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Ding YJ, Li XN, Xiao Z, Li CY, Jia LH. Low vitamin D during pregnancy is associated with infantile eczema by up-regulation of PI3K/AKT/mTOR signaling pathway and affecting FOXP3 expression: A bidirectional cohort study. J Nutr Biochem 2024; 124:109516. [PMID: 37925089 DOI: 10.1016/j.jnutbio.2023.109516] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 10/26/2023] [Accepted: 10/31/2023] [Indexed: 11/06/2023]
Abstract
Vitamin D has received increasing attention because of its association with atopic disease development. Limited studies that have been done on the impact of maternal vitamin D levels during pregnancy on infantile eczema are still debatable. We wanted to discover the effect of maternal vitamin D on infantile eczema and explore whether regulatory T cells (Treg) play a role in this process. 219 pairs of mothers and children were enrolled. Maternal fasting venous blood was collected in pregnancy's second and third trimesters to determine vitamin D levels. Cord blood and placenta samples were collected during childbirth for detecting levels of genes, proteins and cytokines. Pediatricians followed up the prevalence of eczema in infants within 1 year. The reported rate of vitamin D deficiency and insufficiency was 35.6% and 28.3%. Lower maternal 25(OH)D3 levels were related to a higher risk of infantile eczema. Foxp3 gene expression is lower in cord blood of infants with eczema compared to infants without eczema. There was a positive correlation between maternal 25(OH)D3 levels and the expression of FOXP3 gene in cord blood. Compared to vitamin D sufficiency women, vitamin D deficiency women's placental FOXP3 protein expression was decreased and PI3K/AKT/mTOR protein was up-regulated. Our study demonstrates that low prenatal maternal vitamin D levels increased the risk of infantile eczema aged 0-1 year, which might be related to the downregulating of the FOXP3 gene expression in cord blood and decreased placental FOXP3 protein expression. Low placental FOXP3 protein was related with activating PI3K/AKT/mTOR signaling pathway.
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Affiliation(s)
- Ya-Jie Ding
- Huizhou Institute for Occupational Health, Huizhou, China; Department of Child and Adolescent Health, School of Public Health, China Medical University, Shenyang, China; Liaoning Key Laboratory of Obesity and Glucose/Lipid Associated Metabolic Diseases, Shenyang, China
| | - Xue-Ning Li
- Department of Pediatrics, The Fourth Affiliated Hospital of China Medical University, Shenyang, China
| | - Zhe Xiao
- Department of Child and Adolescent Health, School of Public Health, China Medical University, Shenyang, China; Liaoning Key Laboratory of Obesity and Glucose/Lipid Associated Metabolic Diseases, Shenyang, China
| | - Chen-Yang Li
- Department of Child and Adolescent Health, School of Public Health, China Medical University, Shenyang, China; Liaoning Key Laboratory of Obesity and Glucose/Lipid Associated Metabolic Diseases, Shenyang, China
| | - Li-Hong Jia
- Department of Child and Adolescent Health, School of Public Health, China Medical University, Shenyang, China; Liaoning Key Laboratory of Obesity and Glucose/Lipid Associated Metabolic Diseases, Shenyang, China.
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Motamed S, Anari R, Motamed S, Amani R. Vitamin D and biomarkers of inflammation and oxidative stress among pregnant women: a systematic review of observational studies. BMC Immunol 2023; 24:41. [PMID: 37891486 PMCID: PMC10612223 DOI: 10.1186/s12865-023-00577-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 10/16/2023] [Indexed: 10/29/2023] Open
Abstract
OBJECTIVE This systematic review aimed to map the evidence evaluated the relationship between vitamin D and redox and inflammatory status during gestation. METHODS Three databases (PubMed/MEDLINE, Scopus, and Web of Science (WoS)) and reference list of included documents were searched for related observational studies published until 2nd October 2023. To determine the quality of the selected observational studies, the Newcastle-Ottawa Scale (NOS) was used. RESULTS After a primary search of three databases, 19492records were appeared. When duplicates and irrelevant documents were removed, 14 articles were found to have eligible criteria. The design of the identified studies was cross-sectional, case-control and cohort. Evidence showed an adverse association between 25(OH)D and the biomarkers of inflammation, such as high-sensitivity C-reactive protein (hs-CRP), Interleukin-1beta (IL-1β), Interleukin-6 (IL-6), and tumor necrosis factor- alfa (TNF-α) during pregnancy. On the contrary, some studies represented that 25(OH)D positively correlated with hs-CRP in the cord blood. One study suggested a direct association between serum concentrations of 25(OH)D and Interleukin-8 (IL-8), macrophage inflammatory protein (MIP), and TNF-α levels in mothers with gestational diabetes mellitus (GDM). A case-control study showed that lower serum concentration of 25(OH)D positively correlated with total antioxidant capacity (TAC) levels in participants. CONCLUSIONS Evidence confirmed the supposition of the direct relationship between vitamin D levels and biomarkers with anti-inflammatory and anti-oxidative properties. However, the Existence of inconsistent evidence confirms the need for further studies in mothers with GDM and hypertensive disorders. PROSPERO REGISTRATION CODE CRD42020202600.
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Affiliation(s)
| | - Razieh Anari
- National Nutrition and Food Technology Research Institute, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Somayeh Motamed
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Reza Amani
- Department of Clinical Nutrition, School of Nutrition and Food Sciences, Isfahan University of Medical Sciences, Isfahan, Iran
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Ssewanyana D, Borque SL, Lye SJ, Matthews SG. Hepcidin across pregnancy and its correlation with maternal markers of iron and inflammation, maternal body weight outcomes, and offspring neurodevelopmental outcomes: a systematic review and meta-analysis. AJOG GLOBAL REPORTS 2023; 3:100222. [PMID: 37645642 PMCID: PMC10461250 DOI: 10.1016/j.xagr.2023.100222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/31/2023] Open
Abstract
OBJECTIVE This study evaluated the correlation between maternal hepcidin and other biomarkers of iron status, markers of inflammation, and maternal body weight during pregnancy, as well as neurodevelopment in the offspring. DATA SOURCES PubMed, Web of Science, Scopus, and Embase were searched from inception until March 2022. STUDY ELIGIBILITY CRITERIA Studies conducted among pregnant women without apparent pregnancy complications were included. Eligible studies reported correlation coefficients between maternal hepcidin and any outcomes of maternal biomarkers of iron status or inflammatory load during pregnancy, prenatal maternal body weight, and offspring neurodevelopment. Studies without correlation data were eligible if they quantitatively reported volumes of both maternal hepcidin and any marker of iron status and/or inflammatory load during gestation. METHODS Pooled correlation coefficients between maternal hepcidin and outcomes of interest were calculated using the Fisher r-to-Z transformation. Both fixed-effects and DerSimonian and Laird random-effects models were used to calculate pooled correlation coefficient. When meta-analysis was not feasible, results were descriptively synthesized. RESULTS Forty-six studies with 6624 participants were eligible. Hepcidin was significantly correlated with hemoglobin in the third trimester (r=0.21; 95% confidence interval, 0.1-0.32); ferritin in the first (r=0.31; 95% confidence interval, 0.01-0.61) and third trimester (r=0.35; 95% confidence interval, 0.23-0.48); soluble transferrin receptor in the second trimester (r=-0.27; 95% confidence interval, -0.4 to -0.14); total iron-binding capacity in the second trimester (r=0.37; 95% confidence interval, 0.24-0.50); and serum iron in the third trimester (r=0.11; 95% confidence interval, 0.02-0.19). Hepcidin was significantly correlated with the inflammatory marker interleukin-6 in the third trimester (r=0.26; 95% confidence interval, 0.17-0.34) and C-reactive protein in the second (r=0.16; 95% confidence interval, 0.03-0.30) and third trimester (r=0.28; 95% confidence interval, 0.04-0.52). Four out of 5 studies reported weak-to-moderate positive correlation between hepcidin and body mass index. Hepcidin levels varied across body mass index categories. No single study reported the relationship between maternal hepcidin and neurodevelopment in offspring. CONCLUSION Hepcidin weakly to moderately correlates with biomarkers of iron and inflammation in pregnancy.
