1
|
Qu F, Zhang M, Weinstock-Guttman B, Zivadinov R, Qu J, Zhu X, Ramanathan M. An ultra-sensitive and high-throughput trapping-micro-LC-MS method for quantification of circulating vitamin D metabolites and application in multiple sclerosis patients. Sci Rep 2024; 14:5545. [PMID: 38448553 PMCID: PMC10918069 DOI: 10.1038/s41598-024-55939-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Accepted: 02/29/2024] [Indexed: 03/08/2024] Open
Abstract
Quantitative analysis of the biologically-active metabolites of vitamin D (VitD), which are crucial in regulating various physiological and pathological processes, is important for clinical investigations. Liquid chromatography-tandem mass spectrometry (LC-MS) has been widely used for this purpose but existing LC-MS methods face challenges in achieving highly sensitive and accurate quantification of low-abundance VitD metabolites while maintaining high throughput and robustness. Here we developed a novel pipeline that combines a trapping-micro-LC-(T-µLC) with narrow-window-isolation selected-reaction monitoring MS(NWI-SRM) for ultra-sensitive, robust and high-throughput quantification of VitD metabolites in serum samples after derivatization. The selective-trapping and delivery approach efficiently removes matrix components, enabling high-capacity sample loading and enhancing sensitivity, throughput, and robustness. The NWI-SRM further improves the sensitivity by providing high selectivity. The lower limits of quantification (LOQs) achieved were markedly lower than any existing LC-MS methods: 1.0 pg/mL for 1,25(OH)2D3, 5.0 pg/mL for 24,25(OH)2D3, 30 pg/mL for both 25(OH)D2 and 25(OH)D3, all within a 9-min cycle. The method is applied to quantify VitD metabolites from 218 patients with multiple sclerosis. This study revealed negative correlations(r=- 0.44 to - 0.51) between the levels of 25(OH)D2 and all the three D3 metabolites in multiple sclerosis patients.
Collapse
Affiliation(s)
- Flora Qu
- Department of Biochemistry, University at Buffalo, State University of New York, Buffalo, NY, USA
- Department of Pharmaceutical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA
| | - Ming Zhang
- Department of Pharmaceutical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA
| | - Bianca Weinstock-Guttman
- Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, Jacobs Comprehensive MS Treatment and Research Center, University at Buffalo, State University of New York, Buffalo, NY, USA
| | - Robert Zivadinov
- Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA
- Center for Biomedical Imaging at the Clinical Translational Science Institute, University at Buffalo, State University of New York, Buffalo, NY, USA
| | - Jun Qu
- Department of Pharmaceutical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA
- New York State Center of Excellence in Bioinformatics & Life Sciences, Buffalo, NY, USA
| | - Xiaoyu Zhu
- Department of Pharmaceutical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA.
| | - Murali Ramanathan
- Department of Pharmaceutical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA.
| |
Collapse
|
2
|
Zhang QF, Xiao HM, An N, Zhu QF, Feng YQ. Determination of vitamin D metabolites in various biological samples through an improved chemical derivatization assisted liquid chromatography-tandem mass spectrometry approach. ANALYTICAL METHODS : ADVANCING METHODS AND APPLICATIONS 2023; 15:6009-6014. [PMID: 37927098 DOI: 10.1039/d3ay01769a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2023]
Abstract
Vitamin D (VD) metabolites are involved in a variety of important metabolic processes and physiological effects in organisms. Profiling of VD metabolites favors a deep understanding of the physiological role of VD. However, VD metabolites are difficult to detect due to their high chemical structural rigidity, structural similarity, and low sensitivities under liquid chromatography-tandem mass spectrometry (LC-MS). Herein, we present a chemical derivatization assisted LC-MS/MS strategy for the detection of VDs, in which 4-phenyl-1,2,4-triazoline-3,5-dione (PTAD) is employed to derivatize the conjugated diene of VD metabolites and provides sensitizing reporters for MS detection. After PTAD derivatization, the sensitivities of seven VD metabolites increased by 24-276 folds, with the limits of detection ranging from 3 to 20 pg mL-1. Using this method, we achieved a sensitive and accurate quantification of 7 VD metabolites (vitamin D2, vitamin D3, 25-hydroxyvitamin D2, 25-hydroxyvitamin D3, 1,25-dihydroxyvitamin D2, 1,25-dihydroxyvitamin D3, and 1,24,25-trihydroxyvitamin D3) of the VD metabolic pathway in different trace biological samples, including human serum, mouse tissues (namely liver, kidney, lung, and spleen), and cells. We believe that the present method can provide a promising tool for an in-depth analysis of VD metabolism.
Collapse
Affiliation(s)
- Qin-Feng Zhang
- Department of Chemistry, Wuhan University, Wuhan 430072, PR China.
- Hubei Geological Research Laboratory, Wuhan 430034, PR China
| | - Hua-Ming Xiao
- Department of Chemistry, Wuhan University, Wuhan 430072, PR China.
| | - Na An
- Department of Chemistry, Wuhan University, Wuhan 430072, PR China.
| | - Quan-Fei Zhu
- School of Public Health, Wuhan University, Wuhan 430071, PR China.
| | - Yu-Qi Feng
- Department of Chemistry, Wuhan University, Wuhan 430072, PR China.
- School of Public Health, Wuhan University, Wuhan 430071, PR China.
| |
Collapse
|
3
|
Kushioka T, Mano H, Matsuoka S, Nishikawa M, Yasuda K, Ikushiro S, Sakaki T. Analysis of vitamin D metabolites in biological samples using a nanoluc-based vitamin D receptor ligand sensing system: NLucVDR. J Steroid Biochem Mol Biol 2023; 233:106367. [PMID: 37517743 DOI: 10.1016/j.jsbmb.2023.106367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 06/28/2023] [Accepted: 07/22/2023] [Indexed: 08/01/2023]
Abstract
Many assays are currently being developed to measure the levels of vitamin D metabolites in various samples (such as blood, urine, and saliva). This study focused on the measurement of vitamin D metabolites in serum and urine using the NLucVDR assay system, which consists of a split-type nanoluciferase and ligand-binding domain (LBD) of the human vitamin D receptor. Blood and urine samples were collected from 23 participants to validate the NLucVDR assay. The 25(OH)D3 levels in the serum and urine determined by the NLucVDR assay showed good correlations with those determined by standard analytical methods (ECLIA for serum and LC-MS/MS for urine), with correlation coefficients of 0.923 and 0.844 for serum and urine samples, respectively. In the case of serum samples, 25(OH)D3 levels determined by the NLucVDR assay were in good agreement with those determined by ECLIA. Therefore, the NLucVDR assay is a useful tool for measuring serum 25(OH)D3 levels. The contribution of each vitamin D metabolite to the luminescence intensity obtained during the NLucVDR assay depends on its concentration and affinity for NLucVDR. Thus, the contribution of 25(OH)D3 in serum appears to be much higher than that of the other metabolites. In contrast, the 25(OH)D3 levels in the urine determined by the NLucVDR assay were more than 20-fold higher than those determined by a standard analytical method (LC-MS/MS), suggesting that some vitamin D metabolite(s) in the urine remarkably increased the luminescence intensity of the NLucVDR assay. Notably, the 25(OH)D3 concentration in the urine determined by the NLucVDR assay and the serum 25(OH)D3 concentration determined by standard analytical methods showed a significant positive correlation (r = 0.568). These results suggest that the analysis of a small amount of urine using the NLucVDR assay may be useful for predicting the serum 25(OH)D3 levels.
Collapse
Affiliation(s)
- Takuya Kushioka
- FANCL Research Institute, FANCL Corporation, 12-13 Kamishinano, Totsuka-ku, Yokohama, Kanagawa 244-0806, Japan
| | - Hiroki Mano
- Department of Pharmaceutical Engineering, Faculty of Engineering, Toyama Prefectural University, 5180 Kurokawa, Imizu, Toyama 939-0398, Japan
| | - Sayuri Matsuoka
- FANCL Research Institute, FANCL Corporation, 12-13 Kamishinano, Totsuka-ku, Yokohama, Kanagawa 244-0806, Japan
| | - Miyu Nishikawa
- Department of Biotechnology, Faculty of Engineering, Toyama Prefectural University, 5180 Kurokawa, Imizu, Toyama 939-0398, Japan
| | - Kaori Yasuda
- Department of Pharmaceutical Engineering, Faculty of Engineering, Toyama Prefectural University, 5180 Kurokawa, Imizu, Toyama 939-0398, Japan
| | - Shinichi Ikushiro
- Department of Biotechnology, Faculty of Engineering, Toyama Prefectural University, 5180 Kurokawa, Imizu, Toyama 939-0398, Japan
| | - Toshiyuki Sakaki
- Department of Pharmaceutical Engineering, Faculty of Engineering, Toyama Prefectural University, 5180 Kurokawa, Imizu, Toyama 939-0398, Japan.
| |
Collapse
|
4
|
Schorr P, Stokes CS, Volmer DA. Improved quantitative LC-MS/MS analysis of vitamin D metabolites in serum after one-pot double derivatization. J Pharm Biomed Anal 2023; 234:115522. [PMID: 37329649 DOI: 10.1016/j.jpba.2023.115522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 06/04/2023] [Accepted: 06/08/2023] [Indexed: 06/19/2023]
Abstract
In this study, we report a one-pot double derivatization scheme, which used acetylation after a Diels-Alder reaction using 4-phenyl-1,2,4-triazoline-3,5-dione (PTAD) to improve separation efficiency and provide baseline separations of the five vitamin D metabolites 1,25-dihydroxyvitamin D3 (1,25(OH)2D3), 24,25-dihydroxyvitamin D3 (24,25(OH)2D3), 3β-25-hydroxyvitamin D3 (3β-25(OH)D3), 3α-25-hydroxyvitamin D3 (3α-25(OH)D3) and vitamin D3 on a C-18 stationary phase. Vitamin D metabolites are often very challenging to measure quantitatively using mass spectrometry, due to their low serum concentration levels and low ionization efficiencies. Moreover, some of these species are isomers with virtually identical mass spectral dissociation behavior. To overcome the low ionization efficiency and unspecific fragmentation behavior, derivatization using Diels-Alder reactions with Cookson-type reagents such as PTAD are common. These derivatization reactions generally result in more complicated liquid chromatography separations, because both 6R- and 6S-isomers are formed during Diels-Alder reactions. It has been shown that separations have been particularly challenging for the 3α-25(OH)D3 and 3β-25(OH)D3 epimers. Here, we optimized the PTAD derivatization and the esterification using acetic anhydride. By utilizing the esterification catalyst 4-dimethylaminopyridine, we avoided quenching and evaporation between the two derivatization steps, but were also able to perform the esterification at room temperature without heating. The optimized one-pot double derivatization LC-MS/MS assay was validated with respect to inter/intra-day precision, accuracy, recovery and linear dynamic range and applied to metabolic fingerprinting of vitamin D3 metabolites in serum samples. The metabolites 3α-25(OH)D3, 3β-25(OH)D3 and 24,25(OH)2D3, were readily quantified in all investigated samples. The method was, in principle, also fit for purpose for quantification of the native vitamin D3 species; the relatively high blank concentration of the commercial vitamin D-depleted serum used for calibration, however, limited the limits of quantification for this metabolite. The method provided insufficient limits of quantification for serum levels of 1,25(OH)2D3.
Collapse
Affiliation(s)
- Pascal Schorr
- Department of Chemistry, Humboldt Universität zu Berlin, Brook-Taylor Str. 2, Berlin 12489, Germany
| | - Caroline S Stokes
- Thaer Institute, Humboldt Universität zu Berlin, Lentzeallee 75, Berlin 14195, Germany
| | - Dietrich A Volmer
- Department of Chemistry, Humboldt Universität zu Berlin, Brook-Taylor Str. 2, Berlin 12489, Germany.
| |
Collapse
|
5
|
Wise SA, Hahm G, Burdette CQ, Tai SSC, Camara JE, Sempos CT, Williams EL. Determination of 24,25-dihydroxyvitamin D 3 in Vitamin D External Quality Assessment Scheme samples using a reference measurement procedure. J Steroid Biochem Mol Biol 2023; 231:106318. [PMID: 37169270 PMCID: PMC10330830 DOI: 10.1016/j.jsbmb.2023.106318] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 04/19/2023] [Accepted: 05/03/2023] [Indexed: 05/13/2023]
Abstract
Ninety archived human serum samples from the Vitamin D External Quality Assessment Scheme (DEQAS) were analyzed using a reference measurement procedure (RMP) based on isotope dilution liquid chromatography - tandem mass spectrometry (ID LC-MS/MS) for the determination of 24,25-dihydroxyvitamin D3 [24,25(OH)2D3]. These 24,25(OH)2D3 results, in conjunction with concentration values assigned using RMPs for 25-hydroxyvitamin D2 [25(OH)D2] and 25-hydroxyvitamin D3 [25(OH)D3], provide a valuable resource for assessing the accuracy of measurements for 24,25(OH)2D3 and for investigating the relationship between 24,25(OH)2D3 and 25(OH)D3. Results for 24,25(OH)2D3 using the RMP were compared to DEQAS consensus values demonstrating that the consensus values were not sufficient to assess the accuracy of measurements among different laboratories and methods. A multivariable regression analysis approach using historical DEQAS consensus values for various total 25(OH)D assays was used to assess the contribution of 24,25(OH)2D3 concentration on the assay response. The response of several ligand binding assays for total 25(OH)D was shown to be impacted by the presence of 24,25(OH)2D3.
Collapse
Affiliation(s)
- Stephen A Wise
- Office of Dietary Supplements, National Institutes of Health, Bethesda, MD 20892, USA.
| | - Grace Hahm
- National Institute of Standards and Technology (NIST), Gaithersburg, MD 20899, USA
| | - Carolyn Q Burdette
- National Institute of Standards and Technology (NIST), Gaithersburg, MD 20899, USA
| | - Susan S-C Tai
- National Institute of Standards and Technology (NIST), Gaithersburg, MD 20899, USA
| | - Johanna E Camara
- National Institute of Standards and Technology (NIST), Gaithersburg, MD 20899, USA
| | | | | |
Collapse
|
6
|
Usoltseva L, Ioutsi V, Panov Y, Antsupova M, Rozhinskaya L, Melnichenko G, Mokrysheva N. Serum Vitamin D Metabolites by HPLC-MS/MS Combined with Differential Ion Mobility Spectrometry: Aspects of Sample Preparation without Derivatization. Int J Mol Sci 2023; 24:ijms24098111. [PMID: 37175816 PMCID: PMC10179168 DOI: 10.3390/ijms24098111] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 04/28/2023] [Accepted: 04/28/2023] [Indexed: 05/15/2023] Open
Abstract
In current clinical practice, a thorough understanding of vitamin D metabolism is in high demand both for patients with various diseases and for healthy individuals. Analytical techniques that provide simultaneous measurement of multiple metabolites are preferred. Herein, the development of an HPLC-DMS-MS/MS method for the quantitation of vitamin D compounds (25(OH)D3, 25(OH)D2, 1,25(OH)2D3, 3-epi-25(OH)D3, 24,25(OH)2D3, and D3) in serum is described. The selected sample preparation procedure based on the combination of liquid-liquid and solid-phase extraction, which excluded a lengthy derivatization step, was compared with other common approaches. Sensitivity was increased through the implementation of differential ion mobility separation. The proposed assay allowed us to determine the low abundant 1,25(OH)2D3 with the detection limit of 10 pg/mL. The validation study showed good linearity (r2 > 0.99), a wide analytical range (2.5-75 ng/mL for 25(OH)D3), and acceptable precision (<7%) for all metabolites. The recovery ranged from 71% to 93% and the matrix effect from 0.80 to 0.95 depending on the metabolite; accuracy determination was performed using DEQAS controls.
