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Lazarus G, Putra IGNS, Junaidi MC, Oswari JS, Oswari H. The relationship of vitamin D deficiency and childhood diarrhea: a systematic review and meta-analysis. BMC Pediatr 2024; 24:125. [PMID: 38365626 PMCID: PMC10870643 DOI: 10.1186/s12887-024-04599-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Accepted: 01/29/2024] [Indexed: 02/18/2024] Open
Abstract
INTRODUCTION Vitamin D deficiency may increase the risk of childhood diarrhea. We aim to carry out a review and meta-analysis of the evidence relating vitamin D insufficiency to childhood diarrhea. METHODS We searched PubMed, Ovid, Scopus, and Cochrane Library (from inception to August 2022), then independently reviewed the eligibility, and read full-text reviews for selected articles. Keywords used were 'vitamin D', '25-hydroxyvitamin D', 'vitamin D deficiency', 'diarrhea', 'gastroenteritis', 'children', and 'pediatric'. The search was limited to studies only in English and with available full-text. Year limitation was not applied in our search. Unpublished trials, dissertations, preliminary reports, conference abstracts, and repositories were excluded from the study. Newcastle-Ottawa Scale was used as the risk of bias assessment tool. Meta-analysis using the random-effects model was done. RESULTS Out of 5,565 articles, 12 articles were included in our systematic review, however only 7 articles were eligible for meta-analysis. Meta-analysis showed a statistically significant association between vitamin D deficiency and diarrhea in children in developing countries (OR = 1.79; 95% CI = 1.15 to 2.80; p = 0.01). On the secondary outcome, the association of vitamin D deficiency and duration or recurrences of diarrhea are conflicting. CONCLUSIONS There is an association between vitamin D deficiency and the prevalence of diarrhea. Future studies should evaluate the causal association, the impact of vitamin D deficiency on the severity of diarrhea, and whether vitamin D deficiency treatments affects the prevalence of diarrhea.
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Affiliation(s)
- Glen Lazarus
- Department of Child Health, Gastrohepatology Division, Cipto Mangunkusumo Hospital, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - I Gusti Ngurah Sanjaya Putra
- Department of Child Health, Gastroenterology and Hepatology Division, Medical School, Universitas Udayana, Bali, Indonesia
| | - Michelle Clarissa Junaidi
- Department of Child Health, Gastrohepatology Division, Cipto Mangunkusumo Hospital, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Jessica Sylvania Oswari
- Department of Child Health, Gastrohepatology Division, Cipto Mangunkusumo Hospital, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Hanifah Oswari
- Department of Child Health, Gastrohepatology Division, Cipto Mangunkusumo Hospital, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia.
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Calcaterra V, Magenes VC, Tagi VM, Grazi R, Bianchi A, Cena H, Zuccotti G, Fabiano V. Association between Vitamin D Levels, Puberty Timing, and Age at Menarche. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1243. [PMID: 37508740 PMCID: PMC10378582 DOI: 10.3390/children10071243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Revised: 07/15/2023] [Accepted: 07/18/2023] [Indexed: 07/30/2023]
Abstract
Pubertal development represents the process of physical maturation where an adolescent reaches sexual maturity and attains reproductive function. The effects of vitamin D are mainly mediated by the vitamin D receptor (VDR), which is expressed in almost all body cells, including the ovary and human pituitary gland and animal hypothalamus. Thus, vitamin D has gained great interest as pathogenic factor of pubertal disorders and fertility. This narrative review aimed to provide a broad overview of the available literature regarding the association between vitamin D levels, puberty timing, and age at menarche. A review of the data on the involvement of micronutrient deficiency, as a modifiable cause of pubertal disorders, is important for the prediction and prevention of deficiencies as well as for fertility protection and should be considered a public health priority. Reported data support that vitamin D is a regulator of neuroendocrine and ovarian physiology and, more in detail, a deficiency of vitamin D is involved in altered pubertal timing. Considering the long-term consequences of early pubertal development and early menarche, the detection of modifiable causes is crucial in preventive strategies. Future studies in humans and with an increased scale are needed to elucidate the vitamin D role in sexual maturation and puberty development.
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Affiliation(s)
- Valeria Calcaterra
- Department of Internal Medicine and Therapeutics, University of Pavia, 27100 Pavia, Italy
- Pediatric Department, Buzzi Children's Hospital, 20154 Milano, Italy
| | | | | | - Roberta Grazi
- Pediatric Department, Buzzi Children's Hospital, 20154 Milano, Italy
| | - Alice Bianchi
- Pediatric Department, Buzzi Children's Hospital, 20154 Milano, Italy
| | - Hellas Cena
- Laboratory of Dietetics and Clinical Nutrition, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy
- Clinical Nutrition and Dietetics Service, Unit of Internal Medicine and Endocrinology, Clinical Scientific Institutes Maugeri IRCCS, 27100 Pavia, Italy
| | - Gianvincenzo Zuccotti
- Pediatric Department, Buzzi Children's Hospital, 20154 Milano, Italy
- Department of Biomedical and Clinical Science, University of Milano, 20157 Milano, Italy
| | - Valentina Fabiano
- Pediatric Department, Buzzi Children's Hospital, 20154 Milano, Italy
- Department of Biomedical and Clinical Science, University of Milano, 20157 Milano, Italy
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Hashemian H, Shams SE, Salehi S, Dara N, Maroufizadeh S, HassanzadehRad A, Esfandiari MA, Dalili S. Is There a Correlation Between Vitamin D Levels and Acute Diarrhea in Children? ARCHIVES OF PEDIATRIC INFECTIOUS DISEASES 2023; 11. [DOI: 10.5812/pedinfect-135494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 04/08/2023] [Accepted: 04/13/2023] [Indexed: 09/13/2023]
Abstract
Background: Some studies have shown that low vitamin D is a risk factor for infectious diarrhea, but some have rejected it. Objectives: Considering the high prevalence of infectious diarrhea among children, the high prevalence of vitamin D deficiency, and the possible mutual effect of these two, the present study aimed to measure vitamin D in children with acute diarrhea. Methods: This study enrolled 222 children aged 2 - 14 in healthy control and acute diarrhea groups. The 25-hydroxyvitamin D (25(OH)D) level was measured in all samples by the Chemiluminescent Immunoassays (CLIA) method. Results: The mean age of the participants was 5 ± 2.7 years. Patients with acute diarrhea had lower vitamin D than healthy controls (P = 0.04). The frequency of deficient and insufficient vitamin D levels was higher in the acute diarrhea group than in the healthy control group, but insignificantly (P = 0.146). Conclusions: The present study revealed an association between insufficient vitamin D and acute diarrhea. Hence, low vitamin D is a risk factor for acute diarrhea.
