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Alenezi A, Qureshi H, Ahmed OG, Ramanathan M. Air Quality, Allergic Rhinitis, and Asthma. Otolaryngol Clin North Am 2024; 57:293-307. [PMID: 37985273 DOI: 10.1016/j.otc.2023.10.005] [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] [Indexed: 11/22/2023]
Abstract
This review article highlights air pollution as a critical global health concern with emphasis on its effects and role in the development and exacerbation of upper airway and lower airway disease with a focus on allergic rhinitis and asthma. This review underscores the World Health Organization's recognition of air pollution as the biggest environmental threat to human health. It discusses the various components and categories of air pollutants and the evidence-based effects they have on asthma and allergic rhinitis, ranging from pathogenesis to exacerbation of these conditions across various age groups in different geographic locations.
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Affiliation(s)
- Abdulrahman Alenezi
- Department of Otolaryngology- Head and Neck Surgery, Johns Hopkins School of Medicine, Johns Hopkins Outpatient Center, 6th Floor, 601 North Caroline Street, Baltimore, MD 21287-0910, USA
| | - Hannan Qureshi
- Department of Otolaryngology- Head and Neck Surgery, Johns Hopkins School of Medicine, Johns Hopkins Outpatient Center, 6th Floor, 601 North Caroline Street, Baltimore, MD 21287-0910, USA
| | - Omar G Ahmed
- Academic Institute, Houston, TX 77030, USA; Research Institute, Otolaryngology-Head and Neck Surgery, Houston Methodist Hospital, Houston, TX 77030, USA
| | - Murugappan Ramanathan
- Department of Otolaryngology- Head and Neck Surgery, Johns Hopkins School of Medicine, Johns Hopkins Outpatient Center, 6th Floor, 601 North Caroline Street, Baltimore, MD 21287-0910, USA.
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2
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Grove-Laugesen D, Ebbehoj E, Watt T, Riis AL, Østergård T, Bruun BJ, Juel Christiansen J, Hansen KW, Rejnmark L. Effect of Vitamin D Supplementation on Graves' Disease: The DAGMAR Trial. Thyroid 2023; 33:1110-1118. [PMID: 37218433 DOI: 10.1089/thy.2023.0111] [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: 05/24/2023]
Abstract
Objective: Treatment options in Graves' disease (GD) are limited and do not target the underlying autoimmunity, and relapse rates following a course of antithyroid drug (ATD) reach 50%. Previous research has shown promising results for a role of vitamin D in GD. We aimed to investigate whether vitamin D reduces failure to enter and sustain remission in patients with GD treated with ATD. Design: A multicenter, double-blinded, randomized placebo-controlled trial comparing vitamin D 70 mcg once daily (2800 IU) or placebo. The intervention was given first as add-on to ATD treatment, maximally 24 months, and then for 12 months after ATD cessation. Inclusion period was from 2015 to 2017 and study completion by December 2020. Patients included were adults with a first-time diagnosis of GD treated with ATD. Exclusion criteria included pregnancy and glucocorticoid treatment. The primary endpoint was failure to enter and sustain remission defined as relapse of hyperthyroidism within 12 months after ATD cessation, inability to stop ATD within 24 months, or radioiodine treatment or thyroidectomy. Two hundred seventy-eight patients were included in the study, and 4 patients withdrew consent. No adverse effects were found. Results: Participants were aged 44 ± 14 years at enrollment and 79% were female. The risk of failure to enter and sustain remission was 42% [95% confidence interval (CI) 33-50%] in the vitamin D group and 32% [CI 24-40%] in the placebo group corresponding to a relative risk of 1.30 [CI 0.95-1.78]. Conclusions: Vitamin D supplementation did not improve the treatment of GD in patients with normal or insufficient vitamin D status. Thus, supplementation with high-dose vitamin D cannot be recommended for GD. Study registration: ClinicalTrials.gov NCT02384668.
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Affiliation(s)
- Diana Grove-Laugesen
- Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus N, Denmark
| | - Eva Ebbehoj
- Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus N, Denmark
| | - Torquil Watt
- Department of Internal Medicine, Herlev Hospital, Herlev, Hovedstaden, Denmark
| | - Anne Lene Riis
- Medical Department, Regionshospitalet Horsens, Horsens, Midtjylland, Denmark
| | - Torben Østergård
- Medical Department, Aalborg University Hospital, Aalborg, North Denmark Region, Denmark
| | | | | | | | - Lars Rejnmark
- Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus N, Denmark
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Mulligan JK, Nord D, Villanueva MV, Justice J, Lobo B, Schlosser RJ, Atkinson C. Role of C3a as a Novel Regulator of 25(OH)D 3 to 1α,25-Dihydroxyvitamin D 3 Metabolism in Upper Airway Epithelial Cells. JOURNAL OF IMMUNOLOGY (BALTIMORE, MD. : 1950) 2022; 209:262-269. [PMID: 35793909 PMCID: PMC9432430 DOI: 10.4049/jimmunol.2000726] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Accepted: 04/29/2022] [Indexed: 05/21/2023]
Abstract
In patients with chronic rhinosinusitis with nasal polyps, primary human sinonasal epithelial cell (HSNEC) 1α-hydroxylase levels are reduced, as is their ability to metabolize 25-hydroxycholecalciferol [25(OH)D3] to its active metabolite, 1α,25-dihydroxyvitamin D3 [1,25(OH)2D3]. In this study, we sought to identify the factor responsible for the regulation of HSNEC metabolism of 25(OH)D3, focusing on C3 and C3a. Multiple inhaled irritants trigger the release of complement components, C3 and C3a, leading to suppression of 1α-hydroxylase levels in HSNECs. Recombinant C3a was able to decrease 1α-hydroxylase and impair 25(OH)D3 to 1,25(OH)2D3 metabolism, while addition of a C3a receptor antagonist restored conversion. Conversely, 1,25(OH)2D3 suppressed Aspergillus fumigatus-induced C3 and C3a levels in HSNEC supernatant. Given the ability of 1,25(OH)2D3 to modulate LL37 in other cell types, we examined its regulation in HSNECs and relationship to C3a. 1,25(OH)2D3 stimulated the secretion of LL37, whereas A. fumigatus and C3a suppressed it. Conversely, LL37 reduced the release of C3/C3a by HSNECs. Lastly, oral steroid use and in vitro dexamethasone application both failed to increase 1α-hydroxylase or reduce C3a levels. In summary, in this article, we describe for the first time a novel relationship between complement activation and local vitamin D metabolism in airway epithelial cells. The presence of elevated C3/C3a in patients with asthma and/or chronic rhinosinusitis with nasal polyps may account for their impaired HSNEC 25(OH)D3 to 1,25(OH)2D3 metabolism and explain why they receive limited therapeutic benefit from oral vitamin D3 supplementation.
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Affiliation(s)
- Jennifer K Mulligan
- Division of Pulmonary, Critical Care & Sleep Medicine, Department of Medicine, University of Florida, Gainesville, FL
- Department of Otolaryngology, University of Florida, Gainesville, FL; and
| | - Dianna Nord
- Division of Pulmonary, Critical Care & Sleep Medicine, Department of Medicine, University of Florida, Gainesville, FL
| | - Maria V Villanueva
- Division of Pulmonary, Critical Care & Sleep Medicine, Department of Medicine, University of Florida, Gainesville, FL
| | - Jeb Justice
- Department of Otolaryngology, University of Florida, Gainesville, FL; and
| | - Brian Lobo
- Department of Otolaryngology, University of Florida, Gainesville, FL; and
| | - Rodney J Schlosser
- Department of Otolaryngology, Medical University of South Carolina, Charleston, SC
| | - Carl Atkinson
- Division of Pulmonary, Critical Care & Sleep Medicine, Department of Medicine, University of Florida, Gainesville, FL;
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4
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Mongy NNE, Hilal RF. How far is vitamin D implicated in cutaneous infections. Clin Dermatol 2021; 40:198-205. [PMID: 34893391 DOI: 10.1016/j.clindermatol.2021.10.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Vitamin D is an important cornerstone in the immunologic cascade of many skin infections, systemic infections with cutaneous presentations, and other infectious dermatologic diseases where infections could be a culprit. Vitamin D supplementation is proposed as a protective measure against their occurrence and exacerbation, especially with the emergence of several viral pandemics in recent years. Vitamin D plays a key role in the maintenance of a balanced immunologic profile which could be reflected by a lowered incidence and morbidity of infections. Vitamin D screening and supplementation in patients with deficiencies or insufficiencies should be a part of the dermatologic approach to patients with these diseases.
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Affiliation(s)
- Naglaa Nabil El Mongy
- Professor of Dermatology, Kasr Al Ainy Teaching Hospital, Cairo University, Cairo, Egypt
| | - Rana Fathy Hilal
- Associate Professor of Dermatology, Kasr Al Ainy Teaching Hospital, Cairo University, Cairo, Egypt.
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5
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Yang L, Zhao H, Liu K, Wang Y, Liu Q, Sun T, Chen S, Ren L. Smoking behavior and circulating vitamin D levels in adults: A meta-analysis. Food Sci Nutr 2021; 9:5820-5832. [PMID: 34646549 PMCID: PMC8497833 DOI: 10.1002/fsn3.2488] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Revised: 06/20/2021] [Accepted: 07/07/2021] [Indexed: 12/16/2022] Open
Abstract
To determine the effect of smoking on circulating vitamin D in adults, we performed a meta-analysis. Literature before 9 May 2021 was retrieved from electronic literature databases such as EMBASE, PubMed, and Cochrane. The quality of the included studies was assessed by two researchers against the Newcastle-Ottawa scale and JBI Evidence-based Health Care Centre criteria. All eligible studies and statistical analyses were performed using STATA 14. Twenty-four studies with 11,340 participants meeting the criteria were included in the meta-analysis. The results of meta-analysis showed that the level of circulating 25(OH)D in smokers was lower than that in nonsmokers. A subgroup analysis based on vitamin D supplement use showed that both smokers who used vitamin D supplements and smokers who did not use vitamin D supplements had lower blood 25(OH)D levels compared with the control group. In addition, subjects were divided into different subgroups according to age for meta-analysis, and the results showed that the serum 25(OH)D level in each subgroup of smokers was lower than that in the control group. This meta-analysis revealed differences in circulating vitamin D levels between smokers and nonsmokers, with smokers likely to have lower circulating vitamin D levels.
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Affiliation(s)
- Lu Yang
- Hebei General HospitalShijiazhuangChina
| | - Hang Zhao
- Hebei General HospitalShijiazhuangChina
| | - Ke Liu
- Hebei General HospitalShijiazhuangChina
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Orlandi RR, Kingdom TT, Smith TL, Bleier B, DeConde A, Luong AU, Poetker DM, Soler Z, Welch KC, Wise SK, Adappa N, Alt JA, Anselmo-Lima WT, Bachert C, Baroody FM, Batra PS, Bernal-Sprekelsen M, Beswick D, Bhattacharyya N, Chandra RK, Chang EH, Chiu A, Chowdhury N, Citardi MJ, Cohen NA, Conley DB, DelGaudio J, Desrosiers M, Douglas R, Eloy JA, Fokkens WJ, Gray ST, Gudis DA, Hamilos DL, Han JK, Harvey R, Hellings P, Holbrook EH, Hopkins C, Hwang P, Javer AR, Jiang RS, Kennedy D, Kern R, Laidlaw T, Lal D, Lane A, Lee HM, Lee JT, Levy JM, Lin SY, Lund V, McMains KC, Metson R, Mullol J, Naclerio R, Oakley G, Otori N, Palmer JN, Parikh SR, Passali D, Patel Z, Peters A, Philpott C, Psaltis AJ, Ramakrishnan VR, Ramanathan M, Roh HJ, Rudmik L, Sacks R, Schlosser RJ, Sedaghat AR, Senior BA, Sindwani R, Smith K, Snidvongs K, Stewart M, Suh JD, Tan BK, Turner JH, van Drunen CM, Voegels R, Wang DY, Woodworth BA, Wormald PJ, Wright ED, Yan C, Zhang L, Zhou B. International consensus statement on allergy and rhinology: rhinosinusitis 2021. Int Forum Allergy Rhinol 2021; 11:213-739. [PMID: 33236525 DOI: 10.1002/alr.22741] [Citation(s) in RCA: 385] [Impact Index Per Article: 128.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Accepted: 11/09/2020] [Indexed: 02/06/2023]
Abstract
I. EXECUTIVE SUMMARY BACKGROUND: The 5 years since the publication of the first International Consensus Statement on Allergy and Rhinology: Rhinosinusitis (ICAR-RS) has witnessed foundational progress in our understanding and treatment of rhinologic disease. These advances are reflected within the more than 40 new topics covered within the ICAR-RS-2021 as well as updates to the original 140 topics. This executive summary consolidates the evidence-based findings of the document. METHODS ICAR-RS presents over 180 topics in the forms of evidence-based reviews with recommendations (EBRRs), evidence-based reviews, and literature reviews. The highest grade structured recommendations of the EBRR sections are summarized in this executive summary. RESULTS ICAR-RS-2021 covers 22 topics regarding the medical management of RS, which are grade A/B and are presented in the executive summary. Additionally, 4 topics regarding the surgical management of RS are grade A/B and are presented in the executive summary. Finally, a comprehensive evidence-based management algorithm is provided. CONCLUSION This ICAR-RS-2021 executive summary provides a compilation of the evidence-based recommendations for medical and surgical treatment of the most common forms of RS.
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Affiliation(s)
| | | | | | | | | | - Amber U Luong
- University of Texas Medical School at Houston, Houston, TX
| | | | - Zachary Soler
- Medical University of South Carolina, Charleston, SC
| | - Kevin C Welch
- Feinberg School of Medicine, Northwestern University, Chicago, IL
| | | | | | | | | | - Claus Bachert
- Ghent University, Ghent, Belgium.,Karolinska Institute, Stockholm, Sweden.,Sun Yatsen University, Gangzhou, China
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - David A Gudis
- Columbia University Irving Medical Center, New York, NY
| | - Daniel L Hamilos
- Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | | | - Richard Harvey
- University of New South Wales and Macquarie University, Sydney, New South Wales, Australia
| | | | | | | | | | - Amin R Javer
- University of British Columbia, Vancouver, British Columbia, Canada
| | | | | | | | | | | | | | | | | | | | | | - Valerie Lund
- Royal National Throat Nose and Ear Hospital, UCLH, London, UK
| | - Kevin C McMains
- Uniformed Services University of Health Sciences, San Antonio, TX
| | | | - Joaquim Mullol
- IDIBAPS Hospital Clinic, University of Barcelona, Barcelona, Spain
| | | | | | | | | | | | | | | | | | | | - Alkis J Psaltis
- University of Adelaide, Adelaide, South Australia, Australia
| | | | | | | | - Luke Rudmik
- University of Calgary, Calgary, Alberta, Canada
| | - Raymond Sacks
- University of New South Wales, Sydney, New South Wales, Australia
| | | | | | | | | | | | | | | | | | | | | | | | | | - De Yun Wang
- National University of Singapore, Singapore, Singapore
| | | | | | | | - Carol Yan
- University of California San Diego, La Jolla, CA
| | - Luo Zhang
- Capital Medical University, Beijing, China
| | - Bing Zhou
- Capital Medical University, Beijing, China
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7
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Association of serum vitamin D with Chronic RhinoSinusitis in adults residing at high altitudes. Eur Arch Otorhinolaryngol 2020; 278:1067-1074. [PMID: 32945930 DOI: 10.1007/s00405-020-06368-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2020] [Accepted: 09/10/2020] [Indexed: 10/23/2022]
Abstract
PURPOSE To evaluate the association of serum vitamin D levels with chronic rhinosinusitis (CRS) in population residing at high altitudes and to assess its correlation with severity of CRS. METHODS A prospective case-control study comparing vitamin D in 60 cases (30 with nasal polyposis and 30 without) and 31 controls was carried out. Correlation of vitamin D with severity of disease (Lund Mackay CT/LMS and endoscopic Lund Kennedy scores/LKS) was assessed using Spearman's correlation (rs). Logistic regression analysis using vitamin D and confounding factors (Age and gender only, as other variables like smoking, bronchial asthma were exclusion criteria) as dependent and CRS (presence/absence) as independent variable, was also conducted. RESULTS A significantly lower vitamin D levels were found in CRS (14.60 ± 7.68 ng/ml), CRSwNP (13.70 ± 7.88 ng/ml) and CRSsNP (15.49 ± 7.50 ng/ml), when compared to controls (29.36 ± 7.49 ng/ml). Non allergic cases when compared with controls, showed significantly lower vitamin D levels (13.91 ± 6.78 compared to 29.36 ± 7.49 ng/ml). LMS and LKS in CRS showed a moderate correlation with vitamin D (rs: - 0.604 for LMS, rs: - 0.595 for LKS). Logistic regression analysis showed vitamin D levels (Odds-Ratio 0.783) to be an independent predictive factor of CRS. CONCLUSION A significantly lower vitamin D level is associated with CRS, irrespective of presence or absence of nasal polyposis in adults residing at high altitudes. Vitamin D is an independent predictive factor for CRS. There is an inverse moderate correlation of severity of CRS with vitamin D.