Collapse
Affiliation(s)
| | | | - Yuriy Panov
- Endocrinology Research Centre, 117292 Moscow, Russia
| | | | | | | | | |
Collapse
|
7
|
Cutolo M, Smith V, Paolino S, Gotelli E. Involvement of the secosteroid vitamin D in autoimmune rheumatic diseases and COVID-19. Nat Rev Rheumatol 2023; 19:265-287. [PMID: 36977791 PMCID: PMC10043872 DOI: 10.1038/s41584-023-00944-2] [Citation(s) in RCA: 16] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/01/2023] [Indexed: 03/30/2023]
Abstract
Evidence supporting the extra-skeletal role of vitamin D in modulating immune responses is centred on the effects of its final metabolite, 1,25-dihydroxyvitamin D3 (1,25(OH)2D3, also known as calcitriol), which is regarded as a true steroid hormone. 1,25(OH)2D3, the active form of vitamin D, can modulate the innate immune system in response to invading pathogens, downregulate inflammatory responses and support the adaptive arm of the immune system. Serum concentrations of its inactive precursor 25-hydroxyvitamin D3 (25(OH)D3, also known as calcidiol) fluctuate seasonally (being lowest in winter) and correlate negatively with the activation of the immune system as well as with the incidence and severity of autoimmune rheumatic diseases such as rheumatoid arthritis, systemic lupus erythematosus and systemic sclerosis. Thus, a low serum concentration of 25(OH)D3 is considered to be a risk factor for autoimmune rheumatic diseases and vitamin D3 supplementation seems to improve the prognosis; moreover, long-term vitamin D3 supplementation seems to reduce their incidence (i.e. rheumatoid arthritis). In the setting of COVID-19, 1,25(OH)2D3 seems to downregulate the early viral phase (SARS-CoV-2 infection), by enhancing innate antiviral effector mechanisms, as well as the later cytokine-mediated hyperinflammatory phase. This Review provides an update of the latest scientific and clinical evidence concerning vitamin D and immune response in autoimmune rheumatic diseases and COVID-19, which justify the need for monitoring of serum 25(OH)D3 concentrations and for appropriate supplementation following clinical trial-based approaches.
Collapse
Affiliation(s)
- Maurizio Cutolo
- Laboratory of Experimental Rheumatology and Academic Division of Clinical Rheumatology, Department of Internal Medicine and Specialties (DiMI), University of Genova-IRCCS San Martino Polyclinic Hospital, Genoa, Italy.
| | - Vanessa Smith
- Department of Internal Medicine, Department of Rheumatology, University Hospital Ghent, Ghent, Belgium
| | - Sabrina Paolino
- Laboratory of Experimental Rheumatology and Academic Division of Clinical Rheumatology, Department of Internal Medicine and Specialties (DiMI), University of Genova-IRCCS San Martino Polyclinic Hospital, Genoa, Italy
| | - Emanuele Gotelli
- Laboratory of Experimental Rheumatology and Academic Division of Clinical Rheumatology, Department of Internal Medicine and Specialties (DiMI), University of Genova-IRCCS San Martino Polyclinic Hospital, Genoa, Italy
| |
Collapse
|
8
|
Gottlieb C, Henrich M, Liu PT, Yacoubian V, Wang J, Chun R, Adams JS. High- Throughput CAMP Assay (HiTCA): A Novel Tool for Evaluating the Vitamin D-Dependent Antimicrobial Response. Nutrients 2023; 15:1380. [PMID: 36986109 PMCID: PMC10051182 DOI: 10.3390/nu15061380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 03/08/2023] [Accepted: 03/09/2023] [Indexed: 03/14/2023] Open
Abstract
Vitamin D is known to modulate human immune responses, and vitamin D deficiency is associated with increased susceptibility to infection. However, what constitutes sufficient levels or whether vitamin D is useful as an adjuvant therapeutic is debated, much in part because of inadequate elucidation of mechanisms underlying vitamin D's immune modulatory function. Cathelicidin antimicrobial peptide (CAMP) has potent broad-spectrum activity, and the CAMP gene is regulated in human innate immune cells by active 1,25(OH)2D3, a product of hydroxylation of inactive 25(OH)D3 by CYP27B1-hydroxylase. We developed a CRISPR/Cas9-edited human monocyte-macrophage cell line containing the mCherry fluorescent reporter gene at the 3' end of the endogenous CAMP gene. The High Throughput CAMP Assay (HiTCA) developed here is a novel tool for evaluating CAMP expression in a stable cell line that is scalable for a high-throughput workflow. Application of HiTCA to serum samples from a small number of human donors (n = 10) showed individual differences in CAMP induction that were not fully accounted for by the serum vitamin D metabolite status of the host. As such, HiTCA may be a useful tool that can advance our understanding of the human vitamin D-dependent antimicrobial response, which is being increasingly appreciated for its complexity.
Collapse
Affiliation(s)
- Carter Gottlieb
- Department of Orthopaedic Surgery, University of California, Los Angeles, CA 90095, USA
| | - Mason Henrich
- Department of Molecular, Cell & Developmental Biology, University of California, Los Angeles, CA 90095, USA
| | - Philip T. Liu
- Department of Microbiology, Immunology and Molecular Genetics, University of California, Los Angeles, CA 90095, USA
| | - Vahe Yacoubian
- Department of Orthopaedic Surgery, University of California, Los Angeles, CA 90095, USA
| | - Jeffery Wang
- Department of Orthopaedic Surgery, University of California, Los Angeles, CA 90095, USA
| | - Rene Chun
- Department of Orthopaedic Surgery, University of California, Los Angeles, CA 90095, USA
| | - John S. Adams
- Department of Orthopaedic Surgery, University of California, Los Angeles, CA 90095, USA
- Department of Molecular, Cell & Developmental Biology, University of California, Los Angeles, CA 90095, USA
| |
Collapse
|
9
|
Herrmann M. Assessing vitamin D metabolism - four decades of experience. Clin Chem Lab Med 2023; 61:880-894. [PMID: 36639845 DOI: 10.1515/cclm-2022-1267] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Accepted: 12/20/2022] [Indexed: 01/15/2023]
Abstract
One hundred years ago, the role of vitamin D for bone mineralization and the prevention of rickets was discovered. Vitamin D comprises a group of over 50 metabolites with multiple functions that go far beyond calcium homeostasis and bone mineralization. Approximately 50 years ago, first methods for the measurement of 25-hydroxyvitamin D (25(OH)D) in human blood were developed. Over the years, different analytical principals were employed including competitive protein binding assays, high-performance liquid chromatography, various immunoassay and mass spectrometric formats. Until the recent standardization of serum 25(OH)D measurement, agreement between methods was unsatisfactory. Since then, comparability has improved, but substantial variability between methods remains. With the advent of liquid chromatography tandem mass spectrometry (LC-MS/MS), the accurate determination of 25(OH)D and other metabolites, such as 24,25(OH)2D, becomes increasingly accessible for clinical laboratories. Easy access to 25(OH)D testing has triggered extensive clinical research showing that large parts of the population are vitamin D deficient. The variable response of vitamin D deficient individuals to supplementation indicates that assessing patients' vitamin D stores by measuring 25(OH)D provides limited insight into the metabolic situation. Meanwhile, first evidence has emerged suggesting that the simultaneous measurement of 25(OH)D, 24,25(OH)2D and other metabolites allows a dynamic evaluation of patients' vitamin D status on metabolic principals. This may help to identify patients with functional vitamin D deficiency from those without. It can be expected that research into the assessment vitamin D status will continue for another 50 years and that this will help rationalizing our approach in clinical practice.
Collapse
Affiliation(s)
- Markus Herrmann
- Clinical Institute of Medical and Chemical Diagnostics, Medical University of Graz, Graz, Austria
| |
Collapse
|
10
|
Abouzid M, Karaźniewicz-Łada M, Abdelazeem B, Brašić JR. Research Trends of Vitamin D Metabolism Gene Polymorphisms Based on a Bibliometric Investigation. Genes (Basel) 2023; 14:215. [PMID: 36672957 PMCID: PMC9859253 DOI: 10.3390/genes14010215] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 01/05/2023] [Accepted: 01/11/2023] [Indexed: 01/19/2023] Open
Abstract
Vitamin D requires activation to show its pharmacological effect. While most studies investigate the association between vitamin D and disease, only a few focus on the impact of vitamin D metabolism gene polymorphisms (vitDMGPs). This bibliometric study aims to provide an overview of current publications on vitDMGPs (CYP27B1, CYP24A1, CYP2R1, CYP27A1, CYP2R1, DHCR7/NADSYN1), compare them across countries, affiliations, and journals, and inspect keywords, co-citations, and citation bursts to identify trends in this research field. CiteSpace© (version 6.1.R3, Chaomei Chen), Bibliometrix© (R version 4.1.3 library, K-Synth Srl, University of Naples Federico II, Naples, Italy), VOSviewer© (version 1.6.1, Nees Jan van Eck and Ludo Waltman, Leiden University, Leiden, Netherlands) and Microsoft® Excel 365 (Microsoft, Redmond, Washington, USA) classified and summarized Web of Science articles from 1998 to November 2022. We analyzed 2496 articles and built a timeline of co-citations and a bibliometric keywords co-occurrence map. The annual growth rate of vitDMGPs publications was 18.68%, and their relative research interest and published papers were increasing. The United States of America leads vitDMGPs research. The University of California System attained the highest quality of vitDMGPs research, followed by the American National Institutes of Health and Harvard University. The three productive journals on vitDMGPs papers are J. Steroid. Biochem. Mol. Biol., PLOS ONE, and J. Clin. Endocrinol. Metab. We highlighted that the vitDMGPs domain is relatively new, and many novel research opportunities are available, especially those related to studying single nucleotide polymorphisms or markers in a specific gene in the vitamin D metabolism cycle and their association with disease. Genome-wide association studies, genetic variants of vitDMGPs, and vitamin D and its role in cancer risk were the most popular studies. CYP24A1 and CYB27A1 were the most-studied genes in vitDMGPs. Insulin was the longest-trending studied hormone associated with vitDMGPs. Trending topics in this field relate to bile acid metabolism, transcriptome and gene expression, biomarkers, single nucleotide polymorphism, and fibroblast growth factor 23. We also expect an increase in original research papers investigating the association between vitDMGPs and coronavirus disease 2019, hypercalcemia, Smith-Lemli-Opitz syndrome, 27-hydroxycholesterol, and mendelian randomization. These findings will provide the foundations for innovations in the diagnosis and treatment of a vast spectrum of conditions.
Collapse
Affiliation(s)
- Mohamed Abouzid
- Department of Physical Pharmacy and Pharmacokinetics, Faculty of Pharmacy, Poznan University of Medical Sciences, Rokietnicka 3 St., 60-806 Poznan, Poland
- Doctoral School, Poznan University of Medical Sciences, 60-812 Poznan, Poland
| | - Marta Karaźniewicz-Łada
- Department of Physical Pharmacy and Pharmacokinetics, Faculty of Pharmacy, Poznan University of Medical Sciences, Rokietnicka 3 St., 60-806 Poznan, Poland
| | - Basel Abdelazeem
- Department of Internal Medicine, McLaren Health Care, Flint, MI 48532, USA
- Department of Internal Medicine, Michigan State University, East Lansing, MI 48823, USA
| | - James Robert Brašić
- Section of High Resolution Brain Positron Emission Tomography Imaging, Division of Nuclear Medicine and Molecular Imaging, The Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
| |
Collapse
|
11
|
Drábová L, Libenská L, Zedníková M, Vondrášková V, Hajšlová J, Pulkrabová J. Analysis of UV-Treated Mushrooms: Dietary Source of Vitamin D2? LCGC EUROPE 2022. [DOI: 10.56530/lcgc.eu.wi6189z4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
In recent years, dietary intake of vitamin D has become an issue of high concern because this bioactive molecule boosts the immune system and is presumed to provide some protection against Covid-19. Under these conditions, a search for nontraditional dietary sources has appeared as a new challenge. One of the possibilities is irradiation of champignons that contain a high amount of ergosterol, a vitamin D2 precursor. In our study, a fast and sensitive liquid chromatography coupled to tandem mass spectrometry (LC–MS/MS) method for the determination of vitamin D2 in fresh mushrooms and its metabolite 25(OH)D2 in the blood of volunteers regularly consuming UV-treated mushrooms has been introduced. For extraction of desiccated mushrooms, solid-liquid extraction n-hexane–ethyl acetate was used, and n-hexane was employed for blood plasma samples. Separation of target analytes was performed on a polymeric bonding C18 phase column. Satisfactory limits of quantification (LOQs) were reached both for the control of vitamin D2 content in mushrooms (LOQ = 10 ng/g) and for the monitoring of vitamin D2 and D3 metabolite in human blood (LOQ = 2.5 ng/mL). For accurate quantification, isotopic dilution was employed.
Collapse
|
12
|
Alexandridou A, Volmer DA. Sample preparation techniques for extraction of vitamin D metabolites from non-conventional biological sample matrices prior to LC-MS/MS analysis. Anal Bioanal Chem 2022; 414:4613-4632. [PMID: 35501505 PMCID: PMC9174318 DOI: 10.1007/s00216-022-04097-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2022] [Revised: 04/13/2022] [Accepted: 04/22/2022] [Indexed: 12/18/2022]
Abstract
The determination of vitamin D metabolites as status marker or for diagnostic purposes is almost entirely conducted from blood serum or plasma. Other biological matrices, however, have also interested researchers, for two main reasons: (1) alternative matrices may allow non-invasive sampling, permit easier sample transfer and require less demanding storage conditions; and (2) the levels of vitamin D metabolites in other body compartments may further aid the understanding of vitamin D metabolism and function. Thus, the development of reliable and efficient sample preparation protocols for sample matrices other than serum/plasma, which will remove potential interferences and selectively extract the targeted metabolites, is of great importance. This review summarizes sample preparation methods for measurement of vitamin D metabolites using liquid chromatography-(tandem)mass spectrometry in more than ten different human tissues, including hair, saliva, adipose tissue, brain and others.
Collapse
Affiliation(s)
- Anastasia Alexandridou
- Bioanalytical Chemistry, Humboldt University Berlin, Brook-Taylor-Str. 2, 12489, Berlin, Germany
| | - Dietrich A Volmer
- Bioanalytical Chemistry, Humboldt University Berlin, Brook-Taylor-Str. 2, 12489, Berlin, Germany.
| |
Collapse
|
13
|
Xu S, Ni R, Lv L, Chen R, Chen Y, Huang F, Xu Z. Simultaneous determination of vitamin D metabolites 25(OH)D3 and 1α,25(OH)2D3 in human plasma using liquid chromatography tandem mass spectrometry. J Mass Spectrom Adv Clin Lab 2022; 24:65-79. [PMID: 35572785 PMCID: PMC9093011 DOI: 10.1016/j.jmsacl.2022.04.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 03/30/2022] [Accepted: 04/21/2022] [Indexed: 12/14/2022] Open
Abstract
LC-MS/MS method development and optimization for simultaneous determination of 25(OH)D3 and 1α,25(OH)2D3 in human plasma. Lowest concentration of 25(OH)D3 and 1α,25(OH)2D3 was 1000 and 20 pg/mL, respectively. The validated method was applied to a pharmacokinetic study in humans.