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Uwaezuoke SN, Odimegwu CL, Mbanefo NR, Eneh CI, Arodiwe IO, Muoneke UV, Ogbuka FN, Ndiokwelu CO, Akwue AT. Vitamin D 3 supplementation as an adjunct in the management of childhood infectious diarrhea: a systematic review. BMC Infect Dis 2023; 23:159. [PMID: 36918811 PMCID: PMC10015675 DOI: 10.1186/s12879-023-08077-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Accepted: 02/13/2023] [Indexed: 03/16/2023] Open
Abstract
BACKGROUND Some studies have reported the possible role of vitamin D3 in ameliorating disease outcomes in childhood infectious diarrhea. However, findings about its effectiveness and the association of serum vitamin D levels with diarrhea risk appear inconsistent. We aimed to determine the efficacy of oral vitamin D3 as an adjunct in managing childhood infectious diarrhea and the relationship between vitamin D status and the disease. METHODS We searched the PubMed and Google Scholar electronic databases for relevant articles without limiting their year of publication. We selected primary studies that met the review's inclusion criteria, screened their titles and abstracts, and removed duplicates. We extracted data items from selected studies using a structured data-extraction form. We conducted a quality assessment of randomized controlled trials (RCTs) and non-randomized studies with the Cochrane collaboration tool and the Newcastle Ottawa Scale, respectively. We assessed the strength of the relationship between serum vitamin D levels and diarrhea using the correlation model. We estimated the I2 and tau2 values to assess between-study heterogeneity. RESULTS Nine full-text articles were selected, consisting of one RCT, three cross-sectional studies, two cohort studies, two longitudinal/prospective studies, and one case-control study. A total of 5,545 participants were evaluated in the nine studies. Six non-randomized studies provided weak evidence of the relationship between vitamin D levels and diarrhea risk as there was no correlation between the two variables. The only RCT failed to demonstrate any beneficial role of vitamin D3 in reducing the risk of recurrent diarrhea. The calculated I2 and tau2 values of 86.5% and 0.03, respectively suggested a high between-study heterogeneity which precluded a meta-analysis of study results. CONCLUSION Oral vitamin D3 may not be an effective adjunct in managing childhood infectious diarrhea. Additionally, the relationship between vitamin D status and infectious diarrhea appears weak. We recommend more adequately-powered RCTs to determine the effectiveness of vitamin D3 as an adjunct therapy in infectious diarrhea.
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Affiliation(s)
- Samuel N Uwaezuoke
- Department of Pediatrics, The University of Nigeria Teaching Hospital Ituku-Ozalla Enugu, Enugu, Nigeria.
| | - Chioma L Odimegwu
- Department of Pediatrics, The University of Nigeria Teaching Hospital Ituku-Ozalla Enugu, Enugu, Nigeria
| | - Ngozi R Mbanefo
- Department of Pediatrics, The University of Nigeria Teaching Hospital Ituku-Ozalla Enugu, Enugu, Nigeria
| | - Chizoma I Eneh
- Department of Pediatrics, Enugu State University Teaching Hospital, Enugu, Nigeria
| | - Ijeoma O Arodiwe
- Department of Pediatrics, The University of Nigeria Teaching Hospital Ituku-Ozalla Enugu, Enugu, Nigeria
| | - Uzoamaka V Muoneke
- Department of Pediatrics, The University of Nigeria Teaching Hospital Ituku-Ozalla Enugu, Enugu, Nigeria
| | - Francis N Ogbuka
- Department of Pediatrics, Enugu State University Teaching Hospital, Enugu, Nigeria
| | - Chibuzo O Ndiokwelu
- Department of Pediatrics, The University of Nigeria Teaching Hospital Ituku-Ozalla Enugu, Enugu, Nigeria
| | - Anthony T Akwue
- Emergency Department, ASEER field Hospital, Mecca, Kingdom of Saudi Arabia
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Wang X, Geng S. Diet-gut microbial interactions influence cancer immunotherapy. Front Oncol 2023; 13:1138362. [PMID: 37035188 PMCID: PMC10081683 DOI: 10.3389/fonc.2023.1138362] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Accepted: 03/16/2023] [Indexed: 04/11/2023] Open
Abstract
The gut microbiome is involved in the absorption and metabolism of host nutrients and modulates the immune response, affecting the efficacy of immunotherapy for cancer. In patients receiving immunotherapy, appropriate modifications of gut microbiota are thought to improve therapeutic response. Of all the factors that influence the gut microbiota, diet is the most influential and modifiable. Healthy dietary patterns as well as some specific dietary components can help the growth of beneficial microbiota in the gut, thereby protecting against cancers and promoting human health. A growing number of researches have confirmed the positive effects of a diet-gut microbiota approach as an adjuvant therapy for cancer, but controversy remains. Here, we summarize the interactions between diet and gut microbes based on previous studies, and discuss the role of gut microbiota-based dietary strategies in tumor immunotherapy, with the potential mechanisms of actions also intensively discussed.