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8
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Sari E, Oztay F, Tasci AE. Vitamin D modulates E-cadherin turnover by regulating TGF-β and Wnt signalings during EMT-mediated myofibroblast differentiation in A459 cells. J Steroid Biochem Mol Biol 2020; 202:105723. [PMID: 32603782 DOI: 10.1016/j.jsbmb.2020.105723] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Revised: 06/07/2020] [Accepted: 06/24/2020] [Indexed: 12/12/2022]
Abstract
Vitamin D (VitD) has an anti-fibrotic effect on fibrotic lungs. It reduces epithelial-mesenchymal transition (EMT) on tumors. We aimed to investigate target proteins of VitD for the regression of EMT-mediated myofibroblast differentiation. A group of A549 cells were treated with 5 % cigarette smoke extract (CSE) and 5 %CSE + TGF-β (5 ng/ml) to induce EMT. The others were treated with 50 nM VitD 30 min before %5CSE and TGF-β treatments. All cells were collected at 24, 48 and 72 h following 5 %CSE and TGF-β administrations. The expression of p120ctn and NEDD9 proteins acted on E-cadherin turnover in addition to activations of TGF-β and Wnt pathways were examined in these cells and fibrotic human lungs. CSE and TGF-β induced EMT by reducing E-cadherin, p-VDR, SMAD7 and DKK1, increasing α-SMA, p120ctn, Kaiso, NEDD9 and stimulating TGF-β and Wnt/β-catenin signalings in A549 cells. VitD administration reversed these alterations and regressed EMT. Co-immunoprecipitation analysis revealed p-VDR interaction with β-catenin and Kaiso in fibrotic and non-fibrotic human lungs. VitD pre-treatments reduced TGF-β and Wnt/β-catenin signalings by increasing p-VDR, protected from E-cadherin degradation and led to the regression of EMT in A549 cells treated with CSE and TGF-β. Finally, VitD supplementation combined with anti-fibrotic therapeutics can be suggested for treatment of pulmonary fibrosis, which may be developed by smoking, in cases of VitD deficiency.
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Affiliation(s)
- Ezgi Sari
- Istanbul University, Faculty of Science, Department of Biology, 34134, Vezneciler, Istanbul, Turkey.
| | - Fusun Oztay
- Istanbul University, Faculty of Science, Department of Biology, 34134, Vezneciler, Istanbul, Turkey.
| | - Ahmet Erdal Tasci
- Lung Transplantation Center, Department of Thoracic Surgery, Kartal Kosuyolu High Speciality Educational and Research Hospital, Kartal, Istanbul, Turkey.
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Bayirli BA, Öztürk A, Avci B. Serum vitamin D concentration is associated with antimicrobial peptide level in periodontal diseases. Arch Oral Biol 2020; 117:104827. [DOI: 10.1016/j.archoralbio.2020.104827] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Revised: 07/03/2020] [Accepted: 07/07/2020] [Indexed: 12/01/2022]
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Schrumpf JA, van der Does AM, Hiemstra PS. Impact of the Local Inflammatory Environment on Mucosal Vitamin D Metabolism and Signaling in Chronic Inflammatory Lung Diseases. Front Immunol 2020; 11:1433. [PMID: 32754156 PMCID: PMC7366846 DOI: 10.3389/fimmu.2020.01433] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Accepted: 06/03/2020] [Indexed: 02/06/2023] Open
Abstract
Vitamin D plays an active role in the modulation of innate and adaptive immune responses as well as in the protection against respiratory pathogens. Evidence for this immunomodulatory and protective role is derived from observational studies showing an association between vitamin D deficiency, chronic airway diseases and respiratory infections, and is supported by a range of experimental studies using cell culture and animal models. Furthermore, recent intervention studies have now shown that vitamin D supplementation reduces exacerbation rates in vitamin D-deficient patients with chronic obstructive pulmonary disease (COPD) or asthma and decreases the incidence of acute respiratory tract infections. The active vitamin D metabolite, 1,25-dihydroxy-vitamin D (1,25(OH)2D), is known to contribute to the integrity of the mucosal barrier, promote killing of pathogens (via the induction of antimicrobial peptides), and to modulate inflammation and immune responses. These mechanisms may partly explain its protective role against infections and exacerbations in COPD and asthma patients. The respiratory mucosa is an important site of local 1,25(OH)2D synthesis, degradation and signaling, a process that can be affected by exposure to inflammatory mediators. As a consequence, mucosal inflammation and other disease-associated factors, as observed in e.g., COPD and asthma, may modulate the protective actions of 1,25(OH)2D. Here, we discuss the potential consequences of various disease-associated processes such as inflammation and exposure to pathogens and inhaled toxicants on vitamin D metabolism and local responses to 1,25(OH)2D in both immune- and epithelial cells. We furthermore discuss potential consequences of disturbed local levels of 25(OH)D and 1,25(OH)2D for chronic lung diseases. Additional insight into the relationship between disease-associated mechanisms and local effects of 1,25(OH)2D is expected to contribute to the design of future strategies aimed at improving local levels of 1,25(OH)2D and signaling in chronic inflammatory lung diseases.
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Affiliation(s)
- Jasmijn A Schrumpf
- Department of Pulmonology, Leiden University Medical Center, Leiden, Netherlands
| | - Anne M van der Does
- Department of Pulmonology, Leiden University Medical Center, Leiden, Netherlands
| | - Pieter S Hiemstra
- Department of Pulmonology, Leiden University Medical Center, Leiden, Netherlands
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Ganji V, Al-Obahi A, Yusuf S, Dookhy Z, Shi Z. Serum vitamin D is associated with improved lung function markers but not with prevalence of asthma, emphysema, and chronic bronchitis. Sci Rep 2020; 10:11542. [PMID: 32647146 PMCID: PMC7347624 DOI: 10.1038/s41598-020-67967-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2020] [Accepted: 06/18/2020] [Indexed: 12/17/2022] Open
Abstract
Hypovitaminosis D has been linked to several non-bone diseases. Relation between 25-hydroxyvitamin D [25(OH)D] and lung function and lung diseases has received little attention at the global level. Cross-sectional data from three National Health and Nutrition Examination Surveys, 2007–2008, 2009–2010, and 2011–2012 were used to investigate the relationship between serum 25(OH)D concentrations and lung function makers [forced vital capacity (FVC) and forced expiratory volume in 1 s (FEV1)] and lung diseases (asthma, emphysema, and chronic bronchitis) with multivariate regression models (n = 11,983; men, 6,010; women, 5,973). Serum 25(OH)D concentrations were directly associated with FVC and FEV1 (P for trend < 0.01). Individuals in the 4th quartile serum 25(OH)D had significantly higher FVC and FEV1 compared to those in the 1st quartile (P < 0.01). When data were stratified based on gender and smoking status, we found similar associations between serum 25(OH)D concentrations and lung function markers. There was no relation between serum 25(OH)D and prevalence of asthma, chronic bronchitis, and emphysema in US adults. Serum 25(OH)D concentration is associated with improved lung function markers but not with the prevalence of asthma, emphysema, and chronic bronchitis. Controlled studies are needed to determine if the vitamin D supplementation improves lung function in adults and in smokers.
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Affiliation(s)
- Vijay Ganji
- Human Nutrition Department, College of Health Sciences, QU Health, Qatar University, P.O.Box 2713, Doha, Qatar.
| | - Asma Al-Obahi
- Human Nutrition Department, College of Health Sciences, QU Health, Qatar University, P.O.Box 2713, Doha, Qatar
| | - Sumaya Yusuf
- Human Nutrition Department, College of Health Sciences, QU Health, Qatar University, P.O.Box 2713, Doha, Qatar
| | - Zainab Dookhy
- Human Nutrition Department, College of Health Sciences, QU Health, Qatar University, P.O.Box 2713, Doha, Qatar
| | - Zumin Shi
- Human Nutrition Department, College of Health Sciences, QU Health, Qatar University, P.O.Box 2713, Doha, Qatar
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Mathyssen C, Aelbrecht C, Serré J, Everaerts S, Maes K, Gayan-Ramirez G, Vanaudenaerde B, Janssens W. Local expression profiles of vitamin D-related genes in airways of COPD patients. Respir Res 2020; 21:137. [PMID: 32493333 PMCID: PMC7268690 DOI: 10.1186/s12931-020-01405-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Accepted: 05/24/2020] [Indexed: 12/30/2022] Open
Abstract
Treatment of Chronic Obstructive Pulmonary Disease (COPD) is based on bronchodilation, with inhaled corticosteroids or azithromycin associated when frequent exacerbations occur. Despite the proven benefits of current treatment regimens, the need for new interventions in delineated subgroups remains. There is convincing evidence for oral vitamin D supplementation in reducing exacerbations in COPD patients severely deficient for circulating vitamin D. However, little is known about local vitamin D metabolism in the airways and studies examining expression of the vitamin D receptor (VDR), the activating enzyme (CYP27B1) and inactivating enzyme (CYP24A1) of vitamin D in lung tissue of COPD patients are lacking. Therefore, the expression and localization of key enzymes and the receptor of the vitamin D pathway were examined in tissue of 10 unused donor lungs and 10 COPD explant lungs. No differences in the expression of CYP27B1 and CYP24A1 were found. Although protein expression of VDR was significantly lower in COPD explant tissue, there was no difference in downstream expression of the antimicrobial peptide cathelicidin. Whereas CYP27B1 and CYP24A1 were present in all layers of the bronchial epithelium, VDR was only expressed at the apical layer of a fully differentiated bronchial epithelium with no expression in vascular endothelial cells. By contrast, CYP24A1 expression was highly present in lung endothelial cells suggesting that systemic vitamin D can be inactivated before reaching the epithelial compartment and the tissue immune cells. These data support the idea of exploring the role of vitamin D inhalation in patients with COPD.
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Affiliation(s)
- Carolien Mathyssen
- Department CHROMETA, Laboratory of Respiratory diseases and Thoracic Surgery (BREATHE), KU Leuven, Leuven, Belgium
| | - Celine Aelbrecht
- Department CHROMETA, Laboratory of Respiratory diseases and Thoracic Surgery (BREATHE), KU Leuven, Leuven, Belgium
| | - Jef Serré
- Department CHROMETA, Laboratory of Respiratory diseases and Thoracic Surgery (BREATHE), KU Leuven, Leuven, Belgium
| | - Stephanie Everaerts
- Clinical department of Respiratory Diseases, UZ Leuven, Campus Gasthuisberg, ON I Herestraat 49 - bus, 706 3000, Leuven, Belgium
| | - Karen Maes
- Department CHROMETA, Laboratory of Respiratory diseases and Thoracic Surgery (BREATHE), KU Leuven, Leuven, Belgium
| | - Ghislaine Gayan-Ramirez
- Department CHROMETA, Laboratory of Respiratory diseases and Thoracic Surgery (BREATHE), KU Leuven, Leuven, Belgium
| | - Bart Vanaudenaerde
- Department CHROMETA, Laboratory of Respiratory diseases and Thoracic Surgery (BREATHE), KU Leuven, Leuven, Belgium
| | - Wim Janssens
- Department CHROMETA, Laboratory of Respiratory diseases and Thoracic Surgery (BREATHE), KU Leuven, Leuven, Belgium. .,Clinical department of Respiratory Diseases, UZ Leuven, Campus Gasthuisberg, ON I Herestraat 49 - bus, 706 3000, Leuven, Belgium.
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Bavi F, Movahed R, Salehi M, Hossaini S, Bakhshaee M. Chronic rhinosinusitis with polyposis and serum vitamin D levels. ACTA ACUST UNITED AC 2020; 39:336-340. [PMID: 31708580 PMCID: PMC6843586 DOI: 10.14639/0392-100x-2439] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2018] [Accepted: 02/19/2019] [Indexed: 12/22/2022]
Abstract
The pathogenesis of chronic rhinosinusitis (CRS) is still unknown, but it is accepted that various inflammatory factors are responsible for the different CRS subtypes. Vitamin D3 has been shown to alter inflammatory mediators in some diseases and its deficiency might also be associated with CRS with nasal polyposis (CRSwNP). Herein, we investigated serum vitamin D3 levels in patients with CRSwNP and its association with disease severity. In a cross-sectional study, 166 cases with CRSwNP and 172 healthy subjects were enrolled. Serum vitamin D3 levels were measured and compared in both groups. Furthermore, the relationship between serum vitamin-D3 level and the patient’s allergic status and severity of disease (clinically and based on computed tomographic imaging and nasal endoscopy) among patients with CRSwNP was assessed. Serum vitamin D3 level in the CRSwNP group was significantly lower than in the control group (P < 0.0001). After controlling for possible confounding factors, an increase in vitamin D level showed a protective effect in CRSwNP (OR = 0.69 95% CI:0.62-0.76). A negative correlation was found between serum vitamin-D3 level and the Lund-Mackay score (LMS) (P < 0.0001, R = – 0.66), the Lund-Kennedy score (LKS) (P < 0.0001, R = – 0.71) and the Sino-Nasal Outcome Test-22 (P < 0.001, R = – 0.49). Serum vitamin D level in the CRSwNP group was significantly lower than the control group. Disease severity, based on imaging, endoscopic and clinical criteria, was inversely associated with serum vitamin D levels.