Background Although measurement of 25(OH)D3 is a routine analytical method to determine plasma vitamin D status, 1α,25(OH)2D3 is the biologically active form. Hence, simultaneous measurement of 25(OH)D3 and 1α,25(OH)2D3 could provide better insight into vitamin D status and pharmacokinetics. However, 1α,25(OH)2D3 has a low plasma concentration, making its quantification challenging for most analytical techniques. Here, we demonstrate use of liquid chromatography tandem mass spectrometry (LC-MSMS) for the development of a simple and rapid method for the simultaneous quantification of 25(OH)D3 and 1α,25(OH)2D3. Methods Samples were purified from 250 µL human plasma. Chromatography was performed on an analytical column, under gradient conditions using a mobile phase consisting of methanol-lithium acetate. The mass detector was operated in positive multiple reaction monitoring mode. The established method was validated according to the guidance issued by ICH and FDA. Furthermore, a clinical study was performed using this method to detect the plasma concentrations of 1α,25(OH)2D3 after oral administration of calcitriol. Results and conclusion The method was acceptably linear over the concentration ranges of 20–1200 pg/mL for 1α,25(OH)2D3 and 1–60 ng/mL for 25(OH)D3, respectively, with correlation coefficients of r2 > 0.993. Both the inter-assay and intra-assay precision was < 15%, and the analytical recoveries were within 100% ± 10%, with no significant matrix effect or carryover. Thereby, we, provide a facile method for the simultaneous detection of vitamin D metabolites in plasma.
Collapse
|
14
|
Noh JY, Kim MJ, Park JM, Yun TG, Kang MJ, Pyun JC. Quantitative analysis of vitamin D using m/MALDI-TOF mass spectrometry based on a parylene matrix chip. J Anal Sci Technol 2022. [DOI: 10.1186/s40543-021-00313-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
AbstractVitamin D deficiency is associated with various disorders and is diagnosed based on the concentration of 25-hydroxy vitamin D3 (25(OH)D3) in serum. The parylene matrix chip was fabricated to reduce the matrix background noise, and the homogenous distribution of the matrix was retained for the quantitative analysis of 25(OH)D3. The Amplex Red assay was performed to confirm that the sample-matrix mixing zone of the parylene matrix chip was formed below the surface of the parylene-N film. The homogeneous distribution of the matrix was verified from the fluorescence image. For effective analysis using a parylene matrix chip, 25(OH)D3 was modified through the nucleophilic addition of betaine aldehyde (BA) to form a hemiacetal salt. Such modified 25(OH)D3 with a positive charge from BA could be effectively analyzed using MALDI-TOF mass spectrometry. Serum 25(OH)D3 was extracted by liquid–liquid extraction (LLE) and quantified using MALDI-TOF mass spectrometry based on the parylene matrix chip. The intensity of the mass peak of 25(OH)D3 was linearly correlated (r2 = 0.992) with the concentration of 25(OH)D3 spiked in serum, and the LOD was 0.0056 pmol/μL. Energy drinks and vitamin D3 tablets were also employed for the real sample analysis. Finally, the results of the chemiluminescence binding assay and MALDI-TOF mass spectrometry were statistically analyzed to determine the applicability of the method using the Bland–Altman test and Passing–Bablok regression.
Collapse
|
15
|
Wang D, Yu S, Zhang Q, Cheng Q, Xie S, Zhang Y, Guo X, Zou Y, Yin Y, Yu J, Li H, Xia L, Qiu L, Xia W. A robust method for simultaneous measurement of serum 25(OH)D, 1,25(OH) 2 D, and 24,25(OH) 2 D by liquid chromatography-tandem mass spectrometry with efficient separation of 3-epi analogs, 23R,25(OH) 2 D 3 , and 4β,25(OH) 2 D 3. JOURNAL OF MASS SPECTROMETRY : JMS 2022; 57:e4792. [PMID: 34913542 DOI: 10.1002/jms.4792] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Revised: 10/18/2021] [Accepted: 10/31/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND This study aimed to establish a robust, simple method to detect 25-hydroxyvitamin D3 (25(OH)D3 ), 25-hydroxyvitamin D2 (25(OH)D2 ), 1,25-dihydroxyvitamin D3 (1,25(OH)2 D3 ), 1,25-dihydroxyvitamin D2 (1,25(OH)2 D2 ), 24,25-dihydroxyvitamin D3 (24,25(OH)2 D3 ), and 24,25-dihydroxyvitamin D2 (24,25(OH)2 D2 ) simultaneously with efficient separation of 3-epi 25(OH)D3 , 3-epi 24,25(OH)2 D3 , 23R,25(OH)2 D3 , and 4β,25-dihydroxyvitamin D3 (4β,25(OH)2 D3 ) by liquid chromatography-tandem mass spectrometry (LC-MS/MS). METHOD This method was validated according to procedures established by Clinical and Laboratory Standards Institute (CLSI) and then applied in healthy population to determine the distribution of the vitamin D metabolites by LC-MS/MS. RESULTS The total-run CV% of 25(OH)D3 , 25(OH)D2 , 24,25(OH)2 D3 , 24,25(OH)2 D2 , 1,25(OH)2 D3 , and 1,25(OH)2 D2 were 6.30%-8.40%, 5.00%-8.40%, 5.90%-9.00%, 5.60%-9.00%, 5.60%-8.00%, and 7.00%-9.70%, respectively. The linearity correlation coefficients r of these six vitamin D metabolites were >0.99. The matrix effects of 25(OH)D3 , 25(OH)D2 , 24,25(OH)2 D3 , 24,25(OH)2 D2 , 1,25(OH)2 D3 , and 1,25(OH)2 D2 were 90.6%-103.3%, 97.3%-106.3%, 90.7%-106.3%, 100.7%-114.5%, 97.9%-104.6%, and 97.0%-111.0%. The trueness values of 25(OH)D3 , 25(OH)D2 , and 24,25(OH)2 D3 were 93.8%-103.0%, 101.0%, and 96.3%-100%, respectively. CONCLUSION This study successfully established an efficient, accurate, robust method for simultaneous measurement of serum 25(OH)D, 1,25(OH)2 D, and 24,25(OH)2 D by LC-MS/MS with efficient separation of 3-epi analogs, 23R,25(OH)2 D3 , and 4β,25(OH)2 D3 .
Collapse
Affiliation(s)
- Danchen Wang
- Department of Laboratory Medicine, Peking Union Medical College Hospital, Peking Union Chinese Academy of Medical Sciences, Beijing, 100730, China
| | - Songlin Yu
- Department of Laboratory Medicine, Peking Union Medical College Hospital, Peking Union Chinese Academy of Medical Sciences, Beijing, 100730, China
- Technology Innovation Center of Mass Spectrometry for State Market Regulation, Center for Advanced Measurement Science, National Institute of Metrology, Beijing, 100029, China
| | - Qi Zhang
- Department of Laboratory Medicine, Peking Union Medical College Hospital, Peking Union Chinese Academy of Medical Sciences, Beijing, 100730, China
| | - Qian Cheng
- Department of Laboratory Medicine, Peking Union Medical College Hospital, Peking Union Chinese Academy of Medical Sciences, Beijing, 100730, China
| | - Shaowei Xie
- Department of Laboratory Medicine, Peking Union Medical College Hospital, Peking Union Chinese Academy of Medical Sciences, Beijing, 100730, China
| | - Yuanyuan Zhang
- Department of Application Support Center, Shanghai AB Sciex Analytical Instrument Trading Co., Ltd., Beijing, China
| | - Xiuzhi Guo
- Department of Laboratory Medicine, Peking Union Medical College Hospital, Peking Union Chinese Academy of Medical Sciences, Beijing, 100730, China
| | - Yutong Zou
- Department of Laboratory Medicine, Peking Union Medical College Hospital, Peking Union Chinese Academy of Medical Sciences, Beijing, 100730, China
| | - Yicong Yin
- Department of Laboratory Medicine, Peking Union Medical College Hospital, Peking Union Chinese Academy of Medical Sciences, Beijing, 100730, China
| | - Jialei Yu
- Department of Laboratory Medicine, Peking Union Medical College Hospital, Peking Union Chinese Academy of Medical Sciences, Beijing, 100730, China
| | - Honglei Li
- Department of Laboratory Medicine, Peking Union Medical College Hospital, Peking Union Chinese Academy of Medical Sciences, Beijing, 100730, China
| | - Liangyu Xia
- Department of Laboratory Medicine, Peking Union Medical College Hospital, Peking Union Chinese Academy of Medical Sciences, Beijing, 100730, China
| | - Ling Qiu
- Department of Laboratory Medicine, Peking Union Medical College Hospital, Peking Union Chinese Academy of Medical Sciences, Beijing, 100730, China
- State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, 100730, China
| | - Weibo Xia
- Department of Endocrinology, Key Laboratory of Endocrinology, National Commission of Health, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, 100730, China
| |
Collapse
|
16
|
Ahmed S, Siddiqui A, Qureshi A, Hussain SS, Siddiqui I, Imran U. A Cross-Sectional Evaluation of Vitamin D Status and Ovarian Reserve Markers in Subfertile Women: A Single-Center Experience From Pakistan. Cureus 2022; 14:e21757. [PMID: 35251828 PMCID: PMC8889504 DOI: 10.7759/cureus.21757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/31/2022] [Indexed: 11/12/2022] Open
Abstract
Objectives This study was conceived with the objective of assessing the correlation between ovarian reserve markers and vitamin D deficiency (VDD) in a selected group of Pakistani subfertile women presenting at a specialized subfertility treatment centre. The measurements of antral follicle count (AFC), serum anti-Müllerian hormone (AMH), serum follicle-stimulating hormone (FSH), and serum vitamin D (VD) levels were the main tools used for the assessment of ovarian reserve. Materials and methods All female patients aged 18 to 45 years presenting with primary and/or secondary subfertility at the Australian Concept Medical Centre in Karachi, Pakistan from August 2016 to July 2021 were included in the study. The data of all eligible patients were recorded in the pre-defined Performa designed for this study. The Kruskal-Wallis test was applied to report the distribution of the data. The correlation between the categorical variables (25-hydroxyvitamin D [25-OHD] levels with AFC and AMH) was assessed using the chi-square test and Spearman correlation. The comparison was based on vitamin D levels grouped into three categories: deficiency (<20 ng/ml), insufficiency (21-29 ng/ml), and sufficiency (>30 ng/ml). Results One hundred ninety-nine cases were evaluated for AFC and hormone analysis. The mean age and BMI were 32.87±5.49 years and 28.27±4.97 kg/m2.VDD was noted in 127 (68.4%) cases. No significant difference was noted across BMI, age, duration of subfertility, AMH, and FSH across the VD categories. Moreover, a poor correlation was noted between VD, AMH and FSH on the scatter plot, between VD and FSH (r = -0.003, p = 0.966) and between VD and AMH (r = -0.068, p = 0.342), respectively. Conclusions This study showed a high frequency of VDD in Pakistani subfertile women, from a specialized subfertility center in the largest metropolis in the country. However, a statistically significant association was not found between the markers of ovarian reserve and VD, showing no ethnic differences in the native Pakistani population. Hence, VD supplementation is unlikely to have an impact on correcting the ovarian reserve status in subfertile women in Pakistan. However, this is a potential area of interest, and evaluation of other indices of reproduction/ovarian reserve and the effect of confounders is required to test this hypothesis longitudinally.
Collapse
Affiliation(s)
- Sibtain Ahmed
- Pathology and Laboratory Medicine, Aga Khan University, Karachi, PAK
| | | | - Alinah Qureshi
- Student Life Science Gateway, Mc Master University, Ontario, CAN
| | - Syed Sajjad Hussain
- Head Research and Development, Australian Concept Medical Center, Karachi, PAK
| | - Imran Siddiqui
- Pathology and Laboratory Medicine, Aga Khan University, Karachi, PAK
| | - Uzma Imran
- Gynecology and Obstetrics, Australian Concept Medical Centre, Karachi, PAK
| |
Collapse
|
17
|
Alexandridou A, Schorr P, Stokes CS, Volmer DA. Analysis of vitamin D metabolic markers by mass spectrometry: Recent progress regarding the "gold standard" method and integration into clinical practice. MASS SPECTROMETRY REVIEWS 2021. [PMID: 34967037 DOI: 10.1002/mas.21768] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 12/03/2021] [Accepted: 12/13/2021] [Indexed: 06/14/2023]
Abstract
Liquid chromatography/tandem mass spectrometry is firmly established today as the gold standard technique for analysis of vitamin D, both for vitamin D status assessments as well as for measuring complex and intricate vitamin D metabolic fingerprints. While the actual mass spectrometry technology has seen only incremental performance increases in recent years, there have been major, very impactful changes in the front- and back-end of MS-based vitamin D assays; for example, the extension to new types of biological sample matrices analyzed for an increasing number of different vitamin D metabolites, novel sample preparation techniques, new powerful chemical derivatization reagents, as well the continued integration of high resolution mass spectrometers into clinical laboratories, replacing established triple-quadrupole instruments. At the same time, the sustainability of mass spectrometry operation in the vitamin D field is now firmly established through proven analytical harmonization and standardization programs. The present review summarizes the most important of these recent developments.
Collapse
Affiliation(s)
| | - Pascal Schorr
- Department of Bioanalytical Chemistry, Humboldt University Berlin, Berlin, Germany
| | - Caroline S Stokes
- Food and Health Research Group, Faculty of Life Sciences, Humboldt-Universität zu Berlin, Berlin, Germany
- Department of Molecular Toxicology, German Institute of Human Nutrition, Potsdam-Rehbrücke, Germany
| | - Dietrich A Volmer
- Department of Bioanalytical Chemistry, Humboldt University Berlin, Berlin, Germany
| |
Collapse
|
18
|
Huish SA, Jenkinson C, Dunn JA, Meredith DJ, Bland R, Hewison M. Low serum 1,25(OH)2D3 in end-stage renal disease: is reduced 1α-hydroxylase the only problem? Endocr Connect 2021; 10:1291-1298. [PMID: 34519274 PMCID: PMC8558908 DOI: 10.1530/ec-21-0372] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Accepted: 09/13/2021] [Indexed: 12/25/2022]
Abstract
Low serum 1,25-dihydroxyvitamin D (1,25(OH)2D) in end-stage renal disease (ESRD) is considered a consequence of elevated fibroblast growth factor 23 (FGF23) and concomitant reduced activity of renal 1α-hydroxylase (CYP27B1). Current ESRD treatment strategies to increase serum calcium and suppress secondary hyperparathyroidism involve supplementation with vitamin D analogues that circumvent 1α-hydroxylase. This overlooks the potential importance of 25-hydroxyvitamin D (25(OH)D) deficiency as a contributor to low serum 1,25(OH)2D. We investigated the effects of vitamin D (cholecalciferol) supplementation (40,000 IU for 12 weeks and maintenance dose of 20,000 IU fortnightly), on multiple serum vitamin D metabolites (25(OH)D, 1,25(OH)2D3 and 24,25(OH)2D3) in 55 haemodialysis patients. Baseline and 12 month data were compared using related-samples Wilcoxon signed rank test. All patients remained on active vitamin D analogues as part of routine ESRD care. 1,25(OH)2D3 levels were low at baseline (normal range: 60-120 pmol/L). Cholecalciferol supplementation normalised both serum 25(OH)D and 1,25(OH)2D3. Median serum 25(OH)D increased from 35.1 nmol/L (IQR: 23.0-47.5 nmol/L) to 119.9 nmol/L (IQR: 99.5-143.3 nmol/L) (P < 0.001). Median serum 1,25(OH)2D3 and 24,25(OH)2D3 increased from 48.3 pmol/L (IQR: 35.9-57.9 pmol/L) and 3.8 nmol/L (IQR: 2.3-6.0 nmol/L) to 96.2 pmol/L (IQR: 77.1-130.6 pmol/L) and 12.3 nmol/L (IQR: 9-16.4 nmol/L), respectively (P < 0.001). A non-significant reduction in daily active vitamin D analogue dose occurred, 0.94 µmcg at baseline to 0.77 µmcg at 12 months (P = 0.73). The ability to synthesise 1,25(OH)2D3 in ESRD is maintained but is substrate dependent, and serum 25(OH)D was a limiting factor at baseline. Therefore, 1,25(OH)2D3 deficiency in ESRD is partly a consequence of 25(OH)D deficiency, rather than solely due to reduced 1α-hydroxylase activity as suggested by current treatment strategies.
