining of uterus showed squamous metaplasia, glandular and stromal hyperplasia in BaP-exposed rats versus control. The concentrations of BaP metabolites measured by high-pressure liquid chromatography were higher in uterine myometrium of BaP-exposed rats while they were undetectable in controls. Quantitative real-time polymerase chain reaction showed significant increases in mRNA expression of interleukin-1β and -8, tumor necrosis factor-α, connexin 43, cyclo-oxygenase-2 and prostaglandin F2α receptor as compared to controls (P < 0.05). Western blot analysis revealed that BaP exposure caused decreases in class I HDACs 1 and 3 and increases in class II HDAC 5, cyclo-oxygenase-2 and nuclear translocation of NFκB-p65 relative to controls. Our results suggest that gestational exposure to BaP increases incidence of PTB through epigenetic changes that causes increases in the expression of contractile-associated factors through the NFκB pathway. Copyright © 2015 John Wiley & Sons, Ltd.
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Affiliation(s)
- Archana Laknaur
- Department of Obstetrics and Gynecology, Georgia Regents University, Augusta, GA, USA
| | - Terri-Lee Foster
- Center for Women's Health Research, Department of Obstetrics and Gynecology, Meharry Medical College, Nashville, TN, USA
| | - Lesley E Bobb
- Center for Women's Health Research, Department of Obstetrics and Gynecology, Meharry Medical College, Nashville, TN, USA
| | - Aramandla Ramesh
- Department of Biochemistry & Cancer Biology, Meharry Medical College, Nashville, TN, USA
| | - Gwinnett M Ladson
- Center for Women's Health Research, Department of Obstetrics and Gynecology, Meharry Medical College, Nashville, TN, USA
| | - Darryl B Hood
- Division of Environmental Health Sciences, College of Public Health and Department of Neuroscience, College of Medicine, The Ohio State University, Columbus, OH, USA
| | - Ayman Al-Hendy
- Department of Obstetrics and Gynecology, Georgia Regents University, Augusta, GA, USA
| | - Chandrasekhar Thota
- Center for Women's Health Research, Department of Obstetrics and Gynecology, Meharry Medical College, Nashville, TN, USA
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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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Rajagopal SP, Hutchinson JL, Dorward DA, Rossi AG, Norman JE. Crosstalk between monocytes and myometrial smooth muscle in culture generates synergistic pro-inflammatory cytokine production and enhances myocyte contraction, with effects opposed by progesterone. Mol Hum Reprod 2015; 21:672-86. [PMID: 26002969 PMCID: PMC4518137 DOI: 10.1093/molehr/gav027] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2014] [Accepted: 05/19/2015] [Indexed: 11/14/2022] Open
Abstract
Both term and preterm parturition are characterized by an influx of macrophages and neutrophils into the myometrium and cervix, with co-incident increased peripheral blood monocyte activation. Infection and inflammation are strongly implicated in the pathology of preterm labour (PTL), with progesterone considered a promising candidate for its prevention or treatment. In this study, we investigated the effect of monocytes on myometrial smooth muscle cell inflammatory cytokine production both alone and in response to LPS, a TLR4 agonist used to trigger PTL in vivo. We also investigated the effect of monocytes on myocyte contraction. Monocytes, isolated from peripheral blood samples from term pregnant women, were cultured alone, or co-cultured with PHM1-41 myometrial smooth muscle cells, for 24 h. In a third set of experiments, PHM1-41 myocytes were cultured for 24 h in isolation. Cytokine secretion was determined by ELISA or multiplex assays. Co-culture of monocytes and myocytes led to synergistic secretion of pro-inflammatory cytokines and chemokines including IL-6, IL-8 and MCP-1, with the secretion being further enhanced by LPS (100 ng/ml). The synergistic secretion of IL-6 and IL-8 from co-cultures was mediated in part by direct cell–cell contact, and by TNF. Conditioned media from co-cultures stimulated contraction of PHM1-41 myocytes, and the effect was inhibited by progesterone. Both progesterone and IL-10 inhibited LPS-stimulated IL-6 and IL-8 secretion from co-cultures, while progesterone also inhibited chemokine secretion. These data suggest that monocytes infiltrating the myometrium at labour participate in crosstalk that potentiates pro-inflammatory cytokine secretion, an effect that is enhanced by LPS, and can augment myocyte contraction. These effects are all partially inhibited by progesterone.