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Affiliation(s)
- F Bavi
- Otorhinolaryngologist Sinus and Surgical Endoscopic Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - R Movahed
- Otorhinolaryngologist Sinus and Surgical Endoscopic Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - M Salehi
- Clinical Research Unit, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - S Hossaini
- Otorhinolaryngologist Sinus and Surgical Endoscopic Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - M Bakhshaee
- Otorhinolaryngologist Sinus and Surgical Endoscopic Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
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Association of serum vitamin D status with dietary intake and sun exposure in adults. Clin Nutr ESPEN 2019; 34:23-31. [PMID: 31677707 DOI: 10.1016/j.clnesp.2019.09.008] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2019] [Revised: 09/06/2019] [Accepted: 09/13/2019] [Indexed: 11/21/2022]
Abstract
BACKGROUND & AIMS Serum 25(OH)D deficiency is becoming an epidemic. The aim was to assess vitamin D status of the adult Greek population in relation to intake, sun exposure and other factors, using data from the Hellenic National Nutrition and Health Survey (HNNHS). METHODS Data from 1084 adult participants (37.8% males) were analyzed. Vitamin D intake was assessed using 24-h recalls. Serum 25(OH)D concentration was evaluated and related to anthropometric measurements and other covariates including supplements used, by sex. Variables significantly associated with 25(OH)D < 20 ng/ml were assessed using simple and multiple logistic regression. RESULTS Median vitamin D intake from food was 1.23 mcg/day (0.60, 2.44), with 9.1% consuming supplements. Median serum 25(OH)D was 16.72 ng/ml, with no sex differences (P = 0.923). The odds of having 25(OH)D < 20 ng/ml significantly decreased with being very active (OR 0.55, 95% CI 0.35, 0.98), increasing length of sun exposure [1-3 h/day (OR 0.59, 95% CI 0.44, 0.80), >3 h/day (OR 0.36, 95% CI 0.24, 0.55)], and skin colour [light to medium skin (OR 0.47, 95% CI 0.24, 0.91), fairly dark skin colour (OR 0.34, 95% CI 0.17, 0.67) and dark or very dark skin colour (OR 0.34, 95% CI 0.15, 0.75)], compared to respective baseline levels. The odds significantly increased with obesity (OR 1.95, 95% CI 1.24, 3.08), and spring season of blood sample collection (OR 1.75, 95% CI 1.22, 2.50). CONCLUSIONS Vitamin D deficiency is highly prevalent in Greek adults. Relevant public health policies are highly recommended, which could include vitamin D fortification. and suggestion for increased but safe sun exposure.
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15
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Association between serum vitamin D and chronic rhinosinusitis: a meta-analysis. Braz J Otorhinolaryngol 2019; 87:178-187. [PMID: 31653607 PMCID: PMC9422378 DOI: 10.1016/j.bjorl.2019.08.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Accepted: 08/10/2019] [Indexed: 02/05/2023] Open
Abstract
Introduction Chronic rhinosinusitis is a highly heterogeneous chronic inflammation of the upper respiratory tract caused by immune dysfunction in human beings. However, the underlying etiology of this disease has not yet been well established. Several trials have revealed that serum vitamin D level abnormality might play a role in the pathophysiology of chronic rhinosinusitis. Objective The aim of present study was to perform a meta-analysis of studies to compare the serum vitamin D levels between patients with chronic rhinosinusitis and healthy controls and to evaluate the potential associations of serum vitamin D level with the occurrence of chronic rhinosinusitis. Methods Following the PRISMA guidelines, relevant databases incorporating Pubmed, Web of Science, Embase and Cochrane Library were searched from inception to December 1, 2018. Funnel plot symmetry and Egger’ test were used to detect publication biases. The outcomes were presented as Weighted Mean Difference combined with 95% Confidence Intervals to estimate the difference of serum vitamin D levels between patients with chronic rhinosinusitis and controls. Higgins I2 value was used to test for heterogeneity between the included studies. Results Out of 176 studies, only eight studies involving 337 chronic rhinosinusitis patients and 179 healthy controls met the criteria and were included in the meta-analysis. In a pooled analysis of the studies, chronic rhinosinusitis patients showed decreased serum vitamin D status (WMD = −7.80, 95% CI −13.28 to −2.31, p = 0.000). Subgroups analyses based on study location (USA vs. Non-USA), types of biomarkers (25(OH)D3 vs. 25(OH)D) and the study design methods (retrospective vs. prospective) did not reveal heterogeneity. However, phenotypes of chronic rhinosinusitis, with versus without polyposis might account for some degree of heterogeneity. Meanwhile, a lower serum vitamin D level was observed in chronic rhinosinusitis with nasal polyps patients. Conclusion Our findings indicate that serum vitamin D level might be associated with patients with chronic rhinosinusitis as we detected a significant association between lower serum vitamin D status and chronic rhinosinusitis, especially in chronic rhinosinusitis with nasal polyps patients. However, further comprehensive studies are warranted in order to draw firm conclusions.
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Luo CM, Feng J, Zhang J, Gao C, Cao JY, Zhou GL, Jiang YJ, Jin XQ, Yang MS, Pan JY, Wang AL. 1,25-Vitamin D3 protects against cooking oil fumes-derived PM2.5-induced cell damage through its anti-inflammatory effects in cardiomyocytes. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2019; 179:249-256. [PMID: 31054378 DOI: 10.1016/j.ecoenv.2019.04.064] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/27/2018] [Revised: 04/16/2019] [Accepted: 04/22/2019] [Indexed: 06/09/2023]
Abstract
The functional role of 1,25-vitamin D3 in cooking oil fumes (COFs)-derived PM2.5-induced cell damage is largely unexplored. The present study investigated the protective role of 1,25-vitamin D3 against cell injury by possible involvement of JAK/STAT and NF-κB signaling pathways in cardiomyocytes. Cell viability was measured using CCK-8 assay, and cell apoptosis was analyzed by flow cytometry, qRT-PCR and Western blot in cultured rat neonatal cardiomyocytes treated with 1,25-vitamin D3 and COFs-derived PM2.5. Expressions of JAK/STAT and NF-κB signaling pathway were measured by Western blot. The results suggested that treatment with COFs-derived PM2.5 significantly decreased cell viability and increased apoptosis and oxidative stress in cultured rat neonatal cardiomyocytes. 1,25-vitamin D3 pretreatment alleviated the cell injury by increasing cell viability and decreasing apoptosis in the cardiomyocytes. 1,25-vitamin D3 pretreatment also decreased the ROS level and inflammation in the cardiomyocytes. Furthermore, 1,25-vitamin D3 pretreatment alleviated COFs-derived PM2.5-evoked elevation of JAK/STAT and NF-κB signaling pathways. Our study showed that 1,25-vitamin D3 pretreatment protected cardiomyocytes from COFs-derived PM2.5-induced injury by decreasing ROS, apoptosis and inflammation level via activations of the JAK/STAT and NF-κB signaling pathways.
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Affiliation(s)
- Chun-Miao Luo
- Department of Cardiology, The First Affiliated Hospital of Anhui Medical University, HeFei, Anhui, China; Department of Cardiology, The Second People Hospital of Hefei, HeFei, Anhui, China
| | - Jun Feng
- Department of Cardiology, The Second People Hospital of Hefei, HeFei, Anhui, China
| | - Jing Zhang
- Department of Cardiology, The Second People Hospital of Hefei, HeFei, Anhui, China
| | - Chao Gao
- Department of Cardiology, The Second People Hospital of Hefei, HeFei, Anhui, China
| | - Ji-Yu Cao
- Department of Occupational and Environmental Health, School of Public Health, Anhui Medical University, HeFei, Anhui, China; The Teaching Center for Preventive Medicine, School of Public Health, Anhui Medical University, HeFei, Anhui, China
| | - Gao-Liang Zhou
- Department of Cardiology, The Second People Hospital of Hefei, HeFei, Anhui, China
| | - Yong-Jing Jiang
- Department of Cardiology, The Second People Hospital of Hefei, HeFei, Anhui, China
| | - Xiao-Qing Jin
- Department of Cardiology, The Second People Hospital of Hefei, HeFei, Anhui, China
| | - Meng-Si Yang
- Department of Cardiology, The Second People Hospital of Hefei, HeFei, Anhui, China
| | - Jian-Yuan Pan
- Department of Cardiology, The Second People Hospital of Hefei, HeFei, Anhui, China
| | - Ai-Ling Wang
- Department of Cardiology, The First Affiliated Hospital of Anhui Medical University, HeFei, Anhui, China.
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Mathyssen C, Serré J, Sacreas A, Everaerts S, Maes K, Verleden S, Verlinden L, Verstuyf A, Pilette C, Gayan-Ramirez G, Vanaudenaerde B, Janssens W. Vitamin D Modulates the Response of Bronchial Epithelial Cells Exposed to Cigarette Smoke Extract. Nutrients 2019; 11:E2138. [PMID: 31500220 PMCID: PMC6770037 DOI: 10.3390/nu11092138] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Revised: 08/27/2019] [Accepted: 09/03/2019] [Indexed: 12/22/2022] Open
Abstract
In chronic obstructive pulmonary disease (COPD), the bronchial epithelium is the first immune barrier that is triggered by cigarette smoke. Although vitamin D (vitD) has proven anti-inflammatory and antimicrobial effects in alveolar macrophages, little is known about the direct role of vitD on cigarette smoke-exposed bronchial epithelial cells. We examined the effects of vitD on a human bronchial epithelial cell line (16HBE) and on air-liquid culture of primary bronchial epithelial cells (PBEC) of COPD patients and controls exposed for 24 h to cigarette smoke extract (CSE). VitD decreased CSE-induced IL-8 secretion by 16HBE cells, but not by PBEC. VitD significantly increased the expression of the antimicrobial peptide cathelicidin in 16HBE and PBEC of both COPD subjects and controls. VitD did not affect epithelial to mesenchymal transition or epithelial MMP-9 expression and was not able to restore impaired wound healing by CSE in 16HBE cells. VitD increased the expression of its own catabolic enzyme CYP24A1 thereby maintaining its negative feedback. In conclusion, vitD supplementation may potentially reduce infectious exacerbations in COPD by the upregulation of cathelicidin in the bronchial epithelium.
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Affiliation(s)
| | - Jef Serré
- Lab of Respiratory Diseases, CHROMETA, KU Leuven, 3000 Leuven, Belgium.
| | - Annelore Sacreas
- Lab of Respiratory Diseases, CHROMETA, KU Leuven, 3000 Leuven, Belgium.
| | | | - Karen Maes
- Lab of Respiratory Diseases, CHROMETA, KU Leuven, 3000 Leuven, Belgium.
| | - Stijn Verleden
- Lab of Respiratory Diseases, CHROMETA, KU Leuven, 3000 Leuven, Belgium.
| | - Lieve Verlinden
- Clinical and Experimental Endocrinology, CHROMETA, KU Leuven, 3000 Leuven, Belgium.
| | - Annemieke Verstuyf
- Clinical and Experimental Endocrinology, CHROMETA, KU Leuven, 3000 Leuven, Belgium.
| | - Charles Pilette
- Institute of Experimental & Clinical Research-Pole of Pneumology, ENT and Dermatology, Université Catholique de Louvain (UCL), 1200 Brussels, Belgium.
| | | | | | - Wim Janssens
- Lab of Respiratory Diseases, CHROMETA, KU Leuven, 3000 Leuven, Belgium.
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18
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Wynne M, Atkinson C, Schlosser RJ, Mulligan JK. Contribution of Epithelial Cell Dysfunction to the Pathogenesis of Chronic Rhinosinusitis with Nasal Polyps. Am J Rhinol Allergy 2019; 33:782-790. [PMID: 31382760 DOI: 10.1177/1945892419868588] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Background In the past, the airway epithelium was thought to be primarily an inert physical barrier. We now know that the upper airway epithelium plays a critical role in both innate and adaptive immunity, and that epithelial dysfunction is strongly associated with inflammatory airway disease. The pathogenesis of chronic rhinosinusitis is poorly understood, but growing evidence supports a key role for the airway epithelium in the pathophysiology of the disease. Objective The purpose of this study is to explore our current understanding of how dysfunction in human sinonasal epithelial cells (HSNECs) contributes to the pathogenesis of chronic rhinosinusitis with nasal polyps (CRSwNP) and to examine how current and developing therapies affect epithelial cell functions. Methods A literature review of papers published in English pertaining to epithelial cell dysfunction in patients with CRSwNP was performed using the PubMed database. The search utilized combinations of the following key words: sinusitis, polyps, epithelium, pathophysiology, barrier function, dendritic cells, eosinophils, T cells, complement, mucociliary clearance, vitamin D, cytokines, chemokines, taste receptors, steroids, saline, and therapy. Results HSNEC mucociliary clearance, barrier function, secretion of cytokines, influence on dendritic cells, influence on T-cells, regulation of eosinophils, vitamin D metabolism, complement production, and taste receptor function are altered in patients with CRSwNP and contribute to the pathogenesis of the disease. Current therapies utilized to manage CRSwNP counteract the effects of HSNEC dysfunction and relieve key symptoms of the disease. Conclusion HSNECs are key players in both innate and adaptive immunity, and altered epithelial functions are closely intertwined with the pathogenesis of CRSwNP. Our review supports further investigation of altered HSNEC function in patients with CRSwNP and supports development of novel epithelial-targeted therapies for its management.
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Affiliation(s)
- Michael Wynne
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina
| | - Carl Atkinson
- Department of Microbiology and Immunology, Medical University of South Carolina, Charleston, South Carolina.,Department of Surgery, Medical University of South Carolina, Lee Patterson Allen Transplant Immunobiology Laboratory, Charleston, South Carolina
| | - Rodney J Schlosser
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina
| | - Jennifer K Mulligan
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina.,Department of Pediatrics, Medical University of South Carolina, Charleston, South Carolina
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19
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Navarro-Triviño F, Arias-Santiago S, Gilaberte-Calzada Y. Vitamin D and the Skin: A Review for Dermatologists. ACTAS DERMO-SIFILIOGRAFICAS 2019. [DOI: 10.1016/j.adengl.2019.04.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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20
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Xu J, Yuan X, Tao J, Yu N, Wu R, Zhang Y. Association of Circulating 25-Hydroxyvitamin D Levels with Colorectal Cancer: An Updated Meta-Analysis. J Nutr Sci Vitaminol (Tokyo) 2019; 64:432-444. [PMID: 30606966 DOI: 10.3177/jnsv.64.432] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
A higher serum 25-hydroxyvitamin D (25(OH)D) concentration benefits colorectal cancer prevention. However, whether it can improve the prognosis among patients is still under discussion. This study aims to explore the impacts of high level 25(OH)D on the survival of colorectal cancer patients. PubMed, Embase, and Cochrane were searched from January 2000 to August 2017 for relevant articles. Only published studies focusing on the relationship between 25(OH)D levels at or near the time of diagnosis and survival were considered. Two review authors independently assessed the risk of bias for each study, and any disagreement was resolved by discussion or by involving a third assessor. Eleven studies comprising 7,367 patients were included. In these studies, there were considerable differences between the higher 25(OH)D level group and the lower group in terms of overall survival (OS), progression-free survival (PFS) and colorectal cancer-specific survival (CSS) in a random effect model (OS: HR 0.67, 95% CI 0.56-0.80, p<0.00001; CSS: HR 0.73, 95% CI 0.55-0.97, p=0.03; PFS: HR 0.74, 95% CI 0.61-0.90, p=0.003). Moreover, the combined hazard ratios of OS and CSS had considerably significant heterogeneity which may be explained by subgroup analysis. The relationship between 25(OH)D and tumor characteristics/lifestyle factors was also included in the meta-analysis. BMI (p=0.03), smoking (p=0.03) and physical activity (p=0.002) seemed to be associated with circulating 25(OH)D level. Publication bias was undetected. Colorectal cancer patients with higher circulating 25(OH)D level may have a better prognosis.