Collapse
Affiliation(s)
- Sharon A Huish
- University Hospitals of Coventry and Warwickshire NHS Trust, Coventry, UK
- The University of Warwick, Coventry, UK
- Royal Devon and Exeter NHS Foundation Trust, Exeter, UK
| | | | | | | | | | | |
Collapse
|
19
|
Absolute quantification of eleven A, D, E and K vitamers in human plasma using automated extraction and UHPLC-Orbitrap MS. Anal Chim Acta 2021; 1181:338877. [PMID: 34556212 DOI: 10.1016/j.aca.2021.338877] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 07/08/2021] [Accepted: 07/22/2021] [Indexed: 11/22/2022]
Abstract
Fat-Soluble Vitamers [FSV] deficiencies and hypervitaminosis are associated with lifestyle diseases such as cardiovascular disease, diabetes, and cancer. Quantification of FSV and their metabolites in plasma has proved to be one of the most demanding analytical chemistry challenges. Current FSV quantification methods are compromises between breadth of coverage and sensitivity across the physiological range. Here, we developed and validated a sensitive, robust, semi-automated method using liquid-liquid extraction coupled with LC-ESI-MS/MS to quantify 11 FSV across their physiological concentrations in plasma. The addition of Phree® phospholipid removal plates as the last step in the extraction process reduced matrix effects, improving precision, recoveries, and the method's final sensitivity. This method can detect and quantify: retinol, retinoic acid, retinyl palmitate, 25 hydroxyvitamin D3 [25-OH-D3], 1-α-25-dihydroxy-D3, α-tocopherol, γ-tocopherol, α-tocotrienol, phylloquinone [K1], Menatetrenone [MK-4], and menaquinone-7 [MK-7].The Instrument Quantitation Limit [IQL]s for retinol (64.1 ng/mL), 25-OH-D3 (10.2 ng/mL), and α-tocopherol (3000 ng/mL) can detect clinical deficiencies. Our automated method will assist in the understanding of the complex interaction between these compounds and their possible role in health and disease.
Collapse
|
20
|
Determination of Vitamin D3 in the Fortified Sunflower Oil: Comparison of Two Developed Methods. FOOD ANAL METHOD 2021. [DOI: 10.1007/s12161-021-02124-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
21
|
Clarke KE, Hurst EA, Mellanby RJ. Vitamin D metabolism and disorders in dogs and cats. J Small Anim Pract 2021; 62:935-947. [PMID: 34323302 DOI: 10.1111/jsap.13401] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Revised: 06/05/2021] [Accepted: 06/19/2021] [Indexed: 12/20/2022]
Abstract
Vitamin D plays an important role in regulating calcium metabolism and in the development and maintenance of skeletal health of companion animals. There is also a growing interest in understanding the role vitamin D plays in non-skeletal health in both human and veterinary patients. This review provides an update of our current understanding of vitamin D biology in dogs and cats and gives an overview of how vitamin D metabolism can be assessed in companion animals. Congenital and acquired vitamin D disorders are then summarised before the review concludes with a summary of recent studies which have explored the role of vitamin D in the development and outcomes of non-skeletal diseases of dogs and cats.
Collapse
Affiliation(s)
- K E Clarke
- Davies Veterinary Specialists, Manor Farm Business Park, Higham Gobion, Hertfordshire, UK
| | - E A Hurst
- Royal (Dick) School of Veterinary Studies and the Roslin Institute, The University of Edinburgh, Easter Bush Campus, Roslin, Midlothian, UK
| | - R J Mellanby
- Royal (Dick) School of Veterinary Studies and the Roslin Institute, The University of Edinburgh, Easter Bush Campus, Roslin, Midlothian, UK
| |
Collapse
|
22
|
De-la-O A, Jurado-Fasoli L, Castillo MJ, Gutiérrez Á, Amaro-Gahete FJ. Relationship of sedentary time, physical activity and fitness with 1,25-dihydroxyvitamin D in middle-aged sedentary adults: The FIT-AGEING study. Exp Gerontol 2021; 152:111458. [PMID: 34171393 DOI: 10.1016/j.exger.2021.111458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Accepted: 06/14/2021] [Indexed: 11/20/2022]
Abstract
PURPOSE Potential interactions between sedentary behaviour, physical activity (PA), and physical fitness with 25-hydroxyvitamin D (25(OH)D) status have been previously suggested. However, data are scarce concerning the association between these predictors of general health and the main active metabolite of vitamin D, the 1,25-dihidroxyvitamin D (1,25(OH)2D). This study aimed to analyse the relationship of sedentary time, PA levels, and physical fitness (i.e., maximal oxygen uptake (VO2max) and muscular strength) with 1,25(OH)2D in middle-aged sedentary adults. METHODS A total of 73 (39 women) middle-aged sedentary adults (53.7 ± 5.1 years old) participated in this cross-sectional study. Sedentary time and PA intensity levels were objectively measured with triaxial accelerometers for 7 consecutive days. VO2max was determined by a maximum treadmill test. Lower and upper limb muscular strength was assessed by an isokinetic strength test and by a handgrip strength test, respectively. 1,25(OH)2D plasma levels were measured using a DiaSorin Liaison® immunochemiluminometric assay. RESULTS No significant relationships were found between objectively measured sedentary time, PA levels or physical fitness (i.e., VO2max, extension and flexion peak torque, and hand grip strength) and 1,25(OH)2D (all P > 0.05). All results persisted after controlling for age, sex, fat mass or energy, vitamin D, calcium, and phosphorus intake. CONCLUSIONS In summary, our results show that vitamin D status is not affected by physical activity habits and sedentary behaviour in middle-aged sedentary adults.
Collapse
Affiliation(s)
- Alejandro De-la-O
- EFFECTS-262 Research Group, Department of Physiology, Faculty of Medicine, University of Granada, 18071 Granada, Spain.
| | - Lucas Jurado-Fasoli
- EFFECTS-262 Research Group, Department of Physiology, Faculty of Medicine, University of Granada, 18071 Granada, Spain; PROmoting FITness and Health Through Physical Activity (PROFITH) Research Group, Sport and Health University Research Institute, Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, 18071 Granada, Spain.
| | - Manuel J Castillo
- EFFECTS-262 Research Group, Department of Physiology, Faculty of Medicine, University of Granada, 18071 Granada, Spain.
| | - Ángel Gutiérrez
- EFFECTS-262 Research Group, Department of Physiology, Faculty of Medicine, University of Granada, 18071 Granada, Spain.
| | - Francisco J Amaro-Gahete
- EFFECTS-262 Research Group, Department of Physiology, Faculty of Medicine, University of Granada, 18071 Granada, Spain; PROmoting FITness and Health Through Physical Activity (PROFITH) Research Group, Sport and Health University Research Institute, Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, 18071 Granada, Spain.
| |
Collapse
|
23
|
Watson EL, Wilkinson TJ, O'Sullivan TF, Baker LA, Gould DW, Xenophontos S, Graham-Brown M, Major R, Jenkinson C, Hewison M, Philp A, Smith AC. Association between vitamin D deficiency and exercise capacity in patients with CKD, a cross-sectional analysis. J Steroid Biochem Mol Biol 2021; 210:105861. [PMID: 33675951 DOI: 10.1016/j.jsbmb.2021.105861] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Revised: 02/10/2021] [Accepted: 02/23/2021] [Indexed: 10/22/2022]
Abstract
BACKGROUND Evidence is growing for a role of vitamin D in regulating skeletal muscle mass, strength and functional capacity. Given the role the kidneys play in activating total vitamin D, and the high prevalence of vitamin D deficiency in Chronic Kidney Disease (CKD), it is possible that deficiency contributes to the low levels of physical function and muscle mass in these patients. METHODS This is a secondary cross-sectional analysis of previously published interventional study, with in vitro follow up work. 34 CKD patients at stages G3b-5 (eGFR 25.5 ± 8.3 mL/min/1.73m2; age 61 ± 12 years) were recruited, with a sub-group (n = 20) also donating a muscle biopsy. Vitamin D and associated metabolites were analysed in plasma by liquid chromatography tandem-mass spectroscopy and correlated to a range of physiological tests of muscle size, function, exercise capacity and body composition. The effects of 1α,25(OH)2D3 supplementation on myogenesis and myotube size was investigated in primary skeletal muscle cells from vitamin D deficient donors. RESULTS In vivo, there was no association between total or active vitamin D and muscle size or strength, but a significant correlation with V̇O2Peak was seen with total vitamin D (25OHD). in vitro, 1α,25(OH)2D3 supplementation reduced IL-6 mRNA expression, but had no effect upon proliferation, differentiation or myotube diameter. CONCLUSIONS Vitamin D deficiency is not a prominent factor driving the loss of muscle mass in CKD, but may play a role in reduced exercise capacity.
Collapse
Affiliation(s)
- Emma L Watson
- Department of Cardiovascular Sciences, University of Leicester, United Kingdom.
| | | | - Tom F O'Sullivan
- Department of Infection, Immunity and Inflammation, University of Leicester, United Kingdom
| | - Luke A Baker
- Department of Health Sciences, University of Leicester, United Kingdom
| | - Douglas W Gould
- Department of Cardiovascular Sciences, University of Leicester, United Kingdom
| | | | - Matt Graham-Brown
- Department of Cardiovascular Sciences, University of Leicester, United Kingdom
| | - Rupert Major
- Department of Health Sciences, University of Leicester, United Kingdom
| | - Carl Jenkinson
- Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, United Kingdom
| | - Martin Hewison
- Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, United Kingdom; Centre for Endocrinology, Diabetes and Metabolism, Birmingham Health Partners, Birmingham, United Kingdom
| | - Andrew Philp
- Garvan Institute of Medical Research, New South Wales, Australia; UNSW Medicine, UNSW Sydney, New South Wales, Australia
| | - Alice C Smith
- Department of Health Sciences, University of Leicester, United Kingdom
| |
Collapse
|
24
|
A Non-Invasive Hair Test to Determine Vitamin D 3 Levels. Molecules 2021; 26:molecules26113269. [PMID: 34071612 PMCID: PMC8198702 DOI: 10.3390/molecules26113269] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Revised: 05/19/2021] [Accepted: 05/26/2021] [Indexed: 12/29/2022] Open
Abstract
Vitamin D deficiency is being recognized as a global issue and has been implicated in many health issues. Hence, there is an increased interest in developing sensitive, reproducible, and non-invasive assays to measure Vitamin D levels. This study aimed to apply a sensitive liquid chromatography-mass spectrometric assay to hair samples to develop and validate a clinical assay to provide a quarterly average level of vitamin D in one test. Hair samples were collected from 70 male university students/young adults and pulverized/sonicated in methanol/water for 2 h to extract Vitamin D metabolites. A sensitive liquid chromatographic-mass spectrometric assay was employed to quantitate vitamin D and metabolites. Of the eight Vitamin D and metabolites screened, only the primary, clinically significant form of vitamin D (25OHD3) was detected and quantified in hair samples in the range of 17-1541 pg/mg. One-third of the hair samples (21 out of 70) had Vitamin D levels below the LLOD of the assay (10 pg/mg). The mean and standard deviation values for hair (25OHD3) were 276.7 ± 329.9, respectively. This pilot study reveals the potential of the vitamin D hair test in clinical assays as a complementary test to a vitamin D blood test, which would provide a quarterly average.
Collapse
|
25
|
Huynh K, Kempegowda P, Tamblyn J, O' Reilly MW, Mueller JW, Hewison M, Jenkinson C. Development of a LC-MS/MS method to measure serum 3-sulfate and 3-glucuronide 25-hydroxyvitamin D3 metabolites; comparisons to unconjugated 25OHD in pregnancy and polycystic ovary syndrome. Steroids 2021; 169:108812. [PMID: 33636208 DOI: 10.1016/j.steroids.2021.108812] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2020] [Revised: 01/30/2021] [Accepted: 02/16/2021] [Indexed: 11/16/2022]
Abstract
Vitamin D status is routinely assessed by measuring circulating concentrations of 25-hydroxyvitamin D (25OHD2 or 25OHD3). However as deconjugation is not routinely incorporated into sample treatment prior to analysis, conjugated forms of 25OHD (particularly the more abundant 25OHD3) are often not considered in determining serum concentrations of total 25OHD. Two major circulating conjugated forms of 25OHD3 are 25-hydroxyvitamin D3-3-sulfate (25OHD3-S) and 25-hydroxyvitamin D3-3-glucuronide (25OHD3-G). Incorporating these two conjugated metabolites into the measurement of vitamin D status could improve our understanding of vitamin D status in health, particularly if there are changes in sulfation and glucuronidation activities. The aim of this study was to develop a liquid chromatography tandem-mass spectrometry (LC-MS/MS) targeted method for measurement of 25OHD3-S and 25OHD3-G in serum to enable comparisons with circulating levels of the free 25OHD3 form. We developed and validated a new LC-MS/MS method that measured both 25OHD3-S and 25OHD3-G following a solid phase extraction sample preparation method. Partial separation of analytes by LC, and the separation of analytes by the optimized multiple reaction monitoring transitions enabled the quantitation of both 25OHD3-S and 25OHD3-G in the single method. Serum concentrations of 25OHD3-S (24.7 ± 11.8 ng/mL) and 25OHD3-G (2.4 ± 1.2 ng/mL) were shown to be a significant proportion of circulating vitamin D metabolites in healthy donor serums. These levels of 25OHD3-S and 25OHD3-G closely associated with 25OHD3 concentrations, r = 0.728, p = 0.001 and r = 0.632, p = 0.006 respectively. However in serum from pregnant women and non-pregnant women with polycystic ovary syndrome (PCOS) significant differences in the ratios between conjugated and free 25OHD3 were observed between pregnancy groups (25OHD3/25OHD3-S and 25OHD3/25OHD3-G p < 0.001), and between healthy and PCOS subjects (25OHD3/25OHD3-G p < 0.050). Development of this novel high-throughput LC-MS/MS method indicates that 25OHD3-S and 25OHD3-G are substantial components of circulating vitamin D metabolites. The concentrations of these metabolites relative to conventional 25OHD3 may vary in different physiological and pathophysiological settings, and may therefore play an unrecognized but important role in the actions of vitamin D.
Collapse
Affiliation(s)
- K Huynh
- Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, UK
| | - P Kempegowda
- Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, UK
| | - J Tamblyn
- Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, UK
| | - M W O' Reilly
- Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, UK; Department of Medicine, Royal College of Surgeons in Ireland, University of Medicine and Health Sciences, Dublin, Ireland
| | - J W Mueller
- Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, UK
| | - M Hewison
- Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, UK
| | - C Jenkinson
- Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, UK.
| |
Collapse
|
26
|
Abouzid M, Karaźniewicz-Łada M, Pawlak K, Burchardt P, Kruszyna Ł, Główka F. Measurement of plasma 25-hydroxyvitamin D2, 25-hydroxyvitamin D3 and 3-epi-25-hydroxyvitamin D3 in population of patients with cardiovascular disease by UPLC-MS/MS method. J Chromatogr B Analyt Technol Biomed Life Sci 2020; 1159:122350. [PMID: 32890769 DOI: 10.1016/j.jchromb.2020.122350] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Revised: 08/10/2020] [Accepted: 08/25/2020] [Indexed: 01/23/2023]
Abstract
Vitamin D has a potential role in protecting against cardiovascular disease (CVD). Serum 25-hydroxyvitamin D (25D) is the most widely used indicator of vitamin D status in the human body. 25D is estimated as total of 25-hydroxyvitamin D2 (25D2) and 25-hydroxyvitamin D3 (25D3). However, the presence of 3-epi-25-hydroxyvitamin D3 (3epi25D3) can affect 25D measurement. In this research a novel validated UPLC-MS/MS technique was developed to measure three vitamin D metabolites, 25D2, 25D3 and 3epi25D3 in human plasma. A liquid-liquid extraction using hexane was applied for isolation of the analytes from the samples. A chromatographic separation was achieved in a Kinetex F5 analytical column with isocratic elution (water and methanol with 0.1% methanoic acid, 20:80 v/v). Mass spectrometry detection of the metabolites was performed in a triple-quadruple tandem mass spectrometer under positive ion mode. Concentrations of the analytes were estimated in plasma samples of 54 patients. Validation parameters of the UPLC-MS/MS method, including linearity, precision, accuracy, and stability, fulfilled the requirements for bioanalytical assays. The deficient concentration of 25D (<20 ng/mL) was stated in over 60% of patients. 3epi25D3 was present in 78% of samples and its relative amount ranged from 0 to 54.1% of 25D concentration. The analysis of 25D2, 25D3 and 3epi25D3 by the validated UPLC-MS/MS method in plasma of patients with CVD permitted the classification of the patients with insufficient levels of 25D. 3epi25D3 might be relevant in the classification of vitamin D status.