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Affiliation(s)
- Xue Wang
- Department of Oncology, First People's Hospital of Guangyuan, Guangyuan, China
| | - Shitao Geng
- Department of Emergency, First Naval Hospital of Southern Theater Command, Zhanjiang, China
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Mărginean CO, Meliț LE, Borka Balas R, Văsieșiu AM, Fleșeriu T. The Crosstalk between Vitamin D and Pediatric Digestive Disorders. Diagnostics (Basel) 2022; 12:diagnostics12102328. [PMID: 36292016 PMCID: PMC9600444 DOI: 10.3390/diagnostics12102328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 09/18/2022] [Accepted: 09/23/2022] [Indexed: 11/22/2022] Open
Abstract
Vitamin D is a cyclopentane polyhydrophenanthrene compound involved mainly in bone health and calcium metabolism but also autophagy, modulation of the gut microbiota, cell proliferation, immune functions and intestinal barrier integrity. The sources of vitamin D include sunlight, diet and vitamin D supplements. Vitamin D3, the most effective vitamin D isoform is produced in the human epidermis as a result of sunlight exposure. Vitamin D undergoes two hydroxylation reactions in the liver and kidney to reach its active form, 1,25-dihydroxyvitamin D. Recent studies highlighted a complex spectrum of roles regarding the wellbeing of the gastrointestinal tract. Based on its antimicrobial effect, it was recently indicated that vitamin D supplementation in addition to standard eradication therapy might enhance H. pylori eradication rates. Moreover, it was suggested that low levels of vitamin D might also be involved in the acquisition of H. pylori infection. In terms of celiac disease, the negative effects of vitamin D deficiency might begin even during intrauterine life in the setting of maternal deficiency. Moreover, vitamin D is strongly related to the integrity of the gut barrier, which represents the core of the pathophysiology of celiac disease onset, in addition to being correlated with the histological findings of disease severity. The relationship between vitamin D and cystic fibrosis is supported by the involvement of this micronutrient in preserving lung function by clearing airway inflammation and preventing pathogen airway colonization. Moreover, this micronutrient might exert anticatabolic effects in CF patients. Inflammatory bowel disease patients also experience major benefits if they have a sufficient level of circulating vitamin D, proving its involvement in both induction and remission in these patients. The findings regarding the relationship between vitamin D, food allergies, diarrhea and constipation remain controversial, but vitamin D levels should be monitored in these patients in order to avoid hypo- and hypervitaminosis. Further studies are required to fill the remaining gaps in term of the complex impact of vitamin D on gastrointestinal homeostasis.
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Affiliation(s)
- Cristina Oana Mărginean
- Department of Pediatrics I, “George Emil Palade” University of Medicine, Pharmacy, Science, and Technology of Târgu Mureș, Gheorghe Marinescu Street No 38, 540136 Târgu Mureș, Romania
| | - Lorena Elena Meliț
- Department of Pediatrics I, “George Emil Palade” University of Medicine, Pharmacy, Science, and Technology of Târgu Mureș, Gheorghe Marinescu Street No 38, 540136 Târgu Mureș, Romania
- Correspondence:
| | - Reka Borka Balas
- Department of Pediatrics I, “George Emil Palade” University of Medicine, Pharmacy, Science, and Technology of Târgu Mureș, Gheorghe Marinescu Street No 38, 540136 Târgu Mureș, Romania
| | - Anca Meda Văsieșiu
- Department of Infectious Disease, “George Emil Palade” University of Medicine, Pharmacy, Science, and Technology of Târgu Mureș, Gheorghe Marinescu Street No 38, 540136 Târgu Mureș, Romania
| | - Tudor Fleșeriu
- Department of Infectious Disease, County Clinical Hospital Târgu Mureș, Gheorghe Doja Street No 89, 540394 Târgu Mureș, Romania
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Tang J, Gu L, Luo J, Luo H, Zeng Q, Jiang Y. 1,25(OH) 2D 3 promotes the elimination of Klebsiella pneumoniae infection by inducing autophagy through the VDR-ATG16L1 pathway. Int Immunopharmacol 2022; 112:109266. [PMID: 36174418 DOI: 10.1016/j.intimp.2022.109266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2022] [Revised: 09/08/2022] [Accepted: 09/16/2022] [Indexed: 11/15/2022]
Abstract
OBJECTIVE Previous studies have shown that vitamin D has regulatory functions in both innate and adaptive immune responses, indicating that it can perform essential roles in host resistance to pathogen infections. This study aimed to verify its effects on Klebsiella pneumoniae (Kp) infection and explore the underlying mechanisms. METHODS THP-1-derived macrophages were infected with Kp and then incubated with 1,25(OH)2D3. Autophagy induced by 1,25(OH)2D3 was investigated by western blotting and immunofluorescence. Real-time PCR (qPCR) was performed to determine the expression of inflammatory mediators. Baf A1 and 3-MA were used to inhibit autophagy. The intracellular killing of Kp was measured using qPCR and colony-forming unit assays. RNA interference assays were used to silence VDR or ATG16L1. The lungs of C57BL/6 mice were infected with Kp via intratracheal instillation, and the established pneumonia models were used for in vivo validation experiments. RESULTS Treatment with 1,25(OH)2D3 enhanced the bactericidal activity of macrophages and concomitantly reduced the expression of the pro-inflammatory mediators TNF-α and IL-6. Kp infection led to a lower expression level of VDR in macrophages than in the control, whereas co-treatment with 1,25(OH)2D3 up-regulated VDR expression and robustly induced autophagy via the VDR signaling pathway. Silencing ATG16L1 significantly counteracted autophagy induced by 1,25(OH)2D3 in Kp-infected macrophages. Furthermore, we found that when autophagy activity was diminished by ATG16L1 siRNA or blocked by Baf A1, the ability of 1,25(OH)2D3 to promote macrophages to eliminate Kp infection was obviously impaired, as were its anti-inflammatory effects. These protective efficacies of 1,25(OH)2D3 against Kp infection were also validated in vivo using a mouse model of pneumonia. CONCLUSIONS The present study demonstrated the protective features of 1,25(OH)2D3 in macrophages against Kp infection and may provide evidence for further exploration of its potential as an adjunctive therapy agent for the treatment of bacterial infections.
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Affiliation(s)
- Jinhui Tang
- Department of Pathophysiology, Guangdong Provincial Key Laboratory of Proteomics, and State Key Laboratory of Organ Failure Research, Southern Medical University, Guangzhou 510515, China
| | - Liwen Gu
- Department of Emergency Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China
| | - Jieyu Luo
- Department of Emergency Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China
| | - Haihua Luo
- Department of Pathophysiology, Guangdong Provincial Key Laboratory of Proteomics, and State Key Laboratory of Organ Failure Research, Southern Medical University, Guangzhou 510515, China
| | - Qingli Zeng
- Department of Emergency Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China.
| | - Yong Jiang
- Department of Pathophysiology, Guangdong Provincial Key Laboratory of Proteomics, and State Key Laboratory of Organ Failure Research, Southern Medical University, Guangzhou 510515, China.