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Affiliation(s)
- Jianhao Xu
- Department of Oncology, The Second Affiliated Hospital of Soochow University
| | - Xuya Yuan
- Department of Oncology, The Second Affiliated Hospital of Soochow University
| | - Jialong Tao
- Department of Oncology, The Second Affiliated Hospital of Soochow University
| | - Na Yu
- Department of Oncology, The Second Affiliated Hospital of Soochow University
| | - Runhong Wu
- Department of Oncology, The Second Affiliated Hospital of Soochow University
| | - Yusong Zhang
- Department of Oncology, The Second Affiliated Hospital of Soochow University
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21
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Navarro-Triviño FJ, Arias-Santiago S, Gilaberte-Calzada Y. Vitamin D and the Skin: A Review for Dermatologists. ACTAS DERMO-SIFILIOGRAFICAS 2019; 110:262-272. [PMID: 30857638 DOI: 10.1016/j.ad.2018.08.006] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2018] [Revised: 07/28/2018] [Accepted: 08/02/2018] [Indexed: 02/07/2023] Open
Abstract
In recent years, the growing interest in the role played by vitamin D in skin disease has given rise to the publication of many studies of the relationship between this vitamin and certain skin conditions. As dermatologists, we need to understand, among other aspects, how vitamin D is synthesized and the main sources in humans, as well as plasma levels and the factors that can modify them. Of particular interest are the latest discoveries about the role of vitamin D in skin diseases such as lupus erythematosus, ichthyosis, atopic dermatitis, hidradenitis suppurativa, acne, alopecia areata, androgenetic alopecia, melanoma, and nonmelanoma skin cancer. Also of interest is the importance of vitamin D as adjuvant therapy in patients on long-term treatment with corticosteroids. In this review, we provide an overview of the most important and most recent information regarding the relationship between vitamin D and skin disease and discuss the importance of assessing individual vitamin D status and correcting deficiencies.
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Affiliation(s)
- F J Navarro-Triviño
- Unidad de Dermatología Médico-Quirúrgica y Venereología, Hospital Comarcal Alcalá la Real, Jaén, España.
| | - S Arias-Santiago
- Unidad de Gestión Clínica de Dermatología y Venereología, Hospital Universitario Virgen de las Nieves, Granada, España
| | - Y Gilaberte-Calzada
- Servicio de Dermatología, Hospital Universitario Miguel Servet, IIS Aragón, Zaragoza, España
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Mousavi SE, Amini H, Heydarpour P, Amini Chermahini F, Godderis L. Air pollution, environmental chemicals, and smoking may trigger vitamin D deficiency: Evidence and potential mechanisms. ENVIRONMENT INTERNATIONAL 2019; 122:67-90. [PMID: 30509511 DOI: 10.1016/j.envint.2018.11.052] [Citation(s) in RCA: 107] [Impact Index Per Article: 21.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/19/2018] [Revised: 11/20/2018] [Accepted: 11/21/2018] [Indexed: 06/09/2023]
Abstract
Beyond vitamin D (VD) effect on bone homeostasis, numerous physiological functions in human health have been described for this versatile prohormone. In 2016, 95% of the world's population lived in areas where annual mean ambient particulate matter (<2.5 μm) levels exceeded the World Health Organization guideline value (Shaddick et al., 2018). On the other hand, industries disperse thousands of chemicals continually into the environment. Further, considerable fraction of populations are exposed to tobacco smoke. All of these may disrupt biochemical pathways and cause detrimental consequences, such as VD deficiency (VDD). In spite of the remarkable number of studies conducted on the role of some of the above mentioned exposures on VDD, the literature suffers from two main shortcomings: (1) an overview of the impacts of environmental exposures on the levels of main VD metabolites, and (2) credible engaged mechanisms in VDD because of those exposures. To summarize explanations for these unclear topics, we conducted the present review, using relevant keywords in the PubMed database, to investigate the adverse effects of exposure to air pollution, some environmental chemicals, and smoking on the VD metabolism, and incorporate relevant potential pathways disrupting VD endocrine system (VDES) leading to VDD. Air pollution may lead to the reduction of VD cutaneous production either directly by blocking ultraviolet B photons or indirectly by decreasing outdoor activity. Heavy metals may reduce VD serum levels by increasing renal tubular dysfunction, as well as downregulating the transcription of cytochrome P450 mixed-function oxidases (CYPs). Endocrine-disrupting chemicals (EDCs) may inhibit the activity and expression of CYPs, and indirectly cause VDD through weight gain and dysregulation of thyroid hormone, parathyroid hormone, and calcium homeostasis. Smoking through several pathways decreases serum 25(OH)D and 1,25(OH)2D levels, VD intake from diet, and the cutaneous production of VD through skin aging. In summary, disturbance in the cutaneous production of cholecalciferol, decreased intestinal intake of VD, the modulation of genes involved in VD homeostasis, and decreased local production of calcitriol in target tissues are the most likely mechanisms that involve in decreasing the serum VD levels.
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Affiliation(s)
- Sayed Esmaeil Mousavi
- Department of Water and Wastewater Treatment, Water and Wastewater Consulting Engineers (Design & Research), Isfahan, Iran; Social Health Determinants Research Center, Shahrekord University of Medical Sciences, Shahrekord, Iran.
| | - Heresh Amini
- Department of Environmental Health, Harvard T. H. Chan School of Public Health, Boston, MA, United States; Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
| | - Pouria Heydarpour
- MS Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Fatemeh Amini Chermahini
- Cellular and Molecular Research Center, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | - Lode Godderis
- Centre for Environment and Health, Department of Public Health and Primary Care, University of Leuven (KU, Leuven), Belgium; IDEWE, External Service for Prevention at Protection at Work, Heverlee, Belgium
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Tomaszewska M, Sarnowska E, Rusetska N, Kowalik K, Sierdzinski J, Siedlecki JA, Badmaev V, Stohs SJ, Popko M. Role of Vitamin D and Its Receptors in the Pathophysiology of Chronic Rhinosinusitis. J Am Coll Nutr 2018; 38:108-118. [PMID: 30388935 DOI: 10.1080/07315724.2018.1503102] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
OBJECTIVES Chronic rhinosinusitis (CRS) is a disease that represents a challenging therapeutic problem. Vitamin D and its receptors (VDR) are involved in the regulation of the immune system and may play role in CRS. Objectives of this study were to assess the relationships between the total concentration of vitamin D (25VD3) in sera, vitamin D receptor (VDR) expression, 1α-hydroxylase expression, and clinical data, including age, gender, Sino-Nasal Outcome Test (SNOT-22), computerized tomography (CT) scan, allergy status, and vitamin D supplementation in CRS patients with (CRSwNP) and without nasal polyps (CRSsNP), and in a control group. METHODS The studied group comprised 52 patients with CRS without nasal polyps (sNP), 55 with CRS with nasal polyps (wNP), and 59 in the control group. The endpoints were determined by appropriate methods. We conducted immunohistochemical staining of gathered tissue from the ostiomeatal complex for determination of VDR and 1α-hydroxylase. Analytical results were compared with clinical data as already noted. RESULTS A decrease in VDR nuclear staining occurred in CRS patients as compared to controls. Insignificant differences were observed in 1α-hydroxylase, expression in all studied groups, while VDR and cytochrome CYP27B1 protein expression (1α-hydroxylase) correlated with clinical data. CONCLUSIONS The data provide evidence that indicates that vitamin D and its receptor and enzymes may play a role in CRS.
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Affiliation(s)
- Malgorzata Tomaszewska
- a Department of Otorhinolaryngology , Faculty of Medicine and Dentistry, Medical University of Warsaw , Poland
| | - Elzbieta Sarnowska
- b Department of Molecular and Translational Oncology , Maria Sklodowska-Curie-Institute Oncology Center , Warsaw , Poland
| | - Natalia Rusetska
- b Department of Molecular and Translational Oncology , Maria Sklodowska-Curie-Institute Oncology Center , Warsaw , Poland
| | - Katarzyna Kowalik
- a Department of Otorhinolaryngology , Faculty of Medicine and Dentistry, Medical University of Warsaw , Poland
| | - Janusz Sierdzinski
- c Department of Medical Informatics and Telemedicine , Medical University of Warsaw , Warsaw , Poland
| | - Janusz A Siedlecki
- b Department of Molecular and Translational Oncology , Maria Sklodowska-Curie-Institute Oncology Center , Warsaw , Poland
| | - Vladimir Badmaev
- d American Medical Holdings Inc , Staten Island , New York , USA
| | - Sidney J Stohs
- e School of Pharmacy and Health Professions , Creighton University , Omaha , Nebraska , USA
| | - Mariola Popko
- a Department of Otorhinolaryngology , Faculty of Medicine and Dentistry, Medical University of Warsaw , Poland
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24
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London NR, Lina I, Ramanathan M. Aeroallergens, air pollutants, and chronic rhinitis and rhinosinusitis. World J Otorhinolaryngol Head Neck Surg 2018; 4:209-215. [PMID: 30506053 PMCID: PMC6251962 DOI: 10.1016/j.wjorl.2018.08.006] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2018] [Accepted: 08/27/2018] [Indexed: 12/15/2022] Open
Abstract
Chronic rhinitis and rhinosinusitis are among the most common conditions worldwide with significant morbidity and decreased quality of life. Although the pathogenesis of these conditions is multifactorial, there has been increasing evidence for the role of environmental factors such as aeroallergens and air pollutants as initiating or exacerbating factors. This review will outline the current literature focusing on the role of aeroallergens and air pollution in the pathogenesis of chronic sinonasal inflammatory conditions.
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Affiliation(s)
| | | | - Murugappan Ramanathan
- Johns Hopkins Department of Otolaryngology – Head and Neck Surgery, Baltimore, MD 21287, USA
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Mulligan JK, Patel K, Williamson T, Reaves N, Carroll W, Stephenson SE, Gao P, Drake RR, Neely BA, Tomlinson S, Schlosser RJ, Atkinson C. C3a receptor antagonism as a novel therapeutic target for chronic rhinosinusitis. Mucosal Immunol 2018; 11:1375-1385. [PMID: 29907871 PMCID: PMC6162114 DOI: 10.1038/s41385-018-0048-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2017] [Revised: 04/05/2018] [Accepted: 04/30/2018] [Indexed: 02/04/2023]
Abstract
Chronic rhinosinusitis with nasal polyps (CRSwNP) is an inflammatory disease with an unknown etiology. Recent studies have implicated the complement system as a potential modulator of disease immunopathology. We performed proteomic pathway enrichment analysis of differentially increased proteins, and found an enrichment of complement cascade pathways in the nasal mucus of individuals with CRSwNP as compared to control subjects. Sinonasal mucus levels of complement 3 (C3) correlated with worse subjective disease severity, whereas no significant difference in systemic C3 levels could be determined in plasma samples. Given that human sinonasal epithelial cells were the predominate sinonasal source of C3 and complement anaphylatoxin 3a (C3a) staining, we focused on their role in in vitro studies. Baseline intracellular C3 levels were higher in CRSwNP cells, and following exposure to Aspergillus fumigatus (Af) extract, they released significantly more C3 and C3a. Inhibition of complement 3a receptor (C3aR) signaling led to a decrease in Af-induced C3 and C3a release, both in vitro and in vivo. Finally, we found in vivo that C3aR deficiency or inhibition significantly reduced inflammation and CRS development in a mouse model of Af-induced CRS. These findings demonstrate that local sinonasal complement activation correlates with subjective disease severity, and that local C3aR antagonism significantly ameliorates Af-induced CRS in a rodent model.
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Affiliation(s)
- Jennifer K Mulligan
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, SC, USA
- Department of Pediatrics, Medical University of South Carolina, Charleston, SC, USA
| | - Kunal Patel
- Department of Microbiology and Immunology, Medical University of South Carolina, Charleston, SC, USA
- Lee Patterson Allen Transplant Immunobiology Laboratory, Department of Surgery, Medical University of South Carolina, Charleston, SC, USA
| | - Tucker Williamson
- Department of Microbiology and Immunology, Medical University of South Carolina, Charleston, SC, USA
| | - Nicholas Reaves
- Department of Microbiology and Immunology, Medical University of South Carolina, Charleston, SC, USA
| | - William Carroll
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, SC, USA
| | - Sarah E Stephenson
- Department of Microbiology and Immunology, Medical University of South Carolina, Charleston, SC, USA
| | - Peng Gao
- Department of Cell and Molecular Pharmacology and Experimental Therapeutics, Medical University of South Carolina, Charleston, SC, USA
| | - Richard R Drake
- Department of Cell and Molecular Pharmacology and Experimental Therapeutics, Medical University of South Carolina, Charleston, SC, USA
| | - Benjamin A Neely
- Marine Biochemical Sciences, National Institute of Standards and Technology, Charleston, SC, USA
| | - Stephen Tomlinson
- Department of Microbiology and Immunology, Medical University of South Carolina, Charleston, SC, USA
| | - Rodney J Schlosser
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, SC, USA
- Ralph H. Johnson VA Medical Center, Charleston, SC, USA
| | - Carl Atkinson
- Department of Microbiology and Immunology, Medical University of South Carolina, Charleston, SC, USA.
- Lee Patterson Allen Transplant Immunobiology Laboratory, Department of Surgery, Medical University of South Carolina, Charleston, SC, USA.
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Palmer C, Mulligan JK, Smith SE, Atkinson C. The role of regulatory T cells in the regulation of upper airway inflammation. Am J Rhinol Allergy 2018; 31:345-351. [PMID: 29122078 DOI: 10.2500/ajra.2017.31.4472] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Allergic rhinitis (AR) and chronic rhinosinusitis with nasal polyps (CRSwNP) are inflammatory diseases of the upper airway, with a similar immunologic profile, characterized by aberrant and persistent type 2 inflammation. One cell population that has been identified as altered in both disease types is regulatory T cell (Treg). Tregs have the capacity to modulate T-effector function and suppress inflammatory cytokine production in a broad range of cell types. Given the ability of Tregs to control inflammation, the role of Tregs in respiratory diseases has attracted much attention. As discussed in this article, alterations in the Treg numbers and function, or both, have been identified in AR and CRSwNP, although much of the data is conflicting. Here, we explored what is known and, in many cases, unknown about the mechanisms by which Tregs differentiate and function, and how these functions can be controlled in the mucosal microenvironment. By gaining a greater understanding of these processes, it may be possible to harness the natural immunosuppressive activity of Tregs to ameliorate the chronic inflammation associated with AR and CRSwNP.
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Affiliation(s)
- Charlie Palmer
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, USA
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Parva NR, Tadepalli S, Singh P, Qian A, Joshi R, Kandala H, Nookala VK, Cheriyath P. Prevalence of Vitamin D Deficiency and Associated Risk Factors in the US Population (2011-2012). Cureus 2018; 10:e2741. [PMID: 30087817 PMCID: PMC6075634 DOI: 10.7759/cureus.2741] [Citation(s) in RCA: 72] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction 1,25-dihydroxyvitamin D3 (cholecalciferol), the hormonally active form of vitamin D3, is a lipid-soluble compound that plays a significant role in clinical medicine due to its potent effects on calcium homeostasis and bone metabolism. Since foods containing natural vitamin D are rare, the primary source of the compound remains its nonenzymatic dermal synthesis through exposure to ultraviolet rays in sunlight. Although uncommon in most developed countries, recent literature has demonstrated that subclinical vitamin D deficiency can exist in certain populations and plays a role in downstream clinical consequences, including cardiovascular disease, cancer, diabetes, osteoporosis, and fractures. This study aims to identify the prevalence and change in the pattern of vitamin D deficiency in subpopulations throughout the United States to provide a foundation for further clinical studies correlating the clinical outcomes to vitamin deficiency. Methods Data analyzed in this study were collected through National Health and Nutrition Examination Survey (NHANES), specifically from a population of 4962 participants, age ≥20 years, who were hospitalized between 2011 and 2012. This cohort was stratified to divide the population into patients that were vitamin D sufficient (>50 nmol/L) versus patients who were vitamin D deficient (50 nmol/L). The risk factors were compared between the subpopulations in 2005-2006 and 2011-2012. Conclusions The prevalence of vitamin D deficiency is greater in certain clinical subpopulations, and the presence of associated characteristics should raise the index of suspicion for the practicing clinician with regard to conditions associated with vitamin D deficiency, such as osteoporosis and osteomalacia. Further research investigating the pathophysiology of hypovitaminosis D and its clinical consequences can help better understand and prevent the development of associated comorbidities.