Collapse
Affiliation(s)
- Mohamed Abouzid
- Department of Physical Pharmacy and Pharmacokinetics, Poznan University of Medical Sciences, 6 Święcickiego Street, 60-781 Poznan, Poland
| | - Marta Karaźniewicz-Łada
- Department of Physical Pharmacy and Pharmacokinetics, Poznan University of Medical Sciences, 6 Święcickiego Street, 60-781 Poznan, Poland.
| | - Kornel Pawlak
- Department of Physical Pharmacy and Pharmacokinetics, Poznan University of Medical Sciences, 6 Święcickiego Street, 60-781 Poznan, Poland
| | - Paweł Burchardt
- Department of Cardiology, J. Struś Hospital, Szwajcarska 3, 61-285 Poznan, Poland; Biology of Lipid Disorders Department, Poznan University of Medical Sciences, Rokietnicka 8, 60-806 Poznan, Poland
| | - Łukasz Kruszyna
- Department of Vascular and Endovascular Surgery, Angiology and Phlebology, Poznan University of Medical Sciences, Długa 1/2, 60-848, Poznan, Poland
| | - Franciszek Główka
- Department of Physical Pharmacy and Pharmacokinetics, Poznan University of Medical Sciences, 6 Święcickiego Street, 60-781 Poznan, Poland
| |
Collapse
|
27
|
Hurst EA, Homer NZ, Mellanby RJ. Vitamin D Metabolism and Profiling in Veterinary Species. Metabolites 2020; 10:E371. [PMID: 32942601 PMCID: PMC7569877 DOI: 10.3390/metabo10090371] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 09/11/2020] [Accepted: 09/13/2020] [Indexed: 12/17/2022] Open
Abstract
The demand for vitamin D analysis in veterinary species is increasing with the growing knowledge of the extra-skeletal role vitamin D plays in health and disease. The circulating 25-hydroxyvitamin-D (25(OH)D) metabolite is used to assess vitamin D status, and the benefits of analysing other metabolites in the complex vitamin D pathway are being discovered in humans. Profiling of the vitamin D pathway by liquid chromatography tandem mass spectrometry (LC-MS/MS) facilitates simultaneous analysis of multiple metabolites in a single sample and over wide dynamic ranges, and this method is now considered the gold-standard for quantifying vitamin D metabolites. However, very few studies report using LC-MS/MS for the analysis of vitamin D metabolites in veterinary species. Given the complexity of the vitamin D pathway and the similarities in the roles of vitamin D in health and disease between humans and companion animals, there is a clear need to establish a comprehensive, reliable method for veterinary analysis that is comparable to that used in human clinical practice. In this review, we highlight the differences in vitamin D metabolism between veterinary species and the benefits of measuring vitamin D metabolites beyond 25(OH)D. Finally, we discuss the analytical challenges in profiling vitamin D in veterinary species with a focus on LC-MS/MS methods.
Collapse
Affiliation(s)
- Emma A. Hurst
- The Roslin Institute and Royal (Dick) School of Veterinary Studies, The University of Edinburgh, Easter Bush, Midlothian, Edinburgh, Scotland EH25 9RG, UK;
- Mass Spectrometry Core, Edinburgh Clinical Research Facility, Queen’s Medical Research Institute, The University of Edinburgh, Little France Crescent, Edinburgh, Scotland EH16 4TJ, UK;
| | - Natalie Z. Homer
- Mass Spectrometry Core, Edinburgh Clinical Research Facility, Queen’s Medical Research Institute, The University of Edinburgh, Little France Crescent, Edinburgh, Scotland EH16 4TJ, UK;
| | - Richard J. Mellanby
- The Roslin Institute and Royal (Dick) School of Veterinary Studies, The University of Edinburgh, Easter Bush, Midlothian, Edinburgh, Scotland EH25 9RG, UK;
| |
Collapse
|
28
|
Kowalówka M, Główka AK, Karaźniewicz-Łada M, Kosewski G. Clinical Significance of Analysis of Vitamin D Status in Various Diseases. Nutrients 2020; 12:E2788. [PMID: 32933052 PMCID: PMC7551674 DOI: 10.3390/nu12092788] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 09/03/2020] [Accepted: 09/08/2020] [Indexed: 12/17/2022] Open
Abstract
Vitamin D plays a role not only in the proper functioning of the skeletal system and the calcium-phosphate equilibrium, but also in the immune system, the cardiovascular system and the growth and division of cells. Although numerous studies have reported on the analysis of vitamin D status in various groups of patients, the clinical significance of measurements of vitamin D forms and metabolites remains ambiguous. This article reviews the reports analyzing the status of vitamin D in various chronic states. Particular attention is given to factors affecting measurement of vitamin D forms and metabolites. Relevant papers published during recent years were identified by an extensive PubMed search using appropriate keywords. Measurement of vitamin D status proved to be a useful tool in diagnosis and progression of metabolic syndrome, neurological disorders and cancer. High performance liquid chromatography coupled with tandem mass spectrometry has become the preferred method for analyzing the various forms and metabolites of vitamin D in biological fluids. Factors influencing vitamin D concentration, including socio-demographic and biochemical factors as well as the genetic polymorphism of the vitamin D receptor, along with vitamin D transporters and enzymes participating in vitamin D metabolism should be considered as potential confounders of the interpretation of plasma total 25(OH)D concentrations.
Collapse
Affiliation(s)
- Magdalena Kowalówka
- Department of Bromatology, Poznan University of Medical Sciences, 42 Marcelińska Street, 60-354 Poznań, Poland; (M.K.); (A.K.G.); (G.K.)
| | - Anna K. Główka
- Department of Bromatology, Poznan University of Medical Sciences, 42 Marcelińska Street, 60-354 Poznań, Poland; (M.K.); (A.K.G.); (G.K.)
| | - Marta Karaźniewicz-Łada
- Department of Physical Pharmacy and Pharmacokinetics, Poznan University of Medical Sciences, 6 Święcickiego Street, 60-781 Poznań, Poland
| | - Grzegorz Kosewski
- Department of Bromatology, Poznan University of Medical Sciences, 42 Marcelińska Street, 60-354 Poznań, Poland; (M.K.); (A.K.G.); (G.K.)
| |
Collapse
|
29
|
Quantification of fat-soluble vitamins and their metabolites in biological matrices: an updated review. Bioanalysis 2020; 12:625-640. [DOI: 10.4155/bio-2020-0069] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Fat-soluble vitamins (FSVs) are micronutrients essential in maintaining normal physiological function, metabolism and human growth. Ongoing increased awareness regarding FSV concentrations and their impact on human growth along with disease progression warrant the need of developing selective and sensitive analytical methods. LC–MS/MS is currently the method of choice for accurate quantitation of FSVs. However, there are multiple approaches for extraction, separation and calibration of FSVs in biological matrices. This review discusses recent LC–MS/MS methods for the simultaneous quantification of FSVs in biological matrices and summarizes sample pretreatment procedures, chromatographic conditions and calibration approaches. Current challenges and clinical applications in various disease states are also highlighted.
Collapse
|
30
|
Hurst EA, Homer NZ, Denham SG, MacFarlane E, Campbell S, Boswinkel M, Mellanby RJ. Development and application of a LC-MS/MS assay for simultaneous analysis of 25-hydroxyvitamin-D and 3-epi-25-hydroxyvitamin-D metabolites in canine serum. J Steroid Biochem Mol Biol 2020; 199:105598. [PMID: 31958632 DOI: 10.1016/j.jsbmb.2020.105598] [Citation(s) in RCA: 12] [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: 08/14/2019] [Revised: 01/15/2020] [Accepted: 01/16/2020] [Indexed: 12/25/2022]
Abstract
Hypovitaminosis D and hypervitaminosis D are well recognised disorders in dogs. Hypovitaminosis D can occur following consumption of a diet inadequately supplemented with vitamin D or as a sequelae of severe intestinal disease. Hypervitaminosis D may occur as a result of consuming proprietary dog foods over-supplemented with vitamin D or through ingestion of vitamin D containing medicinal products or rodenticides. Consequently, there is a clear need to establish a methodology that can accurately quantify vitamin D metabolites across a broad dynamic range in dogs. The existence of C3-epimers of vitamin D metabolites has yet to be elucidated in dogs, yet are known to interfere with the analysis of vitamin D and have unknown biological activity in other species. Here, we describe the development and validation of a sensitive, specific and robust analytical liquid chromatography tandem mass spectrometry (LC-MS/MS) assay capable of separating and accurately measuring 25-hydroxyvitamin-D2/3 (25(OH)D2/3) and 3-epi-25-hydroxyvitamin-D2/3 (3-epi-25(OH)D2/3). We describe a simplified workflow utilising supported liquid extraction (SLE) without derivatization that provides good linearity (mean r > 0.996) and accuracy across a broad dynamic range of 4-500 nmol/L for D3 metabolites and 7.8-500 nmol/L for D2 metabolites. Upon application of this assay to 117 canine serum samples, 25(OH)D3 was detectable in all samples with a median concentration of 82.1 nmol/L (inter-quartile range (IQR) 59.7-101.8 nmol/L). 3-epi-25(OH)D3 could be detected in 87.2 % of the study population, with a median concentration of 5.2 nmol/L (2.4-8.1 nmol/L). However, 3-epi-25(OH)D3 was quantified below the LLOQ in 40.2 % of these samples. 3-epi-25(OH)D3 contributed on average 6.3 % to 25(OH)D3 status (contribution ranges from 0 to 23.8%) and a positive correlation was detected between 25(OH)D3 and 3-epi-25(OH)D3 concentrations. Free 25(OH)D was also measured using an immunoassay with a median concentration of 15.2 pmol/L (12.5-23.2 pmol/L), and this metabolite was also positively correlated to both 3-epi-25(OH)D3 and 25(OH)D3 concentrations. D2 metabolites were not detected in canine serum as expected. Vitamin D metabolite concentrations were variable between individuals, and research into the causes of this variation should include factors such as breed, age, sex and neuter status to determine the impact of genetic and hormonal factors. Given the clinical importance of vitamin D in dogs, and the immense potential for utilising this species as a model for human disease, further elucidation of the vitamin D pathway in this species would provide immense clinical and research benefit.
Collapse
Affiliation(s)
- Emma A Hurst
- The Roslin Institute and Royal (Dick) School of Veterinary Studies, The University of Edinburgh, Easter Bush, Midlothian, Edinburgh, Scotland, EH25 9RG, United Kingdom; Mass Spectrometry Core, Edinburgh Clinical Research Facility, Queen's Medical Research Institute, The University of Edinburgh, Little France Crescent, Edinburgh, Scotland, EH16 4TJ, United Kingdom.
| | - Natalie Z Homer
- Mass Spectrometry Core, Edinburgh Clinical Research Facility, Queen's Medical Research Institute, The University of Edinburgh, Little France Crescent, Edinburgh, Scotland, EH16 4TJ, United Kingdom.
| | - Scott G Denham
- Mass Spectrometry Core, Edinburgh Clinical Research Facility, Queen's Medical Research Institute, The University of Edinburgh, Little France Crescent, Edinburgh, Scotland, EH16 4TJ, United Kingdom.
| | - Emma MacFarlane
- The Roslin Institute and Royal (Dick) School of Veterinary Studies, The University of Edinburgh, Easter Bush, Midlothian, Edinburgh, Scotland, EH25 9RG, United Kingdom.
| | - Susan Campbell
- The Roslin Institute and Royal (Dick) School of Veterinary Studies, The University of Edinburgh, Easter Bush, Midlothian, Edinburgh, Scotland, EH25 9RG, United Kingdom.
| | - Maaike Boswinkel
- The Roslin Institute and Royal (Dick) School of Veterinary Studies, The University of Edinburgh, Easter Bush, Midlothian, Edinburgh, Scotland, EH25 9RG, United Kingdom.
| | - Richard J Mellanby
- The Roslin Institute and Royal (Dick) School of Veterinary Studies, The University of Edinburgh, Easter Bush, Midlothian, Edinburgh, Scotland, EH25 9RG, United Kingdom.
| |
Collapse
|
31
|
Fraser WD, Tang JCY, Dutton JJ, Schoenmakers I. Vitamin D Measurement, the Debates Continue, New Analytes Have Emerged, Developments Have Variable Outcomes. Calcif Tissue Int 2020; 106:3-13. [PMID: 31741016 DOI: 10.1007/s00223-019-00620-2] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Accepted: 09/23/2019] [Indexed: 10/25/2022]
Abstract
The demand for measurement of vitamin D metabolites for clinical diagnosis and to advance our understanding of the role of vitamin D in human health has significantly increased in the last decade. New developments in technologies employed have enabled the separation and quantification of additional metabolites and interferences. Also, developments of immunoassays have changed the landscape. Programmes and materials for assay standardisation, harmonisation and the expansion of the vitamin D external quality assurance scheme (DEQAS) with the provision of target values as measured by a reference measurement procedure have improved standardisation, quality assurance and comparability of measurements. In this article, we describe developments in the measurement of the commonly analysed vitamin D metabolites in clinical and research practice. We describe current analytical approaches, discuss differences between assays, their origin, and how these may be influenced by physiological and experimental conditions. The value of measuring metabolites beyond 25 hydroxyvitamin D (25(OH)D), the marker of vitamin D status, in routine clinical practice is not yet confirmed. Here we provide an overview of the value and application of the measurement of 1,25 dihydroxyvitamin D, 24,25 dihydroxyvitamin D and free 25OHD in the diagnosis of patients with abnormalities in vitamin D metabolism and for research purposes.
Collapse
Affiliation(s)
- William D Fraser
- Norwich Medical School, University of East Anglia, Norwich Research Park, Floor 2, Bob Champion Research and Education Building, James Watson Road, Norwich, NR4 7UQ, UK.
