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Turck D, Bohn T, Castenmiller J, de Henauw S, Hirsch‐Ernst K, Knutsen HK, Maciuk A, Mangelsdorf I, McArdle HJ, Pentieva K, Siani A, Thies F, Tsabouri S, Vinceti M, Lietz G, Passeri G, Craciun I, Fabiani L, Horvath Z, Valtueña Martínez S, Naska A. Scientific opinion on the tolerable upper intake level for preformed vitamin A and β-carotene. EFSA J 2024; 22:e8814. [PMID: 38846679 PMCID: PMC11154838 DOI: 10.2903/j.efsa.2024.8814] [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] [Indexed: 06/09/2024] Open
Abstract
Following two requests from the European Commission, the EFSA Panel on Nutrition, Novel Foods and Food Allergens (NDA) was asked to deliver a scientific opinion on the revision of the tolerable upper intake level (UL) for preformed vitamin A and β-carotene. Systematic reviews of the literature were conducted for priority adverse health effects of excess vitamin A intake, namely teratogenicity, hepatotoxicity and endpoints related to bone health. Available data did not allow to address whether β-carotene could potentiate preformed vitamin A toxicity. Teratogenicity was selected as the critical effect on which to base the UL for preformed vitamin A. The Panel proposes to retain the UL for preformed vitamin A of 3000 μg RE/day for adults. This UL applies to men and women, including women of child-bearing age, pregnant and lactating women and post-menopausal women. This value was scaled down to other population groups using allometric scaling (body weight0.75), leading to ULs between 600 μg RE/day (infants 4-11 months) and 2600 μg RE/day (adolescents 15-17 years). Based on available intake data, European populations are unlikely to exceed the UL for preformed vitamin A if consumption of liver, offal and products thereof is limited to once per month or less. Women who are planning to become pregnant or who are pregnant are advised not to consume liver products. Lung cancer risk was selected as the critical effect of excess supplemental β-carotene. The available data were not sufficient and suitable to characterise a dose-response relationship and identify a reference point; therefore, no UL could be established. There is no indication that β-carotene intake from the background diet is associated with adverse health effects. Smokers should avoid consuming food supplements containing β-carotene. The use of supplemental β-carotene by the general population should be limited to the purpose of meeting vitamin A requirements.
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Lerner UH. Vitamin A - discovery, metabolism, receptor signaling and effects on bone mass and fracture susceptibility. Front Endocrinol (Lausanne) 2024; 15:1298851. [PMID: 38711977 PMCID: PMC11070503 DOI: 10.3389/fendo.2024.1298851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Accepted: 04/02/2024] [Indexed: 05/08/2024] Open
Abstract
The first evidence of the existence of vitamin A was the observation 1881 that a substance present in small amounts in milk was necessary for normal development and life. It was not until more than 100 years later that it was understood that vitamin A acts as a hormone through nuclear receptors. Unlike classical hormones, vitamin A cannot be synthesized by the body but needs to be supplied by the food as retinyl esters in animal products and ß-carotene in vegetables and fruits. Globally, vitamin A deficiency is a huge health problem, but in the industrialized world excess of vitamin A has been suggested to be a risk factor for secondary osteoporosis and enhanced susceptibility to fractures. Preclinical studies unequivocally have shown that increased amounts of vitamin A cause decreased cortical bone mass and weaker bones due to enhanced periosteal bone resorption. Initial clinical studies demonstrated a negative association between intake of vitamin A, as well as serum levels of vitamin A, and bone mass and fracture susceptibility. In some studies, these observations have been confirmed, but in other studies no such associations have been observed. One meta-analysis found that both low and high serum levels of vitamin A were associated with increased relative risk of hip fractures. Another meta-analysis also found that low levels of serum vitamin A increased the risk for hip fracture but could not find any association with high serum levels of vitamin A and hip fracture. It is apparent that more clinical studies, including large numbers of incident fractures, are needed to determine which levels of vitamin A that are harmful or beneficial for bone mass and fracture. It is the aim of the present review to describe how vitamin A was discovered and how vitamin A is absorbed, metabolized and is acting as a ligand for nuclear receptors. The effects by vitamin A in preclinical studies are summarized and the clinical investigations studying the effect by vitamin A on bone mass and fracture susceptibility are discussed in detail.