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Affiliation(s)
| | - Satish Tadepalli
- Internal Medicine, Hackensack Meridian - Ocean Medical Center, Edison, USA
| | - Pratiksha Singh
- Internal Medicine, Hackensack Meridian - Ocean Medical Center, Edison, USA
| | | | - Rajat Joshi
- Internal Medicine, Penn State Milton S. Hershey Medical Center
| | | | | | - Pramil Cheriyath
- Internal Medicine, Hackensack Meridian - Ocean Medical Center, Edison, USA
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Christensen DN, Franks ZG, McCrary HC, Saleh AA, Chang EH. A Systematic Review of the Association between Cigarette Smoke Exposure and Chronic Rhinosinusitis. Otolaryngol Head Neck Surg 2018; 158:801-816. [PMID: 29460678 DOI: 10.1177/0194599818757697] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Objectives Cigarette smoking and passive smoke exposure have been associated with chronic rhinosinusitis (CRS). Our goal in this systematic review was to (1) determine if there was a strong correlative effect in large population studies between cigarette smoke exposure and the prevalence of CRS, (2) investigate pathogenic mechanisms of cigarette smoke in the upper airway, and (3) determine if a history of cigarette smoking affects the medical and surgical outcomes of CRS. Data Sources MEDLINE, Embase, Cochrane CENTRAL, Web of Science SCI and CPCI-S, and websites. Methods A comprehensive literature review and quantitative meta-analysis of studies based on the PRISMA protocol and examining the relationship between cigarette smoke exposure and CRS was performed. A search strategy was developed using various terms such as sinusitis, rhinitis, rhinosinusitis, and smoking. The articles were categorized by (1) epidemiology, (2) pathophysiology, and (3) outcomes. Data regarding study design, population/setting, methods, and bias were collected. Results The initial search generated 2621 titles/abstracts with 309 articles undergoing secondary review and 112 articles for final review. We determined that there is a strong correlation between active and passive cigarette smoke with the prevalence of CRS. Cigarette smoke challenge to sinonasal epithelia results in the release of inflammatory mediators and altered ciliary beat frequency. Pediatric patients exposed to secondhand smoke appear to have particularly poor outcomes. Conclusion There is clear evidence that cigarette smoke is related to CRS, but longitudinal and mechanistic studies are required to determine a causative effect. This information is critical for greater understanding of CRS health outcomes.
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Affiliation(s)
- Dallin N Christensen
- 1 Department of Otolaryngology-Head and Neck Surgery, The University of Arizona College of Medicine, Tucson, Arizona, USA
| | - Zechariah G Franks
- 1 Department of Otolaryngology-Head and Neck Surgery, The University of Arizona College of Medicine, Tucson, Arizona, USA
| | - Hilary C McCrary
- 1 Department of Otolaryngology-Head and Neck Surgery, The University of Arizona College of Medicine, Tucson, Arizona, USA
| | - Ahlam A Saleh
- 2 The University of Arizona College of Medicine, Tucson, Arizona, USA.,3 The University of Arizona Health Sciences Library, Tucson, Arizona, USA
| | - Eugene H Chang
- 1 Department of Otolaryngology-Head and Neck Surgery, The University of Arizona College of Medicine, Tucson, Arizona, USA
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Konstantinidis I, Fotoulaki M, Iakovou I, Chatziavramidis A, Mpalaris V, Shobat K, Markou K. Vitamin D3 Deficiency and its Association with Nasal Polyposis in Patients with Cystic Fibrosis and Patients with Chronic Rhinosinusitis. Am J Rhinol Allergy 2017; 31:395-400. [DOI: 10.2500/ajra.2017.31.4484] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Background Currently vitamin D3 (VD3) or cholecalciferol is considered an immunomodulator that may be implicated in nasal polyposis (NP) pathophysiology. Objectives This study aimed to investigate if deficiency of VD3 is associated with the presence of NP in patients with cystic fibrosis (CT) and patients with chronic rhinosinusitis (CRS). Methods In total, 152 adult participants were included in five phenotypic groups: CT with NP (CTwNP) (n = 27), CT without NP (CTsNP) (n = 31), CRS with NP (CRSwNP) (n = 32), CRS without NP (CRSsNP) (n = 30), and controls (n = 32). The serum levels of 25(OH)-VD3 <20 ng/mL are considered as a deficiency, 21–29 ng/mL as insufficiency, and >30 ng/mL as sufficiency. Endoscopic and imaging staging of the mucosal disease performed with the Lund-Kennedy (LK) and Lund-Mackay (LM) scoring systems, respectively. The genotype of the patients with CT and the nasal microbial colonization of the patients with CT and patients with CRS were also recorded. Results The patients with CTwNP had the lowest percentage of sufficiency in VD3 and the highest percentage in insufficiency among all the groups. The LM imaging scores were inversely correlated with the VD3 levels in both arms of the study (CT and CRS). Moreover, the LK endoscopic scores had a similar correlation in the CT groups; however, this was not the case with the CRS groups. The genotype of the patients with CT was not correlated with the VD3 serum levels. The patients with positive microbial colonization (mainly Pseudomonas and Staphylococcus aureus) had significantly lower VD3 serum levels in both the CT and CRS process. Conclusion VD3 deficiency seemed to be associated with the presence of nasal polyps in the patients with CRS and in the patients with CT in a similar manner. The lower the level of serum VD3, the more severe the mucosal disease was found in the imaging studies and the more frequent microbial colonization of the patients with CT and the patients with CRS.
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Affiliation(s)
- Iordanis Konstantinidis
- Rhinology Clinic, Second Academic Otorhinolaryngology Department, Papageorgiou Hospital, Aristotle University, Thessaloniki, Greece
| | - Maria Fotoulaki
- Fourth Academic Department of Pediatrics, Papageorgiou Hospital, Aristotle University, Thessaloniki, Greece
| | - Ioannis Iakovou
- Third Academic Department of Nuclear Medicine, Papageorgiou Hospital, Aristotle University, Thessaloniki, Greece
| | - Angelos Chatziavramidis
- Rhinology Clinic, Second Academic Otorhinolaryngology Department, Papageorgiou Hospital, Aristotle University, Thessaloniki, Greece
| | - Vasilios Mpalaris
- Third Academic Department of Nuclear Medicine, Papageorgiou Hospital, Aristotle University, Thessaloniki, Greece
| | - Kseniya Shobat
- Rhinology Clinic, Second Academic Otorhinolaryngology Department, Papageorgiou Hospital, Aristotle University, Thessaloniki, Greece
| | - Konstantinos Markou
- Rhinology Clinic, Second Academic Otorhinolaryngology Department, Papageorgiou Hospital, Aristotle University, Thessaloniki, Greece
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Smith SE, Schlosser RJ, Yawn JR, Mattos JL, Soler ZM, Mulligan JK. Sinonasal T-cell expression of cytotoxic mediators granzyme B and perforin is reduced in patients with chronic rhinosinusitis. Am J Rhinol Allergy 2017; 31:352-356. [PMID: 29122079 PMCID: PMC5691237 DOI: 10.2500/ajra.2017.31.4474] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND CD8+ T cells and natural killer (NK) cells are cytotoxic cells that use granzyme B (GrB) and perforin. Defective cytotoxic function is known to play a role in dysregulated immune response as seen in chronic sinusitis, also referred to as chronic rhinosinusitis (CRS). However, to our knowledge, in the United States, neither GrB or perforin expression has been reported in patients with CRS. OBJECTIVE The aim of this study was to investigate sinonasal cytotoxic cells, their mediators, and cell-specific distribution of these mediators in patients with CRS with nasal polyp (CRSwNP) and in patients with CRS without nasal polyp (CRSsNP). METHODS Blood and sinus tissue samples were taken from patients with CRSsNP (n = 8) and CRSwNP (n = 8) at the time of surgery. Control subjects (n = 8) underwent surgery for cerebrospinal fluid leak repair or to remove non-hormone-secreting pituitary tumors. The cells were analyzed via flow cytometry by using CD8 expression to identify cytotoxic T cells and CD56 expression to identify NK cells. Intracellular GrB and perforin expression were analyzed with flow cytometry. RESULTS We observed no significant differences in plasma or peripheral blood immune cell numbers or specific levels of GrB or perforin among the groups. In the sinonasal mucosa of the patients with CRSsNP and the patients with CRSwNP, there was a significant decrease in GrB and perforin levels (p < 0.05) despite similar or increased numbers of cytotoxic cells when compared with the controls. The overall decrease in GrB and perforin in the sinonasal mucosa of the patients with CRSsNP and the patients with CRSwNP was due to decreased T cell production. There was no difference in total NK cell count or expression of perforin or GrB among all the groups. CONCLUSION Total levels of sinonasal GrB and perforin were decreased in the sinonasal mucosa of both the patients with CRSwNP and the patients with CRSsNP compared with the controls, whereas sinonasal CD8+ T cells, (but not NK cells,), intracellular stores of GrB and perforin were reduced in the patients with CRSwNP compared with the controls.
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Affiliation(s)
- Sarah E. Smith
- From the Department of Otolaryngology—Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina
| | - Rodney J. Schlosser
- From the Department of Otolaryngology—Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina
- Department of Otolaryngology - Head and Neck Surgery, Ralph H. Johnson VA Medical Center, Charleston, South Carolina, and
| | - James R. Yawn
- From the Department of Otolaryngology—Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina
| | - Jose L. Mattos
- From the Department of Otolaryngology—Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina
| | - Zachary M. Soler
- From the Department of Otolaryngology—Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina
| | - Jennifer K. Mulligan
- From the Department of Otolaryngology—Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina
- Department of Pediatrics, Medical University of South Carolina, Charleston, South Carolina
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Dietary vitamin D3 deficiency exacerbates sinonasal inflammation and alters local 25(OH)D3 metabolism. PLoS One 2017; 12:e0186374. [PMID: 29045457 PMCID: PMC5646812 DOI: 10.1371/journal.pone.0186374] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2017] [Accepted: 09/30/2017] [Indexed: 12/21/2022] Open
Abstract
RATIONALE Patients with chronic rhinosinusitis with nasal polyps (CRSwNP) have been shown to be vitamin D3 (VD3) deficient, which is associated with more severe disease and increased polyp size. To gain mechanistic insights into these observational studies, we examined the impact of VD3 deficiency on inflammation and VD3 metabolism in an Aspergillus fumigatus (Af) mouse model of chronic rhinosinusitis (Af-CRS). METHODS Balb/c mice were fed control or VD3 deficient diet for 4 weeks. Mice were then sensitized with intraperitoneal Af, and one week later given Af intranasally every three days for four weeks while being maintained on control or VD3 deficient diet. Airway function, sinonasal immune cell infiltrate and sinonasal VD3 metabolism profiles were then examined. RESULTS Mice with VD3 deficiency had increased Penh and sRaw values as compared to controls as well as exacerbated changes in sRaw when coupled with Af-CRS. As compared to controls, VD3 deficient and Af-CRS mice had reduced sinonasal 1α-hydroxylase and the active VD3 metabolite, 1,25(OH)2D3. Differential analysis of nasal lavage samples showed that VD3 deficiency alone and in combination with Af-CRS profoundly upregulated eosinophil, neutrophil and lymphocyte numbers. VD3 deficiency exacerbated increases in monocyte-derived dendritic cell (DC) associated with Af-CRS. Conversely, T-regulatory cells were decreased in both Af-CRS mice and VD3 deficient mice, though coupling VD3 deficiency with Af-CRS did not exacerbate CD4 or T-regulatory cells numbers. Lastly, VD3 deficiency had a modifying or exacerbating impact on nasal lavage levels of IFN-γ, IL-6, IL-10 and TNF-α, but had no impact on IL-17A. CONCLUSIONS VD3 deficiency causes changes in sinonasal immunity, which in many ways mirrors the changes observed in Af-CRS mice, while selectively exacerbating inflammation. Furthermore, both VD3 deficiency and Af-CRS were associated with altered sinonasal VD3 metabolism causing reductions in local levels of the active VD3 metabolite, 1,25(OH)2D3, even with adequate circulating levels.
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Mulligan JK, O’Connell BP, Pasquini W, Mulligan RM, Smith S, Soler ZM, Atkinson C, Schlosser RJ. Impact of tobacco smoke on upper airway dendritic cell accumulation and regulation by sinonasal epithelial cells. Int Forum Allergy Rhinol 2017; 7:777-785. [PMID: 28574651 PMCID: PMC5544557 DOI: 10.1002/alr.21955] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2017] [Revised: 04/10/2017] [Accepted: 04/18/2017] [Indexed: 12/11/2022]
Abstract
BACKGROUND In these studies we examined the impact of environmental tobacco smoke (ETS) and active smoking on sinonasal dendritic cell (DC) subsets in controls or patients with chronic rhinosinusitis with nasal polyps (CRSwNP). In subsequent in-vitro investigations, we examined the influence of cigarette smoke extract (CSE) on human sinonasal epithelial cells' (HSNECs) ability to regulate DC functions. METHODS Sinonasal tissue, blood, and hair were collected from patients undergoing sinus surgery. Smoking status and ETS exposure were determined by hair nicotine. DC subsets were examined by flow cytometric analysis. Monocyte-derived dendritic cells (moDCs) were treated with conditioned medium from non-smoked-exposed HSNECs (NS-HSNECs) or cigarette-smoke-extract-exposed HSNECs (CSE-HSNECs) to assess the impact of CSE exposure on HSNEC regulation of moDC functions. RESULTS Control subjects who were active smokers displayed increased sinonasal moDC and myeloid dendritic 1 (mDC1) cells and reduced mDC2 cells, whereas, in CRSwNP patients, only moDC and mDC2 cells were altered. ETS was found to increase only moDCs in the CRSwNP patients. In vitro, CSE stimulated HSNEC secretion of the moDC regulatory products chemokine (C-C motif) ligand 20, prostaglandin E2 , and granulocyte-macrophage colony-stimulating factor. CSE exposure also promoted HSNECs to stimulate monocyte and moDC migration. moDCs treated with CSE-HSNEC media stimulated an increase in antigen uptake and expression of CD80 and CD86. Last, CSE-HSNEC-treated moDCs secreted increased levels of interleukin-10, interferon-γ, and thymic stromal lymphopoietin. CONCLUSION Active smoking, and to a lesser degree ETS, alters the sinonasal composition of DCs. A potential mechanism to account for this is that cigarette smoke stimulates HSNECs to induce moDC migration, maturation, and activation.
