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Plebani M, Zaninotto M, Giannini S, Sella S, Fusaro M, Tripepi G, Gallieni M, Herrmann M, Cozzolino M. Vitamin D assay and supplementation: still debatable issues. Diagnosis (Berl) 2024:dx-2024-0147. [PMID: 39295160 DOI: 10.1515/dx-2024-0147] [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: 09/03/2024] [Accepted: 09/06/2024] [Indexed: 09/21/2024]
Abstract
Over the last decades, in addition to the improvement of pathophysiological knowledge regarding the role and mechanisms of action of vitamin D, there has been a progressive advancement in analytical technologies for its measurement, as well as in methodological standardization. A significant number of scientific works, meta-analyses, and guidelines have been published on the importance of vitamin D and the need for supplementation in deficient individuals. However, it appears necessary to clarify the fundamental elements related to the measurement of vitamin D (both at the strictly analytical and post-analytical levels) and the scientific evidence related to the efficacy/safety of supplementation. In particular, there is a need to discuss current recommended levels for deficiency, insufficiency and possible toxicity in the light of evidence from standardization projects. Additionally, given the important interrelations between vitamin D, parathyroid hormone (PTH), and fibroblast growth factor-23 (FGF23), the analytical issues and clinical utility of these biomarkers will be discussed.
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Affiliation(s)
- Mario Plebani
- University of Padova, Padova, Italy
- QI.LAB.MED, Spin-off of the University of Padova, Padova, Italy
| | | | - Sandro Giannini
- Clinica Medica 1, Department of Medicine, -DIMED, University of Padova, Padova, Italy
| | - Stefania Sella
- Clinica Medica 1, Department of Medicine, -DIMED, University of Padova, Padova, Italy
| | - Maria Fusaro
- National Research Council (CNR), Institute of Clinical Physiology (IFC), Pisa, Italy
| | - Giovanni Tripepi
- National Research Council (CNR), Institute of Clinical Physiology (IFC), Reggio Calabria, Italy
| | - Maurizio Gallieni
- Department of Biomedical and Clinical Sciences 'Luigi Sacco', University of Milano, Milan, Italy
| | - Markus Herrmann
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria
| | - Mario Cozzolino
- Renal Division, Department of Health Sciences, University of Milan, Milan, Italy
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2
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Samarakoon N, Chang T, Gunasekara V, Ratnayake P, Jayatillake R, Udagama P. Selected serum cytokines and vitamin D levels as potential prognostic markers of acute ischemic stroke. PLoS One 2024; 19:e0299631. [PMID: 38870172 PMCID: PMC11175438 DOI: 10.1371/journal.pone.0299631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 02/13/2024] [Indexed: 06/15/2024] Open
Abstract
Inflammation-derived oxidative stress is postulated to contribute to neuronal damage leading to poor clinical outcomes in Acute Ischemic Stroke (AIS). We aimed to investigate the association between serum levels of selected cytokines (IL-1β, IFN-γ, IL-4), and vitamin D in ischemic stroke progression, and their accuracy in predicting AIS prognosis, among Sri Lankans. We compared 60 AIS patients admitted in 4 phases post-stroke onset (<6 h; 6-24 h; 24-48 h; 48-96 h; n = 15/phase), with 15 age- and sex-matched controls. The 30-day functional outcome (FO) was assessed using the modified Rankin Scale (mRS). Serum cytokine and vitamin D levels were quantified using sandwich ELISAs, and competitive ELISA, respectively. The CombiROC web tool established optimal prognostic biomarker combinations. Serum IL-1β and IFN-γ were elevated in all four phases following stroke onset while IL-4 was elevated exclusively in the recovery phase (48-96 h) (p<0.05). Th1 bias polarization of the Th1:Th2 cytokine (IFN-γ:IL-4) ratio occurred with AIS progression while a Th2 bias occurred during AIS recovery (p<0.05). Lower serum IL-1β and higher IL-4 levels were associated with a good FO (p<0.05), while lower Vitamin D levels were related to a poor FO (p = 0.001). The triple-biomarker panel, IL-4- IFN-γ -Vit D, accurately predicted AIS prognosis (sensitivity = 100%, specificity = 91.9%, area under the curve = 0.98). Serum immunologic mediators IFN-γ, IL-4, and vitamin D may be useful biomarkers of AIS prognosis and may serve as therapeutic targets in improving stroke outcomes. Vitamin D supplementation may improve the prognosis of AIS patients. Furthermore, binary logistic model fitted for FO indicated Th1:Th2 cytokine ratio (IFN-γ:IL-4), vitamin D status, history of stroke, and ischemic heart disease as significant predictors of AIS prognosis.