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Affiliation(s)
- Ulf H. Lerner
- Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Osteoporosis Centre and Centre for Bone and Arthritis Research at the Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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Skalny AV, Aschner M, Tsatsakis A, Rocha JB, Santamaria A, Spandidos DA, Martins AC, Lu R, Korobeinikova TV, Chen W, Chang JS, Chao JC, Li C, Tinkov AA. Role of vitamins beyond vitamin D 3 in bone health and osteoporosis (Review). Int J Mol Med 2024; 53:9. [PMID: 38063255 PMCID: PMC10712697 DOI: 10.3892/ijmm.2023.5333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Accepted: 11/15/2023] [Indexed: 12/18/2023] Open
Abstract
The objective of the present review was to summarize the molecular mechanisms associated with the effects of the vitamins A, C, E and K, and group B vitamins on bone and their potential roles in the development of osteoporosis. Epidemiological findings have demonstrated an association between vitamin deficiency and a higher risk of developing osteoporosis; vitamins are positively related to bone health upon their intake at the physiological range. Excessive vitamin intake can also adversely affect bone formation, as clearly demonstrated for vitamin A. Vitamins E (tocopherols and tocotrienols), K2 (menaquinones 4 and 7) and C have also been shown to promote osteoblast development through bone morphogenetic protein (BMP)/Smad and Wnt/β‑catenin signaling, as well as the TGFβ/Smad pathway (α‑tocopherol). Vitamin A metabolite (all‑trans retinoic acid) exerts both inhibitory and stimulatory effects on BMP‑ and Wnt/β‑catenin‑mediated osteogenesis at the nanomolar and micromolar range, respectively. Certain vitamins significantly reduce receptor activator of nuclear factor kappa‑B ligand (RANKL) production and RANKL/RANK signaling, while increasing the level of osteoprotegerin (OPG), thus reducing the RANKL/OPG ratio and exerting anti‑osteoclastogenic effects. Ascorbic acid can both promote and inhibit RANKL signaling, being essential for osteoclastogenesis. Vitamin K2 has also been shown to prevent vascular calcification by activating matrix Gla protein through its carboxylation. Therefore, the maintenance of a physiological intake of vitamins should be considered as a nutritional strategy for the prevention of osteoporosis.
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Affiliation(s)
- Anatoly V. Skalny
- Department of Medical Elementology, Peoples' Friendship University of Russia (RUDN University), Moscow 117198, Russia
- Center of Bioelementology and Human Ecology, IM Sechenov First Moscow State Medical University (Sechenov University), Moscow 119146, Russia
| | - Michael Aschner
- Department of Molecular Pharmacology, Albert Einstein College of Medicine, Bronx, NY 10461, USA
| | - Aristidis Tsatsakis
- Laboratory of Toxicology and Forensic Sciences, Division of Morphology, Medical School, University of Crete, 70013 Heraklion, Greece
| | - Joao B.T. Rocha
- Department of Biochemistry and Molecular Biology, CCNE, Federal University of Santa Maria, Santa Maria, RS 97105-900, Brazil
| | - Abel Santamaria
- Faculty of Science, National Autonomous University of Mexico, Mexico City 04510, Mexico
| | - Demetrios A. Spandidos
- Laboratory of Clinical Virology, Medical School, University of Crete, 70013 Heraklion, Greece
| | - Airton C. Martins
- Department of Molecular Pharmacology, Albert Einstein College of Medicine, Bronx, NY 10461, USA
| | - Rongzhu Lu
- Department of Preventive Medicine and Public Health Laboratory Science, School of Medicine, Jiangsu University, Zhenjiang, Jiangsu 212013, P.R. China
| | - Tatiana V. Korobeinikova
- Department of Medical Elementology, Peoples' Friendship University of Russia (RUDN University), Moscow 117198, Russia
- Center of Bioelementology and Human Ecology, IM Sechenov First Moscow State Medical University (Sechenov University), Moscow 119146, Russia
| | - Wen Chen
- Department of Toxicology, School of Public Health, Sun Yat-Sen University, Guangzhou, Guangdong 510080, P.R. China
| | - Jung-Su Chang
- College of Nutrition, Taipei Medical University, Taipei 110, Taiwan, R.O.C
| | - Jane C.J. Chao
- College of Nutrition, Taipei Medical University, Taipei 110, Taiwan, R.O.C
| | - Chong Li
- Department of Orthopedics, Affiliated Kunshan Hospital of Jiangsu University, Suzhou, Jiangsu 215300, P.R. China
| | - Alexey A. Tinkov