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Affiliation(s)
- Jennifer K. Mulligan
- Department of Otolaryngology-Head & Neck Surgery, Medical University of South Carolina, Charleston, South Carolina
- Department of Pediatrics, Medical University of South Carolina, Charleston, South Carolina
| | - Brendan P. O’Connell
- Department of Otolaryngology-Head & Neck Surgery, Medical University of South Carolina, Charleston, South Carolina
| | - Whitney Pasquini
- Department of Otolaryngology-Head & Neck Surgery, Medical University of South Carolina, Charleston, South Carolina
| | - Ryan M. Mulligan
- Department of Otolaryngology-Head & Neck Surgery, Medical University of South Carolina, Charleston, South Carolina
| | - Sarah Smith
- Department of Otolaryngology-Head & Neck Surgery, Medical University of South Carolina, Charleston, South Carolina
| | - Zachary M. Soler
- Department of Otolaryngology-Head & Neck Surgery, Medical University of South Carolina, Charleston, South Carolina
| | - Carl Atkinson
- Department of Microbiology & Immunology, Medical University of South Carolina, Charleston, South Carolina
- Department of Surgery, Medical University of South Carolina, Charleston, South Carolina
| | - Rodney J. Schlosser
- Department of Otolaryngology-Head & Neck Surgery, Medical University of South Carolina, Charleston, South Carolina
- Ralph H. Johnson VA Medical Center, Charleston, South Carolina
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Elbistanlı MS, Koçak HE, Güneş S, Acıpayam H, Şimşek BM, Canpolat S, Kayhan FT. Vit D deficiency is a possible risk factor in ARS. Eur Arch Otorhinolaryngol 2017; 274:3391-3395. [PMID: 28608241 DOI: 10.1007/s00405-017-4635-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2017] [Accepted: 06/07/2017] [Indexed: 12/29/2022]
Abstract
Vitamin D deficiency is effective in the development of acute rhinosinusitis and prolongation of inflammation by increasing inflammation in the sinonasal epithelium. Vitamin D deficiency is important in the development of bone barriers that prevent the complication of acute rhinosinusitis. Although Vitamin D levels may be a variable risk factor for various respiratory tract disorders, there are limited data on the role in sinonasal infections. Our aim was to investigate the association of 25-hydroxy-vitamin D (25OHD) levels with acute rhinosinusitis (ARS) and preseptal cellulitis complications. The type of the study is prospective case-control study. Fifteen patients in the pediatric age group with ARS-induced preseptal cellulitis complication were identified as Group 1, fifteen patients with ARS and without complication were identified as Group 2, and fifteen healthy volunteers were identified as Group 3. Serum 25OHD levels (nmol/l) were measured in addition to routine blood tests at the first admission of patients participating in the study. Statistical analysis was performed between groups. The ages of the cases ranged from 1 to 14 years with a mean of 5.62 ± 3.42 years. 55.6% of the cases (n = 25) were male; 44.4% (n = 20) were female children. As a result of classification in which vitamin D levels were compared with normal values, there was a statistically significant difference according to the presence of ARS (Group-1 and Group 2) and absence of ARS (Group-3) (p < 0.05). A statistically significant difference was also found between Group 1 and Group-3 (p < 0.05). Statistically significant difference between Group 1 and Group 3 suggests that lack of vitamin D predisposes to the complication of preseptal cellulitis. Comparison of Group 1 and 2 with Group 3 (normal subjects) suggests that Vit D has a protective effect against developing sinusitis.
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Affiliation(s)
- Mustafa Suphi Elbistanlı
- Department of Otorhinolaryngology-Head and Neck Surgery, Bakırköy Dr.Sadi Konuk Training and Research Hospital, Zuhuratbaba Mah. Tevfik Sağlam Cad. No: 11, Bakırköy, Istanbul, Turkey
| | - Hasan Emre Koçak
- Department of Otorhinolaryngology-Head and Neck Surgery, Bakırköy Dr.Sadi Konuk Training and Research Hospital, Zuhuratbaba Mah. Tevfik Sağlam Cad. No: 11, Bakırköy, Istanbul, Turkey.
| | - Selçuk Güneş
- Department of Otorhinolaryngology-Head and Neck Surgery, Bakırköy Dr.Sadi Konuk Training and Research Hospital, Zuhuratbaba Mah. Tevfik Sağlam Cad. No: 11, Bakırköy, Istanbul, Turkey
| | - Harun Acıpayam
- Department of Otorhinolaryngology-Head and Neck Surgery, Bakırköy Dr.Sadi Konuk Training and Research Hospital, Zuhuratbaba Mah. Tevfik Sağlam Cad. No: 11, Bakırköy, Istanbul, Turkey
| | - Baver Maşallah Şimşek
- Department of Otorhinolaryngology-Head and Neck Surgery, Bakırköy Dr.Sadi Konuk Training and Research Hospital, Zuhuratbaba Mah. Tevfik Sağlam Cad. No: 11, Bakırköy, Istanbul, Turkey
| | - Sinan Canpolat
- Department of Otorhinolaryngology-Head and Neck Surgery, Bakırköy Dr.Sadi Konuk Training and Research Hospital, Zuhuratbaba Mah. Tevfik Sağlam Cad. No: 11, Bakırköy, Istanbul, Turkey
| | - Fatma Tülin Kayhan
- Department of Otorhinolaryngology-Head and Neck Surgery, Bakırköy Dr.Sadi Konuk Training and Research Hospital, Zuhuratbaba Mah. Tevfik Sağlam Cad. No: 11, Bakırköy, Istanbul, Turkey
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Vargas Buonfiglio LG, Cano M, Pezzulo AA, Vanegas Calderon OG, Zabner J, Gerke AK, Comellas AP. Effect of vitamin D 3 on the antimicrobial activity of human airway surface liquid: preliminary results of a randomised placebo-controlled double-blind trial. BMJ Open Respir Res 2017; 4:e000211. [PMID: 28883932 PMCID: PMC5531307 DOI: 10.1136/bmjresp-2017-000211] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2017] [Indexed: 12/21/2022] Open
Abstract
Introduction Vitamin D3 supplementation has been reported to prevent lung infections and increase the gene expression of antimicrobial peptides such as cathelicidin. We investigated the effect of vitamin D3 supplementation on the antimicrobial activity of airway surface liquid (ASL) in human subjects. Since smoking can increase the risk of respiratory infections, we also investigated the effect of smoking in the cathelicidin response to vitamin D3 in human airway epithelia in vitro. Methods This study is a subanalysis of single-centre community-based randomised placebo-controlled double-blind trial. Participants were randomised to receive 1000 international units per day of oral vitamin D3 or identical placebo for 90 days. Blood and ASL samples were collected preintervention and postintervention. 105 participants were originally enrolled, 86 completed the trial, and due to low protein concentration in the samples, 40 participants were finally analysed. Our primary outcome was ASL antimicrobial activity. We also considered secondary outcomes including changes in serum concentration of 25-hydroxyvitamin D3 (25(OH)D3), 1,25-hydroxyvitamin D3, calcium and parathyroid hormone (PTH). In addition, we studied the effect of cigarette smoke extract (CSE) exposure to primary human airway epithelial cell cultures on the gene expression of cathelicidin in response to vitamin D3 and expression of CYP27B1 (1-alpha hydroxylase), responsible for vitamin D3 activation. Results Vitamin D3 supplementation significantly increased both ASL antimicrobial activity and serum concentration of 25(OH)D3. In a subgroup analysis, we found that smokers did not increase their baseline antimicrobial activity in response to vitamin D3. Exposure to CSE on human airway epithelia decreased baseline CYP27B1 gene expression and cathelicidin response to 25(OH)D3. Conclusion Vitamin D3 supplementation for 90 days increases ASL antimicrobial activity. Data from this preliminary study suggest that smoking may alter the ability of airway epithelia to activate vitamin D3 and increase the gene expression of cathelicidin antimicrobial peptide. Trial registration number NCT01967628; Post-results.
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Affiliation(s)
- Luis G Vargas Buonfiglio
- Department of Internal Medicine, Roy J and Lucille A Carver College of Medicine, University of Iowa, Iowa City, Iowa, USA
| | - Marlene Cano
- Department of Internal Medicine, Roy J and Lucille A Carver College of Medicine, University of Iowa, Iowa City, Iowa, USA
| | - Alejandro A Pezzulo
- Department of Internal Medicine, Roy J and Lucille A Carver College of Medicine, University of Iowa, Iowa City, Iowa, USA
| | - Oriana G Vanegas Calderon
- Department of Pediatrics, Roy J and Lucille A Carver College of Medicine, University of Iowa, Iowa City, Iowa, USA
| | - Joseph Zabner
- Department of Internal Medicine, Roy J and Lucille A Carver College of Medicine, University of Iowa, Iowa City, Iowa, USA
| | - Alicia K Gerke
- Department of Internal Medicine, Roy J and Lucille A Carver College of Medicine, University of Iowa, Iowa City, Iowa, USA
| | - Alejandro P Comellas
- Department of Internal Medicine, Roy J and Lucille A Carver College of Medicine, University of Iowa, Iowa City, Iowa, USA
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Balcells ME, García P, Tiznado C, Villarroel L, Scioscia N, Carvajal C, Zegna-Ratá F, Hernández M, Meza P, González LF, Peña C, Naves R. Association of vitamin D deficiency, season of the year, and latent tuberculosis infection among household contacts. PLoS One 2017; 12:e0175400. [PMID: 28403225 PMCID: PMC5389794 DOI: 10.1371/journal.pone.0175400] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2016] [Accepted: 03/24/2017] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVES Vitamin D (VD) enhances the immune response against Mycobacterium tuberculosis in vitro, and VD deficiency has been described in patients with active tuberculosis (TB). However, the role of hypovitaminosis D in the pathogenesis of early TB infection acquisition is unclear. We aimed to evaluate the association of VD deficiency, season of the year, and latent TB infection in household contacts (HHC), given that this is a potentially modifiable condition often related to nutritional deficiencies and lack of sun exposure. METHODS We prospectively enrolled new pulmonary TB cases (n = 107) and their HHC (n = 144) over a 2-year period in Santiago, Chile. We compared plasma 25-hydroxycholecalciferol (25OHD) levels and examined the influence of season, ethnic background, living conditions, and country of origin. RESULTS Over 77% of TB cases and 62.6% of HHC had VD deficiency (<20 ng/ml). Median 25OHD concentration was significantly lower in TB cases than in HHC (11.7 vs. 18.2 ng/ml, p<0.0001). Migrants HHC had lower 25OHD levels than non-migrants (14.6 vs. 19.0 ng/ml, p = 0.026), and a trend towards a higher burden of latent TB infection (52.9% vs. 35.2%, p = 0.066). Multivariate analysis found VD deficiency in HHC was strongly associated with being sampled in winter/spring (adOR 25.68, 95%CI 7.35-89.7), corresponding to the seasons with lowest solar radiation exposure. Spring enrollment-compared with other seasons-was the chief risk factor for latent TB infection in HHC (adOR 3.14, 95%CI 1.28-7.69). CONCLUSIONS Hypovitaminosis D was highly prevalent in TB cases and also in HHC. A marked seasonality was found for both VD levels and latent TB in HHC, with winter being the season with lowest VD levels and spring the season with the highest risk of latent TB infection.
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Affiliation(s)
- María Elvira Balcells
- Departamento de Enfermedades Infecciosas del Adulto, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Patricia García
- Departamento de Laboratorios Clínicos, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Camila Tiznado
- Departamento de Laboratorios Clínicos, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Luis Villarroel
- Departamento de Salud Pública, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Natalia Scioscia
- Departamento de Laboratorios Clínicos, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Camila Carvajal
- Departamento de Enfermedades Infecciosas del Adulto, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Francesca Zegna-Ratá
- Departamento de Enfermedades Infecciosas del Adulto, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Mariluz Hernández
- Programa de Microbiología y Micología, Facultad de Medicina, Universidad de Chile, Santiago, Chile
| | - Paulina Meza
- Departamento de Laboratorios Clínicos, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Luis F. González
- Instituto de Ciencias Biomédicas, Facultad de Medicina, Universidad de Chile, Santiago, Chile
| | - Carlos Peña
- Servicio de Respiratorio, Hospital San Borja Arriarán, Santiago, Chile
| | - Rodrigo Naves
- Instituto de Ciencias Biomédicas, Facultad de Medicina, Universidad de Chile, Santiago, Chile
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Stokes PJ, Rimmer J. The relationship between serum vitamin D and chronic rhinosinusitis: A systematic review. Am J Rhinol Allergy 2016; 30:23-8. [PMID: 26867526 DOI: 10.2500/ajra.2016.30.4267] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND An exciting development in upper respiratory tract disease is the pathophysiology of vitamin D (VD3). There now is substantial literature to indicate that VD3 acts as an immunomodulator of adaptive and innate immunity locally within the respiratory epithelium. Chronic rhinosinusitis (CRS) places a relatively large socioeconomic burden on developed nations, yet remains a difficult disease to treat. VD3, therefore, has become an area of clinical interest because it may provide an adjunctive drug therapy option in CRS, thereby potentially improving the quality of life of these patients. OBJECTIVE A systematic review of the relationship among serum VD3 levels, CRS phenotype, and disease severity by using outcome assessments. METHODS A systematic search was performed by using the PubMed, MEDLINE, and EMBASE databases. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed. Studies that measured serum VD3 levels and correlated the measurements to any subtype of CRS (with or without nasal polyps) were included for qualitative analysis. RESULTS Seven articles were included (four prospective and three retrospective studies), with a total of 539 patients. There were significantly lower VD3 levels in the polypoid phenotypes of CRS compared with controls. Low VD3 levels were often associated with an increased degree of inflammation. CONCLUSION The available evidence indicated that there is a significant relationship between low VD3 levels and polypoid CRS phenotypes. The association between VD3 levels and disease severity and VD3 potential for drug therapy remains unclear, which warrants further research in the area.
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Affiliation(s)
- Patrick J Stokes
- Department of Surgery, South West Healthcare, Warrnambool, Australia
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Christensen JM, Cheng J, Earls P, Gunton J, Sewell W, Sacks R, Harvey RJ. Vitamin D pathway regulatory genes encoding 1α-hydroxylase and 24-hydroxylase are dysregulated in sinonasal tissue during chronic rhinosinusitis. Int Forum Allergy Rhinol 2016; 7:169-176. [PMID: 27618536 DOI: 10.1002/alr.21852] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2016] [Revised: 07/24/2016] [Accepted: 08/09/2016] [Indexed: 01/23/2023]
Abstract
BACKGROUND Vitamin D deficiency is associated with many inflammatory respiratory disease states. However, serum vitamin D concentrations may not reflect tissue-specific availability. In this study we sought to assess the local expression of genes essential in vitamin D regulation in chronic rhinosinusitis (CRS). METHODS A cross-sectional study of adult patients undergoing endoscopic sinus surgery was performed. Patients were defined as having CRS with polyps (CRSwNP) or without polyps (CRSsNP), or normal sinus mucosa. Sinus mucosal biopsies were assessed using quantitative polymerase chain reaction to determine expression of genes encoding the vitamin D receptor (VDR), 25-hydroxylase (CYP2R1), 1α-hydroxylase (CYP27B1), and 24-hydroxylase (CYP24A1). Expression levels correlated with serum 25(OH)D [sum 25(OH)D2 and 25(OH)D3 ], the 22-item Sinonasal Outcome Test (SNOT-22), and Nasal Symptom Score (NSS). Separate analyses were performed for patients grouped by tissue eosinophilia. RESULTS Thirty-one patients were assessed (age 49.47 ± 18.14 years, 48.4% female), including 8 CRSsNP, 10 CRSwNP, and 13 controls. CRSsNP and CRSwNP mucosa exhibited decreased CYP27B1 compared with controls (0.0437 [Interquartile range (IQR) 0.0999] vs 0.3260 [IQR 2.9384] vs 0.6557 [IQR 1.1005], p = 0.039), whereas CYP24A1 was upregulated (0.8522 [IQR 1.3170] vs 1.2239 [IQR 4.4197] vs 0.1076 [IQR 0.1791], p = 0.025). CYP24A1 was upregulated in both non-eosinophilic CRS and eosinophilic CRS (1.1337 [IQR 2.3790] vs 0.9555 [IQR 3.2811] vs 0.1076 [IQR 0.1791], p = 0.033). Significant correlations were observed between NSS and CYP2R1 (r = -0.432, p = 0.022), CYP24A1 (r = 0.420, P = 0.026), and VDR (r = 0.425, p = 0.024), although no correlations with serum 25(OH)D were observed. CONCLUSIONS The local regulation of vitamin D in sinonasal tissue during CRS may be independent of serum 25(OH)D levels. Vitamin D may be dysregulated at multiple levels, with decreased transcription of the metabolic gene CYP27B1 and increased transcription of the catabolic gene CYP24A1 observed.