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Affiliation(s)
- Derrick Ssewanyana
- Departments of Physiology (Drs Ssewanyana, Lye, and Matthews)
- Medicine (Drs Ssewanyana, Lye, and Matthews), University of Toronto, Toronto, Canada
- Alliance for Human Development, Lunenfeld-Tanenbaum Research Institute, Toronto, Canada (Drs Ssewanyana, Lye, and Matthews)
| | - Stephane L. Borque
- Department of Anesthesiology and Pain Medicine and Pharmacology, University of Alberta, Edmonton, Canada (Dr Borque)
| | - Stephen J. Lye
- Departments of Physiology (Drs Ssewanyana, Lye, and Matthews)
- Medicine (Drs Ssewanyana, Lye, and Matthews), University of Toronto, Toronto, Canada
- Alliance for Human Development, Lunenfeld-Tanenbaum Research Institute, Toronto, Canada (Drs Ssewanyana, Lye, and Matthews)
| | - Stephen G. Matthews
- Departments of Physiology (Drs Ssewanyana, Lye, and Matthews)
- Medicine (Drs Ssewanyana, Lye, and Matthews), University of Toronto, Toronto, Canada
- Alliance for Human Development, Lunenfeld-Tanenbaum Research Institute, Toronto, Canada (Drs Ssewanyana, Lye, and Matthews)
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Grobeisen-Duque O, Mora-Vargas CD, Aguilera-Arreola MG, Helguera-Repetto AC. Cycle Biodynamics of Women's Microbiome in the Urinary and Reproductive Systems. J Clin Med 2023; 12:4003. [PMID: 37373695 DOI: 10.3390/jcm12124003] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 05/24/2023] [Accepted: 05/30/2023] [Indexed: 06/29/2023] Open
Abstract
The genitourinary microbiome plays a crucial role in the establishment and maintenance of urinary and reproductive health in women throughout their lives. Particularly during the reproductive stage, resident microorganisms contribute to implantation and protect against perinatal complications, including preterm birth, stillbirth, and low birth weight, while also serving as the first line of defense against pathogens that can cause infections, such as urinary tract infections and bacterial vaginosis. This review aimed to elucidate the relationship between a healthy microbiome environment and women's overall health. We examine the variability and dynamics of the microbiome during different developmental stages, ranging from the prepubertal to the postmenopausal stage. Furthermore, we explore the significance of a healthy microbiota in successful implantation and pregnancy development and investigate potential differences between women experiencing infertility. In addition, we analyze the local and systemic inflammatory responses associated with the establishment of a dysbiotic state and compare it to a condition where a healthy microbiome was established. Lastly, we present the most recent evidence regarding preventive measures, such as dietary interventions and the use of probiotics to promote and maintain a healthy microbiome, thereby ensuring comprehensive women's health. By highlighting the importance of the genitourinary microbiome in reproductive health, this review aimed to enhance this microbiome's visibility and significance in the field.
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Affiliation(s)
- Orly Grobeisen-Duque
- Departamento de Inmunobioquímica, Instituto Nacional de Perinatología Isidro Espinosa de los Reyes, Ciudad de Mexico 11000, Mexico
- Facultad de Ciencias de la Salud, Universidad Anahuac Mexico, Ciudad de Mexico 52786, Mexico
| | - Carlos Daniel Mora-Vargas
- Departamento de Inmunobioquímica, Instituto Nacional de Perinatología Isidro Espinosa de los Reyes, Ciudad de Mexico 11000, Mexico
- Escuela Nacional de Ciencias Biologicas del Instituto Politecnico Nacional, Ciudad de Mexico 11350, Mexico
| | | | - Addy Cecilia Helguera-Repetto
- Departamento de Inmunobioquímica, Instituto Nacional de Perinatología Isidro Espinosa de los Reyes, Ciudad de Mexico 11000, Mexico
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Moideen K, Nathella PK, Madabushi S, Renji RM, Srinivasan P, Ahamed SF, Rajkumar H, Bethunaickan R, Babu S. Plasma Vitamin D levels in correlation with circulatory proteins could be a potential biomarker tool for pulmonary tuberculosis and treatment monitoring. Cytokine 2023; 168:156238. [PMID: 37276815 DOI: 10.1016/j.cyto.2023.156238] [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: 10/27/2022] [Revised: 04/14/2023] [Accepted: 05/18/2023] [Indexed: 06/07/2023]
Abstract
BACKGROUND Tuberculosis (TB), a life-threatening immune challenging disease to the global human community has to be diagnosed earlier and eliminated in the upcoming era. Vitamin D, a fat-soluble micronutrient, mainly from epidermal cells of the skin and a few dietary sources, is associated with the immune system in various disease management. Therefore, a better understanding of vitamin D metabolism and immune function in tuberculosis should be studied for the consideration of biomarkers. METHODS The study consist of Pulmonary Tuberculosis (PTB) patients (n = 32) at two-time points: Baseline (PTB BL) and after 6 months of anti-TB treatment (ATT) (PTB PT), latently Mtb infected (IFNγ + ) group (n = 32) and a non-LTB healthy control (IFNγ-) group (n = 32). Vitamin D levels were measured using High-performance liquid chromatography (HPLC). The cytokine data from the same participants assayed by ELISA from our earlier investigations were used to correlate it with serum Vitamin D levels. RESULTS The assayed serum Vitamin D levels between the groups showed significantly lowered levels in PTB BL when compared with IFNγ + and IFNγ- groups. And, the Vitamin D levels in the PTB group after ATT were significantly lower than the baseline levels. The Vitamin D data were compared with pro- and anti-inflammatory cytokines and adipokines levels by performing a principal component regression analysis. Based on the PC scores, the study group showed distinct clusters for the TB group and control group. And, the correlation analysis between the study group and immunological indices showed significant correlations. Vitamin D significantly correlated with IFNγ, TNFα, IL17A, IL-4 and Resistin in the TB group, whereas IL-6 and G-CSF in the control group. CONCLUSION The baseline measurement of Vitamin D levels was significantly decreased in the PTB group when compared with IFNγ + and IFNγ- groups showing the importance of Vitamin D as a preventive factor against the TB disease progression. The six-month post-treatment of TB showed a further decrease in Vitamin D levels in PTB. The significantly correlated immunological indices with Vitamin D levels are the biomarker profile that could predict TB.
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Affiliation(s)
- Kadar Moideen
- NIH-NIRT-International Centre for Excellence in Research, India; Department of Immunology, National Institute for Research in Tuberculosis (NIRT), India
| | - Pavan Kumar Nathella
- Department of Immunology, National Institute for Research in Tuberculosis (NIRT), India
| | | | | | - Padmanaban Srinivasan
- Department of Biostatistics, National Institute for Research in Tuberculosis (NIRT), India
| | - Shaik Fayaz Ahamed
- Department of Biostatistics, National Institute for Research in Tuberculosis (NIRT), India
| | | | | | - Subash Babu
- NIH-NIRT-International Centre for Excellence in Research, India; LPD, NIAID, NIH, Bethesda, MD, USA
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Abbe C, Mitchell CM. Bacterial vaginosis: a review of approaches to treatment and prevention. FRONTIERS IN REPRODUCTIVE HEALTH 2023; 5:1100029. [PMID: 37325243 PMCID: PMC10264601 DOI: 10.3389/frph.2023.1100029] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 05/15/2023] [Indexed: 06/17/2023] Open
Abstract
Bacterial vaginosis (BV) is a common cause of vaginitis worldwide and is associated with serious reproductive health outcomes, including increased risk of preterm birth, sexually transmitted infections, and pelvic inflammatory disease. The current and only FDA-approved treatment regimens for BV are antibiotics, such as metronidazole and clindamycin. Antibiotics provide a short-term cure for bacterial vaginosis; however, fail to provide a consistent long-term cure for many women. Fifty to eighty percent of women experience a BV recurrence within a year of completing antibiotic treatment. This may be because after antibiotic treatment, beneficial strains of Lactobacillus, such as L. crispatus, do not recolonize the vagina. In the absence of an effective long-term cure, patients, providers, and researchers are exploring different approaches to treatment and prevention, resulting in a rapid evolution of perspectives on BV pathogenesis and approaches to management. Current areas of investigation for BV management include probiotics, vaginal microbiome transplantation, pH modulation, and biofilm disruption. Behavioral modifications that may help include smoking cessation, condom use and hormonal contraception. Additional strategies considered by many people include dietary modification, non-medical vaginally applied products, choice of lubricant, and treatments from medical practices outside of allopathic medicine. This review aims to provide a comprehensive and up to date outline of the landscape of ongoing and potential treatment and prevention strategies for BV.
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Affiliation(s)
- Carmen Abbe
- Elson S. Floyd College of Medicine, Washington State University, Spokane, WA, United States
| | - Caroline M. Mitchell
- Vincent Center for Reproductive Biology, Massachusetts General Hospital, Boston, MA, United States
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Ma L, Zhang Z, Li L, Zhang L, Lin Z, Qin H. Vitamin D deficiency increases the risk of bacterial vaginosis during pregnancy: Evidence from a meta-analysis based on observational studies. Front Nutr 2022; 9:1016592. [DOI: 10.3389/fnut.2022.1016592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 11/07/2022] [Indexed: 11/23/2022] Open
Abstract
BackgroundBacterial vaginosis (BV) is the most common microbiological syndrome in women of childbearing age, causing numerous adverse health issues in pregnant women. Several observational studies have discussed the association between vitamin D deficiency and the risk of BV during pregnancy, but the results were inconclusive. Therefore, this meta-analysis aimed to explore the association between vitamin D deficiency and BV risk in pregnant women.Materials and methodsWe searched four databases, including PubMed, Embase, Cochrane Library, and Web of Science, from their inception to July 2022. Pooled odds ratios (OR) with corresponding 95% confidence intervals (CI) were estimated using random effects models. Additionally, we conducted subgroup analyses to identify the potential sources of between-study heterogeneity. Sensitivity analysis was performed using the method of exclusion, one study at a time. Publication bias was examined using Egger’s test and funnel plot.ResultsA total of 14 studies from 13 articles including 4,793 participants were eligible for this meta-analysis. The outcome showed that vitamin D deficiency may increase the risk of BV during pregnancy by 54% (OR, 1.54; 95% CI, 1.25–1.91; P < 0.001). In subgroup analyses, positive associations were also found in studies that were: conducted in black women (OR, 1.56; 95% CI, 0.98–2.48; P = 0.060), focused on the first trimester of pregnancy (OR, 2.22; 95% CI, 1.35–3.64; P = 0.002), of high quality (OR, 3.05; 95% CI, 1.26–7.41; P = 0.014), and adjusted for confounders (OR, 1.28; 95% CI, 1.06–1.55; P = 0.012). Sensitivity analysis reported that BV risk during pregnancy resulting from vitamin D deficiency increased by 157% (OR, 2.57; 95% CI, 1.50–4.42; P = 0.001) when removing the first two high-weight studies. Publication bias was observed using Egger’s test (t = 3.43, P = 0.005) and a visual funnel plot.ConclusionThis meta-analysis showed that vitamin D deficiency is positively associated with the risk of BV during pregnancy. Further high-quality prospective cohort studies are needed to determine whether vitamin D intake reduces the prevalence of BV in pregnant women.