- Department of Medical Elementology, Peoples' Friendship University of Russia (RUDN University), Moscow 117198, Russia
- Center of Bioelementology and Human Ecology, IM Sechenov First Moscow State Medical University (Sechenov University), Moscow 119146, Russia
- Laboratory of Ecobiomonitoring and Quality Control, Yaroslavl State University, Yaroslavl 150003, Russia
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Moretti A, Liguori S, Paoletta M, Migliaccio S, Toro G, Gimigliano F, Iolascon G. Bone fragility during the COVID-19 pandemic: the role of macro- and micronutrients. Ther Adv Musculoskelet Dis 2023; 15:1759720X231158200. [PMID: 36937822 PMCID: PMC10015293 DOI: 10.1177/1759720x231158200] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Accepted: 02/01/2023] [Indexed: 03/18/2023] Open
Abstract
Bone fragility is the susceptibility to fracture due to poor bone strength. This condition is usually associated with aging, comorbidities, disability, poor quality of life, and increased mortality. International guidelines for the management of patients with bone fragility include a nutritional approach, mainly aiming at optimal protein, calcium, and vitamin D intakes. Several biomechanical features of the skeleton, such as bone mineral density (BMD), trabecular and cortical microarchitecture, seem to be positively influenced by micro- and macronutrient intake. Patients with major fragility fractures are usually poor consumers of dairy products, fruit, and vegetables as well as of nutrients modulating gut microbiota. The COVID-19 pandemic has further aggravated the health status of patients with skeletal fragility, also in terms of unhealthy dietary patterns that might adversely affect bone health. In this narrative review, we discuss the role of macro- and micronutrients in patients with bone fragility during the COVID-19 pandemic.
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Affiliation(s)
| | - Sara Liguori
- Department of Medical and Surgical Specialties
and Dentistry, University of Campania “Luigi Vanvitelli”, Naples,
Italy
| | - Marco Paoletta
- Department of Medical and Surgical Specialties
and Dentistry, University of Campania “Luigi Vanvitelli”, Naples,
Italy
| | - Silvia Migliaccio
- Department of Movement, Human and Health
Sciences, University of Rome “Foro Italico”, Rome, Italy
| | - Giuseppe Toro
- Department of Medical and Surgical Specialties
and Dentistry, University of Campania “Luigi Vanvitelli”, Naples,
Italy
| | - Francesca Gimigliano
- Department of Physical and Mental Health and
Preventive Medicine, University of Campania “Luigi Vanvitelli”, Naples,
Italy
| | - Giovanni Iolascon
- Department of Medical and Surgical Specialties
and Dentistry, University of Campania “Luigi Vanvitelli”, Naples,
Italy
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Vitamin A Nutritional Status Is a Key Determinant of Bone Mass in Children. Nutrients 2022; 14:nu14214694. [PMID: 36364956 PMCID: PMC9653699 DOI: 10.3390/nu14214694] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 10/24/2022] [Accepted: 11/02/2022] [Indexed: 11/09/2022] Open
Abstract
The bone mass increases that occur during the period of childhood are of great significance for maximizing the peak bone mass in adults and preventing for osteoporosis. Studies have reported that VA can improve the bone health in adults. Moreover, limited studies have assessed such associations in children. In this cross-sectional study including 426 children, we assessed the children’s plasma retinol concentration by liquid chromatography–mass spectrometry and the dietary intake of VA and carotenoids using a structured Food Frequency Questionnaire. Their bone mineral content and bone mineral density (BMD) were measured using dual-energy X-ray absorptiometry. After adjusting for potential confounders, the restricted cubic spline revealed an inverted U-shaped association between plasma retinol concentration and BMD; the estimated effects on the TBLH BMD per μmol/L increase in the plasma retinol concentration were 1.79 × 10−2 g/cm2 below 1.24 μmol/L and −5.78 × 10−3 g/cm2 above this point (p for non-linearity = 0.046). A multiple linear regression analysis revealed a positive association between the plasma retinol concentration and the TBLH BMC (β = 1.89, 95% CI: 1.64 × 10−1–3.62, p = 0.032). In conclusion, an appropriate plasma retinol concentration and greater intakes of dietary VA and β-carotene may enhance the bone mineral status of children who are aged 6–9 years.
