Antiproliferative action of vitamin D

Vitamin D and its binding protein in patients with leiomyomas

AIM

This study examined the levels of VitD, VitD binding protein (DBP), and free VitD in leiomyomas patients and their association with the quantity, dimensions, and site of fibroid growths. Additionally, we evaluated the potentiality of employing these factors as a biomarker tool for the diagnosis and assessment of uterine fibroid progression.

METHODS

This study involved the participation of 55 women with leiomyomas and 50 healthy women. We utilized commercial ELISA kits to measure the levels of total VitD and DBP in their serum. Additionally, we calculated the levels of free VitD and the ratio of VitD to DBP. Moreover, we determined the number, size, and location of the leiomyomas in the patients.

RESULTS

There were no significant differences in the levels of total VitD between the groups. However, patients had significantly lower levels of free VitD and higher levels of DBP compared to the control group. The size of the largest leiomyomas showed a negative relationship with free VitD and a positive relationship with DBP. Receiver operating characteristic analyses, showed that the cut-off value for free VitD was 4.47 pg/mL, with a sensitivity of 75.6% and a specificity of 74.4%. The cut-off value for DBP was 256.2 μg/mL, with a sensitivity of 86% and a specificity of 70.3%.

CONCLUSIONS

Free VitD and DBP potentially contribute to the development of leiomyomas and are linked to the size of these tumors. The measurement of serum levels of these factors could serve as additional biomarkers for the diagnosis of leiomyomas.

Empowering Strategies for Lifestyle Interventions, Diet Modifications, and Environmental Practices for Uterine Fibroid Prevention; Unveiling the LIFE UP Awareness

Uterine fibroids (UFs) are the most common prevalent benign tumor among women of reproductive age, disproportionately affecting women of color. This paper introduces an innovative management strategy for UFs, emphasizing the curbing of disease prevention and progression. Traditionally, medical intervention is deferred until advanced stages, necessitating invasive surgeries such as hysterectomy or myomectomy, leading to high recurrence rates and increased healthcare costs. The strategy, outlined in this review, emphasizes UF disease management and is named LIFE UP awareness-standing for Lifestyle Interventions, Food Modifications, and Environmental Practices for UF Prevention. These cost-effective, safe, and accessible measures hold the potential to prevent UFs, improve overall reproductive health, reduce the need for invasive procedures, and generate substantial cost savings for both individuals and healthcare systems. This review underscores the importance of a proactive UF management method, paving the way for future research and policy initiatives in this domain.

Current and Emerging Treatment Options for Uterine Fibroids

Uterine fibroids are the most common benign neoplasm of the female reproductive tract in reproductive age women. Their prevalence is age dependent and can be detected in up to 80% of women by the age of 50 years. Patients affected by uterine fibroids may experience a significant physical, emotional, social, and financial toll as well as losses in their quality of life. Unfortunately, curative hysterectomy abolishes future pregnancy potential, while uterine-sparing surgical and radiologic alternatives are variously associated with reduced long-term reproductive function and/or high tumor recurrence rates. Recently, pharmacological treatment against uterine fibroids have been widely considered by patients to limit uterine fibroid-associated symptoms such as heavy menstrual bleeding. This hormonal therapy seemed effective through blocking the stimulatory effects of gonadal steroid hormones on uterine fibroid growth. However, they are contraindicated in women actively pursuing pregnancy and otherwise effective only during use, which is limited because of long-term safety and other concerns. Accordingly, there is an urgent unmet need for safe, durable, and fertility-compatible non-surgical treatment options for uterine fibroids. In this review article, we cover the current pharmacological treatments for uterine fibroids including their comparable efficacy and side effects as well as emerging safe natural compounds with promising anti-uterine fibroid effects.

Evidence-Based Approach for Secondary Prevention of Uterine Fibroids (The ESCAPE Approach)

Uterine fibroids (UFs) are common tumors in women of reproductive age. It is imperative to comprehend UFs' associated risk factors to facilitate early detection and prevention. Simple relying on surgical/pharmacological treatment of advanced disease is not only highly expensive, but it also deprives patients of good quality of life (QOL). Unfortunately, even if the disease is discovered early, no medical intervention is traditionally initiated until the disease burden becomes high, and only then is surgical intervention performed. Furthermore, after myomectomy, the recurrence rate of UFs is extremely high with the need for additional surgeries and other interventions. This confused approach is invasive and extremely costly with an overall negative impact on women's health. Secondary prevention is the management of early disease to slow down its progression or even halt it completely. The current approach of watchful observation for early disease is considered a major missed opportunity in the literature. The aim of this article is to present an approach named the ESCAPE (Evidence-Based Approach for Secondary Prevention) of UF management. It comprises simple, inexpensive, and safe steps that can arrest the development of UFs, promote overall reproductive health, decrease the number of unnecessary surgeries, and save billions of health care systems' dollars worldwide.

A Systematic Review of Vitamin D and Fibroids: Pathophysiology, Prevention, and Treatment

Uterine fibroids are the most common tumor of reproductive-age women worldwide and cause significant morbidity in affected women. Vitamin D has emerged as a potential therapy for uterine fibroids based on experimental and epidemiologic evidence. The objective of this systematic review was to evaluate the role of vitamin D in the pathophysiology of uterine fibroids and its efficacy for prevention and treatment of fibroids. A comprehensive search was conducted of Cochrane Library, Embase, PubMed, Scopus, and Web of Science from inception to March 2022. English-language publications that evaluated vitamin D and uterine fibroids in humans, whether experimental or clinical, were considered. The search yielded 960 publications, and 89 publications met inclusion criteria: 23 preclinical studies, 25 clinical studies, and 41 review articles. Preclinical studies indicated that the vitamin D receptor was decreased in fibroid cells. Vitamin D treatment of fibroid cells decreased proliferation, extracellular matrix protein expression, and Wnt/β-catenin signaling. Fourteen clinical studies (n = 3535 participants) assessed serum vitamin D level in women with ultrasound-proven fibroids, and all found an inverse correlation between serum vitamin D level and presence of fibroids. Five clinical studies (n = 472 patients) evaluated treatment of fibroids with vitamin D. Four of five studies showed vitamin D significantly inhibited fibroid growth. One pilot study (n = 109 patients) of vitamin D for secondary prevention of fibroids demonstrated smaller recurrent fibroids in the treated group. These studies provide evidence for vitamin D as a therapy for uterine fibroids and underscore the need for well-designed, randomized, placebo-controlled clinical trials.

Relation between vitamin D and uterine fibroid

Background; Uterine fibroids (UFs) are benign tumors that develop from the uterus' smooth muscle cells and are mostly found in the pelvic. Aim of the work; we aimed to compare serum vitamin D level between patients, have uterine fibroids and those without. Subjects and methods; our current study included 90 females and was conducted as a case control study; 50 were diagnosed with uterine fibroid and 40 were healthy volunteers (control) during the period from July 2019 to July 2020.  they were recruited from Al Zahra’a University Hospital. Serum vitamin D level was measured by ELISA. Results; Vitamin D serum concentrations were significantly lower in the studied females with UFs compared to healthy controls (mean 19.24 ±16.0 vs. 33.83 ±17.5) ng/mL in cases and controls, respectively, with a statistically significant p-value <0.001. Serum vitamin D levels have a significant, linear, negative, moderate association with uterine fibroids size. Conclusion; in our study group, reduced serum vitamin D levels were found to be inversely related to UF burden. A lack of vitamin D may be a risk factor for the incidence of uterine fibroids.