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Affiliation(s)
- Jenna M Christensen
- Rhinology and Skull Base Research Group, St Vincent's Centre for Applied Medical Research, University of New South Wales, Sydney, NSW, Australia
| | - Jasmine Cheng
- Rhinology and Skull Base Research Group, St Vincent's Centre for Applied Medical Research, University of New South Wales, Sydney, NSW, Australia
| | - Peter Earls
- Department of Anatomical Pathology, St Vincent's Hospital, Sydney, NSW, Australia
| | - Jenny Gunton
- Immunopathology Department, Garvan Institute of Medical Research, Sydney, NSW, Australia
| | - William Sewell
- Immunopathology Department, Garvan Institute of Medical Research, Sydney, NSW, Australia
| | - Raymond Sacks
- Faculty of Medicine and Health Sciences, Macquarie University, Sydney, NSW, Australia.,Faculty of Medicine, University of Sydney, Sydney, NSW, Australia
| | - Richard J Harvey
- Rhinology and Skull Base Research Group, St Vincent's Centre for Applied Medical Research, University of New South Wales, Sydney, NSW, Australia.,Faculty of Medicine and Health Sciences, Macquarie University, Sydney, NSW, Australia
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Heulens N, Korf H, Mathyssen C, Everaerts S, De Smidt E, Dooms C, Yserbyt J, Gysemans C, Gayan-Ramirez G, Mathieu C, Janssens W. 1,25-Dihydroxyvitamin D Modulates Antibacterial and Inflammatory Response in Human Cigarette Smoke-Exposed Macrophages. PLoS One 2016; 11:e0160482. [PMID: 27513734 PMCID: PMC4981391 DOI: 10.1371/journal.pone.0160482] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2016] [Accepted: 07/20/2016] [Indexed: 12/26/2022] Open
Abstract
Cigarette smoking is associated with increased inflammation and defective antibacterial responses in the airways. Interestingly, vitamin D has been shown to suppress inflammation and to improve antibacterial defense. However, it is currently unknown whether vitamin D may modulate inflammation and antibacterial defects in human cigarette smoke (CS)-exposed airways. To explore these unresolved issues, alveolar macrophages obtained from non-smoking and smoking subjects as well as human cigarette smoke extract (CSE)-treated THP-1 macrophages were stimulated with 1,25-dihydroxyvitamin D (1,25(OH)2D) to address inflammatory and antibacterial responses. Although basal levels of inflammatory cytokines and chemokines did not differ between non-smoking and smoking subjects, 1,25(OH)2D did reduce levels of IL-6, TNF-α and MCP-1 in alveolar macrophages in response to LPS/IFN-γ, although not statistically significant for TNF-α and IL-6 in smokers. CSE did not significantly alter vitamin D metabolism (expression levels of CYP24A1 or CYP27B1) in THP-1 macrophages. Furthermore, stimulation with 1,25(OH)2D reduced mRNA expression levels and/or protein levels of IL-8, TNF-α and MCP-1 in CSE-treated THP-1 macrophages. 1,25(OH)2D did not improve defects in phagocytosis of E. coli bacteria or the oxidative burst response in CSE-treated THP-1 macrophages or alveolar macrophages from smokers. However, 1,25(OH)2D significantly enhanced mRNA expression and/or protein levels of the antimicrobial peptide cathelicidin in alveolar macrophages and THP-1 macrophages, independently of CS exposure. In conclusion, our results provide the first evidence that vitamin D could be a new strategy for attenuating airway inflammation and improving antibacterial defense in CS-exposed airways.
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Affiliation(s)
- Nele Heulens
- Laboratory of Respiratory Diseases, Department of Clinical and Experimental Medicine, Katholieke Universiteit Leuven, Leuven, Belgium
| | - Hannelie Korf
- Laboratory of Clinical and Experimental Endocrinology, Department of Clinical and Experimental Medicine, Katholieke Universiteit Leuven, Leuven, Belgium
| | - Carolien Mathyssen
- Laboratory of Respiratory Diseases, Department of Clinical and Experimental Medicine, Katholieke Universiteit Leuven, Leuven, Belgium
| | - Stephanie Everaerts
- Laboratory of Respiratory Diseases, Department of Clinical and Experimental Medicine, Katholieke Universiteit Leuven, Leuven, Belgium
| | - Elien De Smidt
- Laboratory of Clinical and Experimental Endocrinology, Department of Clinical and Experimental Medicine, Katholieke Universiteit Leuven, Leuven, Belgium
| | - Christophe Dooms
- Laboratory of Respiratory Diseases, Department of Clinical and Experimental Medicine, Katholieke Universiteit Leuven, Leuven, Belgium
| | - Jonas Yserbyt
- Laboratory of Respiratory Diseases, Department of Clinical and Experimental Medicine, Katholieke Universiteit Leuven, Leuven, Belgium
| | - Conny Gysemans
- Laboratory of Clinical and Experimental Endocrinology, Department of Clinical and Experimental Medicine, Katholieke Universiteit Leuven, Leuven, Belgium
| | - Ghislaine Gayan-Ramirez
- Laboratory of Respiratory Diseases, Department of Clinical and Experimental Medicine, Katholieke Universiteit Leuven, Leuven, Belgium
| | - Chantal Mathieu
- Laboratory of Clinical and Experimental Endocrinology, Department of Clinical and Experimental Medicine, Katholieke Universiteit Leuven, Leuven, Belgium
| | - Wim Janssens
- Laboratory of Respiratory Diseases, Department of Clinical and Experimental Medicine, Katholieke Universiteit Leuven, Leuven, Belgium
- * E-mail:
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Vitamin D3 therapy in patients with asthma complicated by sinonasal disease: Secondary analysis of the Vitamin D Add-on Therapy Enhances Corticosteroid Responsiveness in Asthma trial. J Allergy Clin Immunol 2016; 138:589-592.e2. [PMID: 26971692 DOI: 10.1016/j.jaci.2015.12.1329] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2015] [Revised: 11/29/2015] [Accepted: 12/28/2015] [Indexed: 11/20/2022]
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40
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Orlandi RR, Kingdom TT, Hwang PH, Smith TL, Alt JA, Baroody FM, Batra PS, Bernal-Sprekelsen M, Bhattacharyya N, Chandra RK, Chiu A, Citardi MJ, Cohen NA, DelGaudio J, Desrosiers M, Dhong HJ, Douglas R, Ferguson B, Fokkens WJ, Georgalas C, Goldberg A, Gosepath J, Hamilos DL, Han JK, Harvey R, Hellings P, Hopkins C, Jankowski R, Javer AR, Kern R, Kountakis S, Kowalski ML, Lane A, Lanza DC, Lebowitz R, Lee HM, Lin SY, Lund V, Luong A, Mann W, Marple BF, McMains KC, Metson R, Naclerio R, Nayak JV, Otori N, Palmer JN, Parikh SR, Passali D, Peters A, Piccirillo J, Poetker DM, Psaltis AJ, Ramadan HH, Ramakrishnan VR, Riechelmann H, Roh HJ, Rudmik L, Sacks R, Schlosser RJ, Senior BA, Sindwani R, Stankiewicz JA, Stewart M, Tan BK, Toskala E, Voegels R, Wang DY, Weitzel EK, Wise S, Woodworth BA, Wormald PJ, Wright ED, Zhou B, Kennedy DW. International Consensus Statement on Allergy and Rhinology: Rhinosinusitis. Int Forum Allergy Rhinol 2016; 6 Suppl 1:S22-209. [DOI: 10.1002/alr.21695] [Citation(s) in RCA: 333] [Impact Index Per Article: 41.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2015] [Revised: 11/13/2015] [Accepted: 11/16/2015] [Indexed: 02/06/2023]
Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Valerie Lund
- Royal National Throat Nose and Ear Hospital; London UK
| | - Amber Luong
- University of Texas Medical School at Houston
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Plasma 25-hydroxyvitamin D2 and D3 levels and incidence of postoperative atrial fibrillation. J Nutr Sci 2016; 5:e10. [PMID: 27066255 PMCID: PMC4791515 DOI: 10.1017/jns.2015.38] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2015] [Revised: 11/27/2015] [Accepted: 12/09/2015] [Indexed: 02/07/2023] Open
Abstract
Low circulating levels of total 25-hydroxyvitamin D (25(OH)D) have been associated with an increased risk of adverse effects after cardiac surgery. The metabolites, 25(OH)D2 and 25(OH)D3, provide a good index of vitamin D status. In this study, we examined the association between preoperative plasma levels of total 25(OH)D, 25(OH)D2 and 25(OH)D3 and the risk of postoperative atrial fibrillation (POAF) following open heart surgery. The levels of plasma 25(OH)D2 and 25(OH)D3 in 118 patients, who underwent coronary artery bypass grafting and/or valvular surgery, were measured immediately prior to surgery and on postoperative day 3 by liquid chromatography–tandem mass spectrometry. Patients who developed POAF had higher median plasma levels of 25(OH)D2 than those who remained in sinus rhythm (SR) (P = 0·003), but no significant difference was noted in levels of 25(OH)D3 or total 25(OH)D between the two groups (P > 0·05). By univariate analysis, patients with total 25(OH)D and 25(OH)D2 levels above the median had higher frequency of POAF (P < 0·05) and the incidence of POAF increased significantly with each higher quartile of preoperative plasma levels of 25(OH)D2 (P = 0·001), an association that was independent of confounding factors. In both the SR and POAF groups, the median plasma levels of 25(OH)D2, 25(OH)D3 and total 25(OH)D were lower (P < 0·05) on the third postoperative day compared with preoperatively. Our findings demonstrate that higher plasma levels of 25(OH)D2 are associated with increased risk of POAF, while this is not the case for 25(OH)D3 or total 25(OH)D. The reason for these discrepant results is not clear but warrants further study.
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Lawrence LA, Mulligan JK, Roach C, Pasquini WN, Soler ZM, Banglawala SM, Karnezis TT, Gudis DA, Schlosser RJ. Superoxide dismutase reduces the inflammatory response to Aspergillus and Alternaria in human sinonasal epithelial cells derived from patients with chronic rhinosinusitis. Am J Rhinol Allergy 2016; 29:89-93. [PMID: 25785747 DOI: 10.2500/ajra.2015.29.4155] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND Aspergillus fumigatus and Alternaria alternata are ubiquitous environmental fungal allergens that can exacerbate airway inflammation and contribute to the disease process in patients with chronic rhinosinusitis (CRS). These antigens have been shown to induce human sinonasal epithelial cells (HSNECs) to promote a proinflammatory response, but what is unclear is a means by which to reduce these effects. Inhaled pathogens can induce HSNECs to produce reactive oxygen species (ROS) that trigger cytokine production. OBJECTIVE This study aimed to determine whether the free radical scavenger superoxide dismutase (SOD) could reduce HSNEC-derived inflammation, as measured by interleukin (IL)-6 and IL-8 production, in response to Aspergillus or Alternaria exposure. METHODS Sinus tissue explants were collected at the time of surgery from control patients (n = 7) and patients with CRS with nasal polyps (CRSwNP) (n = 9). HSNECs were cultured from the explants and treated with Aspergillus, Alternaria, and SOD for 24 hours. Cell supernatants and lysates were collected, and IL-6 and IL-8 concentrations were measured using enzyme-linked immunosorbent assay. RESULTS In control and CRSwNP HSNECs, Aspergillus and Alternaria both increased cytokine production (p < 0.05), as measured by IL-6 and IL-8 concentration. SOD treatment reduced the inflammatory response to fungal antigen exposure from CRSwNP HSNECs but not control HSNECs. In CRSwNP patients, SOD significantly decreased IL-6 and IL-8 production after Alternaria exposure and IL-8 after Aspergillus exposure (p < 0.05). CONCLUSIONS When HSNECs from CRSwNP patients are treated with SOD concurrently with Aspergillus or Alternaria, SOD treatment decreases the fungal antigen-induced inflammatory response. The ability to attenuate inflammation induced by common fungal allergens with SOD treatment could provide a novel therapeutic or preventative approach for patients with CRS or other allergic inflammatory airway diseases.
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Affiliation(s)
- Lauren A Lawrence
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, USA
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Carroll WW, Schlosser RJ, O'Connell BP, Soler ZM, Mulligan JK. Vitamin D deficiency is associated with increased human sinonasal fibroblast proliferation in chronic rhinosinusitis with nasal polyps. Int Forum Allergy Rhinol 2016; 6:605-10. [PMID: 26750566 DOI: 10.1002/alr.21704] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2015] [Revised: 11/08/2015] [Accepted: 11/17/2015] [Indexed: 12/27/2022]
Abstract
BACKGROUND Vitamin D3 (VD3) is a steroid hormone with known antiproliferative properties. Patients with chronic rhinosinusitis with nasal polyps (CRSwNP) have been shown to be VD3-deficient. Moreover, VD3 deficiency is associated with worse disease in patients with CRSwNP. One cell type thought to play a role in chronic rhinosinusitis (CRS) is the human sinonasal fibroblast (HSNF). The aim of this study was to investigate VD3 deficiency and HSNF proliferation in CRSwNP. METHODS Blood and sinus tissue explants were collected at the time of surgery from patients with CRSwNP (n = 15). Control subjects (n = 12) were undergoing surgery for cerebrospinal fluid leak repair or to remove non-hormone-secreting pituitary tumors. Ex vivo HSNF proliferation was analyzed with flow cytometry using expression of fibroblast-specific protein (FSP) and the proliferation marker Ki67. Plasma levels of 25-hydroxyvitamin D3 (25VD3) were measured by enzyme-linked immunosorbent assay. In vitro analysis of HSNF proliferation after treatment with calcitriol (1,25VD3) was performed using carboxyfluorescein succinimidyl ester (CFSE) and analyzed with flow cytometry. RESULTS In CRSwNP patients there was an inverse correlation between 25VD3 and proliferating HSNFs (p = 0.0135). This correlation was not seen for control patients (p = 0.3869). In vitro analysis showed that HSNFs from patients with CRSwNP had a higher proliferation index at baseline than HSNFs from control patients (p < 0.01). When treated with 1,25VD3, there was a significant decrease in HSNF proliferation index in patients with CRSwNP (p < 0.01), but not control patients. CONCLUSION VD3 deficiency is associated with increased HSNF proliferation in CRSwNP. Further investigation into how HSNFs and VD3 impact CRSwNP pathophysiology is warranted.