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Ruiz-Romero C, Fernández-Puente P, González L, Illiano A, Lourido L, Paz R, Quaranta P, Perez-Pampín E, González A, Blanco FJ, Calamia V. Association of the serological status of rheumatoid arthritis patients with two circulating protein biomarkers: A useful tool for precision medicine strategies. Front Med (Lausanne) 2022; 9:963540. [PMID: 36388911 PMCID: PMC9651940 DOI: 10.3389/fmed.2022.963540] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 10/03/2022] [Indexed: 08/27/2023] Open
Abstract
Rheumatoid arthritis (RA) is an autoimmune disease characterized by chronic inflammation of the joints and presence of systemic autoantibodies, with a great clinical and molecular heterogeneity. Rheumatoid Factor (RF) and anti-citrullinated protein antibodies (ACPA) are routinely used for the diagnosis of RA. However, additional serological markers are needed to improve the clinical management of this disease, allowing for better patient stratification and the desirable application of precision medicine strategies. In the present study, we investigated those systemic molecular changes that are associated with the RF and ACPA status of RA patients. To achieve this objective, we followed a proteomic biomarker pipeline from the discovery phase to validation. First, we performed an iTRAQ-based quantitative proteomic experiment on serum samples from the RA cohort of the Hospital of Santiago de Compostela (CHUS). In this discovery phase, serum samples from the CHUS cohort were pooled according to their RF/ACPA status. Shotgun analysis revealed that, in comparison with the double negative group (RF-/ACPA-), the abundance of 12 proteins was altered in the RF+/ACPA+ pool, 16 in the RF+/ACPA- pool and 10 in the RF-/ACPA+ pool. Vitamin D binding protein and haptoglobin were the unique proteins increased in all the comparisons. For the verification phase, 80 samples from the same cohort were analyzed individually. To this end, we developed a Multiple Reaction Monitoring (MRM) method that was employed in a comprehensive targeted analysis with the aim of verifying the results obtained in the discovery phase. Thirty-one peptides belonging to 12 proteins associated with RF and/or ACPA status were quantified by MRM. In a final validation phase, the serum levels of alpha-1-acid glycoprotein 1 (A1AG1), haptoglobin (HPT) and retinol-binding protein 4 (RET4) were measured by immunoassays in the RA cohort of the Hospital of A Coruña (HUAC). The increase of two of these putative biomarkers in the double seropositive group was validated in 260 patients from this cohort (p = 0.009 A1AG1; p = 0.003 HPT). The increased level of A1AG1 showed association with RF rather than ACPA (p = 0.023), whereas HPT showed association with ACPA rather than RF (p = 0.013). Altogether, this study has allowed a further classification of the RA seropositive patients into two novel clusters: RF+A1AG+ and ACPA+HPT+. The determination of A1AG1 and HPT in serum would provide novel information useful for RA patient stratification, which could facilitate the effective implementation of personalized medicine in routine clinical practice.
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Affiliation(s)
- Cristina Ruiz-Romero
- Unidad de Proteómica, Grupo de Investigación de Reumatología (GIR), Instituto de Investigación Biomédica de A Coruña (INIBIC), Complexo Hospitalario Universitario de A Coruña (CHUAC), Sergas, Universidade da Coruña (UDC), A Coruña, Spain
- Centro de Investigación Biomédica en Red de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Madrid, Spain
| | - Patricia Fernández-Puente
- Centro de Investigaciones Científicas Avanzadas (CICA), Universidad de A Coruña (UDC), A Coruña, Spain
| | - Lucía González
- Unidad de Proteómica, Grupo de Investigación de Reumatología (GIR), Instituto de Investigación Biomédica de A Coruña (INIBIC), Complexo Hospitalario Universitario de A Coruña (CHUAC), Sergas, Universidade da Coruña (UDC), A Coruña, Spain
| | - Anna Illiano
- CEINGE—Advanced Biotechnology, Naples, Italy
- Department of Chemical Sciences, University of Naples Federico II, Naples, Italy
| | - Lucía Lourido