Association between serum vitamin D level and uterine fibroid in premenopausal women in Indian population

We aim to evaluate the association between serum 25-hydroxyvitamin D₃ levels and total number, volume and location of uterine fibroids (UFs) in premenopausal women in North Indian population. This case control study was undertaken in 310 women between 18 years and 45 years of age. Cases comprised of 102 women with fibroid lesion and the control group included 208 women with normal uterine morphology on ultrasonography. Blood samples were taken for measuring 25-hydroxyvitamin D₃ levels. The mean serum 25-hydroxyvitamin D₃ level in the study and control group was 14.52 ± 7.89 ng/mL and 26.6 ± 14.36 ng/mL respectively (p < 0.05). There was significant inverse correlation between serum 25-hydroxyvitamin D₃ levels and total volume of fibroids (p = 0.000) while none between 25-hydroxyvitamin D₃ levels with location, number of fibroids. 25-hydroxyvitamin D₃ deficiency was more common in the study group (54.90%) compared to healthy controls (6.7%) while sufficiency was more common among controls (67.8% vs. 27.45) (p < 0.05). Women with deficient 25-hydroxyvitamin D₃ levels have an odds of 18.36 for developing uterine fibroid. Women with low parity, those belonging to higher socioeconomic status and having less than 1-hour sun exposure per day were independently found to have high risk for development of UFs. Vitamin D may have a role in growth of UFs. Women not able to get adequate sun exposure due to indoor working conditions may need evaluation and supplementation as prophylaxis for development of fibroid.

Hypovitaminosis D Is Prevalent in Patients With Renal AL Amyloidosis and Associated With Renal Outcome

INTRODUCTION

Vitamin D deficiency is common, but no data have been reported on vitamin D levels in light chain (AL) amyloidosis.

PATIENTS AND METHODS

In this exploratory study, stored serum samples from 173 patients with newly diagnosed AL amyloidosis were analyzed for vitamin studies which included 25-hydroxyvitamin D [25(OH)D], 1,25-dihydroxyvitamin D [1,25(OH)₂D] and vitamin D binding protein (DBP). Measurements were made by liquid chromatography-tandem mass spectrometry. Kidney survival and overall survival (OS) were assessed in association to vitamin D status.

RESULTS

Cardiac and kidney involvement occurred in 69% and 63% of patients, respectively. 25(OH)D deficiency (<20 ng/mL) was seen in 56.6% of the patients and was notably found among patients with heavy proteinuria (96%), hypoalbuminemia (84.3%) and morbidly obese patients (68.3%). Heavy proteinuria (>5 gr/24-h) and vitamin D supplementation were independent predictors of 25(OH)D level on nominal multivariate regression analysis. 1,25(0H)₂D deficiency was noted in 37.6% of patients and was independently associated with low eGFR and hypoalbuminemia. Progression to ESRD occurred in 23.7% of evaluable patients. Patients who progressed to ESRD had lower serum 25(OH)D and 1,25(OH)₂D levels compared to those who did not progress to ESRD. On a multivariate analysis, severe 25(OH)D deficiency was an independent predictor of progression to ESRD as was renal stage, while 1,25(OH)₂D deficiency was not.

CONCLUSIONS

Hypovitaminosis D is common in AL amyloidosis, particularly among patients with heavy proteinuria. Severe 25(OH)D deficiency at time of diagnosis predicts progression to ESRD.

Vitamin D3/phospholipid complex decorated caseinate nanomicelles for targeted delivery of synergistic combination therapy in breast cancer

Targeted delivery of cytotoxic drugs has shown great potential in cancer therapy. In this light, vitamin D3 (vit.D3)-coated micelles were fabricated to encapsulate the cytotoxic drug; etoposide (ETP). Sodium caseinate micelles were first utilized to encapsulate vit.D3 and ETP within their hydrophobic core, then drug-loaded micelles were further decorated with an envelope of vit.D3/ phospholipid complex to enhance the active targeting potency of fabricated micelles via exploiting vit.D3 receptors (VDRs) overexpressed on the outer surface of breast cancer cells. In vitro cytotoxicity studies showed that fabricated micelles exhibited improved anticancer effect on MDA MB-231 and MCF-7 human breast cancer cell lines in comparison to free vit.D3 + ETP without any significant toxicity on normal human lung fibroblast (Wi-38) cells. In vivo biodistribution and efficacy studies in Ehrlich ascites tumor animal model revealed that fabricated micelles manifested improved accumulation in tumor tissue due to active targeting potential of vit.D3 without any remarkable toxicity. More importantly, fabricated micelles resulted in enhanced tumor apoptosis, reduced angiogenesis, invasion and autophagy, besides a decline in the tumor expression levels of both miR-21 and miR-192. Therefore, vit.D3/ETP micelles could serve as a favorable actively targeted anticancer delivery system having a superior effect over the free combination.

Identification of kinase inhibitors that rule out the CYP27B1-mediated activation of vitamin D: an integrated machine learning and structure-based drug designing approach

CYP27B1, a cytochrome P450-containing hydroxylase enzyme, converts vitamin D precursor calcidiol (25-hydroxycholecalciferol) to its active form calcitriol (1α,25(OH)₂D₃). Tyrosine kinase inhibitor such as imatinib is reported to interfere with the activation of vitamin D₃ by inhibiting CYP27B1 enzyme. Consequently, there is a decrease in the serum levels of active vitamin D that in turn may increase the relapse risk among the cancer patients treated with imatinib. Within this framework, the current study focuses on identifying other possible kinase inhibitors that may affect the calcitriol level in the body by inhibiting CYP27B1. To achieve this, we explored multiple machine learning approaches including support vector machine (SVM), random forest (RF), and artificial neural network (ANN) to identify possible CYP27B1 inhibitors from a pool of kinase inhibitors database. The most reliable classification model was obtained from the SVM approach with Matthews correlation coefficient of 0.82 for the external test set. This model was further employed for the virtual screening of kinase inhibitors from the binding database (DB), which tend to interfere with the CYP27B1-mediated activation of vitamin D. This screening yielded around 4646 kinase inhibitors that were further subjected to structure-based analyses using the homology model of CYP27B1, as the 3D structure of CYP27B1 complexed with heme was not available. Overall, five kinase inhibitors including two well-known drugs, i.e., AT7867 (Compound-2) and amitriptyline N-oxide (Compound-3), were found to interact with CYP27B1 in such a way that may preclude the conversion of vitamin D to its active form and hence testify the impairment of vitamin D activation pathway.

Association of Vitamin D receptor gene variations with Gastric cancer risk in Kashmiri population

Vitamin D receptor (VDR) mediates cellular processes like cell cycle arrest and apoptosis which effect cancer susceptibility. VDR single nucleotide polymorphisms (SNPs) have a significant influence on functioning of VDR protein and subsequently contribute to the risk of cancer occurrence and progression. The present case-control study was carried out between 2016 and 2020 to investigate the association of VDR BsmI/ApaITaqI SNPs with Gastric Cancer (GC) risk in ethnic Kashmiri population not only for establishing a molecular marker for GC but also to facilitate the outcomes of personalized medicine in future. The polymorphisms of BsmI and ApaI of the VDR gene were evaluated using Polymerase Chain Reaction-Restriction Fragment Length Polymorphism followed by Di-Deoxy Sanger sequencing in 143 GC cases and 150 controls. The mean age (in years) was 53.5 ± 7.92 and 51.2 ± 8.25 and mean Body mass index was 22.68 ± 4.27 kg/m² and 23.81 ± 3.71 kg/m² for cases and controls respectively. The mean CEA levels of GC cases was 40.2 ± 10.9 ng/ml. Genotypic distribution of VDR BsmI differed significantly between GC cases and controls (GG vs GA + AA; adjusted P = 0.014) and followed dominant mode of inheritence. Stratification of VDR BsmI revealed that frequency of variant genotype (GA + AA) was significantly higher in Preobese GC cases (P = 0.001), GC patients consuming < 5 cups of salt tea/day (P < 0.0001) and with no family history of gastrointestinal cancer (P = 0.014) compared to healthy controls. ATC haplotype associated with high GC risk. In conclusion, our study suggests that VDR BsmI SNP has a significant association with increased risk of GC especially in preobese population and BsmI/ApaITaqI SNPs significantly decreased the overall survival in GC patients of Kashmiri population.