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Affiliation(s)
- Nirmali Samarakoon
- Faculty of Science, Department of Zoology and Environment Sciences, University of Colombo, Colombo, Sri Lanka
| | - Thashi Chang
- Faculty of Medicine, Department of Clinical Medicine, University of Colombo, Colombo, Sri Lanka
| | - Vimukthi Gunasekara
- Faculty of Science, Department of Zoology and Environment Sciences, University of Colombo, Colombo, Sri Lanka
| | - Praneeth Ratnayake
- Faculty of Science, Department of Zoology and Environment Sciences, University of Colombo, Colombo, Sri Lanka
| | - Rasika Jayatillake
- Faculty of Science, Department of Statistics, University of Colombo, Colombo, Sri Lanka
| | - Preethi Udagama
- Faculty of Science, Department of Zoology and Environment Sciences, University of Colombo, Colombo, Sri Lanka
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3
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Gorini F, Tonacci A. Vitamin D: An Essential Nutrient in the Dual Relationship between Autoimmune Thyroid Diseases and Celiac Disease-A Comprehensive Review. Nutrients 2024; 16:1762. [PMID: 38892695 PMCID: PMC11174782 DOI: 10.3390/nu16111762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2024] [Revised: 05/29/2024] [Accepted: 06/03/2024] [Indexed: 06/21/2024] Open
Abstract
Autoimmune thyroid diseases (AITD) are among the most frequent autoimmune disorders, with a multifactorial etiology in which both genetic and environmental determinants are probably involved. Celiac disease (CeD) also represents a public concern, given its increasing prevalence due to the recent improvement of screening programs, leading to the detection of silent subtypes. The two conditions may be closely associated due to common risk factors, including genetic setting, changes in the composition and diversity of the gut microbiota, and deficiency of nutrients like vitamin D. This comprehensive review discussed the current evidence on the pivotal role of vitamin D in modulating both gut microbiota dysbiosis and immune system dysfunction, shedding light on the possible relevance of an adequate intake of this nutrient in the primary prevention of AITD and CeD. While future technology-based strategies for proper vitamin D supplementation could be attractive in the context of personalized medicine, several issues remain to be defined, including standardized assays for vitamin D determination, timely recommendations on vitamin D intake for immune system functioning, and longitudinal studies and randomized controlled trials to definitely establish a causal relationship between serum vitamin D levels and the onset of AITD and CeD.
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Affiliation(s)
- Francesca Gorini
- Institute of Clinical Physiology, National Research Council, 56124 Pisa, Italy;
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4
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Xia Y, Taylor TH, Chen J, Hsia J. Estimation of Numbers of Testing Personnel and Test Volume in the Clinical Laboratory Improvement Amendments of 1988 Certificate of Accreditation and Certificate of Compliance Laboratories in the United States. Arch Pathol Lab Med 2024; 148:443-452. [PMID: 37406294 PMCID: PMC11024983 DOI: 10.5858/arpa.2022-0345-oa] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/28/2023] [Indexed: 07/07/2023]
Abstract
CONTEXT.— Two major categories of laboratories performing nonwaived testing under the Clinical Laboratory Improvement Amendments of 1988 (CLIA) are the Certificate of Accreditation (CoA) and Certificate of Compliance (CoC) laboratories. Accreditation organizations collect more detailed laboratory personnel information than the Centers for Medicare & Medicaid Services (CMS) Quality Improvement and Evaluation System (QIES). OBJECTIVE.— To estimate total numbers of testing personnel and testing volumes in CoA and CoC laboratories, by laboratory type and state. DESIGN.— We developed a statistical inference method by using the respective correlations between testing personnel counts and test volume by laboratory type. RESULTS.— QIES reported 33 033 active CoA and CoC laboratories in July 2021. We estimated testing personnel to be 328 000 (95% CI, 309 000-348 000), which is supported by the count of 318 780 reported by the US Bureau of Labor Statistics. There were twice as many testing personnel in hospital laboratories as in independent laboratories (158 778 versus 74 904, P < .001). Independent laboratories had the highest test volume per person, which was twice as high as physician office laboratories (62 228 versus 30 102, P < .001). Hospital and independent laboratories comprised 34% of all CoA and CoC laboratories but performed the largest portion of testing (81%). Physician office laboratories, accounting for 44% of all CoA and CoC laboratories, performed a comparatively low proportion of total tests (9%). CONCLUSIONS.— Numbers of testing personnel vary considerably by laboratory type and across states. These data can provide valuable insight when assessing laboratory workforce training needs and planning for public health emergencies.