- Unidad de Proteómica, Grupo de Investigación de Reumatología (GIR), Instituto de Investigación Biomédica de A Coruña (INIBIC), Complexo Hospitalario Universitario de A Coruña (CHUAC), Sergas, Universidade da Coruña (UDC), A Coruña, Spain
| | - Rocío Paz
- Unidad de Proteómica, Grupo de Investigación de Reumatología (GIR), Instituto de Investigación Biomédica de A Coruña (INIBIC), Complexo Hospitalario Universitario de A Coruña (CHUAC), Sergas, Universidade da Coruña (UDC), A Coruña, Spain
| | - Patricia Quaranta
- Unidad de Proteómica, Grupo de Investigación de Reumatología (GIR), Instituto de Investigación Biomédica de A Coruña (INIBIC), Complexo Hospitalario Universitario de A Coruña (CHUAC), Sergas, Universidade da Coruña (UDC), A Coruña, Spain
| | - Eva Perez-Pampín
- Laboratorio de Investigación 10 and Rheumatology Unit, Instituto de Investigación Sanitaria (IDIS), Hospital Clínico Universitario de Santiago (CHUS), Santiago de Compostela, Spain
| | - Antonio González
- Laboratorio de Investigación 10 and Rheumatology Unit, Instituto de Investigación Sanitaria (IDIS), Hospital Clínico Universitario de Santiago (CHUS), Santiago de Compostela, Spain
| | - Francisco J. Blanco
- Unidad de Proteómica, Grupo de Investigación de Reumatología (GIR), Instituto de Investigación Biomédica de A Coruña (INIBIC), Complexo Hospitalario Universitario de A Coruña (CHUAC), Sergas, Universidade da Coruña (UDC), A Coruña, Spain
- Grupo de Investigación de Reumatología y Salud (GIR-S), Departamento de Fisioterapia, Medicina y Ciencias Biomédicas, Facultad de Fisioterapia, Universidade da Coruña (UDC), A Coruña, Spain
| | - Valentina Calamia
- Unidad de Proteómica, Grupo de Investigación de Reumatología (GIR), Instituto de Investigación Biomédica de A Coruña (INIBIC), Complexo Hospitalario Universitario de A Coruña (CHUAC), Sergas, Universidade da Coruña (UDC), A Coruña, Spain
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Li Y, Liu J, Zhou H, Liu J, Xue X, Wang L, Ren S. Liquid chromatography-mass spectrometry method for discovering the metabolic markers to reveal the potential therapeutic effects of naringin on osteoporosis. J Chromatogr B Analyt Technol Biomed Life Sci 2022; 1194:123170. [DOI: 10.1016/j.jchromb.2022.123170] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Revised: 02/02/2022] [Accepted: 02/10/2022] [Indexed: 12/15/2022]
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Baybutt RC, Standard JT, Dim D, Quinn T, Hamdan H, Lin D, Kunz K, Bomstein ZS, Estorge BJ, Herndon B, Zia H, Mansour A, Lankachandra M, Molteni A. Cod Liver Oil, but Not Retinoic Acid, Treatment Restores Bone Thickness in a Vitamin A-Deficient Rat. Nutrients 2022; 14:486. [PMID: 35276845 PMCID: PMC8838835 DOI: 10.3390/nu14030486] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Revised: 01/19/2022] [Accepted: 01/19/2022] [Indexed: 02/01/2023] Open
Abstract
Vitamin A plays a prominent role for maintaining optimal bone status, but its impact upon the bone in response to vitamin A deficiency is not well defined. The purpose of this study was to evaluate how replenishing vitamin A by either whole food cod liver oil (COD) or the active metabolite of vitamin A, retinoic acid (RA), altered bone thickness of vitamin A-deficient (VAD) rats. Weanling rats were administered a control diet (CTRL) or VAD diet for 9 weeks. This was followed by four weeks of treatment in which the VAD group was divided into the following 4 subgroups: (1) VAD (9 weeks)-VAD (4 weeks); (2) VAD-CTRL; (3) VAD-COD; and (4) VAD-RA. Compared to controls, VAD rats had thicker bones which showed marked dysplasia. VAD-rats treated with COD produced a thinner bone that was not significantly different from that of untreated rats. In contrast, RA did not significantly change the thicker bone, and also had significantly greater periosteal and endosteal osteoblast numbers compared to VAD-COD. Active osteoclasts were not detected in VAD rats, nor during the treatment period. These findings suggest that the abnormal bone thickness in VAD rats appears to be more effectively restored to bone thickness of untreated control rats when treated with COD.
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Affiliation(s)
- Richard C. Baybutt
- Department of Applied Health Science, Wheaton College, Wheaton, IL 60187, USA; (J.T.S.); (K.K.)