Immune Response: A Missed Opportunity Between Vitamin D and Radiotherapy

Radiotherapy (RT) is a mainstay treatment in several types of cancer and acts by mediating various forms of cancer cell death, although it is still a large challenge to enhance therapy efficacy. Radiation resistance represents the main cause of cancer progression, therefore, overcoming treatment resistance is now the greatest challenge for clinicians. Increasing evidence indicates that immune response plays a role in reprogramming the radiation-induced tumor microenvironment (TME). Intriguingly, radiation-induced immunosuppression possibly overwhelms the ability of immune system to ablate tumor cells. This induces an immune equilibrium, which, we hypothesize, is an opportunity for radiosensitizers to make actions. Vitamin D has been reported to act in synergistic with RT by potentiating antiproliferative effect induced by therapeutics. Additionally, vitamin D can also regulate the TME and may even lead to immunostimulation by blocking immunosuppression following radiation. Previous reviews have focused on vitamin D metabolism and epidemiological trials, however, the synergistic effect of vitamin D and existing therapies remains unknown. This review summarizes vitamin D mediated radiosensitization, radiation immunity, and vitamin D-regulated TME, which may contribute to more successful vitamin D-adjuvant radiotherapy.

Effect of vitamin D on malignant behavior of non-small cell lung cancer cells

OBJECTIVE

To investigate the effects of vitamin D on the malignant behavior of A549 and NCI-H1975 tumor cells (proliferation, apoptosis, invasion, metastasis and drug resistance-related proteins) and the activation of the PI3K/AKT/mTOR signaling pathway, in order to evaluate the effect of vitamin D on the therapeutic action of cisplatin.

METHOD

In vitro cell experiments, CCK-8, flow cytometry, transwell, scratches, MTT and Western blot were used to reveal the effect of vitamin D on non-small cell lung cancer (NSCLC), and the expression of PI3K/AKT/mTOR signaling pathway was also detected. In vivo animal experiments, the nude mice were divided into four groups: control group, vitamin D treatment group, cisplatin treatment group and vitamin D + cisplatin combined treatment group. After tumor formation in vitro, tumor volume changes were calculated and tumor growth curves were drawn, collected tumor tissues for pathological sections. Western blot was used to detect the expression changes of drug-resistance related proteins in tumor tissues. Meanwhile, protein expression changes of PI3K/AKT/mTOR signaling pathway in tumor tissues were detected.

RESULT

In vitro experiments confirm Vitamin D can inhibit the proliferation, invasion and metastasis of non-small cell lung cancer cells A549 and NCI-H1975, promoting cell apoptosis, up-regulate the sensitivity of chemotherapy drugs. These effects of vitamin D may be correlated with the PI3K/AKT/mTOR signaling pathway. In vivo animal experiments, the changes in tumor volume, tumor inflammatory infiltration range, expression of drug-resistant related proteins and signaling pathway related proteins in mice were as follows: The vitamin D and cisplatin combined treatment group was significantly smaller than the control group.

CONCLUSION

Vitamin D can inhibit the proliferation, invasion and metastasis of non-small cell lung cancer (NSCLC) cells A549 and NCI-H1975 and promote apoptosis, up-regulate the sensitivity of chemotherapy drugs. The effect of vitamin D on NSCLC cells A549 and NCI-H1975 was correlated with the PI3K/AKT/mTOR signaling pathway. Vitamin D also promotes the therapeutic effect of CDDP.

Evaluation of 25-hydroxy vitamin D3 levels in patients with a fibroid uterus

A cross sectional study was done at Era's Lucknow Medical College & Hospital, Lucknowwith the objective to evaluate 25-hydroxyVitaminD3 level in women with and without uterine fibroid. Ninety subjects (45 cases and 45 controls) were enrolled. Cases were those having at least 1 uterine fibroid ≥10 mm detected on ultrasonography, while controls were those not having any uterine pathology. Estimation of Serum 25-hydroxyvitaminD3 Level was done. The mean ± SD concentration of 25-hydroxyvitaminD3 was Significantly lower in cases compared with controls (15.10 ± 6.09 vs 26.09 ± 7.90 respectively, p < 0.001).The number of women with 25-hydroxyvitaminD3 deficiency in cases and controls was 9(20%) and 3(6.67%) respectively (p < 0.001). Uterine fibroid size increased proportionately with decrease in 25-hydroxyvitaminD3 levels, (p = 0.014). We concluded that VitaminD3 deficiency is significantly associated with the occurrence of Uterine fibroids. Further studies need to be conducted in order to evaluate the therapeutic benefits VitaminD3 supplementation in the patients of Uterine fibroid.Impact Statementwhat is already known on this subject? Vitamin D is believed to regulate cell proliferation and differentiation, inhibit angiogenesis and stimulate apoptosis. Now a days hypovitaminosis D is believed to be a major risk factor in the development of uterine fibroids. There are several ideas about the use of vitamin D in uterine fibroid prevention or as a long term treatment but ongoing clinical trials in the area remain scarce.what do the results of this study add? Our study showed that 25-hydroxivitamin d3 deficiency is significantly associated with uterine fibroid.Lower levels of 25-hydroxivitamin d3were found to have aninverse relationship with increased size of fibroid uterus.what are the implications of these findings for clinical practice and / or further reasearch? Vitamin D seems to be a promising, safe and low-cost agent for the prevention and treatment of uterine fibroids. However, further studies with larger sample size are needed to confirm our findings.

Risk factors for elevated serum colorectal cancer markers in patients with type 2 diabetes mellitus

The study aims to examine the risk factors for increased colorectal cancer (CRC) markers in patients with type 2 diabetes mellitus (T2DM). The 229 patients retrospectively reviewed were categorized into two groups: CRC tumor marker-positive and -negative groups. Patients who tested positive for all three of the following CRC markers were included in the CRC tumor marker-positive group: serum carcinoembryonic antigen, carbohydrate antigen 19-9 and septin9 methylation. Univariate analysis revealed that most CRC marker-positive patients had higher age, a family history of CRC, history of smoking and alcohol intake, high body mass index (BMI; overweight), longer history of T2DM, worse diabetes control (with high glycated hemoglobin A1c [HbA1c]), lower level of serum vitamin D (VD), high-density lipoprotein cholesterol and higher level of total cholesterol and triglyceride (TG). Logistic regression analysis showed that BMI, VD, HbA1c and TG were independent predictors of CRC marker-positive status (OR, 95% confidence intervals and P values were 1.912 [1.346–2.716], <0.001; 0.773 [0.633–0.943], 0.011; 9.082 [3.52–23.433], <0.001; and 11.597 [3.267–41.164], <0.001, respectively). In this retrospective study, high BMI, HbA1c and TG as well as low level of VD were correlated with CRC tumor marker-positive status in T2DM patients. Patients with these risk factors may benefit from more frequent screening for CRC tumor markers.

Role of anabolic agents in colorectal carcinogenesis: Myths and realities (Review)

Colorectal cancer (CRC) is one of the four leading causes of cancer‑related mortality worldwide. Even though over the past few decades the global scientific community has made tremendous efforts to understand this entity, many questions remain to be raised on this issue and even more to be answered. Epidemiological findings have unveiled numerous environmental and genetic risk factors, each one contributing to a certain degree to the final account of new CRC cases. Moreover, different trends have been revealed regarding the age of onset of CRC between the two sexes. That, in addition to newly introduced therapeutic approaches for various diseases based on androgens, anti‑androgens and anabolic hormones has raised some concerns regarding their possible carcinogenic effects or their synergistic potential with other substances/risk factors, predisposing the individual to CRC. Notably, despite the intense research on experimental settings and population studies, the conclusions regarding the majority of anabolic substances are ambiguous. Some of these indicate the carcinogenic properties of testosterone, dihydrotestosterone (DHT), growth hormone and insulin‑like growth factor (IGF) and others, demonstrating their neutral nature or even their protective one, as in the case of vitamin D. Thus, the synergistic nature of anabolic substances with other CRC risk factors (such as type 2 diabetes mellitus, metabolic syndrome and smoking) has emerged, suggesting a more holistic approach.

Long-term vitamin D treatment decreases human uterine leiomyoma size in a xenograft animal model

OBJECTIVE

To study the effects of short- and long-term vitamin D treatment on uterine leiomyomas in vivo through cell proliferation, extracellular matrix (ECM) degradation, and apoptosis.

DESIGN

Preclinical study of human leiomyoma treatment with vitamin D in an nonhuman animal model.

SETTING

Hospital and university laboratories.