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Affiliation(s)
- Yang Xia
- From the Division of Laboratory Systems, Center for Surveillance, Epidemiology, and Laboratory Services (Xia), Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion (Hsia), the Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Thomas H Taylor
- Pharmacy Practice, College of Pharmacy, Mercer University, Atlanta, Georgia (Taylor Jr)
| | - Jufu Chen
- Cherokee Federal, Tulsa, Oklahoma (Chen)
| | - Jason Hsia
- From the Division of Laboratory Systems, Center for Surveillance, Epidemiology, and Laboratory Services (Xia), Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion (Hsia), the Centers for Disease Control and Prevention, Atlanta, Georgia
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5
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Paparodis RD, Bantouna D, Karvounis E, Zoupas I, Livadas S, Angelopoulos N, Imam S, Papadimitriou DT, Jaume JC. Intense Testing and Use of Vitamin D Supplements Leads to Slow Improvement in Vitamin D Adequacy Rates: A Cross-Sectional Analysis of Real-World Data. Nutrients 2023; 16:111. [PMID: 38201941 PMCID: PMC10780961 DOI: 10.3390/nu16010111] [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: 11/08/2023] [Revised: 12/11/2023] [Accepted: 12/23/2023] [Indexed: 01/12/2024] Open
Abstract
BACKGROUND Vitamin D testing (VDT) and supplement use (VDS) are on the rise, but most patients remain deficient (<30 ng/mL-VDD). We designed the present real-world study to assess this paradox. METHODS We reviewed data from all patients visiting our clinics between 2014 and 2022. We estimated the rate of patients with vitamin D adequacy (≥30 ng/mL) (VDA) by year and month of testing, the dose of VDS (low (≤1200 IU/day), medium (1201-3000 I/day) and high dose (>3000 IU/day)), intake duration (short-term (<12 months) and long-term use (≥12 months)), and timing of use (current use, former use, no use). RESULTS We enrolled n = 6912 subjects with vitamin D measurements: n = 5195 females (75.2%), age 44.0 ± 16.8 years, BMI 27.9 ± 6.5 kg/m2; never users: n = 5553 (80.3%), former users: n = 533 (7.7%), current users: n = 826 (12.0%). Current use of VDS was higher in females. VDT rose from 42.1% in 2014 to 92.7% in 2022, and VDA rose from 14.8% to 25.5% for the same time. VDA was found overall in n = 1511 (21.9%); Never users: n = 864 (15.6%), Former users: n = 123 (23.2%); and Current users: n = 370 (44.8%). The maximal VDA (67.9%) was found in subjects using high-dose VDS in the long term. CONCLUSIONS Despite the significant rise in VDT and VDS use, VDA was found in a minority of patients. Prolonged use of high-dose supplements produces modest improvements in VDA.
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Affiliation(s)
- Rodis D. Paparodis
- Endocrinology, Diabetes and Metabolism Clinics, Private Practice, 26221 Patras, Greece
- Center for Diabetes and Endocrine Research, College of Medicine and Life Sciences, University of Toledo, Toledo, OH 43614, USA;
- Hellenic Endocrine Network, 10682 Athens, Greece; (D.B.); (S.L.); (N.A.); (D.T.P.)
- Department of Medicine, Edward Hines, Jr. VA Hospital, Loyola University Chicago, Hines, IL 60141, USA;
| | - Dimitra Bantouna
- Hellenic Endocrine Network, 10682 Athens, Greece; (D.B.); (S.L.); (N.A.); (D.T.P.)
| | - Evangelos Karvounis
- Endocrine Surgery Center of Excellence, Euroclinic Hospital, 11528 Athens, Greece;
| | - Ioannis Zoupas
- School of Medicine, University of Athens, 11527 Athens, Greece;
| | - Sarantis Livadas
- Hellenic Endocrine Network, 10682 Athens, Greece; (D.B.); (S.L.); (N.A.); (D.T.P.)
- Division of Endocrinology, Diabetes and Metabolism, Athens Medical Center, 11528 Athens, Greece
- Endocrinology, Diabetes and Metabolism Clinics, Private Practice, 11528 Athens, Greece
| | - Nicholas Angelopoulos
- Hellenic Endocrine Network, 10682 Athens, Greece; (D.B.); (S.L.); (N.A.); (D.T.P.)
- Endocrinology, Diabetes and Metabolism Clinics, Private Practice, 65302 Kavala, Greece
| | - Shahnawaz Imam
- Center for Diabetes and Endocrine Research, College of Medicine and Life Sciences, University of Toledo, Toledo, OH 43614, USA;
| | - Dimitrios T. Papadimitriou
- Hellenic Endocrine Network, 10682 Athens, Greece; (D.B.); (S.L.); (N.A.); (D.T.P.)
- Medical School, University of Thessaly, 41223 Larisa, Greece
| | - Juan C. Jaume
- Department of Medicine, Edward Hines, Jr. VA Hospital, Loyola University Chicago, Hines, IL 60141, USA;
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Jin Z, Bertholf RL, Yi X. Advances and challenges in the measurement of 1,25-dihydroxyvitamin D: a comprehensive review. Crit Rev Clin Lab Sci 2023; 60:535-548. [PMID: 37272827 DOI: 10.1080/10408363.2023.2212765] [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: 02/24/2023] [Revised: 04/16/2023] [Accepted: 05/08/2023] [Indexed: 06/06/2023]
Abstract
Vitamin D has received significant attention from clinical societies, researchers, and the general population in recent years. While 25-hydroxyvitamin D (25(OH)D) is the most commonly-used biomarker of vitamin D status, 1α,25-dihydroxyvitamin D (1,25(OH)2D), its bioactive form, plays a critical role in regulating calcium and phosphorus homeostasis and is also involved in the immune system and cellular differentiation. Consequently, accurate measurements of 1,25(OH)2D can aid in the differential diagnosis of calcium-related disorders such as hypocalcemia in vitamin D-dependent rickets and hypercalcemia due to inappropriate increase of serum 1,25(OH)2D in granulomatous diseases. However, due to its lipophilicity and very low circulating concentration, the measurement of 1,25(OH)2D is particularly challenging. Over the past several decades, numerous efforts have been made to develop sensitive, specific, and practical laboratory methods for measuring 1,25(OH)2D. Methods using radioreceptor assay, radioimmunoassay, enzyme immunoassay, enzyme-linked immunosorbent assay, automated chemiluminescent immunoassay, and liquid chromatography-tandem mass spectrometry have been described. Each of these methods has unique advantages and limitations, and some are no longer used. Despite the sophisticated methods in use today, substantial variations between methods still exist. A concerted effort toward standardization of 1,25(OH)2D measurement is needed to ensure accurate and reliable results across laboratories and methods.