- Departments of Diabetes, Endocrinology and Clinical Biochemistry, Norfolk and Norwich University Hospital NHS Foundation Trust, Colney Lane, Norwich, UK.
| | - Jonathan C Y Tang
- Norwich Medical School, University of East Anglia, Norwich Research Park, Floor 2, Bob Champion Research and Education Building, James Watson Road, Norwich, NR4 7UQ, UK
| | - John J Dutton
- Norwich Medical School, University of East Anglia, Norwich Research Park, Floor 2, Bob Champion Research and Education Building, James Watson Road, Norwich, NR4 7UQ, UK
| | - Inez Schoenmakers
- Norwich Medical School, University of East Anglia, Norwich Research Park, Floor 2, Bob Champion Research and Education Building, James Watson Road, Norwich, NR4 7UQ, UK
| |
Collapse
|
32
|
De-la-O A, Jurado-Fasoli L, Castillo MJ, Gracia-Marco L, Gutierrez Á, Amaro-Gahete FJ. Relationship between 1,25-Dihydroxyvitamin D and Body Composition in Middle-Aged Sedentary Adults: The FIT-AGEING Study. Nutrients 2019; 11:nu11112567. [PMID: 31652938 PMCID: PMC6893666 DOI: 10.3390/nu11112567] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2019] [Revised: 10/17/2019] [Accepted: 10/21/2019] [Indexed: 12/17/2022] Open
Abstract
Vitamin D deficiency is a worldwide health problem that, in addition to its well-known negative effects on musculoskeletal health, has been related to a wide range of acute and chronic age-related diseases. However, little is known about the association of body composition with the active, hormonal form of vitamin D, 1,25-dihydroxyvitamin D plasma levels (1,25(OH)2D). Therefore, the aim of this study was to investigate the association of 1,25(OH)2D with body composition including lean and fat body mass as well as bone mineral density (BMD) in middle-aged sedentary adults. A total of 73 (39 women) middle-aged sedentary adults (53.7 ± 5.1 years old) participated in the current study. We measured weight and height, and we used dual energy X-ray absorptiometry to measure lean body mass, fat body mass and BMD. Body mass index (BMI), lean mass index (LMI), and fat mass index (FMI) were calculated. 1,25(OH)2D was measured using a DiaSorin Liaison® immunochemiluminometric analyzer. The results showed a negative association of 1,25(OH)2D with BMI, LMI and BMD (β = −0.274, R2 = 0.075, p = 0.019; β = −0.268, R2 = 0.072, p = 0.022; and β = −0.325, R2 = 0.105, p = 0.005, respectively), which persisted after controlling for age and sex. No significant differences in 1,25(OH)2D across body weight status were observed after controlling for the same covariates. In summary, our results suggest that 1,25(OH)2D could be negatively associated with BMI, LMI and BMD whereas no association was found with FMI in middle-aged sedentary adults.
Collapse
Affiliation(s)
- Alejandro De-la-O
- EFFECTS 262 Research Group, Department of Physiology, Faculty of Medicine, University of Granada, 18071 Granada, Spain.
| | - Lucas Jurado-Fasoli
- EFFECTS 262 Research Group, Department of Physiology, Faculty of Medicine, University of Granada, 18071 Granada, Spain.
| | - Manuel J Castillo
- EFFECTS 262 Research Group, Department of Physiology, Faculty of Medicine, University of Granada, 18071 Granada, Spain.
| | - Luis Gracia-Marco
- PROFITH "PROmoting FITness and Health Through Physical Activity" Research Group, Sport and Health University Research Institute (iMUDS), Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, 18071 Granada, Spain.
| | - Ángel Gutierrez
- EFFECTS 262 Research Group, Department of Physiology, Faculty of Medicine, University of Granada, 18071 Granada, Spain.
| | - Francisco J Amaro-Gahete
- EFFECTS 262 Research Group, Department of Physiology, Faculty of Medicine, University of Granada, 18071 Granada, Spain.
- PROFITH "PROmoting FITness and Health Through Physical Activity" Research Group, Sport and Health University Research Institute (iMUDS), Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, 18071 Granada, Spain.
| |
Collapse
|
33
|
French D. The (Sun)Light and Dark of 25-Hydroxyvitamin D Testing. J Appl Lab Med 2019; 3:460-473. [DOI: 10.1373/jalm.2017.023051] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2018] [Accepted: 05/22/2018] [Indexed: 01/20/2023]
Abstract
Abstract
Background
Vitamin D is obtained by the body via sunlight on the skin, from the diet, or from supplementation. The primary function of vitamin D is to maintain calcium homeostasis and bone health, but in the past decade, numerous other health benefits have been proposed.
Content
With the increased awareness of the potential benefits of maintaining sufficient concentrations of 25-hydroxyvitamin D, clinicians began ordering this test for their patients much more frequently. The number of available methods increased, but with that came a larger focus on the challenges of measuring 25-hydroxyvitamin D accurately due to binding to vitamin D-binding protein and the presence of other vitamin D metabolites. Further, standardization of these assays became a focus for several organizations so that clinical guidelines can be applicable to every patient regardless of what methodology is used in 25-hydroxyvitamin D measurement.
Summary
Improvements are being made in the specificity, accuracy, and standardization of the measurement of 25-hydroxyvitamin D, and the future of this testing is looking brighter.
Collapse
Affiliation(s)
- Deborah French
- Department of Laboratory Medicine, University of California San Francisco, San Francisco, CA
| |
Collapse
|
34
|
Simple Fast Quantification of Cholecalciferol, 25-Hydroxyvitamin D and 1,25-Dihydroxyvitamin D in Adipose Tissue Using LC-HRMS/MS. Nutrients 2019; 11:nu11091977. [PMID: 31443425 PMCID: PMC6770531 DOI: 10.3390/nu11091977] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Revised: 08/16/2019] [Accepted: 08/17/2019] [Indexed: 12/31/2022] Open
Abstract
Vitamin D metabolism is actively modulated in adipose tissue during obesity. To better investigate this process, we develop a specific LC-HRMS/MS method that can simultaneously quantify three vitamin D metabolites, i.e., cholecalciferol, 25-hydroxyvitamin D3 (25(OH)D3), and 1,25-dihydroxyvitamin D3 (1,25(OH)2D3) in a complex matrix, such as mouse adipose tissue and plasma. The method uses pretreatment with liquid–liquid or solid–phase extraction followed by derivatization using Amplifex® reagents to improve metabolite stability and ionization efficiency. Here, the method is optimized by co-eluting stable isotope-labelled internal standards to calibrate each analogue and to spike biological samples. Intra-day and inter-day relative standard deviations were 0.8–6.0% and 2.0–14.4%, respectively for the three derivatized metabolites. The limits of quantification (LoQ) achieved with Amplifex® derivatization were 0.02 ng/mL, 0.19 ng/mL, and 0.78 ng/mL for 1,25(OH)2D3, 25(OH)D3 and cholecalciferol, respectively. Now, for the first time, 1,25(OH)2D3 can be co-quantified with cholecalciferol and 25(OH)D3 in mouse adipose tissue. This validated method is successfully applied to study the impact of obesity on vitamin D status in mice.
Collapse
|
35
|
Jenkinson C. The vitamin D metabolome: An update on analysis and function. Cell Biochem Funct 2019; 37:408-423. [PMID: 31328813 DOI: 10.1002/cbf.3421] [Citation(s) in RCA: 62] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Revised: 05/03/2019] [Accepted: 06/05/2019] [Indexed: 01/08/2023]
Abstract
Current understanding of vitamin D tends to be focussed on the measurement of the major circulating form 25-hydroxyvitamin D3 (25OHD3) and its conversion to the active hormonal form, 1α,25-dihydroxyvitamin D3 (1α,25(OH)2 D3) via the enzyme 25-hydroxyvitamin D-1α-hydroxylase (CYP27B1). However, whilst these metabolites form the endocrine backbone of vitamin D physiology, it is important to recognise that there are other metabolic and catabolic pathways that are now recognised as being crucially important to vitamin D function. These pathways include C3-epimerization, CYP24A1 hydroxylase, CYP11A1 alternative metabolism of vitamin D3, and phase II metabolism. Endogenous metabolites beyond 25OHD3 are usually present at low endogenous levels and may only be functional in specific target tissues rather than in the general circulation. However, the technologies available to measure these metabolites have also improved, so that measurement of alternative vitamin D metabolic pathways may become more routine in the near future. The aim of this review is to provide a comprehensive overview of the various pathways of vitamin D metabolism, as well as describe the analytical techniques currently available to measure these vitamin D metabolites.
Collapse
Affiliation(s)
- Carl Jenkinson
- Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, UK
| |
Collapse
|
36
|
Beentjes CHL, Taylor-King JP, Bayani A, Davis CN, Dunster JL, Jabbari S, Mirams GR, Jenkinson C, Kilby MD, Hewison M, Tamblyn JA. Defining vitamin D status using multi-metabolite mathematical modelling: A pregnancy perspective. J Steroid Biochem Mol Biol 2019; 190:152-160. [PMID: 30926429 PMCID: PMC7614536 DOI: 10.1016/j.jsbmb.2019.03.024] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Revised: 02/11/2019] [Accepted: 03/25/2019] [Indexed: 11/21/2022]
Abstract
Vitamin D deficiency is linked to adverse pregnancy outcomes such as pre-eclampsia (PET) but remains defined by serum measurement of 25-hydroxyvitamin D3 (25(OH)D3) alone. To identify broader changes in vitamin D metabolism during normal and PET pregnancies we developed a relatively simple but fully parametrised mathematical model of the vitamin D metabolic pathway. The data used for parametrisation were serum vitamin D metabolites analysed for a cross-sectional group of women (n = 88); including normal pregnant women at 1 st (NP1, n = 25) and 3rd trimester (NP3, n = 21) and pregnant women with PET (n = 22), as well as non-pregnant female controls (n = 20). To account for the effects various metabolites have upon each other, data were analysed using an ordinary differential equation model of the vitamin D reaction network. Information obtained from the model was then also applied to serum vitamin D metabolome data (n = 50) obtained from a 2nd trimester pregnancy cohort, of which 25 prospectively developed PET. Statistical analysis of the data alone showed no significant difference between NP3 and PET for serum 25(OH)D3 and 24,25(OH)2D3 concentrations. Conversely, a statistical analysis informed by the reaction network model revealed that a better indicator of PET is the ratios of vitamin D metabolites in late pregnancy. Assessing the potential predicative value, no significant difference between NP3 and PET cases at 15 weeks gestation was found. Mathematical modelling offers a novel strategy for defining the impact of vitamin D metabolism on human health. This is particularly relevant within the context of pregnancy, where major changes in vitamin D metabolism occur across gestation, and dysregulated metabolism is evidenced in women with established PET.
Collapse
Affiliation(s)
- C H L Beentjes
- Mathematical Institute, University of Oxford, Oxford, UK
| | - J P Taylor-King
- Department of Chemical Engineering and Biotechnology, University of Cambridge, Cambridge, CB3 OAS, UK; Institute of Molecular Systems Biology, Department of Biology, ETHZ, CH-8093, Zurich, Switzerland
| | - A Bayani
- Department of Physics and Mathematics, School of Science and Technology, Nottingham Trent University, Nottingham, UK
| | - C N Davis
- MathSys CDT, Mathematics Institute, University of Warwick, Coventry, UK
| | - J L Dunster
- Institute for Cardiovascular and Metabolic Research, University of Reading, UK
| | - S Jabbari
- School of Mathematics and Institute of Microbiology and Infection, University of Birmingham, Birmingham, UK
| | - G R Mirams
- Centre for Mathematical Medicine & Biology, Mathematical Sciences, University of Nottingham, UK
| | - C Jenkinson
- Institute of Metabolism and Systems Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
| | - M D Kilby
- Institute of Metabolism and Systems Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK; Centre for Women's & Newborn Health, Birmingham Health Partners, Birmingham Women's & Children's Foundation Hospital, Edgbaston, Birmingham, UK; Centre for Endocrinology, Diabetes and Metabolism, Birmingham Health Partners, Birmingham, UK; Fetal Medicine Centre, Birmingham Women's & Children's Foundation Trust, Edgbaston, Birmingham, UK
| | - M Hewison
- Centre for Women's & Newborn Health, Birmingham Health Partners, Birmingham Women's & Children's Foundation Hospital, Edgbaston, Birmingham, UK; Centre for Endocrinology, Diabetes and Metabolism, Birmingham Health Partners, Birmingham, UK
| | - J A Tamblyn
- Institute of Metabolism and Systems Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK; Centre for Women's & Newborn Health, Birmingham Health Partners, Birmingham Women's & Children's Foundation Hospital, Edgbaston, Birmingham, UK; Centre for Endocrinology, Diabetes and Metabolism, Birmingham Health Partners, Birmingham, UK.
| |
Collapse
|
37
|
Larner DP, Jenkinson C, Chun RF, Westgate CSJ, Adams JS, Hewison M. Free versus total serum 25-hydroxyvitamin D in a murine model of colitis. J Steroid Biochem Mol Biol 2019; 189:204-209. [PMID: 30710745 PMCID: PMC6502676 DOI: 10.1016/j.jsbmb.2019.01.015] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Revised: 12/03/2018] [Accepted: 01/24/2019] [Indexed: 01/04/2023]
Abstract
Inflammatory bowel diseases (IBD) such as ulcerative colitis and Crohn's disease have been linked to vitamin D-deficiency. Using a dextran sodium sulphate (DSS)-induced model of IBD we have shown previously that mice raised on vitamin D-deficient diets from weaning have lower serum 25-hydroxyvitamin D (25OHD) levels and develop more severe colitis compared to vitamin D-sufficient counterparts. We have also shown in vitro that immune responses to 25OHD may depend on 'free' rather than total serum concentrations of 25OHD. To investigate the possible effects of free versus total 25OHD on anti-inflammatory immune responses in vivo we have studied DSS-induced colitis in wild type C57BL/6 mice raised from weaning on diets containing vitamin D2 (D2) or vitamin D3 (D3) only (both 1000 IU/kg feed). 25OHD2 has lower binding affinity for the vitamin D binding protein than 25OHD3 which results in higher levels of free 25OHD2 relative to free 25OHD3 in mice raised on a D2-only diet. Total serum 25OHD concentrations, measured by liquid chromatography-tandem mass spectrometry (LC-MS/MS), showed that D2 mice had significantly lower levels of 25OHD than D3 mice (6.85 ± 2.61 nmol/L vs. 49.16 ± 13.8 nmol/L for D2 and D3 respectively). Despite this, direct ELISA measurement showed no difference in free serum 25OHD levels between D2 and D3 mice (13.62 ± 2.26 pmol/L vs. 14.11 ± 2.24 pmol/L for D2 and D3 respectively). Analysis of DSS-induced colitis also showed no difference in weight loss or disease progression between D2 and D3 mice. These data indicate that despite D2-fed mice being vitamin D-deficient based on serum total 25OHD concentrations, these mice showed no evidence of increased inflammatory colitis disease relative to vitamin D-sufficient D3 mice. We therefore propose that free, rather than total serum 25OHD, may be a better marker of immune responses to vitamin D in vivo.
Collapse
Affiliation(s)
- D P Larner
- Institute of Metabolism and Systems Research, the University of Birmingham, Birmingham, B15 2TT, UK
| | - C Jenkinson
- Institute of Metabolism and Systems Research, the University of Birmingham, Birmingham, B15 2TT, UK
| | - R F Chun
- Dept of Orthopaedic Surgery, David Geffen School of Medicine at UCLA, Los Angeles, CA, 90095, USA
| | - C S J Westgate
- Institute of Metabolism and Systems Research, the University of Birmingham, Birmingham, B15 2TT, UK
| | - J S Adams
- Dept of Orthopaedic Surgery, David Geffen School of Medicine at UCLA, Los Angeles, CA, 90095, USA
| | - M Hewison
- Institute of Metabolism and Systems Research, the University of Birmingham, Birmingham, B15 2TT, UK.
| |
Collapse
|
38
|
Liu TT, Cheong LZ, Man QQ, Zheng X, Zhang J, Song S. Simultaneous profiling of vitamin D metabolites in serum by supercritical fluid chromatography-tandem mass spectrometry (SFC-MS/MS). J Chromatogr B Analyt Technol Biomed Life Sci 2019; 1120:16-23. [PMID: 31060022 DOI: 10.1016/j.jchromb.2019.04.050] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2019] [Revised: 04/24/2019] [Accepted: 04/26/2019] [Indexed: 02/06/2023]
Abstract
Simultaneous profiling of serum vitamin D (VD) metabolites with similar structures is a big challenge. Thus, we developed and validated a SFC-MS/MS method, which is capable of eluting hydrophobic molecules, for quantification of VD2/VD3, 25-OH VD2/VD3, 3-epi-25-OH VD2/VD3, 1,25-(OH)2 VD2/VD3 and 24,25-(OH)2 VD2/VD3. VD metabolites were extracted from human serum using acetonitrile solvent. Column stationary phase, elution gradients, flow rate, column temperature, ion-source type and buffer system in post-column make-up solvent were optimized. Baseline separation of 10 VD metabolites can be achieved using PFP column within 10 min; and detection performed under positive electrospray ionization mode allowed quantification of VD metabolites in serum matrix with a limit of quantification (LOQ) varrying from 0.071 to 0.704 ng/mL. The accuracy was controlled with relative bias lower than 5.5% for QC and NIST samples. The developed method showed excellent intra-assay (0.52-7.93% RSD) and inter-assay (1.35-9.04% RSD) precision. The methodology shows enhanced efficiency and sensitivity as compared to LC-MS/MS method using the same column and mass spectrometer, along with significant correlation and low mean difference bias on measurements. For analysis of trace 1,25-(OH)2 VD2 and 1,25-(OH)2 VD3 in normal human serum or plasma, further improvement of LOQ (like derivatization) should be considered. In conclusion, the use of supercritical fluid not only enhanced safety with reduced solvent cost, but also improved retention and sensitivity as compared to LC-MS/MS method. The developed SFC-MS/MS method is appropriate for high throughput analysis of multiple VD metabolites in human serum with reduced solvent and economic cost.