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Serum vitamin D levels and COVID-19 during pregnancy: A systematic review and meta-analysis. Clin Nutr ESPEN 2022; 51:120-127. [PMID: 36184196 PMCID: PMC9461277 DOI: 10.1016/j.clnesp.2022.09.008] [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: 07/04/2022] [Revised: 08/19/2022] [Accepted: 09/02/2022] [Indexed: 11/21/2022]
Abstract
Background Serum vitamin D levels are reported to be associated with the risk of incidence and severity of COVID-19 in the general population. During pregnancy, immune system alterations in line with changes in vitamin D metabolism may affect the course of COVID-19. Thus, we aimed to systematically review the association between vitamin D, pregnancy, and COVID-19. Methods A systematic literature search was conducted in PubMed, Scopus, Web of Science, Embase, and Google Scholar until the end of May 2022. Mean differences (MD) with 95% CI were used as desired effect sizes to assess the association of serum vitamin D levels with the risk of incidence and severity of COVID-19 in pregnant women. Results Among 259 records, 7 and 6 studies were included in the systematic review and meta-analysis, respectively. All included studies had acceptable quality. Our results demonstrated an insignificant difference between infected women and non-infected controls (MD = -2.55 ng/ml, 95% CI: −6.85 – 1.74). But serum vitamin D levels in severe/moderate cases compared to mild ones (MD = −2.71 ng/ml, 95% CI: −4.18 to −1.24) are significantly lower. Conclusion Based on the current evidence, serum vitamin D level does not associate with the risk of SARS-CoV-2 infection among pregnant women, but we find a significant association with the severity of the disease. These findings may be helpful in similar conditions and future studies to better understand the complex immune alterations during pregnancy.
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Radzey N, Harryparsad R, Meyer B, Chen PL, Gao X, Morrison C, Taku O, Williamson A, Mehou‐Loko C, Lefebvre d'Hellencourt F, Buck G, Smit J, Strauss J, Nanda K, Ahmed K, Beksinska M, Serrano M, Bailey V, Masson L, Deese J. Genital inflammatory status and the innate immune response to contraceptive initiation. Am J Reprod Immunol 2022; 88:e13542. [PMID: 35394678 PMCID: PMC10909525 DOI: 10.1111/aji.13542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 03/14/2022] [Accepted: 03/21/2022] [Indexed: 11/29/2022] Open
Abstract
PROBLEM Data on the effects of contraceptives on female genital tract (FGT) immune mediators are inconsistent, possibly in part due to pre-existing conditions that influence immune mediator changes in response to contraceptive initiation. METHODS This study included 161 South African women randomised to injectable depot medroxyprogesterone acetate (DMPA-IM), copper intrauterine device (IUD), or levonorgestrel (LNG) implant in the Evidence for Contraceptive Options and HIV Outcomes (ECHO) trial. We measured thirteen cytokines and antimicrobial peptides previously associated with HIV acquisition in vaginal swabs using Luminex and ELISA, before, and at 1 and 3 months after contraceptive initiation. Women were grouped according to an overall baseline inflammatory profile. We evaluated modification of the relationships between contraceptives and immune mediators by baseline inflammation, demographic, and clinical factors. RESULTS Overall, LNG implant and copper IUD initiation were associated with increases in inflammatory cytokines, while no changes were observed following DMPA-IM initiation. However, when stratifying by baseline inflammatory profile, women with low baseline inflammation in all groups experienced significant increases in inflammatory cytokines, while those with a high baseline inflammatory profile experienced no change or decreases in inflammatory cytokines. CONCLUSION We conclude that pre-contraceptive initiation immune profile modifies the effect of contraceptives on the FGT innate immune response.
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Affiliation(s)
- Nina Radzey
- Institute of Infectious Disease and Molecular Medicine (IDM)University of Cape TownCape TownSouth Africa
| | - Rushil Harryparsad
- Institute of Infectious Disease and Molecular Medicine (IDM)University of Cape TownCape TownSouth Africa
| | - Bahiah Meyer
- Institute of Infectious Disease and Molecular Medicine (IDM)University of Cape TownCape TownSouth Africa
| | | | | | | | - Ongeziwe Taku
- Institute of Infectious Disease and Molecular Medicine (IDM)University of Cape TownCape TownSouth Africa
| | - Anna‐Lise Williamson
- Institute of Infectious Disease and Molecular Medicine (IDM)University of Cape TownCape TownSouth Africa
| | - Celia Mehou‐Loko
- Institute of Infectious Disease and Molecular Medicine (IDM)University of Cape TownCape TownSouth Africa
| | | | - Gregory Buck
- Virginia Commonwealth UniversityRichmondVirginiaUSA
| | - Jennifer Smit
- MatCH Research Unit (MRU), Department of Obstetrics and GynaecologyUniversity of the WitwatersrandDurbanSouth Africa
| | | | | | - Khatija Ahmed
- Setshaba Research CentreTshwaneSouth Africa
- Department of Medical MicrobiologyUniversity of PretoriaPretoriaSouth Africa
| | - Mags Beksinska
- MatCH Research Unit (MRU), Department of Obstetrics and GynaecologyUniversity of the WitwatersrandDurbanSouth Africa
| | | | | | - Lindi Masson
- Institute of Infectious Disease and Molecular Medicine (IDM)University of Cape TownCape TownSouth Africa
- Disease Elimination Program, Life Sciences DisciplineBurnet InstituteMelbourneAustralia
- Centre for the AIDS Programme of Research in South AfricaDurbanSouth Africa
- Central Clinical SchoolMonash UniversityMelbourneAustralia
| | - Jennifer Deese
- RTI InternationalResearch Triangle ParkNorth CarolinaUSA
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Wang NR, Liu SJ, Xiao GY, Zhang H, Huang YJ, Wang L, He CY. Cord blood 25(OH)D 3, cord blood total immunoglobulin E levels, and food allergies in infancy: A birth cohort study in Chongqing, China. World Allergy Organ J 2022; 15:100645. [PMID: 35432712 PMCID: PMC8980958 DOI: 10.1016/j.waojou.2022.100645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Revised: 03/10/2022] [Accepted: 03/14/2022] [Indexed: 11/30/2022] Open
Abstract
Background Food allergy (FA) in infants has become a common disease worldwide. There are many controversies surrounding the relationships among levels of cord blood 25-hydroxy vitamin D3 [25(OH)D3], total immunoglobulin E (IgE), and FA. Methods In this study, we recruited pregnant women in the third trimester undergoing obstetric examination in Chongqing City, Western China. Healthy full-term singleton births between May to August 2018 and November 2018 to January 2019 were included in the summer-birth and winter-birth cohorts, respectively. Questionnaires on vitamin D status in pregnancy and family allergies were used to investigate the pregnant women. The levels of <12 ng/mL, 12~20 ng/mL, and >20 ng/mL 25(OH)D3 in cord blood detected by liquid chromatography tandem mass spectrometry were considered deficient, insufficient, and sufficient, respectively. The electrochemiluminescence method was used to detect the total lgE levels in cord blood, classified into low-IgE (<0.35 IU/mL) and high-IgE (≥0.35 IU/mL) levels, respectively. Within postnatal 6 months, allergic symptoms in infants were investigated using questionnaire during the infants' monthly physical examinations. Suspected cases of FA underwent a history inquiry, skin prick test, food elimination test, and open-food challenge for diagnosis of FA. Multivariate logistic regression was used to analyze the risk factors of FA in infants. Results In this study, we recruited 741 pairs of pregnant women and infants, including 343 infants in the summer-birth cohort and 398 infants in the winter-birth cohort. The incidence of FA within postnatal 6 months was 6.88%, showing significantly higher incidence of FA in the winter-birth cohorts than in the summer-birth cohorts (10.3% vs. 2.9%, χ2 = 15.682, P = 0.000). Among the 741 infants, 47.1%, 27.5%, and 13.8% of infants had deficient, insufficient, and sufficient 25(OH)D3, respectively, in the cord blood; 81.5% and 18.5% of infants had total low-IgE and total high-IgE levels, respectively, in the cord blood. No significant correlation was found between the 25(OH)D3 and IgE levels (r = -0.038, P = 0.300). Logistic regression analysis showed that winter birth [odds ratio (OR) 95% confidence interval (CI): 4.292 (2.003~8.359)] compared with infants in summer birth group, and sufficient (>20 ng/mL) 25(OH)D3 levels in cord blood [OR (95% CI): 2.355 (1.129~4.911) compared with infants in the deficient group (<12 ng/mL) and 3.782 (1.680~8.514) compared with infants in the insufficient group (12~20 ng/mL)] were independent risk factors for FA in infants within postnatal 6 months. Conclusions Winter birth and sufficient 25(OH)D3 levels in infant cord blood were independent risk factors for FA in infants. 25(OH)D3 and total IgE levels in cord blood cannot be used as predictors of FA in early infancy.
