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Sufian MA, Hamzi W, Hamzi B, Sagar ASMS, Rahman M, Varadarajan J, Hanumanthu M, Azad MAK. Innovative Machine Learning Strategies for Early Detection and Prevention of Pregnancy Loss: The Vitamin D Connection and Gestational Health. Diagnostics (Basel) 2024; 14:920. [PMID: 38732334 PMCID: PMC11083692 DOI: 10.3390/diagnostics14090920] [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: 02/22/2024] [Revised: 03/30/2024] [Accepted: 04/23/2024] [Indexed: 05/13/2024] Open
Abstract
Early pregnancy loss (EPL) is a prevalent health concern with significant implications globally for gestational health. This research leverages machine learning to enhance the prediction of EPL and to differentiate between typical pregnancies and those at elevated risk during the initial trimester. We employed different machine learning methodologies, from conventional models to more advanced ones such as deep learning and multilayer perceptron models. Results from both classical and advanced machine learning models were evaluated using confusion matrices, cross-validation techniques, and analysis of feature significance to obtain correct decisions among algorithmic strategies on early pregnancy loss and the vitamin D serum connection in gestational health. The results demonstrated that machine learning is a powerful tool for accurately predicting EPL, with advanced models such as deep learning and multilayer perceptron outperforming classical ones. Linear discriminant analysis and quadratic discriminant analysis algorithms were shown to have 98 % accuracy in predicting pregnancy loss outcomes. Key determinants of EPL were identified, including levels of maternal serum vitamin D. In addition, prior pregnancy outcomes and maternal age are crucial factors in gestational health. This study's findings highlight the potential of machine learning in enhancing predictions related to EPL that can contribute to improved gestational health outcomes for mothers and infants.
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Affiliation(s)
- Md Abu Sufian
- IVR Low-Carbon Research Institute, Chang’an University, Xi’an 710018, China;
- School of Computing and Mathematical Sciences, University of Leicester, Leicester LE1 7RH, UK
| | - Wahiba Hamzi
- Laboratoire de Biotechnologie, Environnement et Santé, Department of Biology, University of Blida, Blida 09000, Algeria
| | - Boumediene Hamzi
- Department of Computing and Mathematical Sciences, California Institute of Technology, Caltech, CA 91125, USA
- The Alan Turing Institute, London NW1 2DB, UK
- Department of Mathematics, Gulf University for Science and Technology (GUST), Mubarak Al-Abdullah 32093, Kuwait
| | | | - Mustafizur Rahman
- Department of Industrial Engineering, Tsinghua University, Beijing 100084, China
| | - Jayasree Varadarajan
- Centre for Digital Innovation, Manchester Metropolitan University, Manchester M15 6BH, UK
| | - Mahesh Hanumanthu
- School of Computing and Mathematical Sciences, University of Leicester, Leicester LE1 7RH, UK
| | - Md Abul Kalam Azad
- Department of Medicine, Rangpur Medical College and Hospital, Rangpur 5400, Bangladesh
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Kuroshli Z, Novin MG, Nazarian H, Abdollahifar MA, Zademodarres S, Pirani M, Jahvani FA, Fathabady FF, Mofarahe ZS. The Efficacy of Vitamin D Supplement in the Expression and Protein Levels of Endometrial Decidualization Factors in Women with Recurrent Implantation Failure. Reprod Sci 2024; 31:675-686. [PMID: 37816991 DOI: 10.1007/s43032-023-01349-y] [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: 04/25/2023] [Accepted: 09/01/2023] [Indexed: 10/12/2023]
Abstract
Recurrent implantation failure (RIF) is a challenging situation for infertility specialists, and its treatment is introduced as a difficult case in the field of assisted reproductive technology (ART). Vitamin D (VD) is one of the supplements that have been suggested to improve the implantation process. In the present study, the effect of VD on the expression and protein levels of VD receptor (VDR), progesterone receptor (PR), prolactin (PRL), insulin-like growth factor binding protein-1 (IGFBP-1), and homeobox protein A10 (HOXA10) in the endometrial cells of unknown RIF women with and without VD deficiency were assessed by qRT-PCR and immunohistochemistry. Twelve women with unknown RIF and VD deficiency (≤ 20 ng/ml) and twelve women with unknown RIF without VD deficiency (≥ 30 ng/ml) from 2021 to 2022 were identified. Endometrial specimens were collected in the mid-luteal stage before treatment or pregnancy. In the group with VD deficiency, oral medication of VD 50,000 units was prescribed for 2 to 3 months and their serum levels of VD were re-measured, then an endometrial biopsy at the same stage of the menstrual cycle was performed. The expression and protein levels of VDR, PR, PRL, IGFBP1, and HOXA10 in RIF patients with VD deficiency were lower than the RIF patients without VD deficiency (P value < 0.05). Our findings suggest that VD can play a key role in the pregnancy process, especially during embryo implantation and decidualization of the endometrial cells.IRCT registration number: IRCT20220528055006N1, Registration date: 2022-10-15, Registration timing: retrospective.
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Affiliation(s)
- Zahra Kuroshli
- Department of Biology and Anatomical Sciences, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Marefat Ghaffari Novin
- Department of Biology and Anatomical Sciences, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hamid Nazarian
- Department of Biology and Anatomical Sciences, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammad-Amin Abdollahifar
- Department of Biology and Anatomical Sciences, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Shahrzad Zademodarres
- Clinical Research Development Center, Mahdiyeh Education Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Maryam Pirani
- Department of Biology and Anatomical Sciences, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Farideh Arab Jahvani
- Research and Clinical Centre for Infertility, Shahid Sadoughi University of Medical Sciences and Health Services, Yazd, Iran
| | - Fatemeh Fadaei Fathabady
- Department of Biology and Anatomical Sciences, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Zahra Shams Mofarahe
- Department of Biology and Anatomical Sciences, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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Yue C, Ma Y, Wang M, Yuan M, Meng Y, Wang Z, Ying C. CPY27B1-related vitamin D deficiency contributes to the impaired function of CD4 +T cells in Recurrent spontaneous miscarriage. Heliyon 2024; 10:e24499. [PMID: 38298727 PMCID: PMC10827770 DOI: 10.1016/j.heliyon.2024.e24499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2023] [Revised: 01/09/2024] [Accepted: 01/10/2024] [Indexed: 02/02/2024] Open
Abstract
The study aimed to explore the relationship between the expression of cytochrome P450 family 27 subfamily B member 1 (CYP27B1), vitamin D, and impaired T cell subsets in recurrent spontaneous miscarriage (RSM). A Total of 779 healthy women of childbearing age and 1031 women with a history of RSM were involved in this study. The results of flow cytometry showed that the proportion of Tregs was higher in healthy women than in the women with RSM. For cytokines, the levels of interleukin-17 (IL-17) and interferon-gamma (IFN-γ) were significantly higher in RSM patients than in healthy women, while IL-10 was notably lower in RSM patients. Furthermore, compared to healthy individuals, RSM patients had lower levels of serum 25(OH)D detected by chemiluminescence. The frequency of Tregs was negatively correlated with 25(OH)D. Specifically, for every 10 ng/ml increase in 25(OH)D, the percentage of Tregs increased by 0.58 as calculated. IL-17 and IFN-γ were inversely correlated with 25(OH)D, while the serum interleukin-10 (IL-10) level was positively correlated with 25(OH)D. CYP27B1 was found to be expressed in both cytotrophoblast and extracellular villi trophoblast cells. However, reduced expression of CYP27B1 was observed in the placenta with RSM. Notably, the level of 25(OH)D increased in the supernatant of CYP27B1 knockdown BeWo compared to normal cells, while human chorionic gonadotropin (hCG) was significantly reduced. The hCG secretion of CYP27B1 KO BeWo cells was partially restored after 1,25(OH)2D3 supplementation. In addition, 1,25(OH)2D3 treatment could induce more CD4+ T cells to convert to Foxp3+iTreg, which in turn inhibited the secretion of IL-17, IFN-γ. In summary, this research unveiled a connection between reduced CYP27B1 and vitamin D deficiency in RSM. Our study underscores the potential benefits of vitamin D treatment supplementation in the context of RSM. However, it is important to note that further research is imperative to validate these observations.
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Affiliation(s)
- Chaoyan Yue
- Department of Laboratory Medicine, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | - Yanhui Ma
- Department of Laboratory Medicine, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200092, China
| | - Mingyan Wang
- Department of Laboratory Medicine, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | - Minmin Yuan
- Department of Laboratory Medicine, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | - Yi Meng
- Department of Laboratory Medicine, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | - Zhiheng Wang
- Department of Laboratory Medicine, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | - Chunmei Ying
- Department of Laboratory Medicine, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
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Morshed-Behbahani B, Doryanizadeh L, Shahali S, Shahabi S, Montazeri A. Effect of and the association between vitamin D and outcomes of assisted reproductive techniques among infertile men and women: protocol for an overview of systematic reviews and meta-analysis. BMJ Open 2023; 13:e060483. [PMID: 36882256 PMCID: PMC10008453 DOI: 10.1136/bmjopen-2021-060483] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/09/2023] Open
Abstract
INTRODUCTION Vitamin D is associated with many functions of the human reproductive system. Accordingly, it seems that on infertile couples undergoing assisted reproduction technology (ART), treatment outcomes may be affected by the vitamin D. This overview aims to show the effect of vitamin D on infertility treatments outcomes in recent studies by concluding systematic reviews and meta-analyses to achieve a comprehensive result. METHODS AND ANALYSIS This overview protocol is being reported according to the Preferred Reporting Items for Systematic review and Meta-Analysis Protocols (PRISMA-P) statement and was registered in the International Prospective Register of Systematic Reviews. We will include all peer-reviewed systematic reviews and meta-analyses of randomised controlled trials published from inception until December 2022. PubMed, Web of Science, Cochrane Database of Systematic Reviews, Cochrane Database of Abstracts of Reviews of Effects, Scopus, Cochrane Central Register of Controlled Trials and Embase will be searched from the time of publication of the first articles onwards with a comprehensive search strategy. Endnote V.X7 software (Thomson Reuters, New York, New York, USA) will be used to store and manage records. The results will align with guidelines in the Cochrane Handbook of Systematic Reviews of Interventions and the PRISMA statement. ETHICS AND DISSEMINATION This overview will be evaluating the effect of vitamin D status and vitamin D supplementing on results of ART in women and men who are undergoing treatment for infertility. The high prevalence of vitamin D deficiency worldwide and its effects on an important issue such as human fertility might be a very influential factor that leads scientists to strongly recommend its use. However, the more critical concern is that there is no definitive agreement in studies on the relationship between vitamin D and an increased chance of better fertility in men and women undergoing infertility treatment. PROSPERO REGISTRATION NUMBER CRD42021252752.
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Affiliation(s)
- Bahar Morshed-Behbahani
- Department of Midwifery, Shiraz University of Medical Sciences School of Nursing and Midwifery, Shiraz, Iran (the Islamic Republic of)
| | - Leila Doryanizadeh
- Department of Midwifery, Islamic Azad University of Estahban, Estahban, Iran (the Islamic Republic of)
| | - Shadab Shahali
- Department of Reproductive Health and Midwifery, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran (the Islamic Republic of)
| | - Saeed Shahabi
- Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran (the Islamic Republic of)
| | - Ali Montazeri
- Faculty of Humanity Sciences, University of Science and Culture, ACECR, Tehran, Iran (the Islamic Republic of)
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Relationship between Maternal Vitamin D Levels and Adverse Outcomes. Nutrients 2022; 14:nu14204230. [PMID: 36296914 PMCID: PMC9610169 DOI: 10.3390/nu14204230] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 09/28/2022] [Accepted: 10/08/2022] [Indexed: 11/23/2022] Open
Abstract
Vitamin D (VD), a fat-soluble vitamin, has a variety of functions that are important for growth and development, including regulation of cell differentiation and apoptosis, immune system development, and brain development. As such, VD status during pregnancy is critical for maternal health, fetal skeletal growth, and optimal pregnancy outcomes. Studies have confirmed that adverse pregnancy outcomes, such as preeclampsia, low birth weight, neonatal hypocalcemia, poor postnatal growth, skeletal fragility, and increased incidence of autoimmune diseases, can be associated with low VD levels during pregnancy and infancy. Thus, there is growing interest in the role of VD during pregnancy. This review summarizes the potential adverse health outcomes of maternal VD status during pregnancy for both mother and offspring (gestational diabetes mellitus, hypertensive gestational hypertension, intrauterine growth restriction, miscarriage, stillbirth, and preterm birth) and discusses the underlying mechanisms (regulation of cytokine pathways, immune system processing, internal secretion, placental function, etc.) of VD in regulating each of the outcomes. This review aims to provide a basis for public health intervention strategies to reduce the incidence of adverse pregnancies.
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Shi B, Chen J, Chen H, Lin W, Yang J, Chen Y, Wu C, Huang Z. Prediction of recurrent spontaneous abortion using evolutionary machine learning with joint self-adaptive sime mould algorithm. Comput Biol Med 2022; 148:105885. [DOI: 10.1016/j.compbiomed.2022.105885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 07/03/2022] [Accepted: 07/16/2022] [Indexed: 11/03/2022]
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Effects of Vitamin D on Fertility, Pregnancy and Polycystic Ovary Syndrome-A Review. Nutrients 2022; 14:nu14081649. [PMID: 35458211 PMCID: PMC9029121 DOI: 10.3390/nu14081649] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Revised: 04/09/2022] [Accepted: 04/11/2022] [Indexed: 02/06/2023] Open
Abstract
Polycystic ovary syndrome (PCOS) is one of the most common endocrine reproductive disorders in women. Vitamin D deficiency is also quite common in this condition. The degree of vitamin D deficiency correlates with the severity of PCOS. Both male and female vitamin D levels play a role in fertility and affect the outcomes of in vitro fertilization (IVF). Moreover, fertility and IVF indicators are improved by vitamin D not only in healthy women but in those diagnosed with PCOS. Both vitamin D deficiency and PCOS increase pregnancy-related complications. Vitamin D supplementation and optimal vitamin D levels decrease both maternal and fetal risk for complications and adverse events. Furthermore, vitamin D supplementation may ameliorate or even prevent pregnancy-related reversible bone loss in mothers. This review emphasizes the roles of vitamin D deficiency and vitamin D supplementation and their correlation with PCOS regarding reproductive health.