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Affiliation(s)
- Zhicheng Jin
- Department of Pathology and Laboratory Medicine, School of Medicine and Public Health, University of Wisconsin - Madison, Madison, WI, USA
| | - Roger L Bertholf
- Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Houston, TX, USA
- Department of Pathology and Laboratory Medicine, Weill Cornell Medical College, New York, NY, USA
| | - Xin Yi
- Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Houston, TX, USA
- Department of Pathology and Laboratory Medicine, Weill Cornell Medical College, New York, NY, USA
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7
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Martelli M, Salvio G, Santarelli L, Bracci M. Shift Work and Serum Vitamin D Levels: A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19158919. [PMID: 35897284 PMCID: PMC9332580 DOI: 10.3390/ijerph19158919] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 07/19/2022] [Accepted: 07/20/2022] [Indexed: 02/01/2023]
Abstract
Vitamin D deficiency and insufficiency are highly prevalent conditions worldwide due to several factors, including poor sun exposure. Shift workers may be exposed to the risk of hypovitaminosis D due to fewer opportunities for sunlight exposure compared to day workers. A systematic review of the PubMed, SCOPUS, and EMBASE databases was conducted according to the Preferred Reporting Items for Systemic Reviews and Meta-Analyses (PRISMA) statement to investigate the effect of shift work on vitamin D levels. Mean differences (MD) and 95% confidence intervals (CI) of serum 25-OH-D levels in shift workers and non-shift workers were calculated. A total of 13 cross-sectional studies were included in the meta-analysis. We found significantly lower levels of serum 25-OH-D in shift workers compared with non-shift workers (MD: −1.85, 95% CI [−2.49 to −1.21]). Heterogeneity among included studies was high (I2 = 89%, p < 0.0001), and neither subgroup analysis nor meta-regression were able to identify specific sources of the heterogeneity that may be related to the different characteristics of shift work among studies. The monitoring of serum vitamin D levels and prompt correction of any deficiencies should be considered in shift workers. Notably, since a large part of the observations are derived from Koreans, larger epidemiological studies are needed in other populations.
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Affiliation(s)
- Margherita Martelli
- Occupational Health, Department of Clinical and Molecular Sciences, Polytechnic University of Marche, 60126 Ancona, Italy;
| | - Gianmaria Salvio
- Endocrinology Clinic, Department of Clinical and Molecular Sciences, Polytechnic University of Marche, 60126 Ancona, Italy;
| | - Lory Santarelli
- Occupational Health, Department of Clinical and Molecular Sciences, Polytechnic University of Marche, 60126 Ancona, Italy;
- Correspondence: (L.S.); (M.B.)
| | - Massimo Bracci
- Occupational Health, Department of Clinical and Molecular Sciences, Polytechnic University of Marche, 60126 Ancona, Italy;
- Correspondence: (L.S.); (M.B.)
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8
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Clarke KE, Hurst EA, Mellanby RJ. Vitamin D metabolism and disorders in dogs and cats. J Small Anim Pract 2021; 62:935-947. [PMID: 34323302 DOI: 10.1111/jsap.13401] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Revised: 06/05/2021] [Accepted: 06/19/2021] [Indexed: 12/20/2022]
Abstract
Vitamin D plays an important role in regulating calcium metabolism and in the development and maintenance of skeletal health of companion animals. There is also a growing interest in understanding the role vitamin D plays in non-skeletal health in both human and veterinary patients. This review provides an update of our current understanding of vitamin D biology in dogs and cats and gives an overview of how vitamin D metabolism can be assessed in companion animals. Congenital and acquired vitamin D disorders are then summarised before the review concludes with a summary of recent studies which have explored the role of vitamin D in the development and outcomes of non-skeletal diseases of dogs and cats.