Collapse
Affiliation(s)
- Ting-Ting Liu
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - Ling-Zhi Cheong
- Department of Food Science and Technology, College of Food and Pharmaceutical Sciences, Ningbo University, Ningbo, China
| | - Qing-Qing Man
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - Xin Zheng
- Beijing Analysis Center, Shimadzu International Trade (China) Co., Beijing 100020, China
| | - Jian Zhang
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - Shuang Song
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing 100050, China.
| |
Collapse
|
39
|
Tuckey RC, Tang EKY, Maresse SR, Delaney DS. Catalytic properties of 25-hydroxyvitamin D3 3-epimerase in rat and human liver microsomes. Arch Biochem Biophys 2019; 666:16-21. [PMID: 30926433 DOI: 10.1016/j.abb.2019.03.010] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2018] [Revised: 02/26/2019] [Accepted: 03/25/2019] [Indexed: 10/27/2022]
Abstract
25-Hydroxyvitamin D3 3-epimerase catalyzes the 3β → 3α epimerization of 25-hydroxyvitamin D3 (25(OH)D3) producing 3-epi-25-hydroxyvitamin D3 (3-epi-25(OH)D3). 3-Epi-25(OH)D3 is one of the most abundant forms of vitamin D present in the serum. It can be converted to 3-epi-1α,25-dihydroxyvitamin D3 by CYP27B1 which generally displays lower biological activity than 1α,25-dihydroxyvitamin D3 (1,25(OH)2D3). The 25(OH)D3 3-epimerase has been poorly characterized to date and the gene encoding it has not been identified. The 3-epimerase has been reported to be present in the microsomal fraction of cells, including liver cells, and to use NADPH as cofactor. It can also act on 1,25(OH)2D3 and 24,25(OH)2D3 forming the 3α-epimers. In this study we have characterized the activity of the 25(OH)D3 3-epimerase in rat and human liver microsomes, using 25(OH)D3 as substrate and HPLC to analyze product formation. For both rat and human liver microsomes the preferred cofactor was NADH, with the rat enzyme displaying a 6-fold greater catalytic efficiency (Vmax/Km) for NADH over that for NADPH. No activity was observed with oxidized cofactor, either NAD+ or NADP+. This was unexpected since the initial step in the epimerization, predicted to be the oxidation of the 3β-OH to a ketone, would require oxidized cofactor. The rat 3-epimerase in microsomes gave a Km for 25(OH)D3 of 14 μM. The reverse reaction, conversion of 3-epi-25(OH)D3 to 25(OH)D3, was catalyzed by both rat and human liver microsomes but at lower rates than the forward reaction. In conclusion, both rat and human 25-hydroxyvitamin D3 3-epimerase catalyze the reversible interconversion of 25(OH)D3 and 3-epi-25(OH)D3, and use NADH as the preferred cofactor. The lack of requirement for exogenous NAD+ suggests that the enzyme has a tightly bound NAD+ in its active site that is released only upon its reduction.
Collapse
Affiliation(s)
- Robert C Tuckey
- School of Molecular Sciences, The University of Western Australia, Perth, WA, 6009, Australia.
| | - Edith K Y Tang
- School of Molecular Sciences, The University of Western Australia, Perth, WA, 6009, Australia
| | - Stephanie R Maresse
- School of Molecular Sciences, The University of Western Australia, Perth, WA, 6009, Australia
| | - Derek S Delaney
- School of Molecular Sciences, The University of Western Australia, Perth, WA, 6009, Australia
| |
Collapse
|
40
|
Li D, Jeffery LE, Jenkinson C, Harrison SR, Chun RF, Adams JS, Raza K, Hewison M. Serum and synovial fluid vitamin D metabolites and rheumatoid arthritis. J Steroid Biochem Mol Biol 2019; 187:1-8. [PMID: 30611909 PMCID: PMC6444051 DOI: 10.1016/j.jsbmb.2018.10.008] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2018] [Revised: 09/20/2018] [Accepted: 10/18/2018] [Indexed: 12/17/2022]
Abstract
Vitamin D-deficiency has been linked to inflammatory diseases including rheumatoid arthritis (RA). Studies to date have focused on the impact of serum 25-hydroxyvitamin D3 (25(OH)D3), an inactive form of vitamin D, on RA disease activity and progression. However, anti-inflammatory actions of vitamin D are likely to be mediated at sites of RA disease, namely the inflamed joint, and may involve other vitamin D metabolites notably the active form of vitamin D, 1,25-dihydroxyvitamin D3 (1,25(OH)2D3). In the current study serum and synovial fluid samples from n = 20 patients with persistent RA and n = 7 patients with reactive arthritis (ReA) were analysed for multiple vitamin D metabolites. Serum data for RA and ReA patients were compared to healthy controls (HC). There was no significant difference between RA or ReA patients relative to HC for 25(OH)D3, 24,25(OH)2D3, 1,25(OH)2D3 or 25(OH)D2. However, 3-epi-25(OH)D3 was significantly lower in RA and ReA patients compared to HC (p < 0.05). All vitamin D metabolites, apart from 25(OH)D2, were lower in SF compared to serum, and SF 1,25(OH)2D3 was unquantifiable in 13/20 RA and 4/7 ReA samples. SF 25(OH)D3, 3-epi-25(OH)D3 and DBP correlated inversely with swollen joint score, and serum 25(OH)D2 and SF DBP correlated directly with C-reactive protein levels. These data indicate that serum 25(OH)D3 provides only limited insight into the role of vitamin D in RA. Alternative serum metabolites such as 3-epi-25(OH)2D3, and SF metabolites, notably lack of SF 1,25(OH)2D3, may be more closely linked to RA disease severity and progress.
Collapse
Affiliation(s)
- Danyang Li
- Institute of Metabolism and Systems Research, The University of Birmingham, Birmingham, B15 2TT, UK
| | - Louisa E Jeffery
- Institute of Translational Medicine, The University of Birmingham, Birmingham, B15 2TT, UK
| | - Carl Jenkinson
- Institute of Metabolism and Systems Research, The University of Birmingham, Birmingham, B15 2TT, UK
| | - Stephanie R Harrison
- Institute of Metabolism and Systems Research, The University of Birmingham, Birmingham, B15 2TT, UK; Department of Rheumatology, Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, B18 7QH, UK
| | - Rene F Chun
- Department of Orthopaedic Surgery, University of California, Los Angeles, Los Angeles, CA 90095, USA
| | - John S Adams
- Department of Orthopaedic Surgery, University of California, Los Angeles, Los Angeles, CA 90095, USA
| | - Karim Raza
- Department of Rheumatology, Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, B18 7QH, UK; Institute of Inflammation and Ageing, Arthritis Research UK Rheumatoid Arthritis Pathogenesis Centre of Excellence and MRC Arthritis Research UK Centre for Musculoskeletal Ageing Research, University of Birmingham, Birmingham, B15 2TT, UK
| | - Martin Hewison
- Institute of Metabolism and Systems Research, The University of Birmingham, Birmingham, B15 2TT, UK; Centre for Endocrinology, Diabetes and Metabolism, Birmingham Health Partners, Birmingham, B15 2TT, UK.
| |
Collapse
|
41
|
Hengist A, Perkin O, Gonzalez JT, Betts JA, Hewison M, Manolopoulos KN, Jones KS, Koulman A, Thompson D. Mobilising vitamin D from adipose tissue: The potential impact of exercise. NUTR BULL 2019; 44:25-35. [PMID: 34853551 PMCID: PMC8609434 DOI: 10.1111/nbu.12369] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Vitamin D is lipophilic and accumulates substantially in adipose tissue. Even without supplementation, the amount of vitamin D in the adipose of a typical adult is equivalent to several months of the daily reference nutrient intake (RNI). Paradoxically, despite the large amounts of vitamin D located in adipose tissue, individuals with obesity are often vitamin D deficient according to consensus measures of vitamin D status (serum 25-hydroxyvitamin D concentrations). Thus, it appears that vitamin D can become 'trapped' in adipose tissue, potentially due to insufficient lipolytic stimulation and/or due to tissue dysfunction/adaptation resulting from adipose expansion. Emerging evidence suggests that exercise may mobilise vitamin D from adipose (even in the absence of weight loss). If exercise helps to mobilise vitamin D from adipose tissue, then this could have important ramifications for practitioners and policymakers regarding the management of low circulating levels of vitamin D, as well as chronically low levels of physical activity, obesity and associated health conditions. This perspective led us to design a study to examine the impact of exercise on vitamin D status, vitamin D turnover and adipose tissue vitamin D content (the VitaDEx project). The VitaDEx project will determine whether increasing physical activity (via exercise) represents a potentially useful strategy to mobilise vitamin D from adipose tissue.
Collapse
Affiliation(s)
- A Hengist
- Department for Health University of Bath Bath UK
| | - O Perkin
- Department for Health University of Bath Bath UK
| | - J T Gonzalez
- Department for Health University of Bath Bath UK
| | - J A Betts
- Department for Health University of Bath Bath UK
| | - M Hewison
- Institute of Metabolism and Systems Research University of Birmingham Birmingham UK
| | - K N Manolopoulos
- Institute of Metabolism and Systems Research University of Birmingham Birmingham UK
| | - K S Jones
- NIHR BRC Nutritional Biomarker Laboratory University of Cambridge Cambridge UK
| | - A Koulman
- NIHR BRC Nutritional Biomarker Laboratory University of Cambridge Cambridge UK
| | - D Thompson
- Department for Health University of Bath Bath UK
| |
Collapse
|
42
|
Tuckey RC, Cheng CYS, Slominski AT. The serum vitamin D metabolome: What we know and what is still to discover. J Steroid Biochem Mol Biol 2019; 186:4-21. [PMID: 30205156 PMCID: PMC6342654 DOI: 10.1016/j.jsbmb.2018.09.003] [Citation(s) in RCA: 135] [Impact Index Per Article: 27.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Revised: 09/04/2018] [Accepted: 09/04/2018] [Indexed: 01/08/2023]
Abstract
Vitamin D, referring to the two forms, D2 from the diet and D3 primarily derived from phototransformation in the skin, is a prohormone important in human health. The most hormonally active form, 1α,25-dihydroxyvitamin D (1α,25(OH)2D), formed from vitamin D via 25-hydroxyvitamin D (25(OH)D), is not only important for regulating calcium metabolism, but has many pleiotropic effects including regulation of the immune system and has anti-cancer properties. The major circulating form of vitamin D is 25(OH)D and both D2 and D3 forms are routinely measured by LC/MS/MS to assess vitamin D status, due to their relatively long half-lives and much higher concentrations compared to 1α,25(OH)2D. Inactivation of both 25(OH)D and 1α,25(OH)2D is catalyzed by CYP24A1 and 25-hydroxyvitamin D3 3-epimerase. Initial products from these enzymes acting on 25(OH)D3 are 24R,25(OH)2D3 and 3-epi-25(OH)D3, respectively, and both of these can also be measured routinely in some clinical laboratories to further document vitamin D status. With advances in LC/MS/MS and its increased availability, and with the help of studies with recombinant vitamin D-metabolizing enzymes, many other vitamin D metabolites have now been detected and in some cases quantitated, in human serum. CYP11A1 which catalyzes the first step in steroidogenesis, has been found to also act on vitamins D3 and D2 hydroxylating both at C20, but with some secondary metabolites produced by subsequent hydroxylations at other positions on the side chain. The major vitamin D3 metabolite, 20S-hydroxyvitamin D3 (20S(OH)D3), shows biological activity, often similar to 1α,25(OH)2D3 but without calcemic effects. Using standards produced enzymatically by purified CYP11A1 and characterized by NMR, many of these new metabolites have been detected in human serum, with semi-quantitative measurement of 20S(OH)D3 indicating it is present at comparable concentrations to 24R,25(OH)2D3 and 3-epi-25(OH)D3. Recently, vitamin D-related hydroxylumisterols derived from lumisterol3, a previtamin D3 photoproduct, have also been measured in human serum and displayed biological activity in initial in vitro studies. With the current extensive knowledge on the reactions and pathways of metabolism of vitamin D, especially those catalyzed by CYP24A1, CYP27A1, CYP27B1, CYP3A4 and CYP11A1, it is likely that many other of the resulting hydroxyvitamin D metabolites will be measured in human serum in the future, some contributing to a more detailed understanding of vitamin D status in health and disease.
Collapse
Affiliation(s)
- Robert C Tuckey
- School of Molecular Sciences, The University of Western Australia, Perth, WA, 6009, Australia.
| | - Chloe Y S Cheng
- School of Molecular Sciences, The University of Western Australia, Perth, WA, 6009, Australia
| | - Andrzej T Slominski
- Department of Dermatology, University of Alabama at Birmingham, AL, 35294, USA; Comprehensive Cancer Center Cancer Chemoprevention Program, University of Alabama at Birmingham, AL, 35294, USA; VA Medical Center, Birmingham, AL, 35294, USA
| |
Collapse
|
43
|
Recent advances in sample preparation and analysis methods for vitamin D and its analogues in different matrices. Trends Analyt Chem 2019. [DOI: 10.1016/j.trac.2018.11.008] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
|
44
|
Günay NE, Buğday İ, Akalın T. Relationships of the Vitamin D and Platelet Indices in Sjögren’s Syndrome. KOREAN JOURNAL OF CLINICAL LABORATORY SCIENCE 2018. [DOI: 10.15324/kjcls.2018.50.4.484] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Affiliation(s)
- Nahide Ekici Günay
- Department of Clinical Biochemistry, University of Health Science, Kayseri City Training and Research Hospital, Turkey
| | - İrfan Buğday
- Department of General Medicine, University of Health Science, Yeşilhisar State Hospital, Kayseri, Turkey
| | - Tayfun Akalın
- Department of General Medicine, Division of Rheumatology, University of Health Science, Kayseri City Training and Research Hospital, Turkey
| |
Collapse
|
45
|
Amrein K, Papinutti A, Mathew E, Vila G, Parekh D. Vitamin D and critical illness: what endocrinology can learn from intensive care and vice versa. Endocr Connect 2018; 7:R304-R315. [PMID: 30352414 PMCID: PMC6240147 DOI: 10.1530/ec-18-0184] [Citation(s) in RCA: 57] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2018] [Accepted: 10/05/2018] [Indexed: 12/13/2022]
Abstract
The prevalence of vitamin D deficiency in intensive care units ranges typically between 40 and 70%. There are many reasons for being or becoming deficient in the ICU. Hepatic, parathyroid and renal dysfunction additionally increases the risk for developing vitamin D deficiency. Moreover, therapeutic interventions like fluid resuscitation, dialysis, surgery, extracorporeal membrane oxygenation, cardiopulmonary bypass and plasma exchange may significantly reduce vitamin D levels. Many observational studies have consistently shown an association between low vitamin D levels and poor clinical outcomes in critically ill adults and children, including excess mortality and morbidity such as acute kidney injury, acute respiratory failure, duration of mechanical ventilation and sepsis. It is biologically plausible that vitamin D deficiency is an important and modifiable contributor to poor prognosis during and after critical illness. Although vitamin D supplementation is inexpensive, simple and has an excellent safety profile, testing for and treating vitamin D deficiency is currently not routinely performed. Overall, less than 800 patients have been included in RCTs worldwide, but the available data suggest that high-dose vitamin D supplementation could be beneficial. Two large RCTs in Europe and the United States, together aiming to recruit >5000 patients, have started in 2017, and will greatly improve our knowledge in this field. This review aims to summarize current knowledge in this interdisciplinary topic and give an outlook on its highly dynamic future.