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Hosseinirad H, Paktinat S, Mohanazadeh Falahieh F, Mirani M, Karamian A, Karamian A, Shams Mofarahe Z. Effect of 1,25(OH)2-vitamin D3 on decidualization of human endometrial stromal cells. Steroids 2022; 180:108978. [PMID: 35150696 DOI: 10.1016/j.steroids.2022.108978] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 01/10/2022] [Accepted: 02/03/2022] [Indexed: 11/17/2022]
Abstract
Decidualization is the differentiation of endometrial stromal cells (eSC) to rounded, epithelioid-like cells during menstrual cycle and pregnancy. The impairment of this process leads to infertility and a variety of pregnancy disorders, including recurrent miscarriages and uteroplacental disorders. The aim of this study was to evaluate the effect of 1,25(OH)2-vitamin D3 (VD) on transformation of primary eSC into decidual cells. After isolation of eSC from biopsy samples of healthy fertile women and their characterization, the cells were cultured and propagated, and confluent cultures were decidualized for 12 days with progesterone (P4) and estradiol (E2) in presence or absence of VD. Prolactin (PRL) concentration was measured every 48 h in culture medium of eSCs, and ultrastructural changes were evaluated at the end of treatment. The results showed that PRL concentration in culture medium of eSCs was significantly increased in VD-treated decidual cells compared to control groups in a time-dependent manner. Ultrastructural analysis demonstrated that VD enhances many of the ultrastructural changes of decidualized cells including expansion of rough endoplasmic reticulum (rER), increased lipid droplets and high number of euchromatin round nuclei. These results suggest that VD may play an important role during early pregnancy by promoting cellular transformation associated with decidualization.
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Affiliation(s)
- Hossein Hosseinirad
- Department of Biology and Anatomical Sciences, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Shahrokh Paktinat
- Department of Biology and Anatomical Sciences, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Maryam Mirani
- Department of Reproductive Biology, School of Advanced Medical Sciences and Technologies, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Armin Karamian
- Department of Anatomical Sciences, School of Medicine, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Amin Karamian
- Department of Biology and Anatomical Sciences, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Zahra Shams Mofarahe
- Department of Biology and Anatomical Sciences, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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Calcaterra V, Nappi RE, Farolfi A, Tiranini L, Rossi V, Regalbuto C, Zuccotti G. Perimenstrual Asthma in Adolescents: A Shared Condition in Pediatric and Gynecological Endocrinology. CHILDREN 2022; 9:children9020233. [PMID: 35204953 PMCID: PMC8870409 DOI: 10.3390/children9020233] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 02/04/2022] [Accepted: 02/07/2022] [Indexed: 12/12/2022]
Abstract
Asthma is a frequent medical condition in adolescence. The worsening of the most common symptoms perimenstrually is defined as perimenstrual asthma (PMA). The cause of PMA remains unclear, but a role for hormonal milieu is plausible. Data on PMA in adolescents are limited, and its management is not fully established. We aimed to discuss the PMA phenomenon in young females from pathophysiology to preventive strategies, focusing on the relationship with the hormonal pattern. The fluctuation of estrogens at ovulation and before menstruation and the progesterone secretion during the luteal phase and its subsequent withdrawal seem to be the culprits, because the deterioration of asthma is cyclical during the luteal phase and/or during the first days of the menstrual cycle. Conventional asthma therapies are not always effective for PMA. Preventive strategies may include innovative hormonal contraception. Even a possible beneficial effect of other hormonal treatments, including estrogens, progestogens, and androgens, as well as leukotriene receptor antagonists and explorative approach using microbial-directed therapy, is considered. The underlying mechanisms, through which sex-hormone fluctuations influence asthma symptoms, represent a challenge in the clinical management of such a distressing condition. Further studies focused on young females are mandatory to promote adolescent health.
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Affiliation(s)
- Valeria Calcaterra
- Pediatric and Adolescent Unit, Department of Internal Medicine and Therapeutics, University of Pavia, 27100 Pavia, Italy
- Department of Pediatrics, “Vittore Buzzi” Children’s Hospital, 20154 Milano, Italy; (A.F.); (V.R.); (G.Z.)
- Correspondence:
| | - Rossella Elena Nappi
- Research Center for Reproductive Medicine, Gynecological Endocrinology and Menopause, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy; (R.E.N.); (L.T.)
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy
| | - Andrea Farolfi
- Department of Pediatrics, “Vittore Buzzi” Children’s Hospital, 20154 Milano, Italy; (A.F.); (V.R.); (G.Z.)
| | - Lara Tiranini
- Research Center for Reproductive Medicine, Gynecological Endocrinology and Menopause, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy; (R.E.N.); (L.T.)
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy
| | - Virginia Rossi
- Department of Pediatrics, “Vittore Buzzi” Children’s Hospital, 20154 Milano, Italy; (A.F.); (V.R.); (G.Z.)
| | - Corrado Regalbuto
- Pediatric Unit, Fondazione IRCCS Policlinico San Matteo, University of Pavia, 27100 Pavia, Italy;
| | - Gianvincenzo Zuccotti
- Department of Pediatrics, “Vittore Buzzi” Children’s Hospital, 20154 Milano, Italy; (A.F.); (V.R.); (G.Z.)
- Department of Biomedical and Clinical Science “L. Sacco”, University of Milano, 20157 Milano, Italy
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Cermisoni GC, Reschini M, Piccinni MP, Lombardelli L, Logiodice F, Sarais V, Giacomini E, Signorelli S, Cecchele A, Viganò P. OUP accepted manuscript. Hum Reprod Open 2022; 2022:hoac017. [PMID: 35475146 PMCID: PMC9024319 DOI: 10.1093/hropen/hoac017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 03/16/2022] [Indexed: 11/14/2022] Open
Abstract
STUDY QUESTION Is oral Vitamin D supplementation able to modify the intrauterine milieu in terms of cytokine/chemokine pattern? SUMMARY ANSWER No significant differences were detected in cytokine and chemokine levels in endometrial secretions between patients undergoing ART with or without Vitamin D supplementation. WHAT IS KNOWN ALREADY Cytokines and chemokines secreted into the intrauterine environment are fundamental for the molecular crosstalk between the endometrium and the preimplantation embryo. Whether Vitamin D can regulate these mediators in the endometrial environment is still unclear. STUDY DESIGN, SIZE, DURATION This study was an analysis of a secondary outcome from the Supplementation of Vitamin D and Reproductive Outcomes—SUNDRO—clinical trial, a multicenter randomized double-blinded trial designed to explore the effects of Vitamin D replacement in women with Vitamin D levels below 30 ng/ml undergoing autologous ART cycles. Uterine fluid samples were collected from both patients supplemented with Vitamin D (n = 17) and from the placebo group (n = 32). PARTICIPANTS/MATERIALS, SETTING, METHODS Based on cutoff points for Vitamin D insufficiency (20–29.9 ng/ml) or deficiency (<20 ng/ml), 67% of patients in the study were insufficient, and 33% deficient, in Vitamin D, although they were considered together for the analysis. Women received a single dose of 600 000 IU 25-hydroxyvitamin D or placebo from 2 to 12 weeks before oocyte retrieval. Inclusion criteria were female age 18–39 years, with a BMI between 18 and 25 kg/m2. Serum 25-hydroxyvitamin D was assessed at the time of hCG administration. Uterine fluid samples were collected during the secretory phase of the menstrual cycle preceding oocyte retrieval. The quantitative determination of 27 cytokines in endometrial secretion samples was performed by using a multiplex immunoassay. MAIN RESULTS AND THE ROLE OF CHANCE Uterine fluid samples were collected after a median (range) of 21 (12–41) days after the oral Vitamin D supplementation. Both the supplemented and placebo groups had Vitamin D serum levels below 30 ng/ml at baseline/time of randomization ((median 23.4 ng/ml (interquartile range 19.5–28.4) and 23.4 ng/ml (17.8–25.9), respectively). At the time of hCG administration, serum Vitamin D in supplemented subjects was significantly raised compared to the placebo group ((median 52.9 ng/ml (interquartile range 40.7–64.1) and 24.6 ng/ml (19.3–29.2), respectively, P < 0.001). Our data revealed no significant differences in uterine fluid cytokine/chemokine composition of Vitamin D-supplemented women compared with the placebo group. This finding remained when the concentrations of all mediators studied were normalized to total protein. In a further analysis, no significant differences were found in the content of cytokines/chemokines in uterine fluid from women who conceived (n = 19) compared with the nonpregnant group (n = 30). LIMITATIONS, REASONS FOR CAUTION Using a randomized study design (a single dose of 600 000 IU 25-hydroxyvitamin D versus placebo), we found no significant differences between groups. However, we cannot exclude that any benefit of Vitamin D supplementation may be specific for some subgroups of patients, such as those with an imbalance of T-helper 1 and T-helper 2 cell populations. The uterine secretions were collected during the menstrual cycle that preceded oocyte retrieval; therefore, it is possible the uterine fluid collection and analysis in the same cycle of the embryo transfer might have resulted in different conclusions. Moreover, the small sample size could limit the power of the study. WIDER IMPLICATIONS OF THE FINDINGS Our analysis of the uterine secretome profiling failed to show any significant difference in endometrial cytokine/chemokine patterns between women with oral Vitamin D supplementation and the placebo group. Vitamin D may act on the uterine environment through a different mechanism. STUDY FUNDING/COMPETING INTEREST(S) The study was funded by the Italian Ministry of Health following peer review in the competitive ‘Bando di Ricerca Finalizzata e Giovani Ricercatori 2013’ with reference code RF-2013-02358757. The authors declare that they have no conflict of interest. TRIAL REGISTRATION NUMBER EudraCT registration number: 2015-004233-27.
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Affiliation(s)
| | | | - Marie-Pierre Piccinni
- Department of Experimental and Clinical Medicine and Center of Excellence for Research, Transfer and High Education DENOTHE, University of Florence, Florence, Italy
| | - Letizia Lombardelli
- Department of Experimental and Clinical Medicine and Center of Excellence for Research, Transfer and High Education DENOTHE, University of Florence, Florence, Italy
| | - Federica Logiodice
- Department of Experimental and Clinical Medicine and Center of Excellence for Research, Transfer and High Education DENOTHE, University of Florence, Florence, Italy
| | - Veronica Sarais
- Obstetrics and Gynaecology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Elisa Giacomini
- Reproductive Sciences Laboratory, Obstetrics and Gynaecology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Simona Signorelli
- Obstetrics and Gynaecology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Anna Cecchele
- Infertility Unit, Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Paola Viganò
- Correspondence address. Infertility Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Via F. Sforza 28, 20122, Milan, Italy. Tel: +39-02-55034302; E-mail:
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Zhou X, Wu X, Luo X, Shao J, Guo D, Deng B, Wu Z. Effect of Vitamin D Supplementation on In Vitro Fertilization Outcomes: A Trial Sequential Meta-Analysis of 5 Randomized Controlled Trials. Front Endocrinol (Lausanne) 2022; 13:852428. [PMID: 35370977 PMCID: PMC8969598 DOI: 10.3389/fendo.2022.852428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 02/11/2022] [Indexed: 11/13/2022] Open
Abstract
Despite numerous studies indicating an imperative role of vitamin D for reproduction, the importance of vitamin D supplementation on in vitro fertilization (IVF) outcomes remains controversial. We therefore performed this meta-analysis to investigate the IVF outcomes of vitamin D supplementation in infertile women with vitamin D deficiency. We systematically searched PubMed, Embase and the Cochrane library for identifying all relevant studies published before August 2021. Pregnancy rate was defined as the primary outcome while good quality embryo, fertilization rate, ongoing pregnancy, and miscarriage were secondary outcomes. We used Review Manager 5.3 (RevMan) to conduct meta-analysis and examined the robustness of the primary outcome by trial sequential analysis. Five studies were included in the final analysis and it suggested that vitamin D supplementation was associated with improved chemical pregnancy rate (risk ratio [RR] = 1.53, 95% confidence interval [CI] = 1.06 to 2.20, p = 0.02) but not benefited in improving clinical pregnancy rate (RR = 1.34, 95% CI = 0.81 to 2.24, p = 0.25) and all secondary outcomes. Trial sequential analysis suggested further studies are needed to confirm this conclusion. We concluded that vitamin D supplementation should be prescribed to improve chemical pregnancy in infertile women with vitamin D deficiency and more studies are required to further confirm this finding.