- Department of Nutrition Science, East Carolina University, Greenville, NC 27834, USA; (Z.S.B.); (B.J.E.)
| | - Joseph T. Standard
- Department of Applied Health Science, Wheaton College, Wheaton, IL 60187, USA; (J.T.S.); (K.K.)
| | - Daniel Dim
- Department of Pathology and Pharmacology, UMKC School of Medicine, Kansas City, MO 64110, USA; (D.D.); (T.Q.); (H.H.); (B.H.); (H.Z.); (A.M.); (A.M.)
| | - Tim Quinn
- Department of Pathology and Pharmacology, UMKC School of Medicine, Kansas City, MO 64110, USA; (D.D.); (T.Q.); (H.H.); (B.H.); (H.Z.); (A.M.); (A.M.)
| | - Hana Hamdan
- Department of Pathology and Pharmacology, UMKC School of Medicine, Kansas City, MO 64110, USA; (D.D.); (T.Q.); (H.H.); (B.H.); (H.Z.); (A.M.); (A.M.)
| | - Dingbo Lin
- Department of Nutritional Sciences, Oklahoma State University, Stillwater, OK 74078, USA;
| | - Kyle Kunz
- Department of Applied Health Science, Wheaton College, Wheaton, IL 60187, USA; (J.T.S.); (K.K.)
| | - Zachary S. Bomstein
- Department of Nutrition Science, East Carolina University, Greenville, NC 27834, USA; (Z.S.B.); (B.J.E.)
| | - Benjamin J. Estorge
- Department of Nutrition Science, East Carolina University, Greenville, NC 27834, USA; (Z.S.B.); (B.J.E.)
| | - Betty Herndon
- Department of Pathology and Pharmacology, UMKC School of Medicine, Kansas City, MO 64110, USA; (D.D.); (T.Q.); (H.H.); (B.H.); (H.Z.); (A.M.); (A.M.)
| | - Hamid Zia
- Department of Pathology and Pharmacology, UMKC School of Medicine, Kansas City, MO 64110, USA; (D.D.); (T.Q.); (H.H.); (B.H.); (H.Z.); (A.M.); (A.M.)
| | - Ahmad Mansour
- Department of Pathology and Pharmacology, UMKC School of Medicine, Kansas City, MO 64110, USA; (D.D.); (T.Q.); (H.H.); (B.H.); (H.Z.); (A.M.); (A.M.)
| | - Manesha Lankachandra
- Englewood Orthopedic Associates, 410 South Van Brunt Street, Englewood, NJ 07631, USA;
| | - Agostino Molteni
- Department of Pathology and Pharmacology, UMKC School of Medicine, Kansas City, MO 64110, USA; (D.D.); (T.Q.); (H.H.); (B.H.); (H.Z.); (A.M.); (A.M.)
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Harris M, Varnell C, Taylor V, Nehus ST, Zhang B, Erkan E. Hypervitaminosis A in Pediatric Patients With Advanced Chronic Kidney Disease. J Ren Nutr 2021; 32:275-281. [PMID: 34103212 PMCID: PMC8643365 DOI: 10.1053/j.jrn.2021.03.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Revised: 03/07/2021] [Accepted: 03/14/2021] [Indexed: 11/11/2022] Open
Abstract
OBJECTIVE Hypervitaminosis A is well-described but overlooked in chronic kidney disease (CKD) and has been associated with hypercalcemia, contributing to mineral bone disease. Our objective is to assess prevalence of hypervitaminosis A and its association with bone health in an advanced-CKD population. METHODS We performed a retrospective review of 58 children with CKD 4-5 to examine the association between vitamin A levels and bone health and compared these values between a primarily formula-fed (FF) and nonprimarily formula-fed cohort (NFF). RESULTS Fifty-six of 58 patients (97%) had hypervitaminosis A with a mean vitamin A level of 1,475 ± 597 mcg/dL. When compared with the upper limit of normal vitamin A level for age, the FF group's vitamin A level was 2.9x upper limit of normal and the NFF group's vitamin A level was 2.2x upper limit of normal (P = .02). The mean calcium level was 10.3 mg/dL in the FF group and 9.8 mg/dL in the NFF group (P = .057). Percent of patients lower than, within, or greater than goal parathyroid hormone range was statistically significant with 15 (62%) of the FF group lower than goal and 16 (72%) of the NFF cohort greater than goal (P = .006). CONCLUSIONS We concluded vitamin A and calcium levels are higher in the FF versus the NFF population. FF patients are more likely to have parathyroid hormone levels lower than the goal range, placing them at risk for adynamic bone disease. We recommend monitoring vitamin A levels as part of routine nutritional assessments and dietary interventions to prevent hypervitaminosis A to improve bone health in late CKD.