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Affiliation(s)
- K E Clarke
- Davies Veterinary Specialists, Manor Farm Business Park, Higham Gobion, Hertfordshire, UK
| | - E A Hurst
- Royal (Dick) School of Veterinary Studies and the Roslin Institute, The University of Edinburgh, Easter Bush Campus, Roslin, Midlothian, UK
| | - R J Mellanby
- Royal (Dick) School of Veterinary Studies and the Roslin Institute, The University of Edinburgh, Easter Bush Campus, Roslin, Midlothian, UK
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Junqueira L, Polonini H, Ramos C, Ferreira AO, Raposo N, Brandão M. Assessment of a Novel Vitamin D3 Formulation with Nanostructured Lipid Carriers for Transdermal Delivery. Curr Drug Deliv 2021; 19:614-624. [PMID: 34238191 DOI: 10.2174/1567201818666210708121304] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 05/21/2021] [Accepted: 05/30/2021] [Indexed: 11/22/2022]
Abstract
OBJECTIVE Develop and assess a transdermal emulsion loaded with nanostructured lipid carriers for vitamin D3 supplementation. METHODS Vitamin D3 loaded nanostructured lipid carriers, produced via high shear homogenization and ultrasonication, were assessed for their particle size, distribution, morphology, zeta potential, entrapment efficiency, and cytotoxicity. They were incorporated into a transdermal vehicle, and the stability and ex vivo permeation were evaluated. RESULTS Spherical nanoparticles were developed with a particle size of 192.5 nm, a polydispersity index of 0.13, a zeta potential of -29.0 mV, and an entrapment efficiency of 99.75%. They were stable (particle size and distribution) for 15 days when stored in a refrigerator and for 30 days at room temperature and 32 °C. The nanoparticles decreased the drug cytotoxicity against fibroblasts, as shown by IC50 (nanoparticle: 32.48 μg mL-1; vitamin D3: 16.73 μg mL-1). The emulsion loaded with nanoparticles minimized the degradation of vitamin D3 when compared with the nanoparticle dispersion. Additionally, the emulsion provided the skin permeation of vitamin D3 following the recommended daily allowance. CONCLUSION To the best of our knowledge, this is the first study to use nanostructured lipid carriers for transdermal delivery of vitamin D. The developed formulation is a promising strategy to overcome the vitamin D3 variable oral bioavailability. It also represents a comfortable route of administrationd. Thus it could be beneficial for patients and clinicians. However, further studies are needed to allow the permeation of larger amounts of vitamin D3, and the combination of these nanoparticles with microneedles would be interesting.
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Affiliation(s)
- Laura Junqueira
- NUPICS- Núcleo de Pesquisa e Inovação em Ciências da Saúde, Universidade Federal de Juiz de Fora, Juiz de Fora. Brazil
| | - Hudson Polonini
- NUPICS- Núcleo de Pesquisa e Inovação em Ciências da Saúde, Universidade Federal de Juiz de Fora, Juiz de Fora. Brazil
| | | | - Anderson O Ferreira
- NUPICS- Núcleo de Pesquisa e Inovação em Ciências da Saúde, Universidade Federal de Juiz de Fora, Juiz de Fora. Brazil
| | - Nádia Raposo
- NUPICS- Núcleo de Pesquisa e Inovação em Ciências da Saúde, Universidade Federal de Juiz de Fora, Juiz de Fora. Brazil
| | - Marcos Brandão
- NUPICS- Núcleo de Pesquisa e Inovação em Ciências da Saúde, Universidade Federal de Juiz de Fora, Juiz de Fora. Brazil
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10
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Pruszkowska-Przybylska P, Sitek A, Rosset I, Sobalska-Kwapis M, Słomka M, Strapagiel D, Żądzińska E, Morling N. Associations between second to fourth digit ratio, cortisol, vitamin D, and body composition among Polish children. Sci Rep 2021; 11:7029. [PMID: 33782473 PMCID: PMC8007693 DOI: 10.1038/s41598-021-86521-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Accepted: 03/16/2021] [Indexed: 01/17/2023] Open
Abstract
Associations between body characteristics (body composition: fat mass, muscle mass, cell, and water mass as well as body proportion—BMI), the 2D:4D digit ratio, and the concentrations of cortisol and vitamin (25-OH)D among Polish children have not been studied before. A total of 133 (73 girls and 60 boys) healthy Polish children aged 7–11 years were examined. The investigation was divided into three parts: measuring (the length of the second and fourth fingers in both hands, body composition, and body height and mass), questionnaires (socioeconomic status), and laboratory investigations (25-OH vitamin D and cortisol concentrations in saliva measured with ELISA methods). Boys with digit ratios below 1 had lower vitamin D concentration than those with digit ratios equal to or higher than 1 (Z = − 2.33; p = 0.019). Only boys with the male-typical pattern of 2D:4D digit ratio tended to have a lower 25-OH vitamin D concentration in saliva. Thus, it might indicate an effect of prenatal programming on the concentrations of steroid hormones in later life. Neither vitamin D, 2D:4D digit ratio nor the cortisol level was associated with the body components or proportions. More studies are needed to evaluate the molecular and genetic background of this phenomenon.