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Affiliation(s)
- William W Carroll
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, SC
| | - Rodney J Schlosser
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, SC.,Ralph H. Johnson VA Medical Center, Charleston, SC
| | - Brendan P O'Connell
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, SC
| | - Zachary M Soler
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, SC
| | - Jennifer K Mulligan
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, SC.,Ralph H. Johnson VA Medical Center, Charleston, SC.,Department of Pediatrics, Medical University of South Carolina, Charleston, SC
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Schlosser RJ, Carroll WW, Soler ZM, Pasquini WN, Mulligan JK. Reduced sinonasal levels of 1α-hydroxylase are associated with worse quality of life in chronic rhinosinusitis with nasal polyps. Int Forum Allergy Rhinol 2015; 6:58-65. [PMID: 26575398 DOI: 10.1002/alr.21576] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2015] [Revised: 05/05/2015] [Accepted: 05/14/2015] [Indexed: 12/11/2022]
Abstract
BACKGROUND Patients with chronic rhinosinusitis with nasal polyps (CRSwNP) have deficiencies in circulating and sinonasal levels of the inactive form of vitamin D3, 25-hydroxycholecalciferol (25VD3). Moreover, CRSwNP patients have reduced epithelial cell-specific expression of 1α-hydroxylase; the enzyme responsible for the conversion of 25VD3 to its metabolically active form, 1α,25-dihydroxyvitamin D3 (1,25VD3). The objective of this work was to determine the impact of sinonasal 1α-hydroxylase levels combined from all cellular sources on subjective disease severity and to identify variables influencing its expression. METHODS Blood and sinus tissue explants were collected at the time of surgery from control, chronic rhinosinusitis without nasal polyps (CRSsNP), CRSwNP, and allergic fungal rhinosinusitis (AFRS) patients. 1α-Hydroxylase was measured by immunostaining with flow cytometric analysis. Subjective disease severity was measured by the 22-item Sino-Nasal Outcomes Test (SNOT-22). 1,25VD3 and 25VD3 were measured by enzyme-linked immunosorbent assay (ELISA). RESULTS Patients with CRSwNP or AFRS have reduced 1α-hydroxylase and 1,25VD3 compared to controls or CRSsNP. Circulating 1,25VD3 levels were the same among all groups. No differences in sinonasal 1α-hydroxylase or 1,25VD3 were found between CRSwNP and AFRS. Gender, age, race, atopy, and systemic 25VD3 had no impact on sinonasal 1α-hydroxylase levels in any group. However, CRSwNP patients with asthma had higher 1α-hydroxylase than those without asthma. Total 1α-hydroxylase levels inversely correlated with SNOT-22 in CRSwNP, but not CRSsNP. CONCLUSION Patients with CRSwNP and AFRS both have reduced sinonasal 1α-hydroxylase and 1,25VD3 compared to controls or CRSsNP. Reductions in intracellular 1α-hydroxylase combined from all sinonasal cell types were associated with more severe subjective disease severity in CRSwNP.
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Affiliation(s)
- Rodney J Schlosser
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, SC.,Ralph H. Johnson VA Medical Center, Charleston, SC
| | - William W Carroll
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, SC
| | - Zachary M Soler
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, SC
| | - Whitney N Pasquini
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, SC
| | - Jennifer K Mulligan
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, SC.,Ralph H. Johnson VA Medical Center, Charleston, SC.,Department of Pediatrics, Medical University of South Carolina, Charleston, SC
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45
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Esposito S, Lelii M. Vitamin D and respiratory tract infections in childhood. BMC Infect Dis 2015; 15:487. [PMID: 26521023 PMCID: PMC4628332 DOI: 10.1186/s12879-015-1196-1] [Citation(s) in RCA: 88] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2015] [Accepted: 10/08/2015] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Respiratory tract infections (RTIs) remain among of the most important causes of morbidity and mortality among children. Several studies have associated vitamin D deficiency with an increased risk of RTIs, and vitamin D supplementation has been proposed as a possible preventive measure against RTIs in children. The main aim of this review is to summarize the current evidence from the literature about the link between vitamin D and RTIs in children. DISCUSSION Several recent studies have shown that vitamin D has different immunomodulatory properties associated with the risk of RTIs in childhood. In this regard, it is very important to understand the definition of deficiency and insufficiency of vitamin D and when and how to treat this condition. Unfortunately, there is no consensus, although a level of at least 10 ng/mL 25-hydroxycholecalciferol (25[OH]D) is thought to be necessary to promote bone mineralization and calcium homeostasis, and a concentration between 20 ng/mL and 50 ng/mL is considered adequate to provide an immunomodulatory effect. Available data support a role for vitamin D deficiency in the risk of pediatric tuberculosis, recurrent acute otitis media, and severe bronchiolitis, whereas further studies are needed to confirm an association in children with recurrent pharyngotonsillitis, acute rhinosinusitis and community-acquired pneumonia. CONCLUSIONS Maintenance of adequate vitamin D status may be an effective and inexpensive prophylactic method against some RTIs, but the supplementation regimen has not been clearly defined. Further clinical trials are needed to determine the 25(OH)D concentrations associated with an increased risk of RTIs and optimal vitamin D supplementation regimen according to the type of RTI while also taking into consideration vitamin D receptor polymorphisms.
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Affiliation(s)
- Susanna Esposito
- Pediatric Highly Intensive Care Unit, Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via Commenda 9, 20122, Milan, Italy.
| | - Mara Lelii
- Pediatric Highly Intensive Care Unit, Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via Commenda 9, 20122, Milan, Italy.
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46
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Khalid AN, Ladha KS, Luong AU, Quraishi SA. Association of Vitamin D Status and Acute Rhinosinusitis: Results From the United States National Health and Nutrition Examination Survey 2001-2006. Medicine (Baltimore) 2015; 94:e1447. [PMID: 26447998 PMCID: PMC4616759 DOI: 10.1097/md.0000000000001447] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Although vitamin D status may be a modifiable risk factor for various respiratory ailments, limited data exists regarding its role in sinonasal infections. Our goal was to investigate the association of 25-hydroxyvitamin D (25OHD) levels with acute rhinosinusitis (ARS) in a large, nationally representative sample of non-institutionalized individuals from the United States. In this cross-sectional study of individuals ≥ 17 years from the National Health and Nutrition Examination Survey 2001-2006, we used multivariable regression analysis to investigate the association of 25OHD levels with ARS, while adjusting for season, demographics (age, sex, race, and poverty-to-income ratio), and clinical data (smoking, asthma, chronic obstructive pulmonary disease, diabetes mellitus, and neutropenia). A total of 3921 individuals were included in our analyses. Median 25OHD level was 22 (interquartile range 16-28) ng/mL. Overall, 15.8% (95% confidence interval [CI] 14.4-17.7) of participants reported ARS within the 24 hours leading up to their survey participation. After adjusting for season, demographics, and clinical data, 25OHD levels were associated with ARS (odds ratio 0.88, 95% CI 0.78-0.99 per 10 ng/mL). When vitamin D status was dichotomized, 25OHD levels < 20 ng/mL were associated with 33% higher odds of ARS (odds ratio 1.33, 95% CI 1.03-1.72) compared with levels ≥ 20 ng/mL. Our analyses suggest that 25OHD levels are inversely associated with ARS. Randomized, controlled trials are warranted to determine the effect of optimizing vitamin D status on the risk of sinonasal infections.
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Affiliation(s)
- Ayesha N Khalid
- From the Department of Surgery (ANK), Division of Otolaryngology-Head and Neck Surgery, Cambridge Hospital, Cambridge, MA; Department of Laryngology and Otology (ANK), Harvard Medical School; Department of Otolaryngology-Head and Neck Surgery (ANK), Boston University Medical Center; Department of Anesthesia, Critical Care and Pain Medicine (KSL, SAQ), Massachusetts General Hospital; Department of Anaesthesia (KSL, SAQ), Harvard Medical School, Boston, MA; and Department of Otorhinolaryngology-Head and Neck Surgery (AUL), University of Texas Medical School at Houston, Houston, TX
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47
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Carroll WW, O'Connell BP, Schlosser RJ, Gudis DA, Karnezis TT, Lawrence LA, Soler ZM, Mulligan JK. Fibroblast levels are increased in chronic rhinosinusitis with nasal polyps and are associated with worse subjective disease severity. Int Forum Allergy Rhinol 2015; 6:162-8. [DOI: 10.1002/alr.21636] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2015] [Revised: 07/24/2015] [Accepted: 08/04/2015] [Indexed: 12/18/2022]
Affiliation(s)
- William W. Carroll
- Department of Otolaryngology-Head and Neck Surgery; Medical University of South Carolina; Charleston SC
| | - Brendan P. O'Connell
- Department of Otolaryngology-Head and Neck Surgery; Medical University of South Carolina; Charleston SC
| | - Rodney J. Schlosser
- Department of Otolaryngology-Head and Neck Surgery; Medical University of South Carolina; Charleston SC
- Ralph H. Johnson VA Medical Center; Charleston SC
| | - David A. Gudis
- Department of Otolaryngology-Head and Neck Surgery; Medical University of South Carolina; Charleston SC
| | - Tom T. Karnezis
- Department of Otolaryngology-Head and Neck Surgery; Medical University of South Carolina; Charleston SC
| | - Lauren A. Lawrence
- Department of Otolaryngology-Head and Neck Surgery; Medical University of South Carolina; Charleston SC
| | - Zachary M. Soler
- Department of Otolaryngology-Head and Neck Surgery; Medical University of South Carolina; Charleston SC
| | - Jennifer K. Mulligan
- Department of Otolaryngology-Head and Neck Surgery; Medical University of South Carolina; Charleston SC
- Ralph H. Johnson VA Medical Center; Charleston SC
- Department of Pediatrics; Medical University of South Carolina; Charleston SC
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48
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Romano A, Vigna L, Belluigi V, Conti DM, Barberi CE, Tomaino L, Consonni D, Riboldi L, Tirelli AS, Andersen LL. Shift work and serum 25-OH vitamin D status among factory workers in Northern Italy: Cross-sectional study. Chronobiol Int 2015; 32:842-7. [PMID: 26125129 DOI: 10.3109/07420528.2015.1048867] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Low levels of vitamin D are related to muscle weakness, poor balance, and higher risk of falls, and can therefore have a major impact on performance and safety at work. Little knowledge exists on the association between work environment and vitamin D status. This study evaluates vitamin D status in shift workers. In this cross-sectional study, led during early springtime, 96 male shift workers at an engineering factory in Northern Italy, and 100 male daily workers operating nearby, participated. 25-OH vitamin D concentration, anthropometric indexes, fasting glycemia and triglycerides were detected. 51 shift workers underwent anamnesis collection on lifestyle and habits and determination of heel bone mineral density. Vitamin D levels were lower in shift workers than daily ones (13.4 ± 5.3 ng/mL versus 21.9 ± 10.7 ng/mL, p < 0.001). Linear regression analysis adjusted for age, body mass index and smoking habits confirms a statistically significant association between shift work and vitamin D levels (p < 0.0001). An association trend between cigarette smoking and low vitamin D values was found. No significant association was detected between the heel bone mineral density values and vitamin D levels or smoking habits. In conclusion, this cross-sectional study highlights the high prevalence of vitamin D deficit among shift workers compared with daily ones.
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Affiliation(s)
- Alessandro Romano
- Department of Clinical Sciences and Community Health, Post-graduate School of Occupational Medicine, Università degli Studi di Milano , Milan , Italy
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Zhang R, Zhao H, Dong H, Zou F, Cai S. 1α,25-dihydroxyvitamin D₃ counteracts the effects of cigarette smoke in airway epithelial cells. Cell Immunol 2015; 295:137-43. [PMID: 25880105 DOI: 10.1016/j.cellimm.2015.03.004] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2014] [Revised: 02/18/2015] [Accepted: 03/13/2015] [Indexed: 11/28/2022]
Abstract
Cigarette smoke extracts (CSE) alter calpain-1 expression via ERK signaling pathway in bronchial epithelial cells. 1α,25-dihydroxyvitamin D3 (1,25D3) inhibits cigarette smoke-induced epithelial barrier disruption. This study was aimed to explore whether the 1,25D3 counteracted the CSE effects in a human bronchial epithelial cell line (16HBE). In particular, transepithelial electrical resistance (TER) and permeability, expression and distribution of E-cadherin and β-catenin, calpain-1 expression, and ERK phosphorylation were assessed in the CSE-stimulated 16HBE cells. The CSE induced the ERK phosphorylation, improved the calpain-1 expression, increased the distribution anomalies and the cleaving of E-cadherin and β-catenin, and resulted in the TER reduction and the permeability increase. The 1,25D3 reduced these pathological changes. The 1,25D3 mediated effects were associated with a reduced ERK phosphorylation. In conclusion, the present study provides compelling evidences that the 1,25D3 may be considered a possible valid therapeutic option in controlling the cigarette smoke-induced epithelial barrier disruption.
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Affiliation(s)
- Ruhui Zhang
- Department of Respiratory, Chronic Airways Diseases Laboratory, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - Haijin Zhao
- Department of Respiratory, Chronic Airways Diseases Laboratory, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - Hangming Dong
- Department of Respiratory, Chronic Airways Diseases Laboratory, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - Fei Zou
- School of Public Health and Tropical Medicine, Southern Medical University, Guangzhou 510515, China
| | - Shaoxi Cai
- Department of Respiratory, Chronic Airways Diseases Laboratory, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China.
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50
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Yawn J, Lawrence LA, Carroll WW, Mulligan JK. Vitamin D for the treatment of respiratory diseases: is it the end or just the beginning? J Steroid Biochem Mol Biol 2015; 148:326-37. [PMID: 25625665 DOI: 10.1016/j.jsbmb.2015.01.017] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2014] [Revised: 12/16/2014] [Accepted: 01/22/2015] [Indexed: 12/22/2022]
Abstract
A large number of human, animal and in vitro studies have suggested that vitamin D3 (VD3) plays a critical role in inflammatory airway diseases such as asthma, chronic rhinosinusitis, and allergic rhinitis. VD3 acts upon a broad range of immune cells involved in the pathogenesis of these diseases including T-cells, dendritic cells (DCs), macrophages, and B-cells. In addition, VD3 can also regulate the functions of a number of non-immune cells including epithelial cells, fibroblasts, and smooth muscle cells. Given that VD3 has known effects on the immune system, it seems logical that supplementation with VD3 would prove efficacious in the treatment of these three diseases. While many studies, most of which are observational, have suggested that VD3 deficiency is associated with more severe disease, VD3 supplementation trials in humans have resulted in varied outcomes in terms of efficacy. In this review article we will discuss the role of VD3 in these three commonly associated respiratory diseases. We will explore the literature describing associations of VD3 deficiency with patient outcomes, cells in the respiratory microenvironment susceptible to VD3 regulation, conflicting results of VD3 supplementation trials, and potential gaps in our knowledge that may be limiting the widespread use of VD3 for the treatment of respiratory diseases such asthma, chronic rhinosinusitis and allergic rhinitis. This article is part of a Special Issue entitled '17th Vitamin D Workshop'.
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Affiliation(s)
- James Yawn
- Department of Otolaryngology-Head & Neck Surgery, Medical University of South Carolina, Charleston, SC, United States
| | - Lauren A Lawrence
- Department of Otolaryngology-Head & Neck Surgery, Medical University of South Carolina, Charleston, SC, United States
| | - William W Carroll
- Department of Otolaryngology-Head & Neck Surgery, Medical University of South Carolina, Charleston, SC, United States
| | - Jennifer K Mulligan
- Department of Otolaryngology-Head & Neck Surgery, Medical University of South Carolina, Charleston, SC, United States; Department of Pediatrics, Medical University of South Carolina, Charleston, SC, United States; Ralph H. Johnson VA Medical Center, Charleston, SC, United States.
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