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Affiliation(s)
- Nian-Rong Wang
- Department of Children Healthcare, Chongqing Health Center for Women and Children, 120 Longshan Road, Yubei District, Chongqing, 400021, PR China
| | - Shi-Jian Liu
- Department of Clinical Epidemiology and Biostatistics, Children Health Advocacy Institute, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, 1678 Dongfang Road, Pudong New District, Shanghai, 200127, PR China
| | - Gui-Yuan Xiao
- Department of Children Healthcare, Chongqing Health Center for Women and Children, 120 Longshan Road, Yubei District, Chongqing, 400021, PR China
| | - Hua Zhang
- Department of Children Healthcare, Chongqing Health Center for Women and Children, 120 Longshan Road, Yubei District, Chongqing, 400021, PR China
| | - Yu-Jie Huang
- Department of Children Healthcare, Chongqing Health Center for Women and Children, 120 Longshan Road, Yubei District, Chongqing, 400021, PR China
| | - Li Wang
- Department of Children Healthcare, Chongqing Health Center for Women and Children, 120 Longshan Road, Yubei District, Chongqing, 400021, PR China
| | - Chun-Yan He
- Department of Children Healthcare, Chongqing Health Center for Women and Children, 120 Longshan Road, Yubei District, Chongqing, 400021, PR China
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11
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van Harten RM, Tjeerdsma-van Bokhoven JL, de Greeff A, Balhuizen MD, van Dijk A, Veldhuizen EJ, Haagsman HP, Scheenstra MR. d-enantiomers of CATH-2 enhance the response of macrophages against Streptococcus suis serotype 2. J Adv Res 2022; 36:101-112. [PMID: 35127168 PMCID: PMC8799869 DOI: 10.1016/j.jare.2021.05.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 05/20/2021] [Accepted: 05/23/2021] [Indexed: 11/30/2022] Open
Abstract
D-CATH-2 has strong antimicrobial activities towards multiple S.suis strains. D-CATH-2 ameliorates macrophage function. DCATH-2 binds LTA. DCATH-2 has prophylactic effect against S. suis infection in vivo.
Introduction Due to the increase of antibiotic resistant bacterial strains, there is an urgent need for development of alternatives to antibiotics. Cathelicidins can be such an alternative to antibiotics having both a direct antimicrobial capacity as well as an immunomodulatory function. Previously, the full d-enantiomer of chicken cathelicidin-2 (d-CATH-2) has shown to prophylactically protect chickens against infection 7 days post hatch when administered in ovo three days before hatch. Objectives To further evaluate d-CATH-2 in mammals as a candidate for an alternative to antibiotics. In this study, the prophylactic capacity of d-CATH-2 and two truncated derivatives, d-C(1–21) and d-C(4–21), was determined in mammalian cells. Methods Antibacterial assays; immune cell differentiation and modulation; cytotoxicity, isothermal titration calorimetry; in vivo prophylactic capacity of peptides in an S. suis infection model. Results d-CATH-2 and its derivatives were shown to have a strong direct antibacterial capacity against four different S. suis serotype 2 strains (P1/7, S735, D282, and OV625) in bacterial medium and even stronger in cell culture medium. In addition, d-CATH-2 and its derivatives ameliorated the efficiency of mouse bone marrow-derived macrophages (BMDM) and skewed mouse bone marrow-derived dendritic cells (BMDC) towards cells with a more macrophage-like phenotype. The peptides directly bind lipoteichoic acid (LTA) and inhibit LTA-induced activation of macrophages. In addition, S. suis killed by the peptide was unable to further activate mouse macrophages, which indicates that S. suis was eliminated by the previously reported silent killing mechanism. Administration of d-C(1–21) at 24 h or 7 days before infection resulted in a small prophylactic protection with reduced disease severity and reduced mortality of the treated mice. Conclusion d-enantiomers of CATH-2 show promise as anti-infectives against pathogenic S. suis for application in mammals.
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Affiliation(s)
- Roel M. van Harten
- Division of Infectious Diseases and Immunology, Department of Biomolecular Health Sciences, Utrecht University, Utrecht, the Netherlands
| | | | - Astrid de Greeff
- Wageningen Bioveterinary Research, Wageningen University & Research, Houtribweg 39, 8221 RA Lelystad, the Netherlands
| | - Melanie D. Balhuizen
- Division of Infectious Diseases and Immunology, Department of Biomolecular Health Sciences, Utrecht University, Utrecht, the Netherlands
| | - Albert van Dijk
- Division of Infectious Diseases and Immunology, Department of Biomolecular Health Sciences, Utrecht University, Utrecht, the Netherlands
| | - Edwin J.A. Veldhuizen
- Division of Infectious Diseases and Immunology, Department of Biomolecular Health Sciences, Utrecht University, Utrecht, the Netherlands
- Corresponding author.
| | - Henk P. Haagsman
- Division of Infectious Diseases and Immunology, Department of Biomolecular Health Sciences, Utrecht University, Utrecht, the Netherlands
| | - Maaike R. Scheenstra
- Division of Infectious Diseases and Immunology, Department of Biomolecular Health Sciences, Utrecht University, Utrecht, the Netherlands
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12
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Zhao R, Zhou L, Wang S, Xiong G, Hao L. Association between maternal vitamin D levels and risk of adverse pregnancy outcomes: a systematic review and dose-response meta-analysis. Food Funct 2021; 13:14-37. [PMID: 34859252 DOI: 10.1039/d1fo03033g] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Epidemiological studies have investigated the associations between vitamin D and the risk of adverse pregnancy outcomes; however, the results are conflicting and dose-response relationships remain to be confirmed. This study aimed to summarize previous studies on the associations of vitamin D levels with the risk of gestational diabetes mellitus (GDM), pre-eclampsia (PE), gestational hypertension (GH), and caesarean section (C-section), and to clarify the dose-response trends. PubMed, Embase, Scopus, and Web of Science were searched to identify eligible articles. A total of 69 prospective observational studies including cohort studies, case-cohort studies, or nested case-control studies were included in the current systematic review, of which 68 studies were available for meta-analysis. Compared with the lowest level, the highest level of 25(OH)D was significantly associated with a lower risk of GDM (RR: 0.76; 95% CI: 0.66-0.87), PE (RR: 0.74; 95% CI: 0.60-0.90;), and GH (RR: 0.87; 95% CI: 0.79-0.97); however, no significant relationship was found for C-section (RR: 1.00; 95% CI: 0.90-1.12). There was significant between-study heterogeneity for GDM (I2 = 69.2%; Pheterogeneity < 0.001), PE (I2 = 52.0%; Pheterogeneity = 0.001), and C-section (I2 = 59.1%; Pheterogeneity < 0.001), while no heterogeneity was found for GH (I2 = 0.0%; Pheterogeneity = 0.676). For each 25 nmol L-1 increase in 25(OH)D, the pooled RR was 0.92 (95% CI: 0.86-0.97) for GDM and 0.89 (95% CI: 0.84-0.94) for PE, respectively. Notably, the dose-response analysis showed a non-linear relationship between maternal 25(OH)D levels and the risk of PE (Pnon-linearity = 0.009). Our meta-analysis provides further scientific evidence of the inverse association between 25(OH)D levels and the risk of GDM, PE, and GH, which may be useful for the prevention of pregnancy complications. However, more evidence from prospective studies is needed regarding the dietary intake of vitamin D during pregnancy.
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Affiliation(s)
- Rui Zhao
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety and the Ministry of Education (MOE) Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
| | - Leilei Zhou
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety and the Ministry of Education (MOE) Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
| | - Shanshan Wang
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety and the Ministry of Education (MOE) Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
| | | | - Liping Hao
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety and the Ministry of Education (MOE) Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
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13
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Lee ACC, Cherkerzian S, Olson IE, Ahmed S, Chowdhury NH, Khanam R, Rahman S, Andrews C, Baqui AH, Fawzi W, Inder TE, Nartey S, Nelson CA, Oken E, Sen S, Fichorova R. Maternal Diet, Infection, and Risk of Cord Blood Inflammation in the Bangladesh Projahnmo Pregnancy Cohort. Nutrients 2021; 13:3792. [PMID: 34836049 PMCID: PMC8623045 DOI: 10.3390/nu13113792] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2021] [Revised: 10/15/2021] [Accepted: 10/22/2021] [Indexed: 11/16/2022] Open
Abstract
Inflammation may adversely affect early human brain development. We aimed to assess the role of maternal nutrition and infections on cord blood inflammation. In a pregnancy cohort in Sylhet, Bangladesh, we enrolled 251 consecutive pregnancies resulting in a term livebirth from July 2016-March 2017. Stillbirths, preterm births, and cases of neonatal encephalopathy were excluded. We prospectively collected data on maternal diet (food frequency questionnaire) and morbidity, and analyzed umbilical cord blood for interleukin (IL)-1α, IL-1β, IL-6, IL-8 and C-reactive protein. We determined associations between nutrition and infection exposures and cord cytokine elevation (≥75% vs. <75%) using logistic regression, adjusting for confounders. One-third of mothers were underweight (BMI < 18.5 kg/m2) at enrollment. Antenatal and intrapartum infections were observed among 4.8% and 15.9% of the sample, respectively. Low pregnancy intakes of B vitamins (B1, B2, B3, B6, B9 (folate)), fat-soluble vitamins (D, E), iron, zinc, and linoleic acid (lowest vs. middle tertile) were associated with higher risk of inflammation, particularly IL-8. There was a non-significant trend of increased risk of IL-8 and IL-6 elevation with history of ante-and intrapartum infections, respectively. In Bangladesh, improving micronutrient intake and preventing pregnancy infections are targets to reduce fetal systemic inflammation and associated adverse neurodevelopmental outcomes.