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Zafar M, Karkhanis M, Shahbaz M, Khanna A, Barry L, Alam S, Lawrence K, Pun B, Eldebri R, Makanjuola O, Safarova D, Farooq M, Nooredinavand H, Cuison F, Subba K, Singh Randhawa R, Hegner J, Oluwamayowa O, Elyasaky A, Adekunle B, Periasamy M, Abdelbagi M, Maryam Z, Khuu B, Esteves Morete A, Ciroi G, Moran S, O'Neill W, Zafar MJ, Zafar N, Patel M, Golez R, Hadid A, Muhammad T, Mayhead P, Whitehead M, Dashora U. Vitamin D levels and mortality with SARS-COV-2 infection: a retrospective two-centre cohort study. Postgrad Med J 2022; 98:523-528. [PMID: 34489318 PMCID: PMC8423517 DOI: 10.1136/postgradmedj-2021-140564] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2021] [Accepted: 08/22/2021] [Indexed: 12/24/2022]
Abstract
BACKGROUND The role of vitamin D in increased mortality with SARS-COV-2 virus, namely, COVID-19, remains uncertain. We analysed all the patients who were treated as COVID-19-positive with or without a positive swab and were tested for vitamin D levels. METHODS This was a retrospective, study involving 1226 patients swabbed for SARS-CoV-2 between the 10 February 2020 and 1 May 2020 at two hospitals of East Sussex Healthcare NHS Trust. Patients who were swab-positive for COVID-19 or treated as COVID-19-positive on clinical grounds even though swab results were negative were included in this study. We analysed the association of vitamin D levels and mortality, assessing linear and non-linear associations. RESULTS A total of 1226 patients had SARS-CoV-2 RNA swabs in this period with age range from 1 year to 101 years. A cohort of 433 of these patients had swabs and recent vitamin D levels anytime in the previous 3 months. Mortality rates were not found to be associated with vitamin D levels (OR=1.04, 95% CI 0.96 to 1.12). CONCLUSION Our findings suggest similar mortality risk from COVID-19 irrespective of the levels of vitamin D. Larger prospective studies will be needed to confirm these findings.
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Affiliation(s)
- Mansoor Zafar
- Gastroenterology, GIM, Conquest Hospital, Saint Leonards on Sea, UK
| | | | | | | | | | - Saba Alam
- Conquest Hospital, Saint Leonards on Sea, UK
| | | | - Bipin Pun
- Conquest Hospital, Saint Leonards on Sea, UK
| | | | | | | | | | | | | | | | | | | | | | - Amr Elyasaky
- Geriatric, Conquest Hospital, Saint Leonards on Sea, UK
| | | | | | | | | | - Bao Khuu
- General Internal Medicine, Conquest Hospital, East Sussex healthcare NHS Trust, St. Leonards-on-sea, UK
| | | | - Giulio Ciroi
- General Internal Medicine, Conquest Hospital, East Sussex healthcare NHS Trust, St. Leonards-on-sea, UK
| | - Steve Moran
- Microbiology, Eastbourne District General Hospital, East Sussex Healthcare NHS Trust, Eastbourne, UK
| | - William O'Neill
- Microbiology, Eastbourne District General Hospital, Eastbourne, UK
| | - Maaryah J Zafar
- Faculty of Medicine and Pharmacy, University of Oradea, Oradea, Romania
| | - Nadiyah Zafar
- Faculty of Medicine and Pharmacy, University of Oradea, Oradea, Romania
| | - Mirej Patel
- Medical School and Health Science Center, University of Debrecen, Debrecen, Hungary
| | - Raphael Golez
- Geriatric, Conquest Hospital, Saint Leonards on Sea, UK
| | - Abubakr Hadid
- General Internal Medicine, Conquest Hospital, Saint Leonards on Sea, UK
| | - Tila Muhammad
- Gastroenterology, East Sussex Hospitals NHS Trust, Saint Leonards-on-Sea, UK
| | - Philip Mayhead
- Gastroenterology, Eastbourne District General Hospital. East Sussex Healthcare NHS Trust, Eastbourne, UK
| | - Mark Whitehead
- Consultant Physician and Gastroenterologist, Conquest Hospital, Saint Leonards on Sea, East Sussex, UK
| | - Umesh Dashora
- Diabetes and Endocrinology and General Internal Medicine, Conquest Hospital, Saint Leonards on Sea, UK
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Basaran MK, Dogan C, Sursal A, Ozdener F. Effect of Rotavirus Infection on Serum Micronutrients and Atopy in Children. J PEDIAT INF DIS-GER 2022. [DOI: 10.1055/s-0042-1745836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Abstract
Objective Rotavirus is a highly infectious and prevalent ribonucleic acid (RNA) virus that causes fatal gastroenteritis in children. Despite vitamin D deficiency is associated with susceptibility to infections, the relationship between ferritin and vitamin B12 levels is not known. This study aimed to investigate and compare the effect of rotavirus on micronutrient levels, atopy, and the frequency of allergic diseases in children with rotavirus.
Methods There were rotavirus gastroenteritis (RVG) (N = 92) and non-rotavirus (control) groups (N = 95). Serum micronutrient levels (B12, ferritin, and 25-hydroxyvitamin D [25-OH-D3]) were checked during the first control after gastroenteritis healed. Patients were also examined for allergic diseases on an average of 17 (14–32) months following rotavirus infection. Serum immunoglobulin E (IgE), eosinophil count, and percentage were analyzed. Skin tests and respiratory function tests were also performed on patients with allergic disease and asthma symptoms.
Results Mean ferritin, B12, and 25-OH-D3 levels were lower in the RVG group compared with the control group. Allergic diseases in the RVG group were more frequent than in the control group. The prevalence of the allergic disease in the RVG group was 16.3%, as opposed to 5.2% in the control group (p = 0.014). The IgE level was significantly higher in the RVG group.
Conclusion Children with rotavirus infection should be followed closely in terms of allergic diseases and micronutrient deficiency. Furthermore, rotavirus infection should be prevented in the society and early treatment should be made available via tests detecting micronutrient deficiency.