PATIENT(S)/ANIMAL(S)

Human leiomyomas were collected from patients and implanted in ovariectomized NOD-SCID mice.

INTERVENTION(S)

Mice were treated with vitamin D (0.5 μg/kg/d or 1 μg/kg/d) or vehicle for 21 or 60 days.

MAIN OUTCOME MEASURE(S)

Vitamin D effect in xenograft tissue was assessed by monitoring tumor size (¹⁸F-FDG positron-emission tomography/computerized tomography and macroscopic examination), cell proliferation (immunohistochemistry and quantitative real-time polymerase chain reaction [qRT-PCR]), ECM (Western blot), transforming growth factor (TGF) β3 (qRT-PCR), and apoptosis (Westrn blot and TUNEL).

RESULT(S)

Short-term treatment with vitamin D did not appear to alter leiomyoma size, based on in vivo monitoring and macroscopic examination. However, long-term high-dose treatment induced a significant reduction in leiomyoma size. Cell proliferation was not decreased in the short term, whereas 1 μg/kg/d vitamin D in the long term significantly reduced proliferation compared with control. Although collagen-I and plasminogen activator inhibitor 1 were not modified by short-term treatment, they were both significantly reduced by long-term high-dose vitamin D. Similarly, long-term high-dose vitamin D significantly reduced TGF-β3 expression. Finally, apoptosis significantly increased with both short- and long-term high-dose vitamin D treatment.

CONCLUSION(S)

Long-term vitamin D acts as an antiproliferative, antifibrotic, and proapoptotic therapy that provides a safe, nonsurgical therapeutic option for reducing uterine leiomyoma size without side-effects.

Vitamin D in physiological and pathological aging: Lesson from centenarians

Vitamin D is a secosteroid hormone that exerts a pleiotropic action on a wide spectrum of tissues, apparatuses and systems. Thus, vitamin D has assumed an increasingly dominant role as a key determinant of biological mechanisms and specific clinical conditions. Older people frequently present vitamin D deficiency, a status potentially influencing several mechanisms responsible for different age-related diseases. Centenarians symbolize the ideal model for investigating the peculiar traits of longevity, as they have reached an age close to the estimated limit of the human lifespan. Interestingly, despite the profound heterogeneity of centenarians in terms of health status, all these people share the same condition of severe vitamin D deficiency, suggesting that they may have implemented a number of adaptive strategies to cope with the age-related physiological derangement of vitamin D metabolism. The lesson deriving from centenarians' experience suggests that: i) severe vitamin D deficiency does not preclude the possibility of reaching extreme longevity, ii) strategies to prevent hypovitaminosis D may be useful to slow down the processes of "fragilization" occurring in aged people, iii) beneficial effects of vitamin D supplementation need to be confirmed regarding longevity.

Growth inhibition and apoptosis in colorectal cancer cells induced by Vitamin D-Nanoemulsion (NVD): involvement of Wnt/β-catenin and other signal transduction pathways

BACKGROUND

More than the two decades, the question of whether vitamin D has a role in cancer frequency, development, and death has been premeditated in detail. Colorectal, breast, and prostate cancers have been a scrupulous spot of center, altogether, these three malignancies report for approximately 35% of cancer cases and 20% of cancer demises in the United States, and as such are a chief public health apprehension. The aim was to evaluate antitumor activity of Vitamin D-Nanoemulsion (NVD) in colorectal cancer cell lines and HCT116 xenograft model in a comprehensive approach.

METHODS

Two human colorectal cancer cell lines HCT116 and HT29 (gained from College of Pharmacy, King Saud University, KSA were grown. 3-(4, 5-dimethylthiazol-2-yl)-2, 5-diphenyl tetrazoliumbromide protocol were performed to show the impact of NVD and β-catenin inhibitor (FH535) on the viability of HCT116 and HT29 cell lines. Apoptosis/cell cycle assay was performed. Analysis was done with a FACScan (Becton-Dickinson, NJ). About 10,000 cells per sample were harvested and Histograms of DNA were analyzed with ModiFitLT software (verity Software House, ME, USA). Western blotting and RT-PCR were performed for protein and gene expression respectively in in vitro and in vivo.

RESULTS

We found that NVD induced cytotoxicity in colorectal cells in a dose-dependent manner and time dependent approach. Further, our data validated that NVD administration of human colorectal cancer HCT116 and HT29 cells resulted in cell growth arrest, alteration in molecules regulating cell cycle operative in the G2 phase of the cell cycle and apoptosis in a dose dependent approach. Further our results concluded that NVD administration decreases expression of β-catenin gene, AKT gene and Survivin gene and protein expression in in vitro and in vivo.

CONCLUSION

Our findings suggest that targeting β-catenin gene may encourage the alterations of cell cycle and cell cycle regulators. Wnt/β-catenin signaling pathway possibly takes part in the genesis and progression of colorectal cancer cells through regulating cell cycle and the expression of cell cycle regulators.

Dietary Carcinogens and DNA Adducts in Prostate Cancer

Prostate cancer (PC) is the most commonly diagnosed non-cutaneous cancer and the second leading cause of cancer-related to death in men. The major risk factors for PC are age, family history, and African American ethnicity. Epidemiological studies have reported large geographical variations in PC incidence and mortality, and thus lifestyle and dietary factors influence PC risk. High fat diet, dairy products, alcohol and red meats, are considered as risk factors for PC. This book chapter provides a comprehensive, literature-based review on dietary factors and their molecular mechanisms of prostate carcinogenesis. A large portion of our knowledge is based on epidemiological studies where dietary factors such as cancer promoting agents, including high-fat, dairy products, alcohol, and cancer-initiating genotoxicants formed in cooked meats have been evaluated for PC risk. However, the precise mechanisms in the etiology of PC development remain uncertain. Additional animal and human cell-based studies are required to further our understandings of risk factors involved in PC etiology. Specific biomarkers of chemical exposures and DNA damage in the prostate can provide evidence of cancer-causing agents in the prostate. Collectively, these studies can improve public health research, nutritional education and chemoprevention strategies.

Vitamin D3 Level in Women with Uterine Fibroid: An Observational Study in Eastern Indian Population

Purpose

Vitamin D deficiency has been proposed to be a risk factor in the pathogenesis of uterine fibroid in few recently published studies conducted in Europe and Africa. Nevertheless, no study has ever addressed similar query in Indian women where hypovitaminosis is very common.

Methods

A total of 144 women of age group 20-50 years belonging to Jamshedpur, Jharkhand, India, were included in the study. Out of which, 72 women had uterine fibroids and rest healthy women without fibroids served as controls. All women were subjected to ultrasound examination of uterus followed by measurement of serum FSH level (on 3rd day of menstruation) and serum vitamin D₃.

Results

The mean serum concentration of vitamin D₃ was significantly lower in women with uterine fibroids compared to controls (10.81 ± 6.18 vs. 22.91 ± 16.18, p < 0.0001). On further analysis, 62.5% of cases were found to be severely deficient (vitamin D₃ < 10 ng/mL) as compared to 26.39% of controls (p < 0.0001). Besides that, only 2.77% of cases had sufficient vitamin D level as compared to 23.61% of controls (p = 0.0002). The odds ratio (OR) of occurrence of fibroid with serum vitamin D₃ level of < 10 ng/dl compared to that of level > 10 ng/dl was 4.64 (95% confidence interval [CI] 2.28-9.44) (p = 0.0001).

Conclusion

Serum vitamin D₃ level inversely correlated with burden of uterine fibroid and possibly its deficiency is a risk factor for uterine fibroid occurrence in eastern part of India.

Inhibition of tumor cell proliferation in human uterine leiomyomas by vitamin D via Wnt/β-catenin pathway

OBJECTIVE

To assess the effect of vitamin D (VitD) on human uterine leiomyomas through Wnt/β-catenin pathway inhibition, apoptosis induction, and cell growth arrest.

DESIGN

A prospective study comparing leiomyoma vs. myometrium tissues. Paired design study comparing human uterine leiomyoma primary (HULP) cells treated with or without VitD.

SETTING

University hospital.