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Affiliation(s)
- Anne CC Lee
- Department of Pediatric Newborn Medicine, Brigham and Women’s Hospital, Boston, MA 02115, USA; (S.C.); (I.E.O.); (C.A.); (T.E.I.); (S.S.)
- Harvard Medical School, Boston, MA 02115, USA; (C.A.N.); (E.O.); (R.F.)
| | - Sara Cherkerzian
- Department of Pediatric Newborn Medicine, Brigham and Women’s Hospital, Boston, MA 02115, USA; (S.C.); (I.E.O.); (C.A.); (T.E.I.); (S.S.)
- Harvard Medical School, Boston, MA 02115, USA; (C.A.N.); (E.O.); (R.F.)
| | - Ingrid E Olson
- Department of Pediatric Newborn Medicine, Brigham and Women’s Hospital, Boston, MA 02115, USA; (S.C.); (I.E.O.); (C.A.); (T.E.I.); (S.S.)
| | - Salahuddin Ahmed
- Projahnmo Research Foundation, Banani, Dhaka 1213, Bangladesh; (S.A.); (N.H.C.); (S.R.)
| | | | - Rasheda Khanam
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA; (R.K.); (A.H.B.)
| | - Sayedur Rahman
- Projahnmo Research Foundation, Banani, Dhaka 1213, Bangladesh; (S.A.); (N.H.C.); (S.R.)
| | - Chloe Andrews
- Department of Pediatric Newborn Medicine, Brigham and Women’s Hospital, Boston, MA 02115, USA; (S.C.); (I.E.O.); (C.A.); (T.E.I.); (S.S.)
| | - Abdullah H Baqui
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA; (R.K.); (A.H.B.)
| | - Wafaie Fawzi
- Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA;
| | - Terrie E Inder
- Department of Pediatric Newborn Medicine, Brigham and Women’s Hospital, Boston, MA 02115, USA; (S.C.); (I.E.O.); (C.A.); (T.E.I.); (S.S.)
- Harvard Medical School, Boston, MA 02115, USA; (C.A.N.); (E.O.); (R.F.)
| | - Stephanie Nartey
- Department of Obstetrics, Gynecology and Reproductive Biology, Brigham and Women’s Hospital, Boston, MA 02115, USA;
| | - Charles A Nelson
- Harvard Medical School, Boston, MA 02115, USA; (C.A.N.); (E.O.); (R.F.)
- Boston Children’s Hospital, Boston, MA 02115, USA
- Harvard Graduate School of Education, Boston, MA 02138, USA
| | - Emily Oken
- Harvard Medical School, Boston, MA 02115, USA; (C.A.N.); (E.O.); (R.F.)
- Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA;
- Harvard Pilgrim Health Care Institute, Boston, MA 02215, USA
| | - Sarbattama Sen
- Department of Pediatric Newborn Medicine, Brigham and Women’s Hospital, Boston, MA 02115, USA; (S.C.); (I.E.O.); (C.A.); (T.E.I.); (S.S.)
- Harvard Medical School, Boston, MA 02115, USA; (C.A.N.); (E.O.); (R.F.)
| | - Raina Fichorova
- Harvard Medical School, Boston, MA 02115, USA; (C.A.N.); (E.O.); (R.F.)
- Department of Obstetrics, Gynecology and Reproductive Biology, Brigham and Women’s Hospital, Boston, MA 02115, USA;
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14
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Olmos-Ortiz A, Flores-Espinosa P, Díaz L, Velázquez P, Ramírez-Isarraraz C, Zaga-Clavellina V. Immunoendocrine Dysregulation during Gestational Diabetes Mellitus: The Central Role of the Placenta. Int J Mol Sci 2021; 22:8087. [PMID: 34360849 PMCID: PMC8348825 DOI: 10.3390/ijms22158087] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Revised: 07/15/2021] [Accepted: 07/26/2021] [Indexed: 02/07/2023] Open
Abstract
Gestational Diabetes Mellitus (GDM) is a transitory metabolic condition caused by dysregulation triggered by intolerance to carbohydrates, dysfunction of beta-pancreatic and endothelial cells, and insulin resistance during pregnancy. However, this disease includes not only changes related to metabolic distress but also placental immunoendocrine adaptations, resulting in harmful effects to the mother and fetus. In this review, we focus on the placenta as an immuno-endocrine organ that can recognize and respond to the hyperglycemic environment. It synthesizes diverse chemicals that play a role in inflammation, innate defense, endocrine response, oxidative stress, and angiogenesis, all associated with different perinatal outcomes.
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Affiliation(s)
- Andrea Olmos-Ortiz
- Departamento de Inmunobioquímica, Instituto Nacional de Perinatología Isidro Espinosa de los Reyes (INPer), Ciudad de México 11000, Mexico; (A.O.-O.); (P.F.-E.)
| | - Pilar Flores-Espinosa
- Departamento de Inmunobioquímica, Instituto Nacional de Perinatología Isidro Espinosa de los Reyes (INPer), Ciudad de México 11000, Mexico; (A.O.-O.); (P.F.-E.)
| | - Lorenza Díaz
- Departamento de Biología de la Reproducción, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Ciudad de México 14080, Mexico;
| | - Pilar Velázquez
- Departamento de Ginecología y Obstetricia, Hospital Ángeles México, Ciudad de México 11800, Mexico;
| | - Carlos Ramírez-Isarraraz
- Clínica de Urología Ginecológica, Instituto Nacional de Perinatología Isidro Espinosa de los Reyes (INPer), Ciudad de México 11000, Mexico;
| | - Verónica Zaga-Clavellina
- Departamento de Fisiología y Desarrollo Celular, Instituto Nacional de Perinatología Isidro Espinosa de los Reyes (INPer), Ciudad de México 11000, Mexico
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15
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Hoffman MC, Freedman R, Law AJ, Clark AM, Hunter SK. Maternal nutrients and effects of gestational COVID-19 infection on fetal brain development. Clin Nutr ESPEN 2021; 43:1-8. [PMID: 34024500 PMCID: PMC8144544 DOI: 10.1016/j.clnesp.2021.04.019] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Accepted: 04/20/2021] [Indexed: 12/18/2022]
Abstract
BACKGROUND & AIMS Maternal gestational infection is a well-characterized risk factor for offsprings' development of mental disorders including schizophrenia, autism, and attention deficit disorder. The inflammatory response elicited by the infection is partly directed against the placenta and fetus and is the putative pathogenic mechanism for fetal brain developmental abnormalities. Fetal brain abnormalities are generally irreversible after birth and increase risk for later mental disorders. Maternal immune activation in animals models this pathophysiology. SARS-CoV-2 produces maternal inflammatory responses during pregnancy similar to previously studied common respiratory viruses. METHOD Choline, folic acid, Vitamin D, and n-3 polyunsaturated fatty acids are among the nutrients that have been studied as possible mitigating factors for effects of maternal infection and inflammation on fetal development. Clinical and animal studies relevant to their use in pregnant women who have been infected are reviewed. RESULTS Higher maternal choline levels have positive effects on the development of brain function for infants of mothers who experienced viral infections in early pregnancy. No other nutrient has been studied in the context of viral inflammation. Vitamin D reduces pro-inflammatory cytokines in some, but not all, studies. Active folic acid metabolites decrease anti-inflammatory cytokines. N-3 polyunsaturated fatty acids have no effect. CONCLUSIONS Vitamin D and folic acid are already supplemented in food additives and in prenatal vitamins. Despite recommendations by several public health agencies and medical societies, choline intake is often inadequate in early gestation when the brain is forming. A public health initiative for choline supplements during the pandemic could be helpful for women planning or already pregnant who also become exposed or infected with SARS-CoV-2.
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Affiliation(s)
- M Camille Hoffman
- Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, University of Colorado Denver School of Medicine, Mail Stop F-546, Anschutz Medical Center, Aurora, CO, 80045, USA; Department of Psychiatry, University of Colorado Denver School of Medicine, Mail Stop F-546, Anschutz Medical Center, Aurora, CO, 80045, USA.
| | - Robert Freedman
- Department of Psychiatry, University of Colorado Denver School of Medicine, Mail Stop F-546, Anschutz Medical Center, Aurora, CO, 80045, USA.
| | - Amanda J Law
- Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, University of Colorado Denver School of Medicine, Mail Stop F-546, Anschutz Medical Center, Aurora, CO, 80045, USA; Department of Psychiatry, University of Colorado Denver School of Medicine, Mail Stop F-546, Anschutz Medical Center, Aurora, CO, 80045, USA; Department of Cell and Developmental Biology, University of Colorado Denver School of Medicine, Mail Stop F-546, Anschutz Medical Center, Aurora, CO, 80045, USA; Department of Medicine, University of Colorado Denver School of Medicine, Mail Stop F-546, Anschutz Medical Center, Aurora, CO, 80045, USA.
| | - Alena M Clark
- Department of Nutrition and Dietetics, Campus Box 93, University of Northern Colorado, Greeley, CO, 80639, USA.
| | - Sharon K Hunter
- Department of Psychiatry, University of Colorado Denver School of Medicine, Mail Stop F-546, Anschutz Medical Center, Aurora, CO, 80045, USA.