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Affiliation(s)
- Xiaoting Zhou
- Reproductive Medical Center of Yunnan Province, The Affiliated Hospital of Kunming University of Science and Technology, Kunming, China
- Department of Reproductive Medicine, The First People’s Hospital of Yunnan Province, Kunming, China
- Medical School, Kunming University of Science and Technology, Kunming, China
| | - Xiaomei Wu
- Reproductive Medical Center of Yunnan Province, The Affiliated Hospital of Kunming University of Science and Technology, Kunming, China
- Department of Reproductive Medicine, The First People’s Hospital of Yunnan Province, Kunming, China
- Medical School, Kunming University of Science and Technology, Kunming, China
| | - Xi Luo
- Reproductive Medical Center of Yunnan Province, The Affiliated Hospital of Kunming University of Science and Technology, Kunming, China
- Department of Reproductive Medicine, The First People’s Hospital of Yunnan Province, Kunming, China
- Medical School, Kunming University of Science and Technology, Kunming, China
- Faculty of Life Science and Technology, Kunming University of Science and Technology, Kunming, China
| | - Jingyi Shao
- Reproductive Medical Center of Yunnan Province, The Affiliated Hospital of Kunming University of Science and Technology, Kunming, China
- Department of Reproductive Medicine, The First People’s Hospital of Yunnan Province, Kunming, China
| | - Dongqun Guo
- Department of Urology, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, China
| | - Bo Deng
- Reproductive Medical Center of Yunnan Province, The Affiliated Hospital of Kunming University of Science and Technology, Kunming, China
- Department of Reproductive Medicine, The First People’s Hospital of Yunnan Province, Kunming, China
- *Correspondence: Ze Wu, ; Bo Deng,
| | - Ze Wu
- Reproductive Medical Center of Yunnan Province, The Affiliated Hospital of Kunming University of Science and Technology, Kunming, China
- Department of Reproductive Medicine, The First People’s Hospital of Yunnan Province, Kunming, China
- *Correspondence: Ze Wu, ; Bo Deng,
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Gao J, Wang L, Bu L, Song Y, Huang X, Zhao J. Immunopharmacological properties of VitD3: 1,25VitD3 modulates regulatory T cells and Th17 cells and the cytokine balance in PBMCs from women with unexplained recurrent spontaneous abortion [URSA]. Curr Mol Pharmacol 2021; 15:779-793. [PMID: 34649494 DOI: 10.2174/1874467214666211015084803] [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: 01/25/2021] [Revised: 07/16/2021] [Accepted: 09/01/2021] [Indexed: 11/22/2022]
Abstract
BACKGROUND VitD3 may contribute to a successful pregnancy through modulation of immune responses, so VitD3 deficiency may have a role in the immunopathogenesis of unexplained recurrent spontaneous abortion [URSA]. However, the mechanisms of immunomodulatory actions of VitD3 in decreasing the risk of recurrent spontaneous abortion have not been understood well. OBJECTIVE The purpose of this research was to investigate the influence of 1,25VitD3 on regulatory T cells /Th17 axis, the gene expressions and concentrations of related cytokines including, TGF-β, IL-10, IL-6, IL-23, and IL-17A in peripheral blood mononuclear cells [PBMCs] of healthy women as a control group and women with URSA. METHOD Isolation of PBMCs was performed from peripheral blood of the subjects of the studied groups [20 women with URSA as a case group, and 20 control women]. The effects of 1,25VitD3 [50 nM, for 24 hours] on the studied parameters were evaluated and were compared to the positive and negative controls in vitro. Flow cytometry analysis was used to determine the percentages of regulatory T cells and Th17 cells. For gene expression measurement and cytokines assay, Real-time PCR and ELISA were carried out. RESULTS The proportion of regulatory T cells was markedly lower, while the proportion of Th17 cells in women with URSA was considerably higher than in the control group [P=0.01, P=0.01]. The ratio of the frequency of Tregs to the baseline [1,25VitD3/Untreated] increased, while the ratio of the frequency of Th17 cells to the baseline decreased in women with URSA relative to the controls [P= 0.01, P=0.04]. 1,25VitD3 increased IL-10 expressions at both the protein and mRNA levels in PBMCs in women with URSA relative to the control group [P=0.0001, P=0.04]. TGF-β levels in the cultured supernatants decreased significantly in the case group in the presence of 1,25VitD3 relative to the controls [P=0.03]. 1,25VitD3 treatment also significantly decreased gene expressions of IL-6, IL-17A, and IL-23 in PBMCs of women with URSA [P=0.01, P=0.001, P=0.0005], as well as the levels of those cytokines in cell culture supernatants [P=0.03, P=0.02, P=0.01, respectively] in women with URSA relative to the controls. CONCLUSION According to the findings of this research, modulation of immune responses by 1,25VitD3 is accomplished by strengthening Tregs function and inhibiting inflammatory responses of Th17 cells which may have a positive impact on pregnancy outcome. Thus, as an immunomodulating agent, VitD3 may be effective in reducing the risk of URSA.
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Affiliation(s)
- Jiefan Gao
- Department of reproductive medicine, Cangzhou Central Hospital, No. 16, Xinhua West Road, Cangzhou City, Hebei Province, 061014. China
| | - Li Wang
- Department of Gynecology, Shandong Second Provincial General Hospital, No. 4, Duanxing West Road, Huaiyin District, Jinan City, Shandong Province, 250022. China
| | - Lei Bu
- Department of nephrology, Linyi people's hospital, Linyi City, Shandong Province, 276003. China
| | - Yangyang Song
- Department of reproductive medicine, Cangzhou Central Hospital, No. 16, Xinhua West Road, Cangzhou City, Hebei Province, 061014. China
| | - Xiao Huang
- Department of reproductive medicine, Cangzhou Central Hospital, No. 16, Xinhua West Road, Cangzhou City, Hebei Province, 061014. China
| | - Jing Zhao
- Department of nursing, Dongying District People's Hospital, No. 333, Jinan Road, Dongying City, Shandong Province, 257099. China
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13
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Abdollahi E, Rezaee SA, Saghafi N, Rastin M, Clifton V, Sahebkar A, Rafatpanah H. Evaluation of the Effects of 1,25 Vitamin D3 on Regulatory T Cells and T Helper 17 Cells in Vitamin D-deficient Women with Unexplained Recurrent Pregnancy Loss. Curr Mol Pharmacol 2021; 13:306-317. [PMID: 32124705 DOI: 10.2174/1874467213666200303130153] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Revised: 11/27/2019] [Accepted: 12/31/2019] [Indexed: 01/02/2023]
Abstract
BACKGROUND Vitamin D insufficiency and deficiency can be associated with adverse effects on pregnancy outcomes, which may include recurrent pregnancy loss through the mechanisms that are yet unknown. The aim of this study was to evaluate the effect of 1,25VitD3 on regulatory T cells (Tregs) and T helper17 (Th17) cell populations In vitro in unexplained recurrent pregnancy loss (URPL) patients and healthy women. METHODS Samples from 20 non-pregnant women with a history of URPL were compared to 20 normal non-pregnant women. Peripheral blood mononuclear cells (PBMC) were divided into 3 wells for each subject: in the presence of 1, 25 VitD3 (50 nM, for 16 hours), PHA (positive control) (10μM), and without any treatment (as a baseline or negative control). The percentage of regulatory T cells and Th17 cells was measured by flow cytometry at baseline and then after cell culture experiments. RESULTS Our study indicated that the percentage of Tregs in patients with URPL was significantly lower than the control group (2.42 ± 0.27 vs. 3.41 ± 0.29, P= 0.01). The percentage of Th17 cells was significantly greater in URPL patients compared to the control group (2.91 ± 0.33 vs. 1.18± 0.15, P=0.001). 1, 25VitD3 treatment significantly increased the percentage of Tregs from the baseline in the URPL group compared to that in the control group (1.23 ± 0.03 vs. 1.00 ± 0.03, P= 0.01). CONCLUSION Vitamin D deficiency may be a contributor to recurrent pregnancy loss and suggests supplementation of women with Vit D pre-pregnancy may be protective against URPL.
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Affiliation(s)
- Elham Abdollahi
- Department of Medical Immunology and Allergy, Student Research Committee, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran,Graduate Research Trainee in Mater Research Institute-University of Queensland, Translational Research Institute, South Brisbane, Australia
| | - Seyed Abdolrahim Rezaee
- Research Center for HIV/AIDS, HTLV and Viral Hepatitis, Iranian Academic Center for Education, Culture & Research (ACECR), Mashhad Branch, Mashhad, Iran,Inflammation and Inflammatory Diseases Research Centre, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Nafiseh Saghafi
- Department of Gynecology Oncology, Woman Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Maryam Rastin
- Immunology Research Center, BuAli Research Institute, Department of Immunology and Allergy, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Vicki Clifton
- Pregnancy and Development, Mater Research Institute-University of Queensland, Translational Research Institute, South Brisbane, Australia
| | - Amirhossein Sahebkar
- Halal Research Center of IRI, FDA, Tehran, Iran,Biotechnology Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran,Neurogenic Inflammation Research Center, Mashhad University of Medical Sciences, Mashhad, Iran,Polish Mother's Memorial Hospital Research Institute (PMMHRI), Lodz, Poland
| | - Houshang Rafatpanah
- Research Center for HIV/AIDS, HTLV and Viral Hepatitis, Iranian Academic Center for Education, Culture & Research (ACECR), Mashhad Branch, Mashhad, Iran,Inflammation and Inflammatory Diseases Research Centre, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
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Zhao H, Wei X, Yang X. A novel update on vitamin D in recurrent pregnancy loss (Review). Mol Med Rep 2021; 23:382. [PMID: 33760145 PMCID: PMC7986007 DOI: 10.3892/mmr.2021.12021] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2020] [Accepted: 02/15/2021] [Indexed: 12/20/2022] Open
Abstract
Recurrent pregnancy loss (RPL) is usually characterized as ≥3 miscarriages before 20 weeks of gestation. Patients with RPL may have autoimmune abnormalities or alloimmune problems. Vitamin D has a major function on the mechanism of immunomodulation at the maternal-fetal interface. However, whether vitamin D can be used as an effective method to treat patients with RPL requires investigation. It has been reported that vitamin D could prevent the occurrence of antiphospholipid syndrome (APS) by reducing the expression levels of anti-β2 glycoprotein and tissue factor in RPL cases with APS. In addition, there is an opposite relationship between vitamin D and thyroid peroxidase antibody levels in autoimmune thyroid disease cases with RPL. Vitamin D changes the ratio of T helper (Th) 1/Th2 and regulatory T cell/Th17 to a certain extent, as well as affects the activity of natural killer cells and the production of cytokines to reduce the incidence of RPL. The objective of the current review was to address the research progress of vitamin D in RPL in recent years, which could facilitate the use of vitamin D treatment to enhance the pregnancy outcome of RPL. Collectively, it was suggested that vitamin D may be used as an important and effective immunotherapeutic agent for patients with RPL.
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Affiliation(s)
- Haoyu Zhao
- Department of Hepatobiliary Surgery and Organ Transplant, The First Hospital of China Medical University, Shenyang, Liaoning 110001, P.R. China
| | - Xiaoqi Wei
- Department of Obstetrics, The First Hospital of China Medical University, Shenyang, Liaoning 110001, P.R. China
| | - Xiuhua Yang
- Department of Obstetrics, The First Hospital of China Medical University, Shenyang, Liaoning 110001, P.R. China
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15
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Hosseinirad H, Novin MG, Hosseini S, Nazarian H, Safaei Z, Hashemi T, Paktinat S, Mofarahe ZS. Evaluation of Expression and Phosphorylation of Progesterone Receptor in Endometrial Stromal Cells of Patients with Recurrent Implantation Failure Compared to Healthy Fertile Women. Reprod Sci 2021; 28:1457-1465. [PMID: 33449351 DOI: 10.1007/s43032-020-00428-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Accepted: 12/10/2020] [Indexed: 11/30/2022]
Abstract
Recurrent implantation failure (RIF) is the repeated failure of good-quality embryos in implantation process following several assisted reproduction cycles. Disruption of the endometrial receptivity is one of the main causes of RIF. Progesterone plays a pivotal role in the endometrial receptivity through the regulation of gene expression pattern by binding to its receptors in the endometrial cells. The aim of this study was to evaluate the expression level of progesterone receptor (PR) and its phosphorylated form in the endometrial stromal cells (eSC) of RIF patients and compare it to the eSC of healthy fertile women as control group. After isolation of the eSC from biopsy samples of RIF patients and healthy fertile women and their characterization, expression levels of PR mRNA, PR protein, and phospho-Ser294 PR protein were evaluated by quantitative real-time PCR and immunofluorescence staining, respectively. The results demonstrated a significant reduction in PR mRNA expression (P < 0.01.) and phospho-Ser294 PR protein (P < 0.05) level in RIF patients compared to the control group. These data for the first time suggest that the expression of PR and its phosphorylated form are impaired in RIF patients. Therefore, designing therapeutic methods for improving PR expression status and its regulation in the endometrium of RIF patients may help in improving the final reproductive outcomes of these cases.
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Affiliation(s)
- Hossein Hosseinirad
- Department of Biology and Anatomical Sciences, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Marefat Ghaffari Novin
- Department of Biology and Anatomical Sciences, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Sedighe Hosseini
- Preventative Gynecology Research Center (PGRC), Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hamid Nazarian
- Department of Biology and Anatomical Sciences, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Zahra Safaei
- Department of Anatomical Sciences, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Teibeh Hashemi
- Preventative Gynecology Research Center (PGRC), Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Shahrokh Paktinat
- Department of Biology and Anatomical Sciences, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Zahra Shams Mofarahe
- Department of Biology and Anatomical Sciences, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
- Cellular and Molecular Biology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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16
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Doryanizadeh L, Morshed-Behbahani B, Parsanezhad ME, Dabbaghmanesh MH, Jokar A. Calcitriol Effect on Outcomes of in Vitro Fertilization in Infertile Women with Vitamin D Deficiency: A Double-Blind Randomized Clinical Trial. Z Geburtshilfe Neonatol 2020; 225:226-231. [PMID: 32927487 DOI: 10.1055/a-1206-1064] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
INTRODUCTION Recent studies have addressed the role of micronutrients in fertilization, such as vitamin D. The present study aims to explore the effects of using calcitriol, an active form of vitamin D, on IVF results in women with vitamin D deficiency. METHOD This double-blinded randomized clinical trial was done on 180 infertile women, undergone IVF treatment. Out of them, 95 were found to have vitamin D deficiency (blood serum 25-dihydroxy vitamin D <30 ng/ml). Fifty one women in experimental group were treated with two 0.25 µg calcitriol pills daily during 4 weeks (discontinued 8 hours prior to the embryo transfer) and 44 subjects to the placebo group (mean vitamin D deficiency 27.5 ±1.8 in case group vs. 27.6±1.8 in control group, P>0.05). Final analysis includes outcomes of chemical and clinical pregnancy was done on 74 women (including 36 in case and 38 in control group). RESULTS Our study showed that in the experimental group, chemical pregnancy success was significantly higher than that in the control group, 31.4 vs. 18.2% (P<0.05). However, there were no significant differences between the 2 groups in reaching the clinical pregnancy stage (25.5% in case group vs. 13.6% in control group) and continuation of pregnancy into week 20 (9.8% in case group vs. 11.6% in control group) (P>0.05). CONCLUSION Calcitriol administration by improving the implantation process can significantly increase the chances of successful IVF cycle results in infertile women with vitamin D deficiency.