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Affiliation(s)
- Meredith Harris
- Division of Nephrology & Hypertension, Cincinnati Children's Hospital Medical Center, Cincinnati, OH.
| | - Charles Varnell
- Division of Nephrology & Hypertension, Cincinnati Children's Hospital Medical Center, Cincinnati, OH; University of Cincinnati College of Medicine, Cincinnati, OH; James M. Anderson Center for Health Systems Excellence, Cincinnati, OH
| | - Veronica Taylor
- Division of Nephrology, University of Nebraska Medical Center and Children's Hospital and Medical Center, Omaha, NE
| | - Susan Tulley Nehus
- Division of Nephrology & Hypertension, Cincinnati Children's Hospital Medical Center, Cincinnati, OH
| | - Bin Zhang
- University of Cincinnati College of Medicine, Cincinnati, OH; Division is Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH
| | - Elif Erkan
- Division of Nephrology & Hypertension, Cincinnati Children's Hospital Medical Center, Cincinnati, OH; University of Cincinnati College of Medicine, Cincinnati, OH
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10
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Mapping Regional Cortical Bone Responses to Local Changes in Loading and Systemic Stimuli. Methods Mol Biol 2021. [PMID: 32979209 DOI: 10.1007/978-1-0716-0989-7_16] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register]
Abstract
Quantification of cortical bone mass and architecture using μCT is commonplace in osteoporosis and osteoarthritis research. Different groups often report substantially divergent mouse cortical bone responses to nominally comparable interventions. In the case of studies assessing bones' responses to externally applied loading, these differences are commonly associated with methodological differences in the loading regime. This chapter describes a widely published, standardized method of in vivo mouse tibia axial loading to produce lamellar bone formation. Despite uniform application of axial loading, changes in bone mass are highly site-specific within individual bones. For example, the mouse proximal tibia rapidly accrues new bone following axial loading, but this osteogenic response tapers to produce undetectable differences distally. Consequently, the bone sites selected for comparisons substantially influence the magnitude of differences observed. Application of the freely available Site Specificity software allows site-specific responses to be identified by rapidly quantifying cortical bone mass at each 1% site along the bone's length. This high-content screening tool has been informatively applied to study the local effects of changes in loading as well as systemic interventions including hormonal treatment and aging. Automated multisite analyses of cortical mass is increasingly identifying site-specific effects of "systemic" interventions such as global gene deletions. Biological mechanisms underlying this apparent regionalization of cortical responses are largely unknown but may start to be elucidated by increasingly widespread application of Site Specificity methods.
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Yee MMF, Chin KY, Ima-Nirwana S, Wong SK. Vitamin A and Bone Health: A Review on Current Evidence. Molecules 2021; 26:1757. [PMID: 33801011 PMCID: PMC8003866 DOI: 10.3390/molecules26061757] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 03/18/2021] [Accepted: 03/18/2021] [Indexed: 11/16/2022] Open
Abstract
Vitamin A is a fat-soluble micronutrient essential for growth, immunity, and good vision. The preformed retinol is commonly found in food of animal origin whereas provitamin A is derived from food of plant origin. This review summarises the current evidence from animal, human and cell-culture studies on the effects of vitamin A towards bone health. Animal studies showed that the negative effects of retinol on the skeleton were observed at higher concentrations, especially on the cortical bone. In humans, the direct relationship between vitamin A and poor bone health was more pronounced in individuals with obesity or vitamin D deficiency. Mechanistically, vitamin A differentially influenced the stages of osteogenesis by enhancing early osteoblastic differentiation and inhibiting bone mineralisation via retinoic acid receptor (RAR) signalling and modulation of osteocyte/osteoblast-related bone peptides. However, adequate vitamin A intake through food or supplements was shown to maintain healthy bones. Meanwhile, provitamin A (carotene and β-cryptoxanthin) may also protect bone. In vitro evidence showed that carotene and β-cryptoxanthin may serve as precursors for retinoids, specifically all-trans-retinoic acid, which serve as ligand for RARs to promote osteogenesis and suppressed nuclear factor-kappa B activation to inhibit the differentiation and maturation of osteoclasts. In conclusion, we suggest that both vitamin A and provitamin A may be potential bone-protecting agents, and more studies are warranted to support this hypothesis.
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Affiliation(s)
| | | | | | - Sok Kuan Wong
- Department of Pharmacology, Faculty of Medicine, University Kebangsaan Malaysia, Jalan Yaacob Latif, Bandar Tun Razak, Cheras 56000, Kuala Lumpur, Malaysia; (M.M.F.Y.); (K.-Y.C.); (S.I.-N.)