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16
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Dabee S, Passmore JAS, Heffron R, Jaspan HB. The Complex Link between the Female Genital Microbiota, Genital Infections, and Inflammation. Infect Immun 2021; 89:e00487-20. [PMID: 33558324 PMCID: PMC8091093 DOI: 10.1128/iai.00487-20] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
The female genital tract microbiota is part of a complex ecosystem influenced by several physiological, genetic, and behavioral factors. It is uniquely linked to a woman's mucosal immunity and plays a critical role in the regulation of genital inflammation. A vaginal microbiota characterized by a high abundance of lactobacilli and low overall bacterial diversity is associated with lower inflammation. On the other hand, a more diverse microbiota is linked to high mucosal inflammation levels, a compromised genital epithelial barrier, and an increased risk of sexually transmitted infections and other conditions. Several bacterial taxa such as Gardnerella spp., Prevotella spp., Sneathia spp., and Atopobium spp. are well known to have adverse effects; however, the definitive cause of this microbial dysbiosis is yet to be fully elucidated. The aim of this review is to discuss the multiple ways in which the microbiota influences the overall genital inflammatory milieu and to explore the causes and consequences of this inflammatory response. While there is abundant evidence linking a diverse genital microbiota to elevated inflammation, understanding the risk factors and mechanisms through which it affects genital health is essential. A robust appreciation of these factors is important for identifying effective prevention and treatment strategies.
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Affiliation(s)
- Smritee Dabee
- Seattle Children's Research Institute, Seattle, Washington, USA
| | - Jo-Ann S Passmore
- Institute of Infectious Disease and Molecular Medicine (IDM), University of Cape Town, Cape Town, South Africa
- CAPRISA Centre of Excellence in HIV Prevention, University of Cape Town, Cape Town, South Africa
- National Health Laboratory Service, Cape Town, South Africa
| | | | - Heather B Jaspan
- Seattle Children's Research Institute, Seattle, Washington, USA
- Institute of Infectious Disease and Molecular Medicine (IDM), University of Cape Town, Cape Town, South Africa
- University of Washington, Seattle, Washington, USA
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17
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Ghanavatinejad A, Rashidi N, Mirahmadian M, Rezania S, Mosalaei M, Ghasemi J, Zarnani AH. Vitamin D3 Controls TLR4- and TLR2-Mediated Inflammatory Responses of Endometrial Cells. Gynecol Obstet Invest 2021; 86:139-148. [PMID: 33540416 DOI: 10.1159/000513590] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2020] [Accepted: 11/26/2020] [Indexed: 11/19/2022]
Abstract
OBJECTIVES Vitamin D has potent immunoregulatory features and modulates innate and adaptive immune responses. There is a significant association between intrauterine infection-associated inflammatory responses and pregnancy complications such as abortion and preterm labor. Here, we investigated how 1,25 (OH)2 D3 could modulate inflammatory responses of endometrial cells. DESIGN This is an in vitro experimental study. Endometrial stromal cells (ESCs) and whole endometrial cells (WECs) were collected from 15 apparently normal women, and the immunomodulatory effects of 1,25 (OH)2 D3 on lipopolysaccharide (LPS)- or lipoteichoic acid (LTA)-treated ESCs and WECs were investigated. Participants/Materials, Setting, and Methods: Women with no history of abortion, infertility, endometriosis, or sign of vaginal infection were enrolled in this study. Endometrial samples were collected by gynecologists using a Pipelle pipette in the proliferative phase of the menstrual cycle. WECs and ESCs were collected and treated with either LPS or LTA. The levels of IL-6, IL-8, and TNF-α in culture supernatants were quantified using the ELISA technique. TLR2, TLR4, and MyD88 expressions were assessed by RT-qPCR. TLR4 expression at the protein level was studied by the Western blot technique. RESULTS 1,25 Dihydroxycholecalciferol (1,25 (OH)2 D3) significantly reduced TNF-α production in LPS-activated ESCs and TNF-α and IL-6 production by LTA-stimulated WECs. In contrast, 1,25 (OH)2 D3 pretreatment increased the production of IL-8 by LPS- and LTA-stimulated endometrial cells. 1,25 (OH)2 D3 pretreatment markedly reduced LPS-induced TLR4 protein expression by ESCs. LPS treatment of ESCs significantly induced MyD88 gene expression. This effect was reversed when these cells were pretreated with 1,25 (OH)2 D3 before stimulation with LPS. LIMITATIONS Because of the small size of samples, doing experiments all together on some samples was not feasible. Confirmation of the results obtained here needs well-designed in vivo studies. CONCLUSIONS 1,25 (OH)2 D3 is an immunomodulatory molecule essential for maintaining endometrial immune homeostasis by controlling potentially harmful inflammatory responses associated with female reproductive tract infections.
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Affiliation(s)
- Alireza Ghanavatinejad
- Department of Immunology, Pasteur Institute of Iran, Tehran, Iran.,Department of Immunology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Nesa Rashidi
- Immunology Research Center (IRC), Iran University of Medical Sciences, Tehran, Iran
| | - Mahroo Mirahmadian
- Department of Immunology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Simin Rezania
- Biophysics Institute, Medical University of Graz, Graz, Austria
| | - Mahdokht Mosalaei
- Reproductive Immunology Research Center, Avicenna Research Institute, ACECR, Tehran, Iran
| | - Jamileh Ghasemi
- Reproductive Immunology Research Center, Avicenna Research Institute, ACECR, Tehran, Iran
| | - Amir-Hassan Zarnani
- Department of Immunology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran, .,Immunology Research Center (IRC), Iran University of Medical Sciences, Tehran, Iran, .,Reproductive Immunology Research Center, Avicenna Research Institute, ACECR, Tehran, Iran,
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18
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Sheng B, Song Y, Liu Y, Jiang C, Zhu X. Association between vitamin D and uterine fibroids: a study protocol of an open-label, randomised controlled trial. BMJ Open 2020; 10:e038709. [PMID: 33158822 PMCID: PMC7651728 DOI: 10.1136/bmjopen-2020-038709] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Revised: 06/15/2020] [Accepted: 10/08/2020] [Indexed: 12/18/2022] Open
Abstract
INTRODUCTION Uterine fibroids are the most common pelvic benign tumour with no satisfactory long-term medical treatment. Recent studies have demonstrated that vitamin D significantly inhibited the growth of fibroids in vitro, vivo and a small-sample clinical trial. Therefore, the aim of this randomised clinical trial (RCT) is to evaluate whether supplementation with vitamin D could reduce the risk and inhibit the growth of uterine fibroids in reproductive stage women. METHODS AND ANALYSIS The open-label, RCT comprises two parts, including parts I and II. In part I, 2230 vitamin D deficiency or vitamin D insufficiency patients without uterine fibroids will be randomly assigned to two groups: intervention group (according to the level of serum 25-hydroxyvitamin D3, receive 1600 or 800 IU/day of vitamin D3 for 2 years) and control group (followed up at the same time points). By using gynaecological ultrasound examinations, the incidence of uterine fibroids will be employed to measure the outcome in different groups. In part II, 360 uterine fibroids patients with vitamin D deficiency or vitamin D insufficiency will be randomly assigned to intervention group or control group. According to the level of serum 25-hydroxyvitamin D3, 180 patients will receive 1600 or 800 IU/day of vitamin D3 for 2 years. Control group will receive regular follow-up. The outcome measure will be conducted using gynaecological ultrasound examinations to detect the growth of uterine fibroids in each group. ETHICS AND DISSEMINATION This study has been approved by the institutional review board of the Second Affiliated Hospital of Wenzhou Medical University (No. LCKY2018-35). TRIAL REGISTRATION NUMBERS NCT03586947 and NCT03584529.
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Affiliation(s)
- Bo Sheng
- Obstetrics and Gynecology, Wenzhou Medical University Second Affiliated Hospital, Wenzhou, China
| | - Yizuo Song
- Obstetrics and Gynecology, Wenzhou Medical University Second Affiliated Hospital, Wenzhou, China
| | - Yi Liu
- Obstetrics and Gynecology, Wenzhou Medical University Second Affiliated Hospital, Wenzhou, China
| | - Chenchen Jiang
- Clinical Research Center, Wenzhou Medical University Second Affiliated Hospital, Wenzhou, China
| | - Xueqiong Zhu
- Obstetrics and Gynecology, Wenzhou Medical University Second Affiliated Hospital, Wenzhou, China
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Anderson SM, Thurman AR, Chandra N, Jackson SS, Asin S, Rollenhagen C, Ghosh M, Daniels J, Vann NC, Clark MR, Doncel GF. Vitamin D Status Impacts Genital Mucosal Immunity and Markers of HIV-1 Susceptibility in Women. Nutrients 2020; 12:nu12103176. [PMID: 33080839 PMCID: PMC7602985 DOI: 10.3390/nu12103176] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 10/12/2020] [Accepted: 10/13/2020] [Indexed: 01/24/2023] Open
Abstract
While vitamin D insufficiency is known to impact a multitude of health outcomes, including HIV-1, little is known about the role of vitamin D-mediated immune regulation in the female reproductive tract (FRT). We performed a pilot clinical study of 20 women with circulating 25(OH)D levels <62.5 nmol/L. Participants were randomized into either weekly or daily high-dose oral vitamin D supplementation groups. In addition to serum vitamin D levels, genital mucosal endpoints, including soluble mediators, immune cell populations, gene expression, and ex vivo HIV-1 infection, were assessed. While systemic vitamin D levels showed a significant increase following supplementation, these changes translated into modest effects on the cervicovaginal factors studied. Paradoxically, post-supplementation vitamin D levels were decreased in cervicovaginal fluids. Given the strong correlation between vitamin D status and HIV-1 infection and the widespread nature of vitamin D deficiency, further understanding of the role of vitamin D immunoregulation in the female reproductive tract is important.
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Affiliation(s)
- Sharon M. Anderson
- CONRAD, Eastern Virginia Medical School, Norfolk, VA 23507, USA; (A.R.T.); (N.C.); (S.S.J.); (N.C.V.); (M.R.C.); (G.F.D.)