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Affiliation(s)
- Leila Doryanizadeh
- Department of Midwifery, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran (the Islamic Republic of)
| | - Bahar Morshed-Behbahani
- Department of Midwifery, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran (the Islamic Republic of)
| | - Mohammad Ebrahim Parsanezhad
- Department of Gynecology and Obstetrics, Medical School, Shiraz University of Medical Sciences, Shiraz, Iran (the Islamic Republic of)
| | | | - Azam Jokar
- Department of Midwifery, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran (the Islamic Republic of)
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The Efficacy of Traditional Chinese Medicine Shoutai Pill Combined with Western Medicine in the First Trimester of Pregnancy in Women with Unexplained Recurrent Spontaneous Abortion: A Systematic Review and Meta-Analysis. BIOMED RESEARCH INTERNATIONAL 2020; 2020:7495161. [PMID: 32851085 PMCID: PMC7436282 DOI: 10.1155/2020/7495161] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Accepted: 07/16/2020] [Indexed: 02/06/2023]
Abstract
Background Shoutai Pill (STP), a famous classic herbal formula documented in traditional Chinese medicine (TCM), is widely available in China for treating unexplained recurrent spontaneous abortion (URSA). This systematic review and meta-analysis aims at evaluating the efficacy and safety of STP in the first trimester of pregnancy in women with a history of unexplained recurrent spontaneous abortion. Methods The following eight databases were searched from their establishment to Dec 31, 2019, for randomized controlled trials (RCTs): PubMed, Embase, Cochrane Library, Web of Science, China National Knowledge Infrastructure (CNKI), the Chinese BioMedical database (CBM), Chinese Scientific Journal Database (VIP), and the Wanfang database. The quality of evidence was estimated by the Grading of Recommendations Assessment, Development, and Evaluation (GRADE). Results A total of 12 studies (916 patients) with URSA were contained in this meta-analysis. The forest plot showed that patients treated with Shoutai Pill and western medicine had a significantly lower incidence of early pregnancy loss (RR: 0.42; 95% CI: 0.34–0.52; P < 0.01, I2 = 0%). Subgroup analysis revealed that different types of TCM syndrome differentiation had the similar results. Also, in the combined group, patients had a lower TCM syndromes and symptoms and serum D-dimer level, while higher incidence of live birth. Conclusions Our findings suggest that cotreatment with STP and western medicine might be superior to western medicine alone in the first trimester of pregnancy to prevent miscarriage in women with unexplained recurrent spontaneous abortion, and there was no adverse event in the experimental group reported. However, the methodological quality of included RCTs was unsatisfactory; it is necessary to verify its effectiveness with further more standardized researches of rigorous design.
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Immunomodulatory effects of vitamin D3 on gene expression of MDGF, EGF and PDGFB in endometriosis. Reprod Biomed Online 2020; 41:782-789. [PMID: 32883565 DOI: 10.1016/j.rbmo.2020.05.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Revised: 05/20/2020] [Accepted: 05/20/2020] [Indexed: 11/20/2022]
Abstract
RESEARCH QUESTION Endometriosis, an inflammatory disease, is assumed to be associated with an increased production of growth-related cytokines. Based on the emerging immunomodulatory role of vitamin D3 in different inflammatory conditions, this study aimed to examine its modulatory effect on the expression levels of the genes for platelet-derived growth factor-B (PDGFB), monocyte/macrophage-derived growth factor (MDGF, also known as PPBP) and epidermal growth factor (EGF) in peritoneal fluid mononuclear cells (PFMC) in women with and without endometriosis. DESIGN PFMC from 10 women with endometriosis and 10 control participants were treated with vitamin D3.The gene expression levels of PDGFB, MDGF and EGF were measured 6, 24 and 48 h following vitamin D3 administration using real-time PCR. RESULTS Gene expression levels of EGF and PDGFB were higher in the PFMC of women with endometriosis than the control group (P = 0.006, P < 0.001, respectively). Although MDGF expression showed an increase in the endometriosis group compared with non-endometriotic controls, no significant difference was found. Vitamin D3 significantly decreased EGF expression at 6, 24 and 48 h (P < 0.001, P < 0.001 and P = 0.007, respectively), MDGF at 24 and 48 h (P < 0.001 and P = 0.009, respectively) and PDGFB at 6 h (P = 0.047) in the endometriosis group. Vitamin D3 treatment had no significant effect on expression of the genes in the PFMC of non-endometriotic women. CONCLUSIONS The study concluded that PDGFB and EGF gene expression increases in endometriosis, and vitamin D3 could markedly decrease this expression, suggesting its therapeutic potential in endometriosis.
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Vitamin D Effects on the Immune System from Periconception through Pregnancy. Nutrients 2020; 12:nu12051432. [PMID: 32429162 PMCID: PMC7284509 DOI: 10.3390/nu12051432] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Revised: 05/05/2020] [Accepted: 05/11/2020] [Indexed: 12/17/2022] Open
Abstract
Vitamin D is a well-known secosteroid and guardian of bone health and calcium homeostasis. Studies on its role in immunomodulatory functions have expanded its field in recent years. In addition to its impact on human physiology, vitamin D influences the differentiation and proliferation of immune system modulators, interleukin expression and antimicrobial responses. Furthermore, it has been shown that vitamin D is synthesized in female reproductive tissues and, by modulating the immune system, affects the periconception period and reproductive outcomes. B cells, T cells, macrophages and dendritic cells can all synthesize active vitamin D and are involved in processes which occur from fertilization, implantation and maintenance of pregnancy. Components of vitamin D synthesis are expressed in the ovary, decidua, endometrium and placenta. An inadequate vitamin D level has been associated with recurrent implantation failure and pregnancy loss and is associated with pregnancy-related disorders like preeclampsia. This paper reviews the most important data on immunomodulatory vitamin D effects in relation to the immune system from periconception to pregnancy and provides an insight into the possible consequences of vitamin D deficiency before and during pregnancy.
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Wang F, Chang HM, Yi Y, Lin YM, Li H, Leung PCK. TGF-β1 promotes vitamin D-induced prostaglandin E2 synthesis by upregulating vitamin D receptor expression in human granulosa-lutein cells. Am J Physiol Endocrinol Metab 2020; 318:E710-E722. [PMID: 31961707 DOI: 10.1152/ajpendo.00361.2019] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
There is increasing evidence showing the importance of vitamin D (Vit D) and its nuclear receptor, the Vit D receptor (VDR), in female reproductive health. Transforming growth factor-β1 (TGF-β1) and its functional receptors are expressed in human oocytes and granulosa cells that participate in follicular development and ovulation. Recently, Sma- and Mad-related protein 3 (SMAD3; a downstream effector of TGF-β1) has been proposed to mediate crosstalk between the Vit D and TGF-β1 signaling pathways, but this relationship has not been fully explored and has yet to be tested in human granulosa-lutein (hGL) cells. In this study, we showed that TGF-β1 significantly promoted the expression of VDR, and this stimulatory effect occurred through the activin receptor-like kinase 5 type I receptor-mediated SMAD3 and ERK1/2 signaling pathways in hGL cells. Additionally, we showed that Vit D increased the expression of cyclooxygenase 2 (COX-2) and the synthesis of prostaglandin E2 (PGE2) in a time- and dose-dependent manner. Furthermore, we demonstrated a synergistic effect of TGF-β1 and Vit D on the expression of COX-2 and synthesis of PGE2, and this effect could be attenuated by silencing the expression of VDR. Our findings indicate that TGF-β1 upregulates the expression of VDR, which promotes Vit D-induced COX-2 expression and subsequent PGE2 production by activating the SMAD3 and ERK1/2 signaling pathways in hGL cells.
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Affiliation(s)
- Fuxin Wang
- Center of Reproduction and Genetics, Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Suzhou, China
- Department of Obstetrics and Gynaecology, BC Children's Hospital Research Institute, University of British Columbia, Vancouver, British Columbia, Canada
| | - Hsun-Ming Chang
- Department of Obstetrics and Gynaecology, BC Children's Hospital Research Institute, University of British Columbia, Vancouver, British Columbia, Canada
| | - Yuyin Yi
- Department of Obstetrics and Gynaecology, BC Children's Hospital Research Institute, University of British Columbia, Vancouver, British Columbia, Canada
| | - Yung-Ming Lin
- Department of Obstetrics and Gynaecology, BC Children's Hospital Research Institute, University of British Columbia, Vancouver, British Columbia, Canada
| | - Hong Li
- Center of Reproduction and Genetics, Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Suzhou, China
| | - Peter C K Leung
- Department of Obstetrics and Gynaecology, BC Children's Hospital Research Institute, University of British Columbia, Vancouver, British Columbia, Canada
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Effect of 1,25(OH)2-vitamin D3 on expression and phosphorylation of progesterone receptor in cultured endometrial stromal cells of patients with repeated implantation failure. Acta Histochem 2020; 122:151489. [PMID: 31879032 DOI: 10.1016/j.acthis.2019.151489] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2019] [Revised: 12/08/2019] [Accepted: 12/10/2019] [Indexed: 12/12/2022]
Abstract
Repeated implantation failure (RIF) occurs in a condition when good quality embryos fail to implant in the endometrium following several in vitro fertilization (IVF) cycles. Suboptimal endometrial receptivity is one of the main underlying factors that causes this failure. Progesterone is the key regulator of endometrial receptivity which regulates gene expression through binding to its receptors in the endometrial stromal cells (eSC). The aim of this study was to evaluate the effect of 1,25(OH)2-vitamin D3 on progesterone receptor (PR) expression level and its phosphorylation on Ser294 residues in eSC of RIF patients and healthy fertile women. After isolation of the eSC from biopsy samples of RIF patients and healthy fertile women and their characterization, the cells were incubated with vitamin D3 and the expression level of PR mRNA, PR protein and phospho-Ser294 PR protein were evaluated after treatment. The results showed that vitamin D3 treatment increases PR mRNA and protein level and phospho-Ser294 PR protein level in the isolated eSC of both RIF patients and the control group. These results suggest that vitamin D3 may possibly play a key role during the embryo implantation process by affecting the expression pattern and regulatory modifications of the PR in the eSC.
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Karamian A, Nazarian H, Ziai SA, Zarnani AH, Salehpour S, Paktinat S, Novin MG. Pyrvinium pamoate inhibits proliferation and invasion of human endometriotic stromal cells. Hum Exp Toxicol 2019; 39:662-672. [DOI: 10.1177/0960327119896612] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Endometriosis is characterized by the presence of functional endometrial tissue in other pelvic organs. This gynecologic problem occurs in 35–50% of women with pain and infertility. Endometriotic cells share some characteristics such as proliferation, migration, and invasion with tumor cells. Pyrvinium pamoate, an anthelmintic drug approved by the Food and Drug Administration, could inhibit the Wnt/β-catenin signaling pathway and its anticancer effects were examined by several researchers. In this study, 12 ectopic and eutopic endometrial biopsies from females with ovarian endometrioma and 12 endometrial biopsies from nonendometriotic females were obtained. Ectopic (EESCs), eutopic (EuESCs), and control (CESCs) endometrial stromal cells were isolated. Then, the effect of pyrvinium pamoate on the proliferation and invasiveness of in vitro cultured cells was evaluated. The proliferation of CESCs, EuESCs, and EESCs was significantly decreased after treatment with pyrvinium pamoate. In addition, treatment with pyrvinium pamoate significantly inhibited the invasiveness of CESCs, EuESCs, and EESCs compared to nontreated groups. The results of the present research showed that pyrvinium pamoate inhibits the proliferation and invasion of human endometriotic stromal cells in vitro, further investigations on the therapeutic potential of this compound in endometriosis are required.
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Affiliation(s)
- A Karamian
- Department of Biology and Anatomical Sciences, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - H Nazarian
- Department of Biology and Anatomical Sciences, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Men’s Health and Reproductive Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - SA Ziai
- Department of Pharmacology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - A-H Zarnani
- Reproductive Immunology Research Center, Avicenna Research Institute, ACECR, Tehran, Iran
| | - S Salehpour
- Department of Obstetrics and Gynecology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - S Paktinat
- Department of Biology and Anatomical Sciences, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Men’s Health and Reproductive Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - MG Novin
- Department of Biology and Anatomical Sciences, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Men’s Health and Reproductive Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Moghbeli M. Genetics of recurrent pregnancy loss among Iranian population. Mol Genet Genomic Med 2019; 7:e891. [PMID: 31364314 PMCID: PMC6732315 DOI: 10.1002/mgg3.891] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Revised: 07/08/2019] [Accepted: 07/15/2019] [Indexed: 01/15/2023] Open
Abstract
Background Recurrent pregnancy loss (RPL) is one of the most common reproductive disorders which is defined as the occurrence of recurrent miscarriage before 24 weeks of gestation and is observed among 1%–5% of women. Methods Various factors are associated with RPL such as immunological disorders, maternal age, obesity, alcohol, chromosomal abnormality, endocrine disorders, and uterine abnormalities. About half of the RPL cases are related with chromosomal abnormalities. Therefore, RPL genetic tests are mainly limited to karyotyping. However, there is a significant proportion of RPL cases without any chromosomal abnormalities that can be related to the single‐gene aberrations. Therefore, it is required to prepare a diagnostic panel of genetic markers besides karyotyping. Results In the present review, we have summarized all the significant reported genes until now which are associated with RPL among Iranian women. We categorized all the reported genes based on their cellular and molecular functions in order to determine the molecular bases of RPL in this population. Conclusion This review paves the way of introducing a population‐based diagnostic panel of genetic markers for the first time among Iranian RPL cases. Moreover, this review clarifies the genetic and molecular bases of RPL in this population.
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Affiliation(s)
- Meysam Moghbeli
- Medical Genetics Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
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24
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Gonçalves DR, Braga A, Braga J, Marinho A. Recurrent pregnancy loss and vitamin D: A review of the literature. Am J Reprod Immunol 2018; 80:e13022. [PMID: 30051540 DOI: 10.1111/aji.13022] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Accepted: 06/20/2018] [Indexed: 12/18/2022] Open
Abstract
Recurrent pregnancy loss (RPL) affects approximately 1%-2% of reproductive women. Auto- and cellular immune responses seem to be associated with RPL. Vitamin D (VD) has been shown to play a role in the modulation of the immune system. Effects of VD deficiency (VDD) in pregnancy have been associated with preeclampsia, gestational diabetes, fetal growth restriction, preterm labor, and sporadic spontaneous abortion (SA). We systematically reviewed articles that studied women with 2 or more SA and its association with VD. Eleven studies were included. Studies reported a high prevalence of VD insufficiency (VDI) or VDD in women with RPL and suggested that this could be associated with immunological dysregulation and consequently with RPL. Immunological benefits were reported in the peripheral blood of women with RPL after VD exposure. Thus, it is possible to speculate a beneficial role for VD supplementation in RPL. It seems that there are not differences in the vitamin D receptor (VDR) and CYP27B1 expression in endometrium of women with RPL but, in villous and decidual tissues, RPL women seem to have a decreased expression of VDR and, perhaps, a decreased expression of CYP27B1. Further randomized controlled studies are required to investigate the association between VDD or VDI and RPL.