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Affiliation(s)
| | - Aneta Sitek
- Department of Anthropology, Faculty of Biology and Environmental Protection, University of Lodz, 90-237, Lodz, Poland
| | - Iwona Rosset
- Department of Anthropology, Faculty of Biology and Environmental Protection, University of Lodz, 90-237, Lodz, Poland
| | - Marta Sobalska-Kwapis
- The Biobank Lab, Department of Molecular Biophysics, Faculty of Biology and Environmental Protection, University of Lodz, Lodz, Poland.,BBMRI.Pl Consortium, Wrocław, Poland
| | - Marcin Słomka
- The Biobank Lab, Department of Molecular Biophysics, Faculty of Biology and Environmental Protection, University of Lodz, Lodz, Poland.,BBMRI.Pl Consortium, Wrocław, Poland
| | - Dominik Strapagiel
- The Biobank Lab, Department of Molecular Biophysics, Faculty of Biology and Environmental Protection, University of Lodz, Lodz, Poland.,BBMRI.Pl Consortium, Wrocław, Poland
| | - Elżbieta Żądzińska
- Department of Anthropology, Faculty of Biology and Environmental Protection, University of Lodz, 90-237, Lodz, Poland.,Biological Anthropology and Comparative Anatomy Research Unit, School of Medicine, The University of Adelaide, Adelaide, SA, 5005, Australia
| | - Niels Morling
- Section of Forensic Genetics, Department of Forensic Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Frederik V's Vej 11, 2100, Copenhagen, Denmark
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11
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Makris K, Bhattoa HP, Cavalier E, Phinney K, Sempos CT, Ulmer CZ, Vasikaran SD, Vesper H, Heijboer AC. Recommendations on the measurement and the clinical use of vitamin D metabolites and vitamin D binding protein - A position paper from the IFCC Committee on bone metabolism. Clin Chim Acta 2021; 517:171-197. [PMID: 33713690 DOI: 10.1016/j.cca.2021.03.002] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Revised: 01/10/2021] [Accepted: 03/04/2021] [Indexed: 02/08/2023]
Abstract
Vitamin D, an important hormone with a central role in calcium and phosphate homeostasis, is required for bone and muscle development as well as preservation of musculoskeletal function. The most abundant vitamin D metabolite is 25-hydroxyvitamin D [25(OH)D], which is currently considered the best marker to evaluate overall vitamin D status. 25(OH)D is therefore the most commonly measured metabolite in clinical practice. However, several other metabolites, although not broadly measured, are useful in certain clinical situations. Vitamin D and all its metabolites are circulating in blood bound to vitamin D binding protein, (VDBP). This highly polymorphic protein is not only the major transport protein which, along with albumin, binds over 99% of the circulating vitamin D metabolites, but also participates in the transport of the 25(OH)D into the cell via a megalin/cubilin complex. The accurate measurement of 25(OH)D has proved a difficult task. Although a reference method and standardization program are available for 25(OH)D, the other vitamin D metabolites still lack this. Interpretation of results, creation of clinical supplementation, and generation of therapeutic guidelines require not only accurate measurements of vitamin D metabolites, but also the accurate measurements of several other "molecules" related with bone metabolism. IFCC understood this priority and a committee has been established with the task to support and continue the standardization processes of vitamin D metabolites along with other bone-related biomarkers. In this review, we present the position of this IFCC Committee on Bone Metabolism on the latest developments concerning the measurement and standardization of vitamin D metabolites and its binding protein, as well as clinical indications for their measurement and interpretation of the results.
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Affiliation(s)
- Konstantinos Makris
- Clinical Biochemistry Department, KAT General Hospital, 14561 Athens, Greece; Laboratory for Research of the Musculoskeletal System "Th. Garofalidis", Medical School, University of Athens, Athens, Greece.
| | - Harjit P Bhattoa
- Department of Laboratory Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Etienne Cavalier
- Department of Clinical Chemistry, University of Liège, CHU de Liège, Domaine du Sart-Tilman, B-4000 Liège, Belgium
| | - Karen Phinney
- Biomolecular Measurement Division, National Institute of Standards and Technology, Gaithersburg, MD, USA
| | - Christopher T Sempos
- Coordinator, Vitamin D Standardization Program (VDSP), Havre de Grace, MD 21078, USA
| | - Candice Z Ulmer
- Clinical Chemistry Branch, Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Samuel D Vasikaran
- PathWest Laboratory Medicine, Fiona Stanley Hospital, Murdoch, WA, Australia
| | - Hubert Vesper
- Clinical Chemistry Branch, Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Annemieke C Heijboer
- Department of Clinical Chemistry, Endocrine Laboratory, Amsterdam Gastroenterology Endocrinology & Metabolism, Vrije Universiteit Amsterdam and University of Amsterdam, Amsterdam UMC, Amsterdam, Netherlands
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12
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Zhang C, Liu K, Hou J. Extending the vitamin D pathway to vitamin D 3 and CYP27A1 in periodontal ligament cells. J Periodontol 2020; 92:44-53. [PMID: 33107041 DOI: 10.1002/jper.20-0225] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Revised: 09/03/2020] [Accepted: 10/20/2020] [Indexed: 12/16/2022]
Abstract
BACKGROUND In periodontal connective tissue cells, the vitamin D pathway has been elucidated, and vitamin D3 in the main storage form, 25-hydroxy vitamin D3 (25[OH]D3 ), and the functional form, 1,25-dihydroxy vitamin D3 (1,25[OH]2 D3 ), have been found to induce the expression of human cationic antimicrobial protein (hCAP-18)/LL-37. Moreover, synergistic effects between Toll-like receptor agonists and 25(OH)D3 have been reported. This research aimed at extending the vitamin D pathway to vitamin D3 and CYP27A1 in human periodontal ligament cells (hPDLCs) to further explore its function in periodontal inflammatory reaction. METHODS Vitamin D3 was used to stimulate hPDLCs in the presence or absence of Porphyromonas gingivalis lipopolysaccharide (Pg-LPS). Conversely, CYP27A1 RNA interference was performed to further validate the findings. The mRNA expression of hCAP-18 was determined with real-time polymerase chain reaction. Monocyte chemotactic protein-1 (MCP-1) and interleukin-8 (IL-8) were also detected. The cell supernatant levels of LL-37 were detected with enzyme-linked immunosorbent assay. RESULTS Vitamin D3 significantly enhanced the generation of hCAP-18/LL-37. A combination of Pg-LPS and vitamin D3 significantly promoted hCAP-18/LL-37 expression. When the expression of CYP27A1 was knocked down with RNA interference, the induction of hCAP-18/LL-37 expression was significantly inhibited. Therefore, the mRNA levels of MCP-1 and IL-8 in hPDLCs were significantly decreased through the vitamin D pathway. CONCLUSION The vitamin D pathway from vitamin D3 to hCAP-18/LL-37 exists in hPDLCs, and CYP27A1 might be involved in periodontal immune defense.