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Affiliation(s)
- Meryem Keceli Basaran
- Division of Pediatric Gastroenterology, Department of Pediatrics, Gaziosmanpaşa Training and Research Hospital, Istanbul, Turkey
| | - Caner Dogan
- Department of Pediatrics, Gaziosmanpaşa Training and Research Hospital, Istanbul, Turkey
| | - Alihan Sursal
- Department of Neuroscience, Bahcesehir University, School of Medicine, Istanbul, Turkey
| | - Fatih Ozdener
- Department of Pharmacology, Bahcesehir University, School of Medicine, Istanbul, Turkey
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Domenici R, Vierucci F. Exclusive Breastfeeding and Vitamin D Supplementation: A Positive Synergistic Effect on Prevention of Childhood Infections? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19052973. [PMID: 35270666 PMCID: PMC8910000 DOI: 10.3390/ijerph19052973] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 02/25/2022] [Accepted: 02/28/2022] [Indexed: 02/01/2023]
Abstract
Human milk is the best food for infants. Breastfeeding has been associated with a reduced risk of viral and bacterial infections. Breast milk contains the perfect amount of nutrients needed to promote infant growth, except for vitamin D. Vitamin D is crucial for calcium metabolism and bone health, and it also has extra-skeletal actions, involving innate and adaptive immunity. As exclusive breastfeeding is a risk factor for vitamin D deficiency, infants should be supplemented with vitamin D at least during the first year. The promotion of breastfeeding and vitamin D supplementation represents an important objective of public health.
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Laneri S, Brancaccio M, Mennitti C, De Biasi MG, Pero ME, Pisanelli G, Scudiero O, Pero R. Antimicrobial Peptides and Physical Activity: A Great Hope against COVID 19. Microorganisms 2021; 9:1415. [PMID: 34209064 PMCID: PMC8304224 DOI: 10.3390/microorganisms9071415] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 06/07/2021] [Accepted: 06/21/2021] [Indexed: 12/24/2022] Open
Abstract
Antimicrobial peptides (AMPs), α- and β-defensins, possess antiviral properties. These AMPs achieve viral inhibition through different mechanisms of action. For example, they can: (i) bind directly to virions; (ii) bind to and modulate host cell-surface receptors, disrupting intracellular signaling; (iii) function as chemokines to augment and alter adaptive immune responses. Given their antiviral properties and the fact that the development of an effective coronavirus disease 2019 (COVID-19) treatment is an urgent public health priority, they and their derivatives are being explored as potential therapies against COVID-19. These explorations using various strategies, range from their direct interaction with the virus to using them as vaccine adjuvants. However, AMPs do not work in isolation, specifically in their role as potent immune modulators, where they interact with toll-like receptors (TLRs) and chemokine receptors. Both of these receptors have been shown to play roles in COVID-19 pathogenesis. In addition, it is known that a healthy lifestyle accompanied by controlled physical activity can represent a natural weapon against COVID-19. In competitive athletes, an increase in serum defensins has been shown to function as self-protection from the attack of microorganisms, consequently a controlled physical activity could act as a support to any therapies in fighting COVID-19. Therefore, including information on all these players' interactions would produce a complete picture of AMP-based therapies' response.
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Affiliation(s)
- Sonia Laneri
- Department of Pharmacy, University of Naples Federico II, Via Montesano, 80138 Naples, Italy; (S.L.); (M.G.D.B.)
| | - Mariarita Brancaccio
- Department of Molecular Medicine and Medical Biotechnology, University of Naples Federico II, Via S. Pansini 5, 80131 Naples, Italy; (M.B.); (C.M.)
| | - Cristina Mennitti
- Department of Molecular Medicine and Medical Biotechnology, University of Naples Federico II, Via S. Pansini 5, 80131 Naples, Italy; (M.B.); (C.M.)
| | - Margherita G. De Biasi
- Department of Pharmacy, University of Naples Federico II, Via Montesano, 80138 Naples, Italy; (S.L.); (M.G.D.B.)
| | - Maria Elena Pero
- Department of Veterinary Medicine and Animal Production, University of Naples Federico II, Via Federico Delpino 1, 80137 Naples, Italy; (M.E.P.); (G.P.)
| | - Giuseppe Pisanelli
- Department of Veterinary Medicine and Animal Production, University of Naples Federico II, Via Federico Delpino 1, 80137 Naples, Italy; (M.E.P.); (G.P.)
| | - Olga Scudiero
- Department of Molecular Medicine and Medical Biotechnology, University of Naples Federico II, Via S. Pansini 5, 80131 Naples, Italy; (M.B.); (C.M.)
- Ceinge Biotecnologie Avanzate S.C.aR.L., 80131 Naples, Italy
- Task Force on Microbiome Studies, University of Naples Federico II, 80100 Naples, Italy
| | - Raffaela Pero
- Department of Molecular Medicine and Medical Biotechnology, University of Naples Federico II, Via S. Pansini 5, 80131 Naples, Italy; (M.B.); (C.M.)
- Ceinge Biotecnologie Avanzate S.C.aR.L., 80131 Naples, Italy
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12
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Julio-Pieper M, López-Aguilera A, Eyzaguirre-Velásquez J, Olavarría-Ramírez L, Ibacache-Quiroga C, Bravo JA, Cruz G. Gut Susceptibility to Viral Invasion: Contributing Roles of Diet, Microbiota and Enteric Nervous System to Mucosal Barrier Preservation. Int J Mol Sci 2021; 22:ijms22094734. [PMID: 33946994 PMCID: PMC8125429 DOI: 10.3390/ijms22094734] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2021] [Revised: 04/24/2021] [Accepted: 04/26/2021] [Indexed: 02/08/2023] Open
Abstract
The gastrointestinal lumen is a rich source of eukaryotic and prokaryotic viruses which, together with bacteria, fungi and other microorganisms comprise the gut microbiota. Pathogenic viruses inhabiting this niche have the potential to induce local as well as systemic complications; among them, the viral ability to disrupt the mucosal barrier is one mechanism associated with the promotion of diarrhea and tissue invasion. This review gathers recent evidence showing the contributing effects of diet, gut microbiota and the enteric nervous system to either support or impair the mucosal barrier in the context of viral attack.
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Affiliation(s)
- Marcela Julio-Pieper
- Grupo de NeuroGastroBioquímica, Instituto de Química, Facultad de Ciencias, Pontificia Universidad Católica de Valparaíso, Valparaíso 2340000, Chile; (A.L.-A.); (J.E.-V.); (J.A.B.)