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Affiliation(s)
- S P Rajagopal
- MRC Centre for Reproductive Health, University of Edinburgh, Queen's Medical Research Institute, 47 Little France Crescent, Edinburgh EH16 4TJ, UK
| | - J L Hutchinson
- MRC Centre for Reproductive Health, University of Edinburgh, Queen's Medical Research Institute, 47 Little France Crescent, Edinburgh EH16 4TJ, UK
| | - D A Dorward
- MRC Centre for Inflammation Research, University of Edinburgh, Queen's Medical Research Institute, 47 Little France Crescent, Edinburgh EH16 4TJ, UK
| | - A G Rossi
- MRC Centre for Inflammation Research, University of Edinburgh, Queen's Medical Research Institute, 47 Little France Crescent, Edinburgh EH16 4TJ, UK
| | - J E Norman
- MRC Centre for Reproductive Health, University of Edinburgh, Queen's Medical Research Institute, 47 Little France Crescent, Edinburgh EH16 4TJ, UK
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30
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Gernand AD, Klebanoff MA, Simhan HN, Bodnar LM. Maternal vitamin D status, prolonged labor, cesarean delivery and instrumental delivery in an era with a low cesarean rate. J Perinatol 2015; 35:23-8. [PMID: 25102320 PMCID: PMC4281279 DOI: 10.1038/jp.2014.139] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2013] [Revised: 06/15/2014] [Accepted: 06/23/2014] [Indexed: 11/09/2022]
Abstract
OBJECTIVE To examine the association between maternal 25-hydroxyvitamin D (25(OH)D) and adverse labor and delivery outcomes. STUDY DESIGN We measured serum 25(OH)D at ⩽ 26 weeks gestation in a random subsample of vertex, singleton pregnancies in women who labored (n=2798) from the 12-site Collaborative Perinatal Project (1959 to 1966). We used labor and delivery data to classify cases of adverse outcomes. RESULT Twenty-four percent of women were vitamin D deficient (25(OH)D <30 nmol l(-1)), and 4.5, 3.3, 1.9 and 7.5% of women had prolonged stage 1 labor, prolonged stage 2 labor, primary cesarean delivery or indicated instrumental delivery, respectively. After adjustment for prepregnancy body mass index, race and study site, 25(OH)D concentrations were not associated with risk of prolonged stage 1 or 2, cesarean delivery or instrumental delivery. CONCLUSION Maternal vitamin D status at ⩽ 26 weeks was not associated with risk of prolonged labor or operative delivery in an era with a low cesarean rate.