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Affiliation(s)
- Churen Zhang
- Department of Periodontology, Peking University School and Hospital of Stomatology, Beijing, China.,National Clinical Research Center for Oral Diseases, Beijing, China.,National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing, China.,Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - Kaining Liu
- Department of Periodontology, Peking University School and Hospital of Stomatology, Beijing, China.,National Clinical Research Center for Oral Diseases, Beijing, China.,National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing, China.,Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - Jianxia Hou
- Department of Periodontology, Peking University School and Hospital of Stomatology, Beijing, China.,National Clinical Research Center for Oral Diseases, Beijing, China.,National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing, China.,Beijing Key Laboratory of Digital Stomatology, Beijing, China
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13
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Makris K, Sempos C, Cavalier E. The measurement of vitamin D metabolites part II-the measurement of the various vitamin D metabolites. Hormones (Athens) 2020; 19:97-107. [PMID: 32221839 DOI: 10.1007/s42000-020-00188-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Accepted: 03/10/2020] [Indexed: 12/18/2022]
Abstract
Today, the possibility exists to measure a number of different vitamin D metabolites with accurate and precise methods. The most abundant vitamin D metabolite, 25(OH)D, is considered the best marker for estimating vitamin D status and is therefore the most commonly measured in clinical practice. There is no consensus on the added value of measuring other metabolites beyond 25-hydroxyvitamin D, although, in some special clinical scenarios and complicated cases, these metabolites may provide just the information needed for an accurate diagnosis. The problem this review addresses is which metabolite to measure and when and how to measure it.
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Affiliation(s)
- Konstantinos Makris
- Clinical Biochemistry Department, KAT General Hospital, 2 Nikis Str., 14561, Kifissia, Greece.
| | - Christopher Sempos
- Vitamin D Standardization Program (VDSP), Havre de Grace, MD, 21078, USA
| | - Etienne Cavalier
- Department of Clinical Chemistry, University of Liege, CHU de Liege, Belgium
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14
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Makris K, Sempos C, Cavalier E. The measurement of vitamin D metabolites: part I-metabolism of vitamin D and the measurement of 25-hydroxyvitamin D. Hormones (Athens) 2020; 19:81-96. [PMID: 31919677 DOI: 10.1007/s42000-019-00169-7] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Accepted: 12/16/2019] [Indexed: 12/14/2022]
Abstract
It has been more than 80 years since the discovery of vitamin D and its ability to cure rickets in children. Vitamin D is a secosteroid and comes in two distinct forms, vitamin D2 and vitamin D3. During the last 40 years, the synthesis and metabolism of vitamin D were elucidated and more than 50 metabolites of vitamin D have been discovered, though commercial measurement procedures have been developed for only a few of them. The clinical significance of vitamin D in calcium and phosphorus homeostasis is well appreciated. However, recent epidemiological data have indicated that it has several extra-skeletal physiologic actions which are still a matter of scientific debate. Both research findings and the debate around the interpretation of the research results have created increased interest in more measurements of vitamin D. With the ever growing family of measurable vitamin D metabolites and the measuring techniques comes a question: What metabolic product will provide the right answers and which is the best way to measure it. The right choice of analytical technique is connected with the question of which metabolite we aim to measure, what is its serum concentration, and the purpose of the measurement. The aim of the first part of this review is to provide a brief overview of vitamin D metabolism and a more detailed analysis of the existing methods and the status of standardization for the measurement of 25-hydroxyvitamin D.
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Affiliation(s)
- Konstantinos Makris
- Clinical Biochemistry Department, KAT General Hospital, Kifissia, Athens, Greece.