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Temova Rakuša Ž, Škufca P, Kristl A, Roškar R. Quality control of retinoids in commercial cosmetic products. J Cosmet Dermatol 2020; 20:1166-1175. [PMID: 32813932 DOI: 10.1111/jocd.13686] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Revised: 07/29/2020] [Accepted: 08/14/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND Retinoids are widely used in different cosmetic products because of general improvement of skin appearance. However, retinoid concentration in cosmetics is restricted, and one particular form-retinoic acid, is banned in cosmetics due to safety reasons. AIMS Within this study, we aimed to examine the quality of a considerable number of commercial retinoid cosmetic products in terms of their content and labeling, including also screening for the presence of retinoic acid. METHODS An appropriate analytical methodology, based on HPLC-UV for the simultaneous determination of common retinoids, along with a screening method for retinoic acid, was developed and validated. Structural identity confirmation of the newer retinoid-hydroxypinacolone retinoate, was performed by LC-MS. RESULTS Retinol and retinyl palmitate were most often found, in concentrations mostly below 0.3%, and up to 1.3% retinol equivalents. Determined contents deviated significantly from the quantitatively declared ones in seven products (0%-130%). In more than half of the tested products, inconsistencies between the contained and labeled retinoid were noticed. These products, as well as 14 additional anti-age cosmetics, were screened for retinoic acid, which was detected in two products. CONCLUSIONS The obtained results from retinoids assay in commercial cosmetic products confirmed that the proposed method is appropriate for their routine analysis. The presence of retinoic acid in two products and determined retinoid contents above the Scientific Committee on Consumer Safety recommendations in 20% of the tested cosmetics reveal the need for their more strict regulation and quality control to ensure their efficacy and safety.
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Affiliation(s)
| | - Petja Škufca
- Faculty of Pharmacy, University of Ljubljana, Ljubljana, Slovenia
| | - Albin Kristl
- Faculty of Pharmacy, University of Ljubljana, Ljubljana, Slovenia
| | - Robert Roškar
- Faculty of Pharmacy, University of Ljubljana, Ljubljana, Slovenia
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Yan Y, Wang L, Ge L, Pathak JL. Osteocyte-Mediated Translation of Mechanical Stimuli to Cellular Signaling and Its Role in Bone and Non-bone-Related Clinical Complications. Curr Osteoporos Rep 2020; 18:67-80. [PMID: 31953640 DOI: 10.1007/s11914-020-00564-9] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
PURPOSE OF REVIEW Osteocytes comprise > 95% of the cellular component in bone tissue and produce a wide range of cytokines and cellular signaling molecules in response to mechanical stimuli. In this review, we aimed to summarize the molecular mechanisms involved in the osteocyte-mediated translation of mechanical stimuli to cellular signaling, and discuss their role in skeletal (bone) diseases and extra-skeletal (non-bone) clinical complications. RECENT FINDINGS Two decades before, osteocytes were assumed as a dormant cells buried in bone matrix. In recent years, emerging evidences have shown that osteocytes are pivotal not only for bone homeostasis but also for vital organ functions such as muscle, kidney, and heart. Osteocyte mechanotransduction regulates osteoblast and osteoclast function and maintains bone homeostasis. Mechanical stimuli modulate the release of osteocyte-derived cytokines, signaling molecules, and extracellular cellular vesicles that regulate not only the surrounding bone cell function and bone homeostasis but also the distant organ function in a paracrine and endocrine fashion. Mechanical loading and unloading modulate the osteocytic release of NO, PGE2, and ATPs that regulates multiple cellular signaling such as Wnt/β-catenin, RANKL/OPG, BMPs, PTH, IGF1, VEGF, sclerostin, and others. Therefore, the in-depth study of the molecular mechanism of osteocyte mechanotransduction could unravel therapeutic targets for various bone and non-bone-related clinical complications such as osteoporosis, sarcopenia, and cancer metastasis to bone.
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Affiliation(s)
- Yongyong Yan
- Key Laboratory of Oral Medicine, Guangzhou Institute of Oral Disease, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangzhou, 510140, China
| | - Liping Wang
- Key Laboratory of Oral Medicine, Guangzhou Institute of Oral Disease, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangzhou, 510140, China
| | - Linhu Ge
- Key Laboratory of Oral Medicine, Guangzhou Institute of Oral Disease, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangzhou, 510140, China.
| | - Janak L Pathak
- Key Laboratory of Oral Medicine, Guangzhou Institute of Oral Disease, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangzhou, 510140, China.
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