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Affiliation(s)
| | - António Braga
- Department of Obstetrics and Gynecology, Centro Hospitalar do Porto, Porto, Portugal
| | - Jorge Braga
- Department of Obstetrics and Gynecology, Centro Hospitalar do Porto, Porto, Portugal
| | - António Marinho
- UMIB, Instituto de Ciências Biomédicas de Abel Salazar (ICBAS), Universidade do Porto, Porto, Portugal.,Clinical Immunology Unit, Centro Hospitalar do Porto, Porto, Portugal
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Ikemoto Y, Kuroda K, Nakagawa K, Ochiai A, Ozaki R, Murakami K, Jinushi M, Matsumoto A, Sugiyama R, Takeda S. Vitamin D Regulates Maternal T-Helper Cytokine Production in Infertile Women. Nutrients 2018; 10:nu10070902. [PMID: 30011861 PMCID: PMC6073370 DOI: 10.3390/nu10070902] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2018] [Revised: 07/02/2018] [Accepted: 07/10/2018] [Indexed: 12/31/2022] Open
Abstract
Vitamin D (VD) deficiency is associated with reproductive failure. However, the relationship between VD and maternal immunity remains unclear. We investigated the clinical efficacy of VD in maternal T-helper (Th) cytokines in 276 infertile women and examined for Th1 and Th2 cells based on the deficient, insufficient, and sufficient serum 25-hydroxyvitamin D3 (25[OH]VD) levels (<12, 12–30, and >30 ng/mL, respectively). Most infertile women had a low-level of VD (87.3%). Immunological tests of pre-/post-VD supplementation were performed in patients who were deficient and insufficient in VD. Of 23 patients, 11 (47.8%) exhibited sufficient VD levels after supplementation. Th1/Th2 cell ratio in patients with insufficient VD was significantly decreased after supplementation (p = 0.004). After supplementation, serum 25(OH)VD levels of the patients: 11 in the sufficient group showed significant decreases in Th1 cell level and Th1/Th2 cell ratio (p = 0.032 and 0.010, respectively), whereas no significant differences in Th1/Th2 cell ratio were recognized in the insufficient group. Furthermore, mid-luteal endometrial biopsies (n = 18) were processed for primary cultures and measured interferon [IFN]-γ and interleukin [IL]-4 in condition media. Decidualizing cultures with 1,25-dihydroxvitamin D3 (1,25[OH]2VD) decreased IFN-γ. Sufficient VD supplementation in women with insufficient VD may optimize maternal T-helper cytokines during pregnancy via rebalancing the Th1/Th2 cell ratio.
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Affiliation(s)
- Yuko Ikemoto
- Department of Obstetrics and Gynecology, Juntendo University, Faculty of Medicine, Tokyo 1138421, Japan.
| | - Keiji Kuroda
- Department of Obstetrics and Gynecology, Juntendo University, Faculty of Medicine, Tokyo 1138421, Japan.
- Center for Reproductive Medicine and Implantation Research, Sugiyama Clinic Shinjuku, Tokyo 1160023, Japan.
| | - Koji Nakagawa
- Center for Reproductive Medicine and Implantation Research, Sugiyama Clinic Shinjuku, Tokyo 1160023, Japan.
| | - Asako Ochiai
- Department of Obstetrics and Gynecology, Juntendo University, Faculty of Medicine, Tokyo 1138421, Japan.
| | - Rie Ozaki
- Department of Obstetrics and Gynecology, Juntendo University, Faculty of Medicine, Tokyo 1138421, Japan.
| | - Keisuke Murakami
- Department of Obstetrics and Gynecology, Juntendo University, Faculty of Medicine, Tokyo 1138421, Japan.
| | - Makoto Jinushi
- Department of Obstetrics and Gynecology, Juntendo University, Faculty of Medicine, Tokyo 1138421, Japan.
| | - Akemi Matsumoto
- Department of Obstetrics and Gynecology, Juntendo University, Faculty of Medicine, Tokyo 1138421, Japan.
| | - Rikikazu Sugiyama
- Center for Reproductive Medicine and Implantation Research, Sugiyama Clinic Shinjuku, Tokyo 1160023, Japan.
| | - Satoru Takeda
- Department of Obstetrics and Gynecology, Juntendo University, Faculty of Medicine, Tokyo 1138421, Japan.
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26
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Sharif K, Sharif Y, Watad A, Yavne Y, Lichtbroun B, Bragazzi NL, Amital H, Shoenfeld Y. Vitamin D, autoimmunity and recurrent pregnancy loss: More than an association. Am J Reprod Immunol 2018; 80:e12991. [PMID: 29923244 DOI: 10.1111/aji.12991] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2018] [Accepted: 05/16/2018] [Indexed: 12/15/2022] Open
Abstract
Recurrent pregnancy loss (RPL) affects close to 1% of couples; however, the etiology is known in only about 50% of the cases. Recent studies show that autoimmune dysregulation is a probable cause of RPL, which in some cases may be overlooked. In order for a pregnancy to proceed to term, early modulation of immunologic response is required to induce tolerance to the semi-allogenic fetus. Certain subsets of both the innate and adaptive immune responses play a role in the induction of fetomaternal tolerance. A relatively predominant T-cell helper (Th) 2 and T regulatory (Treg) cell population seem to favor a better pregnancy outcome, whereas Th1 and Th17 cell populations appear to have an opposite effect. Lately, the role of vitamin D in the modulation of immune response was established. Vitamin D has been shown to promote a more favorable environment for pregnancy through various mechanisms, such as enhancement of the shift toward Th2 cells and regulation of immune cell differentiation and cytokine secretion. Therefore, it seems that vitamin D deficiency sways the balance toward a worse outcome and may play a part in recurrent pregnancy loss. This review sheds light on the immunologic changes, which occur in early pregnancy and the regulatory role vitamin D has in the maintenance of this delicate balance.
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Affiliation(s)
- Kassem Sharif
- Department of Medicine 'B', Sheba Medical Center, Tel-Hashomer, Israel.,Zabludowicz center for Autoimmune Diseases, Sheba Medical Center, Tel-Hashomer, Israel.,Sackler Faculty of Medicine, Tel-Aviv University, Tel-Hashomer, Israel
| | - Yousra Sharif
- Sackler Faculty of Medicine, Tel-Aviv University, Tel-Hashomer, Israel
| | - Abdulla Watad
- Department of Medicine 'B', Sheba Medical Center, Tel-Hashomer, Israel.,Zabludowicz center for Autoimmune Diseases, Sheba Medical Center, Tel-Hashomer, Israel.,Sackler Faculty of Medicine, Tel-Aviv University, Tel-Hashomer, Israel
| | - Yarden Yavne
- Department of Medicine 'B', Sheba Medical Center, Tel-Hashomer, Israel.,Zabludowicz center for Autoimmune Diseases, Sheba Medical Center, Tel-Hashomer, Israel.,Sackler Faculty of Medicine, Tel-Aviv University, Tel-Hashomer, Israel
| | - Benjamin Lichtbroun
- Department of Medicine, Rutgers-Robert Wood Johnson Medical School, Piscataway, New Jersey, USA
| | | | - Howard Amital
- Department of Medicine 'B', Sheba Medical Center, Tel-Hashomer, Israel.,Zabludowicz center for Autoimmune Diseases, Sheba Medical Center, Tel-Hashomer, Israel.,Sackler Faculty of Medicine, Tel-Aviv University, Tel-Hashomer, Israel
| | - Yehuda Shoenfeld
- Zabludowicz center for Autoimmune Diseases, Sheba Medical Center, Tel-Hashomer, Israel
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27
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Reduction of respiratory infections in asthma patients supplemented with vitamin D is related to increased serum IL-10 and IFNγ levels and cathelicidin expression. Cytokine 2018; 108:239-246. [PMID: 29402723 DOI: 10.1016/j.cyto.2018.01.001] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2017] [Revised: 11/24/2017] [Accepted: 01/02/2018] [Indexed: 02/07/2023]
Abstract
BACKGROUND Vitamin D is a molecule that modulates the immune response and shows anti-inflammatory effects that are beneficial for the control of chronic diseases such as asthma. The trial aim was to explore the effect of vitamin D supplementation on the colonization of pathogenic bacteria in the upper respiratory tract of allergic asthmatic patients. METHODS This study was conducted in 86 patients between 18 and 50 years of age who were randomly divided into two groups. Both groups received the treatment recommended by the Global Initiative for Asthma (GINA). One group also received calcitriol (1,25-(OH)2D3), and the other group received a placebo. At baseline and 6 months, skin prick tests were conducted, pharyngeal bacterial cultures were performed, and cathelicidin LL-37 was measured in sputum. Serum levels of IgE, eosinophils, IL-5, IL-9, IL-10, IL-13, and IFNγ were quantified at the beginning and the end of the study. RESULTS Serum levels of IL-10 and IFNγ increased significantly in the group of patients with vitamin D supplementation, while IL-5, IL-9, and IL-13 decreased significantly. At the end of the trial, IgE and eosinophil levels significantly decreased but allergen sensitivity did not show any changes from baseline. Respiratory infections were drastically reduced, and this decrease was related to the number of patients who had high serum levels of IL-10 and IFNγ and expressed LL-37 in their sputum. CONCLUSION Treatment of asthma patients with vitamin D reduced respiratory infections, and this effect was related to the increase of cathelicidin LL-37.
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28
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Vitamin D deficiency and high serum IL-6 concentration as risk factors for tubal factor infertility in Chinese women. Nutrition 2018; 49:24-31. [DOI: 10.1016/j.nut.2017.11.016] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2017] [Revised: 11/21/2017] [Accepted: 11/27/2017] [Indexed: 12/11/2022]
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29
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Ganguly A, Tamblyn JA, Finn-Sell S, Chan SY, Westwood M, Gupta J, Kilby MD, Gross SR, Hewison M. Vitamin D, the placenta and early pregnancy: effects on trophoblast function. J Endocrinol 2018; 236:R93-R103. [PMID: 29109081 DOI: 10.1530/joe-17-0491] [Citation(s) in RCA: 57] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2017] [Accepted: 11/06/2017] [Indexed: 01/01/2023]
Abstract
Pregnancy is associated with significant changes in vitamin D metabolism, notably increased maternal serum levels of active vitamin D, 1,25-dihydroxyvitamin (1,25(OH)2D). This appears to be due primarily to increased renal activity of the enzyme 25-hydroxyvitamin D-1α-hydroxylase (CYP27B1) that catalyzes synthesis of 1,25(OH)2D, but CYP27B1 expression is also prominent in both the maternal decidua and fetal trophoblast components of the placenta. The precise function of placental synthesis of 1,25(OH)2D remains unclear, but is likely to involve localized tissue-specific responses with both decidua and trophoblast also expressing the vitamin D receptor (VDR) for 1,25(OH)2D. We have previously described immunomodulatory responses to 1,25(OH)2D by diverse populations of VDR-expressing cells within the decidua. The aim of the current review is to detail the role of vitamin D in pregnancy from a trophoblast perspective, with particular emphasis on the potential role of 1,25(OH)2D as a regulator of trophoblast invasion in early pregnancy. Vitamin D deficiency is common in pregnant women, and a wide range of studies have linked low vitamin D status to adverse events in pregnancy. To date, most of these studies have focused on adverse events later in pregnancy, but the current review will explore the potential impact of vitamin D on early pregnancy, and how this may influence implantation and miscarriage.
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Affiliation(s)
- Ankana Ganguly
- Institute of Metabolism and Systems ResearchThe University of Birmingham, Birmingham, UK
| | - Jennifer A Tamblyn
- Institute of Metabolism and Systems ResearchThe University of Birmingham, Birmingham, UK
- Fetal Medicine CentreBirmingham Women's NHS Foundation Trust, Birmingham, UK
- CEDAMBirmingham Health Partners, The University of Birmingham, Birmingham, UK
| | - Sarah Finn-Sell
- Division of Developmental Biology and MedicineMaternal and Fetal Health Research Centre, School of Medicine, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
| | - Shiao-Y Chan
- Department of Obstetrics and GynaecologyYong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Melissa Westwood
- Division of Developmental Biology and MedicineMaternal and Fetal Health Research Centre, School of Medicine, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
| | - Janesh Gupta
- Institute of Metabolism and Systems ResearchThe University of Birmingham, Birmingham, UK
- Fetal Medicine CentreBirmingham Women's NHS Foundation Trust, Birmingham, UK
| | - Mark D Kilby
- Institute of Metabolism and Systems ResearchThe University of Birmingham, Birmingham, UK
- Fetal Medicine CentreBirmingham Women's NHS Foundation Trust, Birmingham, UK
| | - Stephane R Gross
- School of Life and Health SciencesAston University, Birmingham, UK
| | - Martin Hewison
- Institute of Metabolism and Systems ResearchThe University of Birmingham, Birmingham, UK
- CEDAMBirmingham Health Partners, The University of Birmingham, Birmingham, UK
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30
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Ji JL, Muyayalo KP, Zhang YH, Hu XH, Liao AH. Immunological function of vitamin D during human pregnancy. Am J Reprod Immunol 2017; 78. [PMID: 28585734 DOI: 10.1111/aji.12716] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2017] [Accepted: 05/04/2017] [Indexed: 12/21/2022] Open
Abstract
The well-established classic role of vitamin D is implicated in the regulation of the balance between calcium and phosphorus. Furthermore, vitamin D is also involved in many non-classic physiological processes, mainly including the regulation of cell proliferation, differentiation, apoptosis and immune function, participation in the inflammatory response and maintenance of genome stability function. During pregnancy, vitamin D receptor and its metabolic enzymes are expressed at the placenta and decidua, indicating the potential role in the mechanism of immunomodulation at the maternal-fetal interface. The insufficiency or deficiency of vitamin D may affect the mother directly and is related to specific pregnancy outcomes, such as preeclampsia, gestational diabetes, and recurrent miscarriage. This article reviews the effects of vitamin D on immune regulation during pregnancy.