| | - Christopher Sempos
- Vitamin D Standardization Program (VDSP), Havre de Grace, MD, 21078, USA
| | - Etienne Cavalier
- Department of Clinical Chemistry, University of Liege, CHU de Liege, Liege, Belgium
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15
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Bikle DD. Vitamin D: Newer Concepts of Its Metabolism and Function at the Basic and Clinical Level. J Endocr Soc 2020; 4:bvz038. [PMID: 32051922 PMCID: PMC7007804 DOI: 10.1210/jendso/bvz038] [Citation(s) in RCA: 73] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Accepted: 01/06/2020] [Indexed: 02/08/2023] Open
Abstract
The interest in vitamin D continues unabated with thousands of publications contributing to a vast and growing literature each year. It is widely recognized that the vitamin D receptor (VDR) and the enzymes that metabolize vitamin D are found in many cells, not just those involved with calcium and phosphate homeostasis. In this mini review I have focused primarily on recent studies that provide new insights into vitamin D metabolism, mechanisms of action, and clinical applications. In particular, I examine how mutations in vitamin D metabolizing enzymes-and new information on their regulation-links vitamin D metabolism into areas such as metabolism and diseases outside that of the musculoskeletal system. New information regarding the mechanisms governing the function of the VDR elucidates how this molecule can be so multifunctional in a cell-specific fashion. Clinically, the difficulty in determining vitamin D sufficiency for all groups is addressed, including a discussion of whether the standard measure of vitamin D sufficiency, total 25OHD (25 hydroxyvitamin) levels, may not be the best measure-at least by itself. Finally, several recent large clinical trials exploring the role of vitamin D supplementation in nonskeletal diseases are briefly reviewed, with an eye toward what questions they answered and what new questions they raised.
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Affiliation(s)
- Daniel D Bikle
- Department of Medicine and Endocrine Research Unit, Veterans Affairs Medical Center and University of California, San Francisco, California
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16
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Vitamin D testing: advantages and limits of the current assays. Eur J Clin Nutr 2020; 74:231-247. [DOI: 10.1038/s41430-019-0553-3] [Citation(s) in RCA: 46] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Revised: 12/17/2019] [Accepted: 12/18/2019] [Indexed: 12/25/2022]
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17
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Christakos S, Li S, De La Cruz J, Bikle DD. New developments in our understanding of vitamin metabolism, action and treatment. Metabolism 2019; 98:112-120. [PMID: 31226354 PMCID: PMC6814307 DOI: 10.1016/j.metabol.2019.06.010] [Citation(s) in RCA: 59] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2019] [Revised: 06/07/2019] [Accepted: 06/14/2019] [Indexed: 12/14/2022]
Abstract
Although vitamin D has been reported to have pleiotropic effects including effects on the immune system and on cancer progression, the principal action of vitamin D is the maintenance of calcium and phosphate homeostasis. The importance of vitamin D in this process is emphasized by the consequences of vitamin D deficiency which includes rickets in children and osteomalacia in adults. Vitamin D deficiency has also been reported to increase the risk of falls and osteoporotic fractures. Although vitamin D fortification of foods (including dairy products) has contributed to a marked decrease in rickets in the Western world, vitamin D deficiency in children and adults is still prevalent world-wide. This review summarizes new developments in our understanding of vitamin D endocrine system and addresses clinical syndromes related to abnormalities in vitamin D metabolism and action. In addition, the current understanding of the evaluation of vitamin D deficiency and sufficiency and recommendations for achieving vitamin D sufficiency are discussed.
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Affiliation(s)
- Sylvia Christakos
- Department of Microbiology, Biochemistry and Molecular Genetics, Rutgers, the State University of New Jersey, New Jersey Medical School, Newark, NJ, USA.
| | - Shanshan Li
- Department of Microbiology, Biochemistry and Molecular Genetics, Rutgers, the State University of New Jersey, New Jersey Medical School, Newark, NJ, USA
| | - Jessica De La Cruz
- Department of Microbiology, Biochemistry and Molecular Genetics, Rutgers, the State University of New Jersey, New Jersey Medical School, Newark, NJ, USA
| | - Daniel D Bikle
- Departments of Medicine and Dermatology, University of California and VA Medical Center, San Francisco, CA, USA
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18
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The utility of complement assays in clinical immunology: A comprehensive review. J Autoimmun 2018; 95:191-200. [PMID: 30391025 DOI: 10.1016/j.jaut.2018.10.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Accepted: 10/17/2018] [Indexed: 12/19/2022]
Abstract
The multi-tasking organ liver, which is the major synthesis site of most serum proteins, supplies humoral components of the innate, - including proteins of the complement system; and, less intensely, also of the acquired immune system. In addition to hepatocyte origins, C1q, factor D, C3, C7 and other protein components of the complement system are produced at various body locations by monocytes/macrophages, lymphocytes, adipocytes, endometrium, enterocytes, keratinocytes and epithelial cells; but the contribution of these alternate sites to the total serum concentrations is slight. The two major exceptions are factor D, which cleaves factor B of the alternative pathway derived largely from adipocytes, and C7, derived largely from polymorphonuclear leukocytes and monocytes/macrophages. Whereas the functional meaning of the extrahepatic synthesis of factor D remains to be elucidated, the local contribution of C7 may up- or downregulate the complement attack. The liver, however, is not classified as part of the immune system but is rather seen as victim of autoimmune diseases, a point that needs apology. Recent histological and cell marker technologies now turn the hands to also conceive the liver as proactive autoimmune disease catalyst. Hosting non-hepatocytic cells, e.g. NK cells, macrophages, dendritic cells as well as T and B lymphocytes, the liver outreaches multiple sites of the immune system. Immunopharmacological follow up of liver transplant recipients teaches us on liver-based presence of ABH-glycan HLA phenotypes and complement mediated ischemia/regeneration processes. In clinical context, the adverse reactions of the complement system can now be curbed by specific drug therapy. This review extends on the involvement of the complement system in liver autoimmune diseases and should allow to direct therapeutic opportunities.
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