Collapse
Affiliation(s)
- K Amrein
- Thyroid Endocrinology Osteoporosis Institute Dobnig, Graz, Austria
- Division of Endocrinology and Diabetology, Department of Internal Medicine, Medical University of Graz, Graz, Austria
- Correspondence should be addressed to K Amrein:
| | - A Papinutti
- Department of General Surgery, Medical University of Graz, Graz, Austria
| | - E Mathew
- Department of General Surgery, Medical University of Graz, Graz, Austria
- Department of General Surgery, St. Elisabeth’s Hospital, Graz, Austria
| | - G Vila
- Division of Endocrinology and Metabolism, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria
| | - D Parekh
- Clinician Scientist in Critical Care, Birmingham, Acute Care Research Group, Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK
| |
Collapse
|
46
|
Parekh D, Dancer RCA, Scott A, D'Souza VK, Howells PA, Mahida RY, Tang JCY, Cooper MS, Fraser WD, Tan L, Gao F, Martineau AR, Tucker O, Perkins GD, Thickett DR. Vitamin D to Prevent Lung Injury Following Esophagectomy-A Randomized, Placebo-Controlled Trial. Crit Care Med 2018; 46:e1128-e1135. [PMID: 30222631 PMCID: PMC6250246 DOI: 10.1097/ccm.0000000000003405] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
OBJECTIVES Observational studies suggest an association between vitamin D deficiency and adverse outcomes of critical illness and identify it as a potential risk factor for the development of lung injury. To determine whether preoperative administration of oral high-dose cholecalciferol ameliorates early acute lung injury postoperatively in adults undergoing elective esophagectomy. DESIGN A double-blind, randomized, placebo-controlled trial. SETTING Three large U.K. university hospitals. PATIENTS Seventy-nine adult patients undergoing elective esophagectomy were randomized. INTERVENTIONS A single oral preoperative (3-14 d) dose of 7.5 mg (300,000 IU; 15 mL) cholecalciferol or matched placebo. MEASUREMENTS AND MAIN RESULTS Primary outcome was change in extravascular lung water index at the end of esophagectomy. Secondary outcomes included PaO2:FIO2 ratio, development of lung injury, ventilator and organ-failure free days, 28 and 90 day survival, safety of cholecalciferol supplementation, plasma vitamin D status (25(OH)D, 1,25(OH)2D, and vitamin D-binding protein), pulmonary vascular permeability index, and extravascular lung water index day 1 postoperatively. An exploratory study measured biomarkers of alveolar-capillary inflammation and injury. Forty patients were randomized to cholecalciferol and 39 to placebo. There was no significant change in extravascular lung water index at the end of the operation between treatment groups (placebo median 1.0 [interquartile range, 0.4-1.8] vs cholecalciferol median 0.4 mL/kg [interquartile range, 0.4-1.2 mL/kg]; p = 0.059). Median pulmonary vascular permeability index values were significantly lower in the cholecalciferol treatment group (placebo 0.4 [interquartile range, 0-0.7] vs cholecalciferol 0.1 [interquartile range, -0.15 to -0.35]; p = 0.027). Cholecalciferol treatment effectively increased 25(OH)D concentrations, but surgery resulted in a decrease in 25(OH)D concentrations at day 3 in both arms. There was no difference in clinical outcomes. CONCLUSIONS High-dose preoperative treatment with oral cholecalciferol was effective at increasing 25(OH)D concentrations and reduced changes in postoperative pulmonary vascular permeability index, but not extravascular lung water index.
Collapse
Affiliation(s)
- Dhruv Parekh
- Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, United Kingdom
| | - Rachel C A Dancer
- Birmingham Acute Care Research Group, Institute of Inflammation and Aging, University of Birmingham, Birmingham, United Kingdom
- Academic Department of Anaesthesia, Critical Care, Resuscitation and Pain, Heartlands Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom
| | - Aaron Scott
- Birmingham Acute Care Research Group, Institute of Inflammation and Aging, University of Birmingham, Birmingham, United Kingdom
| | - Vijay K D'Souza
- Birmingham Acute Care Research Group, Institute of Inflammation and Aging, University of Birmingham, Birmingham, United Kingdom
| | - Phillip A Howells
- Birmingham Acute Care Research Group, Institute of Inflammation and Aging, University of Birmingham, Birmingham, United Kingdom
| | - Rahul Y Mahida
- Birmingham Acute Care Research Group, Institute of Inflammation and Aging, University of Birmingham, Birmingham, United Kingdom
| | - Jonathan C Y Tang
- Norwich Medical School, University of East Anglia, Norwich, United Kingdom
| | - Mark S Cooper
- Discipline of Medicine, Concord Clinical School, University of Sydney, NSW, Australia
| | - William D Fraser
- Norwich Medical School, University of East Anglia, Norwich, United Kingdom
| | - LamChin Tan
- University Hospitals Coventry and Warwickshire NHS Trust, Coventry, United Kingdom
| | - Fang Gao
- Birmingham Acute Care Research Group, Institute of Inflammation and Aging, University of Birmingham, Birmingham, United Kingdom
- Academic Department of Anaesthesia, Critical Care, Resuscitation and Pain, Heartlands Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom
| | - Adrian R Martineau
- Blizard Institute, Queen Mary University of London, London, United Kingdom
| | - Olga Tucker
- Birmingham Acute Care Research Group, Institute of Inflammation and Aging, University of Birmingham, Birmingham, United Kingdom
- Academic Department of Anaesthesia, Critical Care, Resuscitation and Pain, Heartlands Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom
| | - Gavin D Perkins
- Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, United Kingdom
- Academic Department of Anaesthesia, Critical Care, Resuscitation and Pain, Heartlands Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom
| | - David R Thickett
- Birmingham Acute Care Research Group, Institute of Inflammation and Aging, University of Birmingham, Birmingham, United Kingdom
- Queen Elizabeth Hospital University Hospitals, Birmingham NHS Foundation Trust, Birmingham, United Kingdom
| |
Collapse
|
47
|
Shah I, Akhtar MK, Hisaindee S, Rauf MA, Sadig M, Ashraf SS. Clinical diagnostic tools for vitamin D assessment. J Steroid Biochem Mol Biol 2018; 180:105-117. [PMID: 28988826 DOI: 10.1016/j.jsbmb.2017.10.003] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2017] [Revised: 09/28/2017] [Accepted: 10/05/2017] [Indexed: 11/25/2022]
Abstract
Vitamin D deficiency has been implicated in a plethora of diseases including rheumatoid arthritis, Parkinson's disease, Alzheimer's disease, and osteoporosis. Deficiency of this vitamin is a global epidemic affecting both developing and developed nations. Within a clinical context, the qualitative and quantitative analysis of vitamin D is therefore vital. The main metabolic markers for assessing vitamin D status in humans are the hydroxylated forms of vitamin D, 25OHD3 and 25OHD2 on account of their long half-lives within the body and excellent stability. An adequate level for healthy individuals of these hydroxylated forms is estimated to be around 20-40ng/ml of blood. There are three main analytical techniques for determining the levels of 25OHD3 and 25OHD2. The first technique is immunoassay-based and can be performed in a rapid, high throughput, automated manner, allowing as many as 240 tests per hour with the duration of each assay as little as 18min. Furthermore, it offers excellent sensitivity with a detection range of 3.4-156ng/ml. A major downside of immunoassays is that they are unable to distinguish between the various forms of vitamin D. While HPLC is a highthroughput low cost instrument it is not a very sensitive technique and cannot quantify the down stream metabolites of vitamin D. The third technique, namely liquid chromatography-mass spectrometry (LC-MS/), provides excellent sensitivity with a wide dynamic range from 0.068pg/ml to 100ng/ml. Additionally, it offers a high level of separation and permits identification of vitamin D-related metabolites. However, a huge limitation with LC/MS/MS is their poor throughput for sample analyses. As yet, there is no analytical technique which combines the fine detection capabilities of LC/MS/MS and the rapid, automated format of immunoassay, for vitamin D analyses. Future attention therefore needs to be given to this area if the current clinical diagnostic tools for vitamin D analysis are to be further improved.
Collapse
Affiliation(s)
- Iltaf Shah
- Department of Chemistry, College of Science, UAE University, Al Ain, United Arab Emirates.
| | - M Kalim Akhtar
- Department of Chemistry, College of Science, UAE University, Al Ain, United Arab Emirates
| | - Soleiman Hisaindee
- Department of Chemistry, College of Science, UAE University, Al Ain, United Arab Emirates
| | - Muhammad A Rauf
- Department of Chemistry, College of Science, UAE University, Al Ain, United Arab Emirates
| | - Mohammed Sadig
- Department of Chemistry, College of Science, UAE University, Al Ain, United Arab Emirates
| | - S Salman Ashraf
- Department of Chemistry, College of Science, UAE University, Al Ain, United Arab Emirates
| |
Collapse
|
48
|
Jenkinson C, Taylor A, Storbeck KH, Hewison M. Analysis of multiple vitamin D metabolites by ultra-performance supercritical fluid chromatography-tandem mass spectrometry (UPSFC-MS/MS). J Chromatogr B Analyt Technol Biomed Life Sci 2018; 1087-1088:43-48. [PMID: 29709871 DOI: 10.1016/j.jchromb.2018.04.025] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2017] [Revised: 03/15/2018] [Accepted: 04/12/2018] [Indexed: 11/18/2022]
Abstract
In recent years, increased interest in the human health benefits of vitamin D has led to demand for improved analysis of patient vitamin D 'status'. Studies to date have focused primarily on a single vitamin D metabolite, 25-hydroxyvitamin D, despite the existence of a broad range of vitamin D metabolites, referred to as the vitamin D metabolome. This study reports on the development of a rapid UPSFC-MS/MS method for the analysis of nine vitamin D metabolites in human serum. Optimum separation was obtained with a Lux-Cellulose chiral column. We observed an orthogonal elution order when compared with ultra-high performance liquid chromatography (UHPLC). The order of elution was reversed based on hydroxyl- group number, however elution order did not differ between isomeric changes in hydroxyl- group position or epimers. Although UPSFC yielded superior resolution and selectivity over previously developed UHPLC-MS/MS methods, improvements in sensitivity could not be achieved owing to the lower injection volume required for UPSFC relative to UHPLC. Method validation was performed on the developed UPSFC-MS/MS method and found to be within acceptable limits. Applying the method to the analysis of human serum samples showed a significant correlation with serum concentrations of metabolites measured by UHPLC-MS/MS (25OHD3 r = 0.997, P=<0.001, and 3-epi-25OHD3 r = 0.996, P ≤0.001). These data indicate that UPSFC provides an efficient analytical platform for rapid analysis of multiple vitamin D metabolites from serum.
Collapse
Affiliation(s)
- Carl Jenkinson
- Institute of Metabolism and Systems Research, the University of Birmingham, Birmingham B15 2TT, UK.
| | - Angela Taylor
- Institute of Metabolism and Systems Research, the University of Birmingham, Birmingham B15 2TT, UK
| | - Karl-Heinz Storbeck
- Department of Biochemistry, Stellenbosch University, Stellenbosch 7600, South Africa
| | - Martin Hewison
- Institute of Metabolism and Systems Research, the University of Birmingham, Birmingham B15 2TT, UK; CEDAM, Birmingham Health Partners, the University of Birmingham, Birmingham B15 2TT, UK
| |
Collapse
|
49
|
Vitamin D status and its influence on outcomes following major burn injury and critical illness. BURNS & TRAUMA 2018; 6:11. [PMID: 29721511 PMCID: PMC5910591 DOI: 10.1186/s41038-018-0113-4] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Accepted: 03/23/2018] [Indexed: 12/11/2022]
Abstract
Vitamin D deficiency is common among the general population. It is also observed in up to 76% of critically ill patients. Despite the high prevalence of hypovitaminosis D in critical illness, vitamin D is often overlooked by medical staff as the clinical implications and consequences of vitamin D deficiency in acute contexts remain to be fully understood. Vitamin D has a broad range of pleotropic effects on various processes and systems including the immune-inflammatory response. 1α,25-dihydroxyvitamin D (1,25(OH)2D), has been shown to promote a tolerogenic immune response limiting deleterious inflammatory effects, modulation of the innate immune system, and enhancement of anti-microbial peptides. Vitamin D deficiency is frequently observed in critically ill patients and has been related to extrinsic causes (i.e., limited sunlight exposure), magnitude of injury/illness, or the treatment started by medical doctors including fluid resuscitation. Low levels of vitamin D in critically ill patients have been associated with sepsis, organ failure, and mortality. Despite this, there are subpopulations of critical illness, such as burn patients, where the literature regarding vitamin D status and its influence on outcomes remain insufficient. Thermal injury results in damage to both burned and non-burned tissues, as well as induces an exaggerated and persistent immune-inflammatory and hypermetabolic response. In this review, we propose potential mechanisms in which burn injury affects the vitamin D status and summarizes current literature investigating the influence of vitamin D status on outcomes. In addition, we reviewed the literature and trials investigating vitamin D supplementation in critically ill patients and discuss the therapeutic potential of vitamin D supplementation in burn and critically ill patients. We also highlight current limitations of studies that have investigated vitamin D status and supplementation in critical illness. Thermal injury influences vitamin D status. More studies investigating vitamin D depletion in burn patients and its influence on prognosis, via standardized methodology, are required to reach definitive conclusions and influence clinical practice.
Collapse
|
50
|
The When, What & How of Measuring Vitamin D Metabolism in Clinical Medicine. Nutrients 2018; 10:nu10040482. [PMID: 29652819 PMCID: PMC5946267 DOI: 10.3390/nu10040482] [Citation(s) in RCA: 53] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2018] [Revised: 04/03/2018] [Accepted: 04/11/2018] [Indexed: 12/18/2022] Open
Abstract
We now have the ability to measure a number of different vitamin D metabolites with very accurate methods. The most abundant vitamin D metabolite, 25-hydroxyvitamin D, is currently the best marker for overall vitamin D status and is therefore most commonly measured in clinical medicine. The added value of measuring metabolites beyond 25-hydroxyvitamin D, like 1,25-, and 24,25-dihydroxyvitamin D is not broadly appreciated. Yet, in some more complicated cases, these metabolites may provide just the information needed for a legitimate diagnosis. The problem at present, is knowing when to measure, what to measure and how to measure. For 25-hydroxyvitamin D, the most frequently used automated immunoassays do not meet the requirements of today’s standards for certain patient groups and liquid chromatography-tandem mass spectrometry is the desired method of choice in these individuals. The less frequently measured 1,25-dihydroxyvitamin D metabolite enables us to identify a number of conditions, including 1α-hydroxylase deficiency, hereditary vitamin D-resistant rickets and a number of granulomatous diseases or lymphoproliferative diseases accompanied by hypercalcaemia. Furthermore, it discriminates between the FGF23-mediated and non-FGF23-mediated hypophosphatemic syndromes. The 24,25-dihydroxyvitamin D metabolite has proven its value in the diagnosis of idiopathic infantile hypercalcaemia and has the potential of having value in identifying other diseases. For both metabolites, the understanding of the origin of differences between assays is limited and requires further attention. Nonetheless, in every way, appropriate measurement of vitamin D metabolism in the clinical laboratory hinges eminently on the comprehension of the value of the different metabolites, and the importance of the choice of method.
Collapse
|