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Affiliation(s)
- Jin-Lu Ji
- Family Planning Research Institute, Center for Reproductive Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Kahinho P Muyayalo
- Family Planning Research Institute, Center for Reproductive Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yong-Hong Zhang
- Family Planning Research Institute, Center for Reproductive Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xiao-Hui Hu
- Family Planning Research Institute, Center for Reproductive Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Ai-Hua Liao
- Family Planning Research Institute, Center for Reproductive Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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31
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Wang LQ, Yan XT, Yan CF, Zhang XW, Hui LY, Xue M, Yu XW. Women with Recurrent Miscarriage Have Decreased Expression of 25-Hydroxyvitamin D3-1α-Hydroxylase by the Fetal-Maternal Interface. PLoS One 2016; 11:e0165589. [PMID: 28033387 PMCID: PMC5199009 DOI: 10.1371/journal.pone.0165589] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2016] [Accepted: 10/16/2016] [Indexed: 12/31/2022] Open
Abstract
Background Effects of vitamin D deficiency in pregnancy have been associated with some adverse pregnancy outcomes. The 25-hydroxyvitamin D3-1α-hydroxylase (CYP27B1) is integral to the vitamin D metabolic pathway. The enzyme catalyzes localized conversion of pro-hormone 25-hydroxyvitamin D3 to active 1,25-dihydroxyvitamin D3. Our aim was to investigate the expression of CYP27B1 at the fetal-maternal interface in the first trimester pregnancy and to determine whether CYP27B1 was associated with recurrent miscarriage (RM). Methods Expressions of CYP27B1 mRNA and protein in villi and decidua from 20 women undergoing primary miscarriage, 20 women with RM and 20 women with normal pregnancy were evaluated by western blot, and quantitative real-time PCR. The co-localization of CYP27B1 and certain cytokines including IL-10, IFN-γ, TNF-α, and IL-2 expression were examined using immunohistochemistry and confocal microscopy. Results Women with RM had a significantly lower expression of CYP27B1 mRNA and protein in villous and decidual tissues compared with the normal pregnant women (P = 0.000 in villus, P = 0.002 in decidua for mRNA; P = 0.036 in villus, P = 0.007 in decidua for protein.). Compared with the normal pregnancy, immunostaining for CYP27B1 was significantly decreased in villous trophoblasts and decidual glandular epithelial cells in RM women. No significant differences in the localization of CYP27B1, IL-10, IFN-γ, TNF-α, and IL-2 expression were identified between the normal pregnant and RM women. Conclusions Women with RM have a lower level of CYP27B1 expression in chorionic villi and decidua compared with normal pregnant women, suggesting that reduced CYP27B1 expression may be associated with RM. The consistent localization of CYP27B1 and IL-10, IFN-γ, TNF-α, and IL-2 expression in villous and decidual tissues suggests the importance of the local production of 1,25(OH)2D3 at the fetal-maternal interface to regulate cytokine responses.
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Affiliation(s)
- Li-qin Wang
- Department of Obstetrics and Gynecology in First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
- Nursing Department in Xi’an Medical College, Xi’an, China
| | - Xiao-ting Yan
- Department of Obstetrics and Gynecology in First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Chun-fang Yan
- Reproductive Center in Fourth Hospital of Xi'an, Xi’an, China
| | - Xin-wen Zhang
- Department of Obstetrics and Gynecology in First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
- Reproductive Center in Fourth Hospital of Xi'an, Xi’an, China
| | - Ling-yun Hui
- Laboratory Department in First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Mingzhan Xue
- Clinical Sciences Research Lab, Translational Medicine Section, Division of Biomedical Sciences, Warwick Medical School, University of Warwick, University Hospital, Coventry, United Kingdom
| | - Xue-wen Yu
- Department of Obstetrics and Gynecology in First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
- * E-mail:
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32
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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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33
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Yan X, Wang L, Yan C, Zhang X, Hui L, Sheng Q, Xue M, Yu X. Decreased expression of the vitamin D receptor in women with recurrent pregnancy loss. Arch Biochem Biophys 2016; 606:128-33. [PMID: 27477959 DOI: 10.1016/j.abb.2016.07.021] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2016] [Revised: 07/25/2016] [Accepted: 07/27/2016] [Indexed: 12/31/2022]
Abstract
The multiple functions of vitamin D3 have stimulated interest in the role that this vitamin may play during pregnancy. The present study investigated the expression of the vitamin D receptor (VDR) in women during the first trimester of pregnancy in order to determine whether VDR is associated with recurrent pregnancy loss (RPL). Forty women at 7-10 weeks gestation with RPL and 40 women of similar gestational age with a healthy pregnancy were recruited. VDR mRNA and protein in chorionic villi and decidua were evaluated by immunohistochemistry, confocal laser scanning microscopy (CLSM), western blot, and quantitative real-time polymerase chain reaction. The serum levels of VDR were measured by an enzyme-linked immunosorbent assay. Women with RPL had a significantly weaker expression of VDR mRNA in villi and decidual tissues compared with the control women (both p < 0.0001). Western blot analysis showed an approximately 46% decrease in VDR expression in villi and a 52% decrease in decidua in the RPL vs. the controls. Serum VDR levels were also significantly lower in the RPL group than in the control group (p = 0.003). Compared with the controls, immunohistochemical and CLSM analysis revealed significantly lower VDR expression in villous cytotrophoblasts and stromal cells, as well as in decidual glandular epithelial and stromal cells (all p < 0.05). In conclusion, these observations show that women with RPL have lower levels of VDR expression in chorionic villi, decidua and serum compared with normal pregnant women, suggesting that decreased VDR expression in the first trimester pregnancy may be associated with RPL.
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Affiliation(s)
- Xiaoting Yan
- Department of Obestetrics and Gynecology in First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, China
| | - Liqin Wang
- Nursing Department in Xi'an Medical College, Xi'an, 710021, China
| | - Chunfang Yan
- Center of Reproduction Medicine in Fourth Hospital of Xi'an City, Xi'an, 710004, China
| | - Xinwen Zhang
- Department of Obestetrics and Gynecology in First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, China; Center of Reproduction Medicine in Fourth Hospital of Xi'an City, Xi'an, 710004, China
| | - Lingyun Hui
- Laboratory Department in First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, China
| | - Qiu Sheng
- Department of Obestetrics and Gynecology in First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, China
| | - Mingzhan Xue
- Clinical Sciences Research Lab, Warwick Medical School, University of Warwick, University Hospital, Coventry, CV2 2DX, UK
| | - Xuewen Yu
- Department of Obestetrics and Gynecology in First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, China.
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Goyal R, Billings TL, Mansour T, Martin C, Baylink DJ, Longo LD, Pearce WJ, Mata-Greenwood E. Vitamin D status and metabolism in an ovine pregnancy model: effect of long-term, high-altitude hypoxia. Am J Physiol Endocrinol Metab 2016; 310:E1062-71. [PMID: 27143557 PMCID: PMC4935137 DOI: 10.1152/ajpendo.00494.2015] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2015] [Accepted: 04/25/2016] [Indexed: 12/15/2022]
Abstract
Vitamin D status increases during healthy mammalian pregnancy, but the molecular determinants remain uncharacterized. The first objective of this study was to determine the effects of pregnancy, and the second objective was to examine the role of chronic hypoxia on vitamin D status and metabolism in an ovine model. We analyzed the plasma levels of cholecalciferol, 25-OH-D, and 1α,25-(OH)2D in nonpregnant ewes, near-term pregnant ewes, and their fetuses exposed to normoxia (low altitude) or hypoxia (high-altitude) for 100 days. Hypoxic sheep had increased circulating levels of 25-OH-D and 1α,25-(OH)2D compared with normoxic sheep. Hypoxia increases in 25-OH-D were associated with increased expression of renal 25-hydroxylases CYP2R1 and CYP2J. Pregnancy did not increase further the plasma levels of 25-OH-D, but it significantly increased those of the active metabolite, 1α,25-(OH)2D, in both normoxic and hypoxic ewes. Increased bioactivation of vitamin D correlated with increased expression of the vitamin D-activating enzyme CYP27b1 and decreased expression of the inactivating enzyme CYP24a1 in maternal kidneys and placentas. Hypoxia increased parathyroid hormone levels and further increased renal CYP27b1. Pregnancy and hypoxia decreased the expression of vitamin D receptor (VDR) in maternal kidney and lung, with opposite effects on placental VDR. We conclude that ovine pregnancy is a model of increased vitamin D status, and long-term hypoxia further improves vitamin D status due to pregnancy- and hypoxia-specific regulation of VDR and metabolic enzymes.
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Affiliation(s)
| | | | | | | | - David J Baylink
- Department of Medicine, School of Medicine, Loma Linda University, Loma Linda, California
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Hou W, Yan XT, Bai CM, Zhang XW, Hui LY, Yu XW. Decreased serum vitamin D levels in early spontaneous pregnancy loss. Eur J Clin Nutr 2016; 70:1004-8. [PMID: 27222154 PMCID: PMC5023787 DOI: 10.1038/ejcn.2016.83] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2015] [Revised: 03/21/2016] [Accepted: 04/18/2016] [Indexed: 01/03/2023]
Abstract
Background/Objectives: Effects of vitamin D deficiency in pregnancy have been associated with some adverse pregnancy outcomes. The objective of this study was to analyze the relationship between vitamin D deficiency in childbearing aged women and pregnancy loss (PL) in the first trimester. Subjects/Methods: This is a cross-sectional study. Plasma was collected from 60 nulliparous women with singleton at 7–9 weeks of gestation (30 with viable gestation and 30 with PL) and 60 non-gravid childbearing aged women (30 with a successful pregnancy history, and 30 with one or more spontaneous first-trimester PL history). Quantitation of serum 25-hydroxyvitamin D (25(OH)D) and 25-hydroxyvitamin D-1 alpha hydroxylase (CYP27B1) was assayed. Results: By pregnancy/non-gravid, normal pregnant women had higher 25(OH)D (49.32 μg/l) and CYP27B1 (82.00 pg/ml) than PL women (34.49 μg/l and 37.87 pg/ml, both P<0.01); the non-gravid women with a successful pregnancy history also had higher 25(OH)D (39.56 μg/l) and CYP27B1 (39.04 pg/ml) than women with PL history (12.30 μg/l and 12.35 pg/ml, both P<0.01). The 96.7% of non-gravid women with PL history and 43.3% of PL women had serum 25(OH)D concentrations below 30 μg/l. There was a strong association between low vitamin D levels and PL (odds ratio 1.71; 95% confidence interval: 1.2–2.4, P<0.001). The regression analyses showed that PL was significantly inversely correlated with 25(OH)D (P<0.01) and CYP27B1 levels (P<0.01). Conclusions: Vitamin D deficiency associated with PL in the first trimester of pregnancy. Decreased serum vitamin D levels among childbearing aged women with the failed clinical pregnancies history may predispose to increased risk for PL.
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Affiliation(s)
- W Hou
- Department of Obstetrics & Gynecology, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.,Department of Maternal Health Care, Maternal and Child Health Hospital of Shaanxi Province, Xi'an, China
| | - X-T Yan
- Department of Obstetrics & Gynecology, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - C-M Bai
- Department of Maternal Health Care, Maternal and Child Health Hospital of Shaanxi Province, Xi'an, China
| | - X-W Zhang
- Department of Obstetrics & Gynecology, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.,Department of Obstetrics & Gynecology, Fourth hospital of Xi'an City, Xi'an, China
| | - L-Y Hui
- Laboratory Department, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - X-W Yu
- Department of Obstetrics & Gynecology, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
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36
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Hosseini S, Shokri F, Ansari Pour S, Jeddi-Tehrani M, Nikoo S, Yousefi M, Zarnani AH. A shift in the balance of T17 and Treg cells in menstrual blood of women with unexplained recurrent spontaneous abortion. J Reprod Immunol 2016; 116:13-22. [PMID: 27128988 DOI: 10.1016/j.jri.2016.03.001] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2015] [Revised: 02/15/2016] [Accepted: 03/10/2016] [Indexed: 12/22/2022]
Abstract
To determine usefulness of menstrual blood for assessment of differential frequency of T cell subsets, peripheral blood (PB) and menstrual blood (MB) from healthy fertile (n=15), unexplained recurrent spontaneous abortion (URSA) women (n=15) and unexplained infertile women (n=8) were collected in the second day of menstrual bleeding. Frequency of T cell subsets was measured by flow cytometry. URSA and unexplained infertile patients had higher frequency of TCRαβ(+)CD3(+)CD56(-) and CD45RO(+) T cells as well as CD45RO(+)/CD45RO(-) ratio in PB as compared to MB. Frequency of CD3(+)TCRγδ(+) cells in PB of unexplained infertile and MB of URSA patients were significantly lower than that in fertile group. In all groups MB contained higher percentage of CD4(+)CD25(+)Foxp3(+) regulatory and lower percentages of CD16(+) T cells compared to PB. T17 cells (CD3(+)CD56(-)IL-17(+)) was found to be significantly higher in MB of only fertile and unexplained infertile subjects and not URSA patients in comparison with PB. Compared to PB, only fertile women had higher T17:Treg ratio in their MB. URSA women had significantly lower MB T17 cells and T17:Treg ratio compared to those in fertile and unexplained infertile women. Based on the findings presented here, we speculate that MB has its own unique immune milieu which is not solely continuation of the immune environment of secretory endometrium. Indeed, immunophenotyping of MB immune cells could potentially be a useful tool for investigation of immunological disturbances in pregnancy-related disorders.
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Affiliation(s)
- Samira Hosseini
- Department of Immunology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Fazel Shokri
- Department of Immunology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
| | - Soheila Ansari Pour
- Avicenna Infertility Clinic, Avicenna Research Institute, ACECR, Tehran, Iran
| | - Mahmood Jeddi-Tehrani
- Monoclonal Antibody Research Center, Avicenna Research Institute, ACECR, Tehran, Iran
| | - Shohreh Nikoo
- Reproductive Immunology Research Center, Avicenna Research Institute, ACECR, Tehran, Iran
| | - Mehdi Yousefi
- Immunology Research Center, Tabriz University of Medical Science, Tehran, Iran
| | - Amir-Hassan Zarnani
- Reproductive Immunology Research Center, Avicenna Research Institute, ACECR, Tehran, Iran; Immunology Research Center, Iran University of Medical Sciences, Tehran, Iran.