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Affiliation(s)
- Alison D. Gernand
- Department of Epidemiology, University of Pittsburgh, Graduate School of Public Health, Pittsburgh, PA and Department of Nutritional Sciences, The Pennsylvania State University, University Park, PA
| | - Mark A. Klebanoff
- Departments of Pediatrics and of Obstetrics and Gynecology, Ohio State University College of Medicine and The Research Institute, Nationwide Children’s Hospital, Columbus, OH
| | - Hyagriv N. Simhan
- Department of Obstetrics and Gynecology, School of Medicine, University of Pittsburgh and Division of Maternal-Fetal Medicine, Magee-Womens Hospital, Pittsburgh, PA
| | - Lisa M. Bodnar
- Department of Epidemiology, Graduate School of Public Health and Department of Obstetrics and Gynecology, School of Medicine, University of Pittsburgh, Pittsburgh, PA Pittsburgh, PA
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31
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Mohamed SA, Thota C, Browne PC, Diamond MP, Al-Hendy A. Why is Preterm Birth Stubbornly Higher in African-Americans? ACTA ACUST UNITED AC 2014; 1. [PMID: 25905109 DOI: 10.15406/ogij.2014.01.00019] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Sara A Mohamed
- Department of Obstetrics and Gynecology, Georgia Regents University, USA ; Department of Obstetrics and Gynecology, Mansoura faculty of medicine, Egypt
| | - Chandra Thota
- Department of Obstetrics and Gynecology, Georgia Regents University, USA
| | - Paul C Browne
- Department of Obstetrics and Gynecology, Georgia Regents University, USA
| | - Michael P Diamond
- Department of Obstetrics and Gynecology, Georgia Regents University, USA
| | - Ayman Al-Hendy
- Department of Obstetrics and Gynecology, Georgia Regents University, USA
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32
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Gan X, Chen B, Shen Z, Liu Y, Li H, Xie X, Xu X, Li H, Huang Z, Chen J. High GPX1 expression promotes esophageal squamous cell carcinoma invasion, migration, proliferation and cisplatin-resistance but can be reduced by vitamin D. Int J Clin Exp Med 2014; 7:2530-2540. [PMID: 25356106 PMCID: PMC4211756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2014] [Accepted: 08/28/2014] [Indexed: 06/04/2023]
Abstract
Esophageal cancer is one of the most common cancers worldwide. Despite recent progress in the development of novel therapies, esophageal carcinoma remains an aggressive cancer associated with a poor prognosis. The glutathione peroxidase 1 (GPX1) gene located on chromosome 3p21.3 is associated with the cancer of several organs. According to available information, GPX1, a gene downstream of NF-κB, is considered to exert adverse effects on tumour progression and enhance malignancy in some cancers but has not been reported in esophageal cancer. It is also reported that vitamin D (Vit. D), a widely used drug in the clinical setting, could suppress GPX1 expression through the NF-κB pathway. Thus, it is speculated that Vit. D could reduce malignancy in esophageal cancer by altering the NF-κB pathway. In this study, we confirmed our speculation by finding that Vit. D, through the inhibition of GPX1, decreased the migratory, invasive and proliferative capabilities, as well as cisplatin resistance, in esophageal cancer cells. Furthermore, when invasion and migration were reduced in the GPX1-inhibited cells, the expression of urokinase type plasminogen activator (uPA) and matrix metalloproteinase-2 (MMP2) was also suppressed correspondingly. Therefore, we believe that, in esophageal cancer cells, the expression of GPX1 can promote invasion, migration, proliferation and cisplatin resistance, and Vit. D can reduce the associated malignancy through the NF-κB pathway. The Vit. D- and NF-κB-mediated decrease in GPX1 expression resulted in a decrease in MMP2- and uPA-mediated invasion and migration.
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Affiliation(s)
- Xiangfeng Gan
- Department of Thoracic Surgery, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen UniversityGuangzhou 510120, P.R. China
| | - Baishen Chen
- Department of Thoracic Surgery, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen UniversityGuangzhou 510120, P.R. China
| | - Zhuojian Shen
- Department of Thoracic Surgery, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen UniversityGuangzhou 510120, P.R. China
| | - Yeqing Liu
- Department of Pathology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen UniversityGuangzhou 510120, P.R. China
| | - Haifeng Li
- Department of Pathology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen UniversityGuangzhou 510120, P.R. China
| | - Xuan Xie
- Department of Thoracic Surgery, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen UniversityGuangzhou 510120, P.R. China
| | - Xia Xu
- Department of Thoracic Surgery, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen UniversityGuangzhou 510120, P.R. China
| | - Haigang Li
- Department of Pathology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen UniversityGuangzhou 510120, P.R. China
| | - Zhiquan Huang
- Department of Oral and Maxillofacial Surgery, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen UniversityGuangzhou 510120, P.R. China
| | - Ju Chen
- Department of Thoracic Surgery, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen UniversityGuangzhou 510120, P.R. China
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