PATIENT(S)

Human uterine leiomyoma and myometrium were collected from women (aged 35-52 years) without hormonal treatment.

INTERVENTION(S)

Samples were collected from women undergoing surgery due to symptomatic uterine leiomyoma pathology.

MAIN OUTCOME MEASURE(S)

Uterine leiomyoma and myometrium tissues were analyzed by western blot (WB) to determine proliferation, Wnt/β-catenin, and apoptosis pathways. HULP cells were used to study VitD effect in cell proliferation (WB), cell cycle (flow cytometry), Wnt/β-catenin and apoptosis genes (polymerase chain reaction arrays), Wnt-related proteins (protein array), and apoptosis (terminal deoxynucleotidyl transferase-mediated dUTP nick end-labeling [TUNEL] assay).

RESULTS

Human leiomyoma tissues compared with matched myometrium showed higher proliferation (fold change = 8.16; P=.0006) and altered Wnt/β-catenin pathway (fold change = 5.5; P<.0001), whereas no differences in apoptosis were observed. VitD induced cell growth arrest and decreased proliferation in HULP cells (fold change = 0.74; P=.007). Moreover, VitD decreased Wnt-pathway expression in HULP cells at gene (activity score = -0.775; P<.001) and protein levels. However, VitD did not induce apoptosis expression.

CONCLUSION

Increased proliferation and Wnt/β-catenin pathway deregulation play a role in the development and growth of leiomyomas, whereas apoptosis appears not to contribute. VitD exerts an antiproliferative action on HULP cells through cell growth arrest and Wnt/β-catenin pathway inhibition, but not through apoptosis regulation, suggesting VitD as an effective therapy to stabilize leiomyoma size and prevent its growth.

Leptin blocks the inhibitory effect of vitamin D on adipogenesis and cell proliferation in 3T3-L1 adipocytes

Recently, we demonstrated high serum leptin and 25(OH)D (calcidiol) in obese animals, with high C/EBP_β and PPAR_γ expression in adipose tissue. Since the role of vitamin D in adipogenesis remains controversial and hyperleptinemia is found in obesity, we asked if leptin could interfere in vitamin D action on adipocytes. Here, we studied the direct effect of these two hormones upon 3T3L1 preadipocytes incubated with or without 1,25(OH)2D (100 nM, 24 h) and with leptin (10^-7 M, 4 h later). RT-PCR (VDR and Cyp27b1/1α-hydroxylase), western blotting (VDR, Cyp27b1/1α-hydroxylase, ObR-b, C/EBP_β, PPAR_γ and Bax content), a cell proliferation assay and an Annexin V-FITC binding assay were performed. Incubation with 1,25(OH)2D decreased Cyp27b1/1α-hydroxylase and VDR. Co-incubation of 1,25(OH)2D and leptin did not change Cyp27b1/1α-hydroxylase and had no additive effect upon the decreased VDR mRNA. Incubation with 1,25(OH)2D decreased C/EBP_β and PPARγ. In the cell proliferation assay, 1,25(OH)2D decreased the number of 3T3L1 cells. No changes in OBR-b or apoptotic parameters (Bax and annexin-V) were observed. The 1,25(OH)2D decreased pro-adipogenic factors and proliferation of adipocytes. However, since it inhibits the conversion of 25(OH)D to 1,25(OH)2D and VDR mRNA long-term, it could decrease the vitamin D response in adipocytes, leading to greater adipogenesis. The co-incubation of both hormones, simulating what occurs in obesity, even neutralizing the effect on Cyp27b1/1α-hydroxylase, did not change the vitamin D sensitivity but decreased SOCS-3 and pSTAT-3. Thus, an excess of vitamin D and hyperleptinemia could decrease vitamin D sensitivity in adipocytes, contributing to increased adipogenesis.

Vitamin D and Uterine Fibroids-Review of the Literature and Novel Concepts

This article provides a detailed review of current knowledge on the role of vitamin D and its receptor in the biology and management of uterine fibroids (UFs). Authors present ideas for future steps in this area. A literature search was conducted in PubMed using the following key words: "uterine fibroid" and "vitamin D". The results of the available studies, published in English from January 2002 up to April 2018, have been discussed. Vitamin D is a group of steroid compounds with a powerful impact on many parts of the human body. This vitamin is believed to regulate cell proliferation and differentiation, inhibit angiogenesis, and stimulate apoptosis. Nowadays, hypovitaminosis D is believed to be a major risk factor in the development of UFs. In many studies vitamin D appears to be a powerful factor against UFs, resulting in inhibition of tumor cell division and a significant reduction in its size, however, the exact role of this compound and its receptor in the pathophysiology of UFs is not fully understood. According to available studies, vitamin D and its analogs seem to be promising, effective, and low-cost compounds in the management of UFs and their clinical symptoms, and the anti-tumor activities of vitamin D play an important role in UF biology. The synergy between vitamin D and selected anti-UF drugs is a very interesting issue which requires further research. Further studies about the biological effect of vitamin D on UF biology are essential. Vitamin D preparations (alone or as a co-drugs) could become new tools in the fight with UFs, with the additional beneficial pleiotropic effect.

Prognostic value of circulating vitamin D binding protein, total, free and bioavailable 25-hydroxy vitamin D in patients with colorectal cancer

Numerous studies have suggested that there was a significantly positive association between circulating total 25-hydroxyvitamin D (25(OH)D) and survival in colorectal cancer patients. Moreover, plasma vitamin D was also found significantly associated with the concentration of vitamin D binding protein (VDBP). However, there was no paper to clarify the prognostic value of VDBP, free and bioavailable 25(OH)D in colorectal carcinogenesis. The aim of this study was to comprehensively assess the prognostic value of VDBP, total, free and bioavailable 25(OH)D in stage I-III colorectal cancer patients. A total of 206 colorectal cancer patients were enrolled in this prospective study. Preoperative plasma total 25(OH)D and VDBP concentrations were measured by direct enzyme-linked immunosorbent assay, and albumin concentration was measured by Beckman automatic biochemical analyzer. Free and bioavailable 25(OH)D concentrations were calculated based on the concentrations of plasma VDBP, total 25(OH) D and albumin. X-title program was used to determine the optimal cut-off values of VDBP, total, free and bioavailable 25(OH)D. Results showed that elevated free and bioavailable 25(OH)D were significantly associated with better 5-year overall survival (OS) by univariate analysis. By multivariate cox analysis, we also found that the high level of free 25(OH)D (HR = 0.442, 95%CI = 0.238–0.819, P < 0.010) could be identified as an independent factor for better OS. In conclusion, our study suggested that higher levels of free and bioavailable 25(OH)D were associated with better OS in stage I-III colorectal cancer patients. Moreover, free 25(OH)D could be considered as an independent prognostic biomarker for OS.

Autophagy, apoptosis, vitamin D, and vitamin D receptor in hepatocellular carcinoma associated with hepatitis C virus

The aims of this study were to investigate the interplay between autophagy and apoptosis and to investigate the association between both of autophagy and apoptosis and vitamin D and its receptor in hepatitis C virus (HCV) viral infection and its implication in the progression into hepatocellular carcinoma (HCC).A cross-sectional study where serum levels of microtubule-associated protein 1A/1B-light chain 3 (LC3); marker of autophagy, caspase-3; marker of apoptosis, vitamin D3 and vitamin D receptor (VDR) were measured in healthy subjects as well as HCV and HCV-HCC patients using enzyme-linked immunosorbent assay technique.Collectively, the liver profile revealed hepatic dysfunctions in HCV patients with or without HCC. A significant reduction in the serum concentration levels LC3 and caspase-3 were observed referring to the down regulation of autophagy and host-mediated apoptosis in HCV patients with or without HCC. Deficiency of vitamin D and decreased levels of its receptor were observed in HCV and HCV-HCC patients.The perturbation in vitamin D/VDR axis, which modulates both of autophagy and apoptosis in HCV infection, may point out to its involvement and implication in the pathogenesis of HCV infection and the development of HCV-related HCC. Therefore, supplementation with vitamin D may not be the only solution to restore the vital biological functions of vitamin D but VDR-targeted therapy may be of great importance in this respect.