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37
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Guo J, Chen L, Luo N, Li C, Chen R, Qu X, Liu M, Kang L, Cheng Z. LPS/TLR4-mediated stromal cells acquire an invasive phenotype and are implicated in the pathogenesis of adenomyosis. Sci Rep 2016; 6:21416. [PMID: 26898650 PMCID: PMC4761971 DOI: 10.1038/srep21416] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2015] [Accepted: 01/20/2016] [Indexed: 12/25/2022] Open
Abstract
The present study tested whether the LPS/TLR4 signal pathway in endometrial stromal cells is essential for the pathogenesis of adenomyosis. We tested the expression of TLR4, MD2 in the endometrium without adenomyosis (CE), the eutopic endometrium with adenomyosis (EuE) and the ectopic endometrium with adenomyosis (EE). We isolated the stromal cells from CE, EuE and EE (CESC, EuESC, EESC), treated with lipopolysaccharide (LPS) and TLR4 antagonist and detected the cell viability. And we also measured the key protein of the TLR4 signal pathway and inflammatory proliferation and invasive growth of experimental cells. We found that the viability of experimental cells treated with LPS was significantly greater than that of the non-treated cells, blocked by the TLR4 antagonist VIPER. TLR4 signal pathway and inflammatory proliferation and invasive growth of experimental cells stimulated by LPS, and it was inhibited by VIPER. This study suggested that stromal cells were activated by the TLR4 signalling pathway, which processed the cellular inflammatory proliferation and invasive growth involved in the pathogenesis of adenomyosis.
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Affiliation(s)
- Jing Guo
- Department of Obstetrics and Gynecology, Yangpu Hospital, Tongji University School of Medicine, Tengyue Road 450#, Shanghai, 200090, China
| | - Li Chen
- Department of Obstetrics and Gynecology, Yangpu Hospital, Tongji University School of Medicine, Tengyue Road 450#, Shanghai, 200090, China
| | - Ning Luo
- Department of Obstetrics and Gynecology, Yangpu Hospital, Tongji University School of Medicine, Tengyue Road 450#, Shanghai, 200090, China
| | - Caixia Li
- Department of Obstetrics and Gynecology, Yangpu Hospital, Tongji University School of Medicine, Tengyue Road 450#, Shanghai, 200090, China
| | - Rong Chen
- Department of Obstetrics and Gynecology, Yangpu Hospital, Tongji University School of Medicine, Tengyue Road 450#, Shanghai, 200090, China
| | - Xiaoyan Qu
- Department of Obstetrics and Gynecology, Yangpu Hospital, Tongji University School of Medicine, Tengyue Road 450#, Shanghai, 200090, China
| | - Mingmin Liu
- Department of Obstetrics and Gynecology, Yangpu Hospital, Tongji University School of Medicine, Tengyue Road 450#, Shanghai, 200090, China
| | - Le Kang
- Department of Obstetrics and Gynecology, Yangpu Hospital, Tongji University School of Medicine, Tengyue Road 450#, Shanghai, 200090, China
| | - Zhongping Cheng
- Department of Obstetrics and Gynecology, Yangpu Hospital, Tongji University School of Medicine, Tengyue Road 450#, Shanghai, 200090, China
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38
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Delbandi AA, Mahmoudi M, Shervin A, Zarnani AH. 1,25-Dihydroxy Vitamin D3 Modulates Endometriosis-Related Features of Human Endometriotic Stromal Cells. Am J Reprod Immunol 2015; 75:461-73. [DOI: 10.1111/aji.12463] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2015] [Accepted: 11/18/2015] [Indexed: 12/22/2022] Open
Affiliation(s)
- Ali-Akbar Delbandi
- Immunology Research Center; Iran University of Medical Sciences; Tehran Iran
- Immunology Research Center; School of Medicine; Mashhad University of Medical Sciences; Mashhad Iran
| | - Mahmoud Mahmoudi
- Immunology Research Center; School of Medicine; Mashhad University of Medical Sciences; Mashhad Iran
| | - Adel Shervin
- Reproductive Biotechnology Research Center; Avicenna Research Institute; ACECR; Tehran Iran
| | - Amir-Hassan Zarnani
- Immunology Research Center; Iran University of Medical Sciences; Tehran Iran
- Reproductive Immunology Research Center; Avicenna Research Institute; ACECR; Tehran Iran
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39
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Ota K, Dambaeva S, Kim MWI, Han AR, Fukui A, Gilman-Sachs A, Beaman K, Kwak-Kim J. 1,25-Dihydroxy-vitamin D3 regulates NK-cell cytotoxicity, cytokine secretion, and degranulation in women with recurrent pregnancy losses. Eur J Immunol 2015; 45:3188-99. [PMID: 26257123 DOI: 10.1002/eji.201545541] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2015] [Revised: 07/02/2015] [Accepted: 08/05/2015] [Indexed: 12/20/2022]
Abstract
Vitamin D has a pivotal role in regulating immune responses by promoting Th2 immune responses and suppressing Th1 responses. Propensities to a Th1 immune response and increased NK-cell levels and cytotoxicity have been reported in women with recurrent pregnancy losses (RPL). In women with RPL, vitamin D deficiency is prevalent; however, the effect of vitamin D on NK cells is largely unknown. In this study, we demonstrated that CD69(+) activating receptor expression on NK cells was significantly decreased by incubation with 1,25(OH)2 D3 in a dose-dependent manner, while CD158a and CD158b inhibitory receptor expression was upregulated. The degranulation marker CD107a was significantly downregulated on NK cells following incubation with 1,25(OH)2 D3 . NK-cell conjugation with K562 target cells was not affected by 1,25(OH)2 D3 ; however, depolarization of perforin granules in conjugated NK cells was significantly increased. TLR4 expression on NK cells was significantly decreased and TNF-α and IFN-γ production was significantly reduced by 1,25(OH)2 D3 through interference with NF-κB. Our results suggest 1,25(OH)2 D3 has immune regulatory effects on NK cell cytotoxicity, cytokine secretion and degranulation process as well as TLR4 expression. Potential therapeutic application of 1,25(OH)2 D3 for dysregulated NK-cell immunity should be explored in the future.
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Affiliation(s)
- Kuniaki Ota
- Department of Microbiology and Immunology, Chicago Medical School at Rosalind Franklin University of Medicine and Science, North Chicago, IL, USA.,Reproductive Medicine, Department of Obstetrics and Gynecology, Chicago Medical School at Rosalind Franklin University of Medicine and Science, Vernon Hills, IL, USA
| | - Svetlana Dambaeva
- Department of Microbiology and Immunology, Chicago Medical School at Rosalind Franklin University of Medicine and Science, North Chicago, IL, USA
| | - Michael Woo-Il Kim
- Department of Microbiology and Immunology, Chicago Medical School at Rosalind Franklin University of Medicine and Science, North Chicago, IL, USA
| | - Ae-Ra Han
- Department of Microbiology and Immunology, Chicago Medical School at Rosalind Franklin University of Medicine and Science, North Chicago, IL, USA.,Reproductive Medicine, Department of Obstetrics and Gynecology, Chicago Medical School at Rosalind Franklin University of Medicine and Science, Vernon Hills, IL, USA
| | - Atsushi Fukui
- Department of Obstetrics and Gynecology, Hirosaki University School of Medicine, Hirosaki, Aomori, Japan
| | - Alice Gilman-Sachs
- Department of Microbiology and Immunology, Chicago Medical School at Rosalind Franklin University of Medicine and Science, North Chicago, IL, USA
| | - Kenneth Beaman
- Department of Microbiology and Immunology, Chicago Medical School at Rosalind Franklin University of Medicine and Science, North Chicago, IL, USA
| | - Joanne Kwak-Kim
- Department of Microbiology and Immunology, Chicago Medical School at Rosalind Franklin University of Medicine and Science, North Chicago, IL, USA.,Reproductive Medicine, Department of Obstetrics and Gynecology, Chicago Medical School at Rosalind Franklin University of Medicine and Science, Vernon Hills, IL, USA
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40
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Andersen LB, Jørgensen JS, Jensen TK, Dalgård C, Barington T, Nielsen J, Beck-Nielsen SS, Husby S, Abrahamsen B, Lamont RF, Christesen HT. Vitamin D insufficiency is associated with increased risk of first-trimester miscarriage in the Odense Child Cohort. Am J Clin Nutr 2015; 102:633-8. [PMID: 26178723 DOI: 10.3945/ajcn.114.103655] [Citation(s) in RCA: 64] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2014] [Accepted: 06/17/2015] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Miscarriage is the most common negative outcome of pregnancy, and identification of modifiable risk factors is potentially of great importance for public health. Low vitamin D concentrations in pregnancy are widespread worldwide, and vitamin D deficiency is implicated in immune cell regulation at the feto-maternal interface and several diseases of pregnancy. OBJECTIVE We investigated whether 25-hydroxyvitamin D serum concentration was a modifiable risk factor for early miscarriage. DESIGN In a prospective cohort study of 1683 pregnant women donating serum before gestational week 22, we investigated the association between maternal serum concentrations of serum 25-hydroxyvitamin D [25(OH)D] and the risk of subsequent miscarriage (n = 58). RESULTS The adjusted hazard of first-trimester miscarriage was lower with higher 25(OH)D concentrations (HR: 0.98; 95% CI: 0.96, 0.99). Concentrations of 25(OH)D <50 nmol/L were associated with a >2-fold increased adjusted HR for miscarriage (HR: 2.50; 95% CI: 1.10, 5.69). Concentrations of 25(OH)D were not associated with an increased risk of second-trimester miscarriage. CONCLUSIONS We found an association between 25(OH)D and first-trimester miscarriages, suggesting vitamin D as a modifiable risk factor for miscarriage. To test this hypothesis, randomized controlled trials should investigate the possible effect of vitamin D supplementation to increase 25(OH)D concentrations in early pregnancy, or before conception, to decrease risk of miscarriage. This trial was registered at clinicaltrials.gov as NCT02434900.
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Affiliation(s)
- Louise B Andersen
- Institute for Clinical Research and Hans Christian Andersen Children's Hospital
| | - Jan S Jørgensen
- Institute for Clinical Research and Department of Obstetrics and Gynecology
| | - Tina K Jensen
- Department of Environmental Medicine, Institute of Public Health, University of Southern Denmark, Odense, Denmark
| | - Christine Dalgård
- Department of Environmental Medicine, Institute of Public Health, University of Southern Denmark, Odense, Denmark
| | - Torben Barington
- Odense Patient Data Explorative Network (OPEN), Department of Clinical Immunology, and
| | - Jan Nielsen
- Center for Clinical Epidemiology, Odense University Hospital, Odense, Denmark
| | - Signe S Beck-Nielsen
- Institute for Clinical Research and Department of Pediatrics, Hospital of Southwest Denmark, Esbjerg, Denmark
| | - Steffen Husby
- Institute for Clinical Research and Hans Christian Andersen Children's Hospital, Odense Child Cohort, Hans Christian Andersen Children's Hospital, Odense, Denmark
| | - Bo Abrahamsen
- Institute for Clinical Research and Odense Patient Data Explorative Network (OPEN), Department of Medicine, Holbæk Hospital, Holbæk, Denmark; and
| | - Ronald F Lamont
- Institute for Clinical Research and Division of Surgery, University College London, Northwick Park Institute of Medical Research Campus, United Kingdom
| | - Henrik T Christesen
- Institute for Clinical Research and Hans Christian Andersen Children's Hospital,
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41
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Tavakoli M, Salek-Moghaddam A, Jeddi-Tehrani M, Talebi S, Kazemi-Sefat GE, Vafaei S, Mohammadzadeh A, Sheikhhassani S, Zarnani AH. Comparable vitamin D3 metabolism in the endometrium of patients with recurrent spontaneous abortion and fertile controls. Mol Reprod Dev 2015; 82:356-64. [DOI: 10.1002/mrd.22486] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2015] [Accepted: 03/04/2015] [Indexed: 12/31/2022]
Affiliation(s)
- Maryam Tavakoli
- Reproductive Immunology Research Center; Avicenna Research Institute; ACECR; Tehran Iran
| | | | - Mahmood Jeddi-Tehrani
- Monoclonal Antibody Research Center; Avicenna Research Institute; ACECR; Tehran Iran
| | - Saeed Talebi
- Department of Medical Genetics; School of Medicine; Tehran University of Medical Sciences; Tehran Iran
| | | | - Sedigheh Vafaei
- Nanobiotechnology Research Center; Avicenna Research Institute; ACECR; Tehran Iran
| | - Afsaneh Mohammadzadeh
- Reproductive Immunology Research Center; Avicenna Research Institute; ACECR; Tehran Iran
| | - Shahrzad Sheikhhassani
- Obstetrics and Gynecology-Oncology Department; Vali-asr Hospital; Tehran University of Medical Sciences; Tehran Iran
| | - Amir-Hassan Zarnani
- Reproductive Immunology Research Center; Avicenna Research Institute; ACECR; Tehran Iran
- Immunology Research Center; Iran University of Medical Sciences; Tehran Iran
- Nanobiotechnology Research Center; Avicenna Research Institute; ACECR; Tehran Iran
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42
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Alp H, Tekgündüz KŞ, Akkar MK. Maternal and cord blood vitamin D status in high-altitude pregnancy. J Matern Fetal Neonatal Med 2015; 29:571-5. [PMID: 25690026 DOI: 10.3109/14767058.2015.1011119] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE We aimed to explore the risk factors that may lead to vitamin D deficiency in pregnant women living in moderately high-altitude regions. METHODS The study was conducted prospectively between November 2012 and July 2013. City of Erzurum is located at an altitude of 1900-2200 m, north Turkey at 39°4' latitude. Healthy mothers that gave birth after completing 37th week of their pregnancies and healthy neonates weighting >2500 g were included in the study. For 25-hydroxyvitamin D (25(OH)D) analyses venous blood samples of 2 ml were obtained from the umbilical cord and the mother. Questionnaires were developed covering the demographical characteristics and possible risk factors for mothers. RESULTS Totally 81 mothers and neonates were included into the study. The mean 25(OH)D level of mothers was 7.1 ± 6.5 ng/ml. It was noted that 45 (55.7%) mothers had severe deficiency. Multivariate linear regression analysis showed that the dressing style and the level of sunlight received by the house were independent factors affecting the level of 25(OH)D. CONCLUSION Our findings showed that cultural factors had significant effects on vitamin D levels. We believe that appropriate dose of vitamin D prophylaxis should be administered to pregnant women, considering the risk factors as well as the geographical features.