- CONRAD, Eastern Virginia Medical School, Arlington, VA 22209, USA
- Correspondence:
| | - Andrea R. Thurman
- CONRAD, Eastern Virginia Medical School, Norfolk, VA 23507, USA; (A.R.T.); (N.C.); (S.S.J.); (N.C.V.); (M.R.C.); (G.F.D.)
- CONRAD, Eastern Virginia Medical School, Arlington, VA 22209, USA
| | - Neelima Chandra
- CONRAD, Eastern Virginia Medical School, Norfolk, VA 23507, USA; (A.R.T.); (N.C.); (S.S.J.); (N.C.V.); (M.R.C.); (G.F.D.)
- CONRAD, Eastern Virginia Medical School, Arlington, VA 22209, USA
| | - Suzanne S. Jackson
- CONRAD, Eastern Virginia Medical School, Norfolk, VA 23507, USA; (A.R.T.); (N.C.); (S.S.J.); (N.C.V.); (M.R.C.); (G.F.D.)
- CONRAD, Eastern Virginia Medical School, Arlington, VA 22209, USA
| | - Susana Asin
- V.A. Medical Center, White River Junction, VT 05009, USA; (S.A.); (C.R.)
- Geisel School of Medicine at Dartmouth, Hanover, NH 03755, USA
| | - Christiane Rollenhagen
- V.A. Medical Center, White River Junction, VT 05009, USA; (S.A.); (C.R.)
- Geisel School of Medicine at Dartmouth, Hanover, NH 03755, USA
| | - Mimi Ghosh
- Milken Institute School of Public Health and Health Services, George Washington University, Washington, DC 20052, USA; (M.G.); (J.D.)
| | - Jason Daniels
- Milken Institute School of Public Health and Health Services, George Washington University, Washington, DC 20052, USA; (M.G.); (J.D.)
| | - Nikolas C. Vann
- CONRAD, Eastern Virginia Medical School, Norfolk, VA 23507, USA; (A.R.T.); (N.C.); (S.S.J.); (N.C.V.); (M.R.C.); (G.F.D.)
- CONRAD, Eastern Virginia Medical School, Arlington, VA 22209, USA
| | - Meredith R. Clark
- CONRAD, Eastern Virginia Medical School, Norfolk, VA 23507, USA; (A.R.T.); (N.C.); (S.S.J.); (N.C.V.); (M.R.C.); (G.F.D.)
- CONRAD, Eastern Virginia Medical School, Arlington, VA 22209, USA
| | - Gustavo F. Doncel
- CONRAD, Eastern Virginia Medical School, Norfolk, VA 23507, USA; (A.R.T.); (N.C.); (S.S.J.); (N.C.V.); (M.R.C.); (G.F.D.)
- CONRAD, Eastern Virginia Medical School, Arlington, VA 22209, USA
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de O Farias MC, Cavalcante TDLT, Assunção ML, Bueno NB. Association between maternal or cord blood concentrations of 25-hydroxycholecalciferol or vitamin D supplementation during pregnancy and the cytokines profile in the umbilical cord blood: Systematic literature review. J Steroid Biochem Mol Biol 2020; 203:105739. [PMID: 32846186 DOI: 10.1016/j.jsbmb.2020.105739] [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: 02/21/2020] [Revised: 08/12/2020] [Accepted: 08/14/2020] [Indexed: 10/23/2022]
Abstract
INTRODUCTION Evidence suggests that vitamin D suppresses the production of pro-inflammatory cytokines and induces the production of anti-inflammatory cytokines during pregnancy. OBJECTIVES To assess, through a systematic literature review, the relationship between maternal or cord blood concentrations of 25-hydroxycholecalciferol (25-OH-D) or vitamin D supplementation during pregnancy and the cytokines profile in the umbilical cord. METHODS The following databases were searched: PUBMED, CENTRAL, Web of Science, LILACS, and gray literature, up to July 2020. The search strategy included terms related to the exposure (25-OH-D) and the primary outcome (cytokines). Observational studies and randomized clinical trials were included, measuring cytokines in the umbilical cord blood, or in ex vivo bioassays, and blood concentrations of 25-OH-D, either throughout pregnancy or in the umbilical cord blood. Studies with twin pregnancies, with placental or autoimmune diseases, were excluded. The protocol is registered in PROSPERO (number CRD42019136643). RESULTS From 14,605 unique articles identified in the databases, 28 were read in full, and of these, eight met the eligibility criteria, being three randomized clinical trials, and five observational studies. The eight studies showed adequate methodological quality. IL-10 was the most studied cytokine, being reported in seven studies. There were higher concentrations of IL-10 in the umbilical cord of women with 25-OH-D sufficiency in the observational studies. Clinical trials showed mixed results with the use of ex vivo bioassays with several stimulants. Associations with other cytokines were less consistent or absent. CONCLUSION 25-OH-D status is positively associated with the IL-10 levels of the umbilical cord, in observational studies.
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Affiliation(s)
- Myrla C de O Farias
- Faculdade de Nutrição, Universidade Federal de Alagoas, Campus A. C. Simões, BR 104 Norte, Km 96,7, Tabuleiro dos Martins, CEP 57.072-970, Maceió, Alagoas, Brazil
| | - Thayse de L T Cavalcante
- Faculdade de Nutrição, Universidade Federal de Alagoas, Campus A. C. Simões, BR 104 Norte, Km 96,7, Tabuleiro dos Martins, CEP 57.072-970, Maceió, Alagoas, Brazil
| | - Monica L Assunção
- Faculdade de Nutrição, Universidade Federal de Alagoas, Campus A. C. Simões, BR 104 Norte, Km 96,7, Tabuleiro dos Martins, CEP 57.072-970, Maceió, Alagoas, Brazil
| | - Nassib B Bueno
- Faculdade de Nutrição, Universidade Federal de Alagoas, Campus A. C. Simões, BR 104 Norte, Km 96,7, Tabuleiro dos Martins, CEP 57.072-970, Maceió, Alagoas, Brazil.
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Pereira JN, Chactoura J, Nohra F, Diogenes MEL, Bezerra FF. Free and Bioavailable Fractions of Vitamin D: Association with Maternal Characteristics in Brazilian Pregnant Women. J Nutr Metab 2020; 2020:1408659. [PMID: 33014456 PMCID: PMC7519195 DOI: 10.1155/2020/1408659] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Revised: 09/01/2020] [Accepted: 09/08/2020] [Indexed: 12/13/2022] Open
Abstract
Normal pregnancy is characterized by many changes in vitamin D metabolism, challenging the assessment of vitamin D status based exclusively on serum total 25-hydroxyvitamin D (25(OH)D). We hypothesized that measuring free and bioavailable fractions contributes to a better vitamin D status assessment in late pregnancy. Our aim was to evaluate a broad set of biomarkers of vitamin D status in Brazilian women in the third trimester of pregnancy. This cross-sectional study was conducted in women (n = 123, 18-44 y, 27-41 wk gestation) attended in a public maternity in Rio de Janeiro (2016-2018). Biomarkers included serum concentrations of total 25(OH)D3, parathyroid hormone (PTH), vitamin D-binding protein (DBP), and free and bioavailable fractions of 25(OH)D3. Vitamin D insufficiency (<50 nmol/L) was prevalent in 47.9% of the pregnant women. Serum 25(OH)D3 was inversely associated with the gestational week (β = -0.71, 95% confidence interval (CI): -1.31 to -0.16) and season, being lower in autumn (β = -9.90, 95% CI: -16.14 to -3.64) and winter (β = -16.74, 95%CI: -23.13 to -10.34). Concentrations of DBP, and free and bioavailable 25(OH)D3 were also inversely associated with winter months (P < 0.05). DBP was directly associated with prepregnancy BMI (β = 5.84, 95% CI: 0.62 to 11.06). The recognized season-effect on total 25(OH)D3 appeared to also occur on free and bioavailable fractions. Although advanced gestational age was associated with lower total 25(OH)D3, our results suggest an adaptive mechanism responsible for maintaining free fraction during the 3rd trimester. We also suggest that starting pregnancy in obese condition may have an impact on vitamin D bioavailability, which deserves further investigation.
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Affiliation(s)
- Joana N. Pereira
- Instituto de Nutrição, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Julia Chactoura
- Instituto de Nutrição, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Fernanda Nohra
- Instituto de Nutrição, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Maria Eduarda L. Diogenes
- Instituto de Nutrição, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil
- Instituto Nacional de Câncer José Alencar Gomes da Silva, Rio de Janeiro, Brazil
| | - Flávia F. Bezerra
- Instituto de Nutrição, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil
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Woo J, Koenig MD, Engeland CG, Kominiarek MA, White-Traut R, Yeatts P, Giurgescu C. Neighborhood disorder predicts lower serum vitamin D levels in pregnant African American women: A pilot study. J Steroid Biochem Mol Biol 2020; 200:105648. [PMID: 32142935 PMCID: PMC7278495 DOI: 10.1016/j.jsbmb.2020.105648] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Revised: 02/04/2020] [Accepted: 03/03/2020] [Indexed: 01/01/2023]
Abstract
Pregnant African American women are more likely to live in neighborhoods with more disorder (e.g., vacant housing, littler, crime) and to have vitamin D deficiency due to their darker skin pigmentation and poor production of vitamin D [25(OH)D] from ultraviolet rays. However, no study has examined the potential link between neighborhood disorder and 25(OH)D status in African American pregnant women. Forty-one pregnant African American women completed validated questionnaires about perceived neighborhood disorder (6 items; 3-point scale; range 6-18) and with concurrent serum levels of 25-hydroxyvitamin D [25(OH)D] assessed during pregnancy at 18-24 weeks gestation. Higher levels of perceived neighborhood disorder were associated with lower levels of serum 25(OH)D. Pregnant African American women who report higher disorder in their neighborhood may spend less time outside. Health care providers should include assessment of perceived neighborhood disorder. Future research needs to evaluate the relationships among neighborhood disorder and 25(OH)D levels among pregnant African American women.