- Correspondence:
| | - Alejandra López-Aguilera
- Grupo de NeuroGastroBioquímica, Instituto de Química, Facultad de Ciencias, Pontificia Universidad Católica de Valparaíso, Valparaíso 2340000, Chile; (A.L.-A.); (J.E.-V.); (J.A.B.)
| | - Johana Eyzaguirre-Velásquez
- Grupo de NeuroGastroBioquímica, Instituto de Química, Facultad de Ciencias, Pontificia Universidad Católica de Valparaíso, Valparaíso 2340000, Chile; (A.L.-A.); (J.E.-V.); (J.A.B.)
| | | | - Claudia Ibacache-Quiroga
- Centro de Micro-Bioinnovación (CMBi), Escuela de Nutrición y Dietética, Facultad de Farmacia, Universidad de Valparaíso, Valparaíso 2340000, Chile;
| | - Javier A. Bravo
- Grupo de NeuroGastroBioquímica, Instituto de Química, Facultad de Ciencias, Pontificia Universidad Católica de Valparaíso, Valparaíso 2340000, Chile; (A.L.-A.); (J.E.-V.); (J.A.B.)
| | - Gonzalo Cruz
- Centro de Neurobiología y Fisiopatología Integrativa (CENFI), Instituto de Fisiología, Facultad de Ciencias, Universidad de Valparaíso, Valparaíso 2340000, Chile;
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13
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Grant WB, Lahore H, McDonnell SL, Baggerly CA, French CB, Aliano JL, Bhattoa HP. Evidence that Vitamin D Supplementation Could Reduce Risk of Influenza and COVID-19 Infections and Deaths. Nutrients 2020; 12:nu12040988. [PMID: 32252338 PMCID: PMC7231123 DOI: 10.3390/nu12040988] [Citation(s) in RCA: 1049] [Impact Index Per Article: 262.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Revised: 03/30/2020] [Accepted: 03/31/2020] [Indexed: 02/06/2023] Open
Abstract
The world is in the grip of the COVID-19 pandemic. Public health measures that can reduce the risk of infection and death in addition to quarantines are desperately needed. This article reviews the roles of vitamin D in reducing the risk of respiratory tract infections, knowledge about the epidemiology of influenza and COVID-19, and how vitamin D supplementation might be a useful measure to reduce risk. Through several mechanisms, vitamin D can reduce risk of infections. Those mechanisms include inducing cathelicidins and defensins that can lower viral replication rates and reducing concentrations of pro-inflammatory cytokines that produce the inflammation that injures the lining of the lungs, leading to pneumonia, as well as increasing concentrations of anti-inflammatory cytokines. Several observational studies and clinical trials reported that vitamin D supplementation reduced the risk of influenza, whereas others did not. Evidence supporting the role of vitamin D in reducing risk of COVID-19 includes that the outbreak occurred in winter, a time when 25-hydroxyvitamin D (25(OH)D) concentrations are lowest; that the number of cases in the Southern Hemisphere near the end of summer are low; that vitamin D deficiency has been found to contribute to acute respiratory distress syndrome; and that case-fatality rates increase with age and with chronic disease comorbidity, both of which are associated with lower 25(OH)D concentration. To reduce the risk of infection, it is recommended that people at risk of influenza and/or COVID-19 consider taking 10,000 IU/d of vitamin D3 for a few weeks to rapidly raise 25(OH)D concentrations, followed by 5000 IU/d. The goal should be to raise 25(OH)D concentrations above 40-60 ng/mL (100-150 nmol/L). For treatment of people who become infected with COVID-19, higher vitamin D3 doses might be useful. Randomized controlled trials and large population studies should be conducted to evaluate these recommendations.
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Affiliation(s)
- William B. Grant
- Sunlight, Nutrition, and Health Research Center, P.O. Box 641603, San Francisco, CA 94164-1603, USA
- Correspondence: ; Tel.: +1-415-409-1980
| | - Henry Lahore
- 2289 Highland Loop, Port Townsend, WA 98368, USA;
| | - Sharon L. McDonnell
- GrassrootsHealth, Encinitas, CA 92024, USA; (S.L.M.); (C.A.B.); (C.B.F.); (J.L.A.)
| | - Carole A. Baggerly
- GrassrootsHealth, Encinitas, CA 92024, USA; (S.L.M.); (C.A.B.); (C.B.F.); (J.L.A.)
| | - Christine B. French
- GrassrootsHealth, Encinitas, CA 92024, USA; (S.L.M.); (C.A.B.); (C.B.F.); (J.L.A.)
| | - Jennifer L. Aliano
- GrassrootsHealth, Encinitas, CA 92024, USA; (S.L.M.); (C.A.B.); (C.B.F.); (J.L.A.)
| | - Harjit P. Bhattoa
- Department of Laboratory Medicine, Faculty of Medicine, University of Debrecen, Nagyerdei Blvd 98, H-4032 Debrecen, Hungary;
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14
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Grant WB, Lahore H, McDonnell SL, Baggerly CA, French CB, Aliano JL, Bhattoa HP. Evidence that Vitamin D Supplementation Could Reduce Risk of Influenza and COVID-19 Infections and Deaths. Nutrients 2020. [PMID: 32252338 DOI: 10.20944/preprints202003.0235.v2] [Citation(s) in RCA: 65] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
The world is in the grip of the COVID-19 pandemic. Public health measures that can reduce the risk of infection and death in addition to quarantines are desperately needed. This article reviews the roles of vitamin D in reducing the risk of respiratory tract infections, knowledge about the epidemiology of influenza and COVID-19, and how vitamin D supplementation might be a useful measure to reduce risk. Through several mechanisms, vitamin D can reduce risk of infections. Those mechanisms include inducing cathelicidins and defensins that can lower viral replication rates and reducing concentrations of pro-inflammatory cytokines that produce the inflammation that injures the lining of the lungs, leading to pneumonia, as well as increasing concentrations of anti-inflammatory cytokines. Several observational studies and clinical trials reported that vitamin D supplementation reduced the risk of influenza, whereas others did not. Evidence supporting the role of vitamin D in reducing risk of COVID-19 includes that the outbreak occurred in winter, a time when 25-hydroxyvitamin D (25(OH)D) concentrations are lowest; that the number of cases in the Southern Hemisphere near the end of summer are low; that vitamin D deficiency has been found to contribute to acute respiratory distress syndrome; and that case-fatality rates increase with age and with chronic disease comorbidity, both of which are associated with lower 25(OH)D concentration. To reduce the risk of infection, it is recommended that people at risk of influenza and/or COVID-19 consider taking 10,000 IU/d of vitamin D3 for a few weeks to rapidly raise 25(OH)D concentrations, followed by 5000 IU/d. The goal should be to raise 25(OH)D concentrations above 40-60 ng/mL (100-150 nmol/L). For treatment of people who become infected with COVID-19, higher vitamin D3 doses might be useful. Randomized controlled trials and large population studies should be conducted to evaluate these recommendations.