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Affiliation(s)
- Handan Alp
- a Department of Pediatrics, Faculty of Medicine , Atatürk University , Erzurum , Turkey
| | | | - Mevlüt Kürşat Akkar
- a Department of Pediatrics, Faculty of Medicine , Atatürk University , Erzurum , Turkey
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43
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Pacis MM, Fortin CN, Zarek SM, Mumford SL, Segars JH. Vitamin D and assisted reproduction: should vitamin D be routinely screened and repleted prior to ART? A systematic review. J Assist Reprod Genet 2014; 32:323-35. [PMID: 25547950 DOI: 10.1007/s10815-014-0407-9] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2014] [Accepted: 12/11/2014] [Indexed: 12/19/2022] Open
Abstract
PURPOSE To review the current literature regarding the role of vitamin D status in pregnancy outcomes in women undergoing assisted reproductive technology (ART) and to assess cost-effectiveness of routine vitamin D deficiency screening and repletion prior to initiation of ART. METHODS A systematic literature review was conducted using PubMed. Relevant study outcomes were compared among the selected studies. A cost-benefit analysis was performed using a decision tree mathematical model with sensitivity analyses from the perspective of direct societal cost. Published data were used to estimate probabilities and costs in 2014 US dollars. RESULTS Thirty-four articles were retrieved, of which eight met inclusion criteria. One study demonstrated a negative relationship between vitamin D status and ART outcomes, while two studies showed no association. The remaining five studies concluded that ART outcomes improved after vitamin D repletion. CONCLUSION The majority of reviewed studies reported a decrement in ART outcomes in patients with vitamin D deficiency. Cost-benefit analyses suggested that screening and supplementing vitamin D prior to ART might be cost effective, but further evidence is needed. Given the absence of Level I evidence regarding vitamin D status and ART outcomes, full endorsement of routine vitamin D screening and supplementation prior to ART is premature.
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Affiliation(s)
- Michelle M Pacis
- Department of Obstetrics and Gynecology, Dartmouth-Hitchcock Medical Center, One Medical Center Drive, Lebanon, NH, 03756, USA
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44
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Wöbke TK, Sorg BL, Steinhilber D. Vitamin D in inflammatory diseases. Front Physiol 2014; 5:244. [PMID: 25071589 PMCID: PMC4078458 DOI: 10.3389/fphys.2014.00244] [Citation(s) in RCA: 116] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2014] [Accepted: 06/12/2014] [Indexed: 02/06/2023] Open
Abstract
Changes in vitamin D serum levels have been associated with inflammatory diseases, such as inflammatory bowel disease (IBD), rheumatoid arthritis, systemic lupus erythematosus, multiple sclerosis (MS), atherosclerosis, or asthma. Genome- and transcriptome-wide studies indicate that vitamin D signaling modulates many inflammatory responses on several levels. This includes (i) the regulation of the expression of genes which generate pro-inflammatory mediators, such as cyclooxygenases or 5-lipoxygenase, (ii) the interference with transcription factors, such as NF-κB, which regulate the expression of inflammatory genes and (iii) the activation of signaling cascades, such as MAP kinases which mediate inflammatory responses. Vitamin D targets various tissues and cell types, a number of which belong to the immune system, such as monocytes/macrophages, dendritic cells (DCs) as well as B- and T cells, leading to individual responses of each cell type. One hallmark of these specific vitamin D effects is the cell-type specific regulation of genes involved in the regulation of inflammatory processes and the interplay between vitamin D signaling and other signaling cascades involved in inflammation. An important task in the near future will be the elucidation of the regulatory mechanisms that are involved in the regulation of inflammatory responses by vitamin D on the molecular level by the use of techniques such as chromatin immunoprecipitation (ChIP), ChIP-seq, and FAIRE-seq.
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Affiliation(s)
- Thea K Wöbke
- Institute of Pharmaceutical Chemistry, Goethe University Frankfurt Frankfurt, Germany
| | - Bernd L Sorg
- Institute of Pharmaceutical Chemistry, Goethe University Frankfurt Frankfurt, Germany
| | - Dieter Steinhilber
- Institute of Pharmaceutical Chemistry, Goethe University Frankfurt Frankfurt, Germany
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45
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Hosseini S, Zarnani AH, Asgarian-Omran H, Vahedian-Dargahi Z, Eshraghian MR, Akbarzadeh-Pasha Z, Arefi S, Jeddi-Tehrani M, Shokri F. Comparative analysis of NK cell subsets in menstrual and peripheral blood of patients with unexplained recurrent spontaneous abortion and fertile subjects. J Reprod Immunol 2014; 103:9-17. [PMID: 24725996 DOI: 10.1016/j.jri.2014.03.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2014] [Accepted: 03/04/2014] [Indexed: 10/25/2022]
Abstract
Natural killer (NK) cells play a fundamental role in maintaining pregnancy. Based on the availability and non-invasive method of collection of menstrual blood (MB), here we investigated for the first time a comparative analysis of NK cell subsets in MB and peripheral blood (PB) of women with recurrent spontaneous abortion (RSA) and fertile women. PB and MB of healthy fertile (n=15) and RSA women (n=15) were sampled simultaneously on the second day of the menstrual cycle. Proportions of CD56+CD3-CD16+/-, CD56+CD3-CCR7+/-, and CD56+CD3-CD45RO+/- cells were analyzed using flow cytometry. In the MB of both groups, proportions of CD16+ and CD45RO- NK cells were significantly lower than in the PB. In parallel, CD56+CD16+CCR7- and CCR7+ cells were present in significantly smaller amounts in MB than in PB. However, the amounts of CD56+CD16-CCR7- and CCR7+ cells were greater in MB. In comparison to the fertile group, the percentage of MB CD45RO+ NK cells was significantly lower and frequencies of PB CD16-, CD45RO- and CD56+CD16+CCR7+ subsets were significantly higher in RSA patients. Different subsets of NK cells are differentially distributed in MB in comparison with PB in women with RSA and fertile subjects. Population differences of NK cell subsets in RSA patients and normal controls were more clearly reflected at the systemic level.
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Affiliation(s)
- Samira Hosseini
- Department of Immunology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Amir-Hassan Zarnani
- Reproductive Immunology Research Center, Avicenna Research Institute, ACECR, Tehran, Iran; Immunology Research Center, Iran University of Medical Sciences, Tehran, Iran; Nanobiotechnology Research Center, Avicenna Research Institute, ACECR, Tehran, Iran.
| | - Hossein Asgarian-Omran
- Department of Immunology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | | | | | - Zahra Akbarzadeh-Pasha
- Reproductive Immunology Research Center, Avicenna Research Institute, ACECR, Tehran, Iran
| | - Soheila Arefi
- Reproductive Immunology Research Center, Avicenna Research Institute, ACECR, Tehran, Iran
| | - Mahmood Jeddi-Tehrani
- Monoclonal Antibody Research Center, Avicenna Research Institute, ACECR, Tehran, Iran
| | - Fazel Shokri
- Department of Immunology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran; Monoclonal Antibody Research Center, Avicenna Research Institute, ACECR, Tehran, Iran.
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Goyal R, Zhang L, Blood AB, Baylink DJ, Longo LD, Oshiro B, Mata-Greenwood E. Characterization of an animal model of pregnancy-induced vitamin D deficiency due to metabolic gene dysregulation. Am J Physiol Endocrinol Metab 2014; 306:E256-66. [PMID: 24326417 DOI: 10.1152/ajpendo.00528.2013] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Vitamin D deficiency has been associated with pregnancy complications such as preeclampsia, gestational diabetes, and recurrent miscarriage. Therefore, we hypothesized differences in vitamin D status between healthy [Sprague-Dawley (SD) and Lewis (LW)] and complicated [Brown Norway (BN)] rat pregnancies. In SD, LW, and BN rats, we analyzed the maternal plasma levels of the vitamin D metabolites 25-OH-D and 1,25-(OH)2-D at prepregnancy, pregnancy, and postpartum. Analysis of the active metabolite 1,25-(OH)2-D showed a twofold increase in pregnant SD and LW rats but a nearly 10-fold decrease in pregnant BN rats compared with nonpregnant controls. BN rats had a pregnancy-dependent upregulation of CYP24a1 expression, a key enzyme that inactivates vitamin D metabolites. In contrast, the maternal renal expression of CYP24a1 in SD and LW rats remained constant throughout pregnancy. Analysis of the vitamin D receptor (VDR) indicated that LW and SD but not BN rats experience a pregnancy-induced 10-fold decrease in maternal renal VDR protein levels. Further analysis of bisulfite-converted and genomic DNA indicated that the observed differences in maternal renal regulation of CYP24a1 during pregnancy and lactation are not due to differences in CYP24a1 promoter methylation or single-nucleotide polymorphisms. Finally, supplementation with 1,25-(OH)2-D significantly improved the reproductive phenotype of BN rats by increasing litter size and maternal-fetal weight outcomes. We conclude that BN rats represent a novel animal model of pregnancy-specific vitamin D deficiency that is linked to pregnancy complications. Vitamin D deficiency in BN rats correlates with maternal renal CYP24a1 upregulation followed by CYP27b1 upregulation.
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Gutierrez JA, Jones KA, Flores R, Singhania A, Woelk CH, Schooley RT, Wyles DL. Vitamin D Metabolites Inhibit Hepatitis C Virus and Modulate Cellular Gene Expression. ACTA ACUST UNITED AC 2014; 3. [PMID: 26594646 DOI: 10.4172/2324-8955.1000129] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND AND AIMS Previous studies suggest that low serum 25-hydroxyvitamin D [25(OH) D] levels are associated with reduced responsiveness to interferon and ribavirin therapy. We investigated the impact of vitamin D metabolites on HCV and cellular gene expression in cultured hepatoma cells. METHODS HCV Replicon cell lines stably expressing luciferase reporter constructs (genotype 1b and 2a replicon) or JC1-Luc2a were incubated in the presence of vitamin D2, vitamin D3 or 1,25-dihydroxyvitamin D3 (1,25(OH)2D3). Presence of HCV was quantified by a luciferase reporter assay and immunoblot of the Core protein. Synergy of interferon-alpha A/D (IFN-α) and 1,25(OH)2D3 was evaluated using the Chou-Talalay method. Cellular gene expression by microarray analysis using Illumina Bead Chips and real-time quantitative PCR. RESULTS Vitamin D2, D3 and 1,25(OH)2D3 each demonstrated anti-HCV activity at low micro molar concentrations. In vitro conversion from D3 to 25(OH)D3 was shown by LC/MS/MS. Combination indices of 1,25(OH)2D3 and IFN-α demonstrated a synergistic effect (0.23-0.46) and significantly reduced core expression by immunoblot. Differentially expressed genes were identified between Huh7.5.1 cells in the presence and absence of 1,25(OH)2D3 and HCV. Genes involved with classical effects of vitamin D metabolism and excretion were activated, along with genes linked to autophagy such as G-protein coupled receptor 37 (GPR37) and Hypoxia-inducible factor 1-alpha (HIF1a). Additionally, additive effects of 1,25(OH)2D3 and IFN-α were seen on mRNA expression of chemokine motif ligand 20 (CCL20). CONCLUSIONS This study shows that vitamin D reduces HCV protein production in cell culture synergistically with IFN-α. Vitamin D also activates gene expression independently and additively with IFN-α and this may explain its ability to aid in the clearance of HCV in vivo.
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Affiliation(s)
- Julio A Gutierrez
- Texas Liver Institute, Department of Hepatology, University of Texas Health Science Center San Antonio, USA ; Division of Infectious Diseases, University of California, San Diego, USA
| | - Krysten A Jones
- Division of Infectious Diseases, University of California, San Diego, USA
| | - Roxana Flores
- Division of Infectious Diseases, University of California, San Diego, USA
| | - Akul Singhania
- Division of Infectious Diseases, University of California, San Diego, USA ; Clinical and Experimental Sciences, Southampton General Hospital, USA
| | - Christopher H Woelk
- Division of Infectious Diseases, University of California, San Diego, USA ; Clinical and Experimental Sciences, Southampton General Hospital, USA
| | - Robert T Schooley
- Division of Infectious Diseases, University of California, San Diego, USA
| | - David L Wyles
- Division of Infectious Diseases, University of California, San Diego, USA
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Influence of vitamin D levels on in vitro fertilization outcomes in donor-recipient cycles. Fertil Steril 2013; 101:447-52. [PMID: 24210230 DOI: 10.1016/j.fertnstert.2013.10.008] [Citation(s) in RCA: 86] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2013] [Revised: 10/04/2013] [Accepted: 10/04/2013] [Indexed: 11/21/2022]
Abstract
OBJECTIVE To elucidate the role of vitamin D in reproduction by examining the relationship between recipient vitamin D levels and pregnancy rates in donor-recipient IVF cycles. DESIGN Retrospective cohort study. SETTING Academic tertiary care center. PATIENT(S) Ninety-nine recipients of egg donation at University of Southern California Fertility. INTERVENTION(S) Serum was collected from egg donor recipients before ET and was tested for vitamin D levels [25(OH)D]. MAIN OUTCOME MEASURE(S) Clinical pregnancy as defined by sonographic presence of a heartbeat at 7-8 weeks of gestation. RESULT(S) In a diverse population of 99 recipients (53% Caucasian, 20% Asian, 16% Hispanic, 7% African American), adjusted clinical pregnancy rates were lower among vitamin D-deficient recipients than among vitamin D-replete recipients (37% vs. 78%). Live-birth rates were 31% among vitamin D-deficient recipients, compared with 59% among vitamin D-replete recipients. There were no differences in adjusted clinical pregnancy and live-birth rates among recipients who were vitamin D deficient [25(OH)D<20 ng/mL] vs. among those who were vitamin D insufficient [20 ng/mL ≤ 25(OH)D<30 ng/mL]. CONCLUSION(S) Nonreplete vitamin D status [25(OH)D<30 ng/mL] was associated with lower pregnancy rates in recipients of egg donation. Since the oocyte donor-recipient model is able to separate the impact of vitamin D on oocyte vs. endometrium, these data suggest that the effects of vitamin D may be mediated through the endometrium.
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Role of 1,25-dihydroxyvitamin D (vitamin D3) as immunomodulator in recurrent missed miscarriage. MIDDLE EAST FERTILITY SOCIETY JOURNAL 2013. [DOI: 10.1016/j.mefs.2013.04.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Eutopic and ectopic stromal cells from patients with endometriosis exhibit differential invasive, adhesive, and proliferative behavior. Fertil Steril 2013; 100:761-9. [DOI: 10.1016/j.fertnstert.2013.04.041] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2013] [Revised: 04/16/2013] [Accepted: 04/25/2013] [Indexed: 01/21/2023]
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