Changes in vitamin D endocrinology during aging in adults

Worldwide, vitamin D deficiency is a common finding. Within individuals 25-hydroxyvitamin D (25OH)D) concentrations remain fairly stable over time although large differences in individual longitudinal changes exist. During aging vitamin D metabolism and activity changes in several different ways. Intestinal resistance to 1,25(OH)2D develops which hampers intestinal calcium uptake. Vitamin D receptor number decreases with aging in several organs involved in calcium metabolism and 1alpha-hydroxylase activity decreases mainly due to a decrease in renal function reducing vitamin D activation. Effects of 1,25(OH)2D on cell proliferation and differentiation may influence potential anti-cancer effects whereas regulation of telomere length may result in longevity. In older individuals, vitamin D supplementation has positive effects on fracture risk, number of falls and physical function. Supplementation in older populations warrants specific attention. Effects on "non-classical" outcomes may be revealed by ongoing large randomized clinical trials with high doses of vitamin D.

Implications of the nutrition transition for vitamin D intake and status in Aboriginal groups in the Canadian Arctic

Aboriginal Canadians have low intakes of vitamin D and are shifting away from consumption of traditional foods. Higher body mass index, skin pigmentation, and geographic latitude of residence further predispose Canadian Aboriginal populations to low vitamin D status. Low vitamin D status could compromise bone health and other health outcomes. Studies assessing vitamin D status of different Aboriginal groups are limited. The aim of this review is to examine the literature on vitamin D status and intakes of Canadian Aboriginal populations living in the Arctic. PubMed was searched for relevant articles published from 1983 to 2013. The prevalence of 25-hydroxy vitamin D deficiency ranged from 13.9% to 76.0% among children and adults in the summer. Furthermore, mean vitamin D intakes among all age groups were below the estimated average requirement. As vitamin D deficiency has been recently associated with chronic diseases, and Aboriginal populations living in the Arctic are at high risk for low vitamin D status, their vitamin D status should be assessed regularly across seasons.

Dietary factors and polymorphisms in vitamin D metabolism genes: the risk and prognosis of colorectal cancer in northeast China

CYP24A1 and CYP27B1 are critical genes determining 1α,25(OH)₂D₃ concentration and impacting on carcinogenesis. A case–control study including 528 colorectal cancer (CRC) patients and 605 cancer-free controls and a follow-up study with 317 cases were conducted in northeast China. Genotypes were tested by TaqMan Genotyping Assays. Individuals carrying the GG genotype of CYP27B1 G > T (rs10877012) exhibited decreased CRC risk compared with those with the TT genotype (OR_adjusted (OR_adj) = 0.57, 95% Confidence Interval (CI) = 0.38–0.84). Compared with the TT genotype, a significant association between the CC genotype of CYP27B1 C > T (rs4646536) and a reduced risk of CRC was observed (OR_adj = 0.59, 95% CI = 0.40–0.88). We also observed significant combined effects of the two polymorphisms in CYP27B1 with dietary factors, including the intake of cereals, overnight meal, allium vegetables, pork, canned fruit, and braised fish, on CRC risk. These associations remained significant after Bonferroni correction for multiple comparisons. The Hazard Ration (HR) of patients with the AA genotype (CYP24A1 A > G, rs4809957) was 2.38 (95% CI = 1.30–4.37) when compared with the GG genotype. Thus, our findings suggested that two polymorphisms in CYP27B1 are associated with CRC susceptibility. CYP24A1 A > G (rs4809957) polymorphism may lead to a worse prognosis of CRC.

Behavioural Effects of Adult Vitamin D Deficiency in BALB/c Mice Are not Associated with Proliferation or Survival of Neurons in the Adult Hippocampus

Epidemiological studies have shown that up to one third of adults have insufficient levels of vitamin D and there is an association between low vitamin D concentrations and adverse brain outcomes, such as depression. Vitamin D has been shown to be involved in processes associated with neurogenesis during development. Therefore, the aim of this study was to test the hypothesis that adult vitamin D (AVD) deficiency in BALB/c mice was associated with (a) adult hippocampal neurogenesis at baseline, b) following 6 weeks of voluntary wheel running and (c) a depressive-like phenotype on the forced swim test (FST), which may be linked to alterations in hippocampal neurogenesis. We assessed proliferation and survival of adult born hippocampal neurons by counting the number of cells positive for Ki67 and doublecortin (DCX), and incorporation of 5-Bromo-2’-Deoxyuridine (BrdU) within newly born mature neurons using immunohistochemistry. There were no significant effects of diet on number of Ki67⁺, DCX⁺ or BrdU⁺ cells in the dentate gyrus. All mice showed significantly increased number of Ki67⁺ cells and BrdU incorporation, and decreased immobility time in the FST, after voluntary wheel running. A significant correlation was found in control mice between immobility time in the FST and level of hippocampal neurogenesis, however, no such correlation was found for AVD-deficient mice. We conclude that AVD deficiency was not associated with impaired proliferation or survival of adult born neurons in BALB/c mice and that the impact on rodent behaviour may not be due to altered neurogenesis per se, but to altered function of new hippocampal neurons or processes independent of adult neurogenesis.

1α,25(OH)2 Vitamin D3 Modulates Avian T Lymphocyte Functions without Inducing CTL Unresponsiveness

1,25-Dihydroxyvitamin D3 (Vitamin D) is a naturally synthesized fat soluble vitamin shown to have immunomodulatory, anti-inflammatory and cancer prevention properties in human and murine models. Here, we studied the effects of Vitamin D on the functional abilities of avian T lymphocytes using chicken Interferon (IFN)-γ ELISPOT assay, BrdU proliferation assay, Annexin V apoptosis assay and PhosFlow for detecting phosphorylated signalling molecules. The results demonstrate that Vitamin D significantly inhibited the abilities of T lymphocytes to produce IFN-γ and proliferate in vitro (P≤0.05), but retained their ability to undergo degranulation, which is a maker for cytotoxicity of these cells. Similarly, Vitamin D did not inhibit Extracellular signal-Regulated Kinase (ERK) 1/2 phosphorylation, a key mediator in T cell signalling, in the stimulated T lymphocytes population, while reduced ERK1/2 phosphorylation levels in the unstimulated cells. Our data provide evidence that Vitamin D has immuno-modulatory properties on chicken T lymphocytes without inducing unresponsiveness and by limiting immuno-pathology can promote protective immunity against infectious diseases of poultry.

Vitamin D (25-0H D3) status and pathological response to neoadjuvant chemotherapy in stage II/III breast cancer: Data from the NEOZOTAC trial (BOOG 10-01)

BACKGROUND

Serum levels of 25-OH vitamin D3 (vitamin D) have been shown to be prognostic for disease-free survival in patients with breast cancer. We investigated the predictive value of these levels for pathological response after neoadjuvant chemotherapy in patients with breast cancer taking part in the NEOZOTAC phase-III trial. Additionally, the effect of chemotherapy on vitamin D levels was studied.

MATERIALS AND METHODS

Serum vitamin D was measured at baseline and before the last cycle of chemotherapy. The relationship between these measurements and clinical outcome, as defined by pathological complete response in breast and lymph nodes (pCR) was examined.

RESULTS

Baseline and end of treatment vitamin D data were available in 169 and 91 patients, respectively. Median baseline vitamin D values were 58.0 nmol/L. In patients treated with chemotherapy only, serum vitamin D levels decreased during neoadjuvant chemotherapy (median decrease of 16 nmol/L, P = 0.003). The prevalence of vitamin D levels < 50 nmol/L increased from 38.3% at baseline to 55.9% after chemotherapy. In the total population, baseline and end of therapy vitamin D levels were not related to pathological response. No associations were found between pCR and vitamin D level changes.

CONCLUSION

The significant decrease in vitamin D post-neoadjuvant chemotherapy suggests that vitamin D levels should be monitored and in case of decrease of vitamin D levels, correction may be beneficial for skeletal health and possibly breast cancer outcome.