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Affiliation(s)
- William B Grant
- Sunlight, Nutrition, and Health Research Center, P.O. Box 641603, San Francisco, CA 94164-1603, USA
| | - Henry Lahore
- 2289 Highland Loop, Port Townsend, WA 98368, USA
| | | | | | | | | | - Harjit P Bhattoa
- Department of Laboratory Medicine, Faculty of Medicine, University of Debrecen, Nagyerdei Blvd 98, H-4032 Debrecen, Hungary
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15
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Lee C. Controversial Effects of Vitamin D and Related Genes on Viral Infections, Pathogenesis, and Treatment Outcomes. Nutrients 2020; 12:nu12040962. [PMID: 32235600 PMCID: PMC7230640 DOI: 10.3390/nu12040962] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2020] [Revised: 03/23/2020] [Accepted: 03/26/2020] [Indexed: 12/11/2022] Open
Abstract
Vitamin D (VD) plays an essential role in mineral homeostasis and bone remodeling. A number of different VD-related genes (VDRG) are required for the metabolic activation of VD and the subsequent induction of its target genes. They include a set of genes that encode for VD-binding protein, metabolic enzymes, and the VD receptor. In addition to its well-characterized skeletal function, the immunoregulatory activities of VD and the related polymorphisms of VDRG have been reported and linked to its therapeutic and preventive actions for the control of several viral diseases. However, in regards to their roles in the progression of viral diseases, inconsistent and, in some cases, contradictory results also exist. To resolve this discrepancy, I conducted an extensive literature search by using relevant keywords on the PubMed website. Based on the volume of hit papers related to a certain viral infection, I summarized and compared the effects of VD and VDRG polymorphism on the infection, pathogenesis, and treatment outcomes of clinically important viral diseases. They include viral hepatitis, respiratory viral infections, acquired immunodeficiency syndrome (AIDS), and other viral diseases, which are caused by herpesviruses, dengue virus, rotavirus, and human papillomavirus. This review will provide the most current information on the nutritional and clinical utilization of VD and VDRG in the management of the key viral diseases. This information should be valuable not only to nutritionists but also to clinicians who wish to provide evidence-based recommendations on the use of VD to virally infected patients.
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Affiliation(s)
- Choongho Lee
- College of Pharmacy, Dongguk University, Goyang 10326, Korea
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16
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The Correlation Between Vitamin D and Bacterial Diarrhea in Children. ARCHIVES OF PEDIATRIC INFECTIOUS DISEASES 2019. [DOI: 10.5812/pedinfect.84382] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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17
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Saggese G, Vierucci F, Prodam F, Cardinale F, Cetin I, Chiappini E, de’ Angelis GL, Massari M, Miraglia Del Giudice E, Miraglia Del Giudice M, Peroni D, Terracciano L, Agostiniani R, Careddu D, Ghiglioni DG, Bona G, Di Mauro G, Corsello G. Vitamin D in pediatric age: consensus of the Italian Pediatric Society and the Italian Society of Preventive and Social Pediatrics, jointly with the Italian Federation of Pediatricians. Ital J Pediatr 2018; 44:51. [PMID: 29739471 PMCID: PMC5941617 DOI: 10.1186/s13052-018-0488-7] [Citation(s) in RCA: 121] [Impact Index Per Article: 20.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2017] [Accepted: 04/16/2018] [Indexed: 02/07/2023] Open
Abstract
Vitamin D plays a pivotal role in the regulation of calcium-phosphorus metabolism, particularly during pediatric age when nutritional rickets and impaired bone mass acquisition may occur.Besides its historical skeletal functions, in the last years it has been demonstrated that vitamin D directly or indirectly regulates up to 1250 genes, playing so-called extraskeletal actions. Indeed, recent data suggest a possible role of vitamin D in the pathogenesis of several pathological conditions, including infectious, allergic and autoimmune diseases. Thus, vitamin D deficiency may affect not only musculoskeletal health but also a potentially wide range of acute and chronic conditions. At present, the prevalence of vitamin D deficiency is high in Italian children and adolescents, and national recommendations on vitamin D supplementation during pediatric age are lacking. An expert panel of the Italian Society of Preventive and Social Pediatrics reviewed available literature focusing on randomized controlled trials of vitamin D supplementation to provide a practical approach to vitamin D supplementation for infants, children and adolescents.
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Affiliation(s)
- Giuseppe Saggese
- Department of Clinical and Experimental Medicine, Section of Paediatrics, University of Pisa, Pisa, Italy
| | | | - Flavia Prodam
- Division of Pediatrics, Department of Health Sciences, Interdisciplinary Research Center of Autoimmune Diseases (IRCAD), University of Piemonte Orientale, Novara, Italy
| | - Fabio Cardinale
- Pediatric Unit, Division of Pulmonology, Allergy, and Immunology, AOU Policlinico-Giovanni XXIII, Bari, Italy
| | - Irene Cetin
- Department of Mother and Child, Hospital Luigi Sacco, University of Milano, Milan, Italy
| | - Elena Chiappini
- Pediatric Infectious Disease Unit, Department of Health Sciences, University of Florence, Anna Meyer Children’s University Hospital, Florence, Italy
| | - Gian Luigi de’ Angelis
- Gastroenterology and Digestive Endoscopy Unit and Clinical Paediatrics Unit, Department of Paediatrics and Maternal Medicine, University of Parma Hospital Trust, Parma, Italy
| | - Maddalena Massari
- Department of Mother and Child, Hospital Luigi Sacco, University of Milano, Milan, Italy
| | - Emanuele Miraglia Del Giudice
- Department of Woman, Child and General and Specialist Surgery, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Michele Miraglia Del Giudice
- Department of Woman, Child and General and Specialist Surgery, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Diego Peroni
- Department of Clinical and Experimental Medicine, Section of Paediatrics, University of Pisa, Pisa, Italy
| | - Luigi Terracciano
- Pediatric Primary Care, National Pediatric Health Care System, Milan, Italy
| | | | - Domenico Careddu
- Pediatric Primary Care, National Pediatric Health Care System, Novara, Italy
| | - Daniele Giovanni Ghiglioni
- Pediatric Highly Intensive Care Unit, Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Gianni Bona
- Division of Pediatrics, University of Piemonte Orientale, Novara, Italy
| | - Giuseppe Di Mauro
- Pediatric Primary Care, National Pediatric Health Care System, Caserta, Italy
| | - Giovanni Corsello
- Department of Sciences for Health Promotion and Mother and Child Care, Neonatal Intensive Care Unit, AOUP, University of Palermo, Palermo, Italy
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18
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Differences of Rotavirus Vaccine Effectiveness by Country: Likely Causes and Contributing Factors. Pathogens 2017; 6:pathogens6040065. [PMID: 29231855 PMCID: PMC5750589 DOI: 10.3390/pathogens6040065] [Citation(s) in RCA: 97] [Impact Index Per Article: 13.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2017] [Revised: 11/05/2017] [Accepted: 11/07/2017] [Indexed: 12/15/2022] Open
Abstract
Rotaviruses are a major cause of acute gastroenteritis in infants and young children worldwide and in many other mammalian and avian host species. Since 2006, two live-attenuated rotavirus vaccines, Rotarix® and RotaTeq®, have been licensed in >100 countries and are applied as part of extended program of vaccination (EPI) schemes of childhood vaccinations. Whereas the vaccines have been highly effective in high-income countries, they were shown to be considerably less potent in low- and middle-income countries. Rotavirus-associated disease was still the cause of death in >200,000 children of <5 years of age worldwide in 2013, and the mortality is concentrated in countries of sub-Saharan Africa and S.E. Asia. Various factors that have been identified or suggested as being involved in the differences of rotavirus vaccine effectiveness are reviewed here. Recognition of these factors will help to achieve gradual worldwide improvement of rotavirus vaccine effectiveness.