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Affiliation(s)
- J Woo
- College of Nursing, Texas Woman's University, P.O. Box 425498, Denton, TX, 76204-5498, United States.
| | - M D Koenig
- College of Nursing, University of Illinois at Chicago, Department of Women, Children, and Family Health Science, 845 S. Damen Ave, Chicago, IL 60612, United States.
| | - C G Engeland
- Department of Biobehavioral Health, The Pennsylvania State University, University Park PA, 16802, United States; College of Nursing, The Pennsylvania State University, University Park PA, 16802, United States.
| | - M A Kominiarek
- Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Northwestern University Feinberg School of Medicine 250 E Superior, Chicago, IL 60611, United States.
| | - R White-Traut
- Director of Nursing Research, Children's Hospital of Wisconsin, Professor Emerita University of Illinois at Chicago, Department of Women, Children, and Family Health Science, 845 S Damen Ave, Chicago, IL 60612, United States.
| | - P Yeatts
- Center for Research and Data Analysis, Texas Woman's University, United States
| | - C Giurgescu
- College of Nursing, University of Central Florida, 12201 Research Parkway, Suite 300, Orlando, FL 32826, United States.
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Barrientos-Durán A, Fuentes-López A, de Salazar A, Plaza-Díaz J, García F. Reviewing the Composition of Vaginal Microbiota: Inclusion of Nutrition and Probiotic Factors in the Maintenance of Eubiosis. Nutrients 2020; 12:nu12020419. [PMID: 32041107 PMCID: PMC7071153 DOI: 10.3390/nu12020419] [Citation(s) in RCA: 72] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Revised: 01/29/2020] [Accepted: 02/04/2020] [Indexed: 02/06/2023] Open
Abstract
The vaginal microbiota has importance in preserving vaginal health and defending the host against disease. The advent of new molecular techniques and computer science has allowed researchers to discover microbial composition in depth and associate the structure of vaginal microbial communities. There is a consensus that vaginal flora is grouped into a restricted number of communities, although the structure of the community is constantly changing. Certain Community-State Types (CSTs) are more associated with poor reproductive outcomes and sexually transmitted diseases (STDs) meanwhile, CSTs dominated by Lactobacillus species—particularly Lactobacillus crispatus—are more related to vaginal health. In this work, we have reviewed how modifiable and non-modifiable factors may affect normal vaginal microbiota homeostasis—including sexual behavior, race or ethnicity, and hygiene. Special interest has been given to how the use of probiotics, diet intake, and use of hormone replacement therapies (HRTs) can potentially impact vaginal microbiota composition.
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Affiliation(s)
- Antonio Barrientos-Durán
- Hospital Clínico Universitario San Cecilio, Servicio de Microbiología, Instituto de Investigación ibs. GRANADA, Avenida de la Ilustración S/N, 18016 Granada, Spain
| | - Ana Fuentes-López
- Hospital Clínico Universitario San Cecilio, Servicio de Microbiología, Instituto de Investigación ibs. GRANADA, Avenida de la Ilustración S/N, 18016 Granada, Spain
| | - Adolfo de Salazar
- Hospital Clínico Universitario San Cecilio, Servicio de Microbiología, Instituto de Investigación ibs. GRANADA, Avenida de la Ilustración S/N, 18016 Granada, Spain
| | - Julio Plaza-Díaz
- Department of Biochemistry and Molecular Biology II, School of Pharmacy, University of Granada, 18071 Granada, Spain
- Institute of Nutrition and Food Technology “José Mataix”, Biomedical Research Center, University of Granada, Armilla, 18016 Granada, Spain
- Instituto de Investigación Biosanitaria ibs GRANADA, Complejo Hospitalario Universitario de Granada, 18014 Granada, Spain
| | - Federico García
- Hospital Clínico Universitario San Cecilio, Servicio de Microbiología, Instituto de Investigación ibs. GRANADA, Avenida de la Ilustración S/N, 18016 Granada, Spain
- Correspondence:
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Tuddenham S, Ghanem KG, Caulfield LE, Rovner AJ, Robinson C, Shivakoti R, Miller R, Burke A, Murphy C, Ravel J, Brotman RM. Associations between dietary micronutrient intake and molecular-Bacterial Vaginosis. Reprod Health 2019; 16:151. [PMID: 31640725 PMCID: PMC6806504 DOI: 10.1186/s12978-019-0814-6] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Accepted: 09/23/2019] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVES Bacterial vaginosis (BV), a clinical condition characterized by decreased vaginal Lactobacillus spp., is difficult to treat. We examined associations between micronutrient intake and a low-Lactobacillus vaginal microbiota as assessed by molecular methods (termed "molecular-BV"). METHODS This cross-sectional analysis utilized data collected at the baseline visit of the Hormonal Contraception Longitudinal Study, a cohort of reproductive-aged women followed over 2 years while initiating or ceasing hormonal contraception (HC). The Block Brief 2000 Food Frequency Questionnaire was administered and micronutrient intakes were ranked. Vaginal microbiota composition was assessed using 16S rRNA gene amplicon sequencing and clustered into community state types (CSTs) based on the types and relative abundance of bacteria detected. Associations between the lowest estimated quartile intake of nutrients and having a low-Lactobacillus CST (molecular-BV) were evaluated by logistic regression. Separate models were built for each nutrient controlling for age, body mass index, behavioral factors, HC use and total energy intake. We also conducted a literature review of existing data on associations between micronutrient intakes and BV. RESULTS Samples from 104 women were included in this analysis. Their mean age was 25.8 years (SD 4.3), 29.8% were African American, 48.1% were using HC, and 25% had molecular-BV. In adjusted multivariable analyses, the lowest quartile of betaine intake was associated with an increased odds of molecular-BV (aOR 9.2, p value < 0.01, [CI 2.4-35.0]). CONCLUSIONS This is the first study to assess the association between estimated micronutrient intake and molecular-BV. Lower energy-adjusted intake of betaine was associated with an increased risk of molecular-BV. Betaine might have direct effects on the vaginal microenvironment or may be mediated through the gut microbiota. Additional research is needed to determine reproducibility of this finding and whether improved intake of select micronutrients such as betaine decreases the risk of BV and its sequelae.
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Affiliation(s)
- Susan Tuddenham
- Department of Medicine, Johns Hopkins University School of Medicine, 5200 Eastern Ave, MFL Center Tower, Suite 381, Baltimore, MD, 21224, USA.
| | - Khalil G Ghanem
- Department of Medicine, Johns Hopkins University School of Medicine, 5200 Eastern Ave, MFL Center Tower, Suite 381, Baltimore, MD, 21224, USA
| | - Laura E Caulfield
- Center for Human Nutrition, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Alisha J Rovner
- Department of Behavioral Health and Nutrition, University of Delaware, Newark, DE, USA
| | - Courtney Robinson
- Institute for Genome Sciences, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Rupak Shivakoti
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA
| | - Ryan Miller
- Department of Pediatrics, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Anne Burke
- Department of Obstetrics and Gynecology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Catherine Murphy
- Department of Medicine, Johns Hopkins University School of Medicine, 5200 Eastern Ave, MFL Center Tower, Suite 381, Baltimore, MD, 21224, USA.,New York Medical College, Maria Fareri Children's Hospital, Valhalla, NY, USA
| | - Jacques Ravel
- Institute for Genome Sciences, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Rebecca M Brotman
- Institute for Genome Sciences, University of Maryland School of Medicine, Baltimore, MD, USA
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Milliken S, Allen RM, Lamont RF. The role of antimicrobial treatment during pregnancy on the neonatal gut microbiome and the development of atopy, asthma, allergy and obesity in childhood. Expert Opin Drug Saf 2019; 18:173-185. [PMID: 30739516 DOI: 10.1080/14740338.2019.1579795] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
INTRODUCTION The use of antibiotics prenatally, during pregnancy, or neonatally may have adverse effects on the neonatal gut microbiome, and adversely affect the development of the infant immune system, leading to childhood atopy, asthma, allergy and obesity. AREAS COVERED Vaginal eubiosis and dysbiosis from molecular-based, cultivation-independent techniques, and how this affects the neonatal gut microbiome and early development of the immune system, the association between maternal antibiotics and the beneficial role of vitamin D in the development of atopy, asthma, allergy and obesity, efforts to reduce the use of antibiotics in pregnancy and therapeutic interventions such as vaginal 'seeding', probiotics, breastfeeding and neonatal dietary supplementation. EXPERT OPINION Currently available research gives insufficient attention to confounding variables. There remains uncertainty as to whether it is relevant that the mother suffered from the same condition as the purported infant outcome variable, for which she may have received antibiotics. In most studies, there is a lack of control for the number of antibiotic courses administered, the timing of use, the use of broad spectrum or narrow range antibiotics, the indication for antibiotics, the dose-dependent nature of the effect, the class of antibiotics used, or a varying degree of risk.
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Affiliation(s)
- Sarah Milliken
- a Department of Obstetrics and Gynaecology, Simpsons