Resurgence of vitamin D: Old wine in new bottle

There are early references of it in ancient text and physicians have discussed its importance and features of its deficiency in the past. Vitamin D has again regained interest with recent dramatic rise in the incidence of deficiency in the developing as well as developing world. In this review article, we discuss the biochemical and role of vitamin D in the skeletal system. We also discuss the recommended dietary requirements and features of skeletal deficiency. Extra-skeletal roles of vitamin D deficiency have been a matter of debate lately and it has also been discussed in detail in this article. In conclusion, it would not be wrong to label vitamin D as one of the most important vitamin involved in the metabolism of the musculoskeletal system and any clinician, especially the orthopaedician, should be well versed with its overall mechanism and roles in the human body.

Role of vitamin D in uterine fibroid biology

OBJECTIVE

To provide a detailed summary of current scientific knowledge on uterine fibroids (leiomyomas) in vitro and in in vivo animal models, as well as to postulate the potential role of vitamin D3 as an effective, inexpensive, safe, long-term treatment option for uterine fibroids.

DESIGN

PubMed search articles were used to identify the most relevant studies on uterine fibroids, as well as effects of vitamin D3 on uterine fibroid cells and fibroid tumor growth in in vivo animal models.

SETTING

University research laboratory.

PATIENT(S)

Not applicable.

INTERVENTION(S)

None.

MAIN OUTCOME MEASURE(S)

Not applicable.

RESULT(S)

Despite numerous publications available on uterine fibroids, information about the role that vitamin D3 plays in the regulation of uterine fibroids is limited. Most of the recent vitamin D3-related studies on uterine fibroids were published from our group. Recent studies have demonstrated that vitamin D deficiency plays a significant role in the development of uterine fibroids. Our recent studies have demonstrated that vitamin D3 reduces leiomyoma cell proliferation in vitro and leiomyoma tumor growth in in vivo animal models. These results postulate the potential role of vitamin D3 for an effective, safe, nonsurgical medical treatment option for uterine fibroids.

CONCLUSION(S)

This article reviews human and animal studies and uncovers new possibilities for understanding the vitamin D-based therapeutic option for an effective, safe, long-term treatment of uterine fibroids. On the basis of these results, a clinical trial with vitamin D3 or a hypocalcemic analog, paricalcitol, may be warranted for nonsurgical medical treatment of uterine fibroids.

The role of telomeres and vitamin D in cellular aging and age-related diseases

Aging is a complex biological process characterized by a progressive decline of organ functions leading to an increased risk of age-associated diseases and death. Decades of intensive research have identified a range of molecular and biochemical pathways contributing to aging. However, many aspects regarding the regulation and interplay of these pathways are insufficiently understood. Telomere dysfunction and genomic instability appear to be of critical importance for aging at a cellular level. For example, age-related diseases and premature aging syndromes are frequently associated with telomere shortening. Telomeres are repetitive nucleotide sequences that together with the associated sheltrin complex protect the ends of chromosomes and maintain genomic stability. Recent studies suggest that micronutrients, such as vitamin D, folate and vitamin B12, are involved in telomere biology and cellular aging. In particular, vitamin D is important for a range of vital cellular processes including cellular differentiation, proliferation and apoptosis. As a result of the multiple functions of vitamin D it has been speculated that vitamin D might play a role in telomere biology and genomic stability. Here we review existing knowledge about the link between telomere biology and cellular aging with a focus on the role of vitamin D. We searched the literature up to November 2014 for human studies, animal models and in vitro experiments that addressed this topic.

Calcitriol reduces thrombospondin-1 and increases vascular endothelial growth factor in breast cancer cells: implications for tumor angiogenesis

Calcitriol, a potent antineoplastic vitamin D metabolite, inhibits proliferation, induces apoptosis and slows the growth of tumors. Calcitriol also may exert either antiangiogenic or proangiogenic effects depending on the tissue. Vascular endothelial growth factor (VEGF) and thrombospondin-1 (Tsp-1) are key factors involved in promoting and inhibiting angiogenesis, respectively. The effects of calcitriol on Tsp-1 have not been studied in the mammary gland, while VEGF regulation is not clear, since opposite outcomes have been demonstrated. Therefore, the present study was undertaken to investigate the effects of calcitriol on VEGF and Tsp-1 expression in primary breast tumor-derived cells and a panel of established breast cancer cell lines. In vivo studies in athymic mice were also performed in order to gain further insight into the biological effects of calcitriol on angiogenesis. Real time-PCR and ELISA analyses showed that calcitriol stimulated VEGF mRNA expression and protein secretion while elicited the opposite effect on Tsp-1 in 7 out of 8 cell lines studied, independently of the cell phenotype (P<0.05 in n=5). In vivo, calcitriol significantly inhibited the relative tumoral volume after 4 weeks of treatment; however, serum VEGF was higher in calcitriol-treated animals compared to controls (P<0.05). The integrated fluorescence intensity analysis of CD31, a vessel marker, showed that xenografted breast cancer cells developed tumors with similar vascular density regardless of the treatment. Nevertheless, larger necrotic areas were observed in the tumors of calcitriol-treated mice compared to controls. Since the antineoplastic activity of calcitriol has been consistently demonstrated in several studies including this one, our results suggest that the antitumoral effect of calcitriol in vivo involve different mechanisms not necessarily related to the inhibition of tumor vascularization. Overall, our findings indicate that calcitriol can impact the angiogenic process in breast cancer by regulating VEGF and Tsp-1 expression. This article is part of a Special Issue entitled '16th Vitamin D Workshop'.

Systematic review and meta-analysis on vitamin D receptor polymorphisms and cancer risk

The vitamin D receptor (VDR) can influence cancer susceptibility through binding to vitamin D. However, the previous studies were contradictory. Therefore this meta-analysis was conducted to clarify the association between VDR polymorphisms (BsmI, TaqI, FokI, and ApaI) and cancer risk. One hundred twenty-six studies were enrolled through PubMed. For VDR BsmI polymorphism, significantly increased cancer risks were observed in the overall analysis. In the further stratified analysis, increased risks were observed in colorectal and skin cancer, especially in Caucasian population. However, no significant associations were observed in other VDR polymorphisms in the overall analysis. In the further subgroup analysis, increased risks were found in oral, breast, and basal cell cancer while decreased risk was found in prostate cancer in t allele carriers of TaqI polymorphism. For VDR FokI polymorphism, increased risks were found in ovarian and skin cancer while decreased risk in glioma in f allele carriers. For VDR ApaI polymorphism, increased risk was observed in basal cell cancer, especially in Asian population in a allele carriers. In conclusion, these results indicated that b allele of BamI polymorphism was a risk factor for cancer susceptibility. Meanwhile, t allele of TaqI polymorphism was a risk factor for oral, breast, and basal cell cancer and a protective factor for prostate cancer. Moreover, f allele of FokI polymorphism was a risk factor for ovarian and skin cancer and a protective factor for glioma. Finally, a allele of ApaI polymorphism was a risk factor for basal cell cancer in Asian population.

Systematic review and meta-analysis on vitamin D receptor polymorphisms and cancer risk

The vitamin D receptor (VDR) can influence cancer susceptibility through binding to vitamin D. However, the previous studies were contradictory. Therefore this meta-analysis was conducted to clarify the association between VDR polymorphisms (BsmI, TaqI, FokI, and ApaI) and cancer risk. One hundred twenty-six studies were enrolled through PubMed. For VDR BsmI polymorphism, significantly increased cancer risks were observed in the overall analysis. In the further stratified analysis, increased risks were observed in colorectal and skin cancer, especially in Caucasian population. However, no significant associations were observed in other VDR polymorphisms in the overall analysis. In the further subgroup analysis, increased risks were found in oral, breast, and basal cell cancer while decreased risk was found in prostate cancer in t allele carriers of TaqI polymorphism. For VDR FokI polymorphism, increased risks were found in ovarian and skin cancer while decreased risk in glioma in f allele carriers. For VDR ApaI polymorphism, increased risk was observed in basal cell cancer, especially in Asian population in a allele carriers. In conclusion, these results indicated that b allele of BamI polymorphism was a risk factor for cancer susceptibility. Meanwhile, t allele of TaqI polymorphism was a risk factor for oral, breast, and basal cell cancer and a protective factor for prostate cancer. Moreover, f allele of FokI polymorphism was a risk factor for ovarian and skin cancer and a protective factor for glioma. Finally, a allele of ApaI polymorphism was a risk factor for basal cell cancer in Asian population.

1,25-dihydroxyvitamin d3 reduces extracellular matrix-associated protein expression in human uterine fibroid cells

Uterine fibroids (leiomyomas) are the most common benign tumors associated with excessive deposition of extracellular matrix (ECM)-associated proteins that increase fibroid tumorigenicity. Herein, we determined the expression levels of vitamin D receptor (VDR) protein in human uterine fibroids and compared these levels to those in adjacent normal myometrium. Using Western blot analysis, we found that more than 60% of uterine fibroids analyzed (25 of 40) expressed low levels of VDR. We also found that the biologically active 1,25-dihydroxyvitamin D3 (1,25[OH]2D3), which functions via binding to its nuclear VDR, induced VDR in a concentration-dependent manner and reduced ECM-associated fibrotic and proteoglycans expression in immortalized human uterine fibroid cell line (HuLM). At 1-10 nM concentrations, 1,25(OH)2D3 significantly induced (P < 0.05) nuclear VDR, which was further stimulated by higher concentrations of 1,25(OH)2D3 in HuLM cells. 1,25(OH)2D3 at 10 nM also significantly reduced (P < 0.05) the protein expression of ECM-associated collagen type 1, fibronectin, and plasminogen activator inhibitor-1 (PAI-1) in HuLM cells. We also found that 1,25(OH)2D3 reduced mRNA and protein expressions of proteoglycans such as fibromodulin, biglycan, and versican in HuLM cells. Moreover, the aberrant expression of structural smooth muscle actin fibers was reduced by 1,25(OH)2D3 treatment in a concentration-dependent manner in HuLM cells. Taken together, our results suggest that human uterine fibroids express reduced levels of VDR compared to the adjacent normal myometrium and that treatment with 1,25(OH)2D3 can potentially reduce the aberrant expression of major ECM-associated proteins in HuLM cells. Thus, 1,25(OH)2D3 might be an effective, safe, nonsurgical treatment option for human uterine fibroids.

Vitamin D receptor and colorectal cancer

Colorectal cancer (CRC) is the third cause of cancer-related morbidity and mortality in America following lung cancer and stomach cancer. In China and other Asian countries, increasingly Westernized diets have led to a high incidence of CRC. The vitamin D receptor (VDR) can mediate 1,25(OH)₂D₃ to regulate cell growth and differentiation in a variety of normal tissues or tumor tissues. VDR gene polymorphisms are closely related to the occurrence and development of CRC. This article summarizes the recent progress in understanding the relationship between VDR and CRC in terms of the structure and function of VDR, mechanisms of CRC inhibition, correlation between VDR polymorphisms and CRC, and the development of analogs of VDR ligands.

[Vitamin D and breast cancer: physiopathology, biological and clinical implications]

There is a recent increase in interest of vitamin D and breast cancer, facing the number of publications on the subject. This increase have several reasons, on the one hand, vitamin D deficiency is more and more prevalent and, on the other hand, there are new data that highlights the extra-bone effects of vitamin D, especially in breast cancer, the vitamin D is involved in the breast cancer risk factor, the prognosis, and the interaction with breast cancer treatments. This combination between vitamin D deficiency and breast cancer is extremely usual, and combined with all cancer clinical parameters: the incidence, the tumour biology, the clinical presentation, the prognosis, and the antineoplastic treatment tolerance. This vitamin D deficiency is increased after adjuvant cancer treatments. And yet, this problem increases bone metabolism disruptions in breast cancer patients, inducing osteoporotic risk at long time, even though this population is curable. This problem is therefore serious in the adjuvant breast cancer treatment. Unfortunately, in this population, the current recommendations are clearly insufficient, and the current randomized clinical trial results would contribute to define the best way to correct the vitamin D deficiency, quickly and secure.

Meta-analysis of the relation between the VDR gene TaqIpolymorphism and genetic susceptibility to prostate cancer in Asian populations

BACKGROUND

Polymorphisms of the Taq I gene have been associated with prostate cancer risk.

METHODS

We applied a fixed-effects model to combine odds ratios (ORs) and 95% confidence intervals (95% CI). The Egger's test was carried out to evaluate potential publication bias.

RESULTS

A total of 10 case-control studies enrolling 1,141 prostate cancer patients and 1,685 controls were included in this meta-analysis. Compared with the T allele, the OR for the C allele was 0.81 (0.70-0.94). The ORs for CT and CC+CT genotypes were 0.86 (0.74-1.01) and 0.84 (0.73-0.97) compared to wide type genotype (homozygote TT).

CONCLUSIONS

The present meta-analysis suggests that the TF gene Taq I polymorphism may reduce the prostate cancer risk in Asian populations.

Potent 19-norvitamin D analogs for prostate and liver cancer therapy

The active form of vitamin D(3), 1α,25(OH)(2)D(3) or calcitriol, is known to inhibit the proliferation and invasiveness of many types of cancer cells, including prostate and liver cancer cells. These findings support the use of 1α,25(OH)(2)D(3) for prostate and liver cancer therapy. However, 1α,25(OH)(2)D(3) can cause hypercalcemia, thus, analogs of 1α,25(OH)(2)D(3) that are less calcemic but exhibit potent antiproliferative activity would be attractive as therapeutic agents. We have developed 2α-functional group substituted 19-norvitamin D(3) analogs with and without 14-epimerization. Among them, 2α- and 2β-(3-hydroxypropyl)-1α,25-dihydroxy-19-norvitamin D(3) (MART-10 and -11, respectively) and 14-epi-2α- and 14-epi-2β-(3-hydroxypropyl)-1α,25-dihydroxy-19-norvitamin D(3) (14-epi-MART-10 and 14-epi-MART-11, respectively) were found to be the most promising. In this review, we discuss the synthesis of this unique class of vitamin D analogs, the molecular mechanism of anticancer actions of vitamin D, and the biological evaluation of these analogs for potential application to the prevention and treatment of prostate and liver cancer.

Serum vitamin D3 level inversely correlates with uterine fibroid volume in different ethnic groups: a cross-sectional observational study

PURPOSE

Currently there is no effective medicinal treatment for uterine fibroids (UFs), a common health disorder that affects women of reproductive age. Identification of modifiable risk factors such as vitamin D (Vit D) deficiency could help develop novel strategies for the prevention and/or treatment of UFs. The purpose of this study was to identify whether low serum Vit D3 levels correlate with increased risk of UFs.

METHODS

A total of 154 premenopausal women were recruited for this cross-sectional study. The control group comprised 50 subjects with a normal, fibroid-free uterine structure, confirmed by transvaginal ultrasonography. The 104 case subjects had at least one fibroid lesion that was 2 cm(3) in volume or larger, confirmed by transvaginal ultrasonography. For each case subject, total uterine volume and total volume of all existing fibroids were measured in three perpendicular planes, with volume determined according to the prolate ellipse formula (a × b × c × 0.523), where a is height, b is width, and c is depth. Serum Vit D [25(OH) D3] levels were measured by radioimmunoassay. The independent t-test was used to compare serum Vit D levels across groups. Correlations were assessed by Spearman's rank correlation test.

RESULTS

Lower serum 25-(OH) Vit D levels were significantly associated with the occurrence of UFs (P = 0.01). A statistically significant inverse correlation was also observed between serum 25-(OH) Vit D levels and total UF volume (r = -0.31; P = 0.002) within the case cohort. Subjects with larger fibroid volumes had lower serum Vit D levels and vice versa. Data stratified for ethnicity showed a statistically significant inverse correlation between serum 25-(OH) Vit D levels and total fibroid volume in black subjects (r = -0.42; P = 0.001). An inverse correlation was also evident in white subjects (r = -0.86; P = 0.58) but this did not reach statistical significance.

CONCLUSION

Lower serum Vit D levels are inversely correlated with UF burden in different ethnic groups. Vit D deficiency is a possible risk factor for the occurrence of UFs.