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19
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Banerjee S, Basu S, Sen A, Sengupta J. The effect of vitamin D and calcium supplementation in pediatric steroid-sensitive nephrotic syndrome. Pediatr Nephrol 2017; 32:2063-2070. [PMID: 28725977 DOI: 10.1007/s00467-017-3716-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2017] [Revised: 05/28/2017] [Accepted: 05/30/2017] [Indexed: 12/12/2022]
Abstract
BACKGROUND Low serum levels of total 25-hydroxycholecalciferol (25(OH)D) occur in nephrotic syndrome (NS). We aimed to assess the effects of vitamin D3 and calcium supplementation on 25(OH)D levels, bone mineralization, and NS relapse rate in children with steroid-sensitive NS. METHODS A randomized controlled trial (RCT) was performed in children with steroid-sensitive NS. The treatment group received vitamin D3 (60,000 IU orally, weekly for 4 weeks) and calcium supplements (500 to 1,000 mg/day for 3 months) after achieving NS remission. Blood samples for bone biochemistry were taken during relapse (T0), after 6 weeks (T1) and 6 months (T2) of randomization, whereas a lumbar DXA scan was performed at T0 and T2. Renal ultrasound was performed after study completion in the treatment group and in all patients with hypercalciuria. RESULTS Of the 48 initial recruits, 43 patients completed the study. Post-intervention, 25(OH)D levels showed significant improvements in the treatment group compared with controls at T1 (p < 0.001) and T2 (p < 0.001). However, this was not associated with differences in bone mineral content (BMC) (p = 0.44) or bone mineral density (BMD) (p = 0.64) between the groups. Additionally, there was no reduction in relapse number in treated patients (p = 0.54). Documented hypercalciuria occurred in 52% of patients in the treatment group, but was not associated with nephrocalcinosis. CONCLUSIONS Although supplementation with calcium and vitamin D improved 25(OH)D levels significantly, there was no effect on BMC, BMD or relapse rate over a 6-month follow-up. Occurrence of hypercalciuria mandates caution and appropriate monitoring if using such therapy. Appropriate dosage of vitamin D3 remains uncertain and studies examining biologically active vitamin D may provide answers.
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Affiliation(s)
- Sushmita Banerjee
- Department of Paediatric Nephrology, Institute of Child Health and Calcutta Medical Research Institute, Kolkata, India.
| | - Surupa Basu
- Department of Biochemistry, Institute of Child Health, Kolkata, India
| | - Ananda Sen
- Department of Family Medicine and Department of Biostatistics, University of Michigan, Ann Arbor, MI, USA
| | - Jayati Sengupta
- Department of Paediatric Nephrology, Institute of Child Health, Kolkata, India
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20
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Grant WB, Bhattoa HP, Boucher BJ. Seasonal variations of U.S. mortality rates: Roles of solar ultraviolet-B doses, vitamin D, gene exp ression, and infections. J Steroid Biochem Mol Biol 2017; 173:5-12. [PMID: 28088363 DOI: 10.1016/j.jsbmb.2017.01.003] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2016] [Revised: 12/13/2016] [Accepted: 01/06/2017] [Indexed: 12/31/2022]
Abstract
Death rates in the U.S. show a pronounced seasonality. The broad seasonal variation shows about 25% higher death rates in winter than in summer with an additional few percent increase associated with the Christmas and New Year's holidays. A pronounced increase in death rates also starts in mid-September, shortly after the school year begins. The causes of death with large contributions to the observed seasonality include diseases of the circulatory system; the respiratory system; the digestive system; and endocrine, nutritional, and metabolic diseases. Researchers have identified several factors showing seasonal variation that could possibly explain the seasonal variations in mortality rate. These factors include seasonal variations in solar ultraviolet-B(UVB) doses and serum 25-hydroxyvitamin D [25(OH)D] concentrations, gene expression, ambient temperature and humidity, UVB effects on environmental pathogen load, environmental pollutants and allergens, and photoperiod (or length of day). The factors with the strongest support in this analysis are seasonal variations in solar UVB doses and 25(OH)D concentrations. In the U.S., population mean 25(OH)D concentrations range from 21ng/mL in March to 28ng/mL in August. Measures to ensure that all people had 25(OH)D concentrations >36ng/mL year round would probably reduce death rates significantly.
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Affiliation(s)
- William B Grant
- Sunlight, Nutrition, and Health Research Center, PO Box 641603, San Francisco, CA, 94164-1603, USA.
| | - Harjit Pal Bhattoa
- Department of Laboratory Medicine, Faculty of Medicine, University of Debrecen, Nagyerdei blvd 98, Debrecen, H-4032, Hungary
| | - Barbara J Boucher
- The Blizard Institute, Barts & The London School of Medicine & Dentistry, Queen Mary University of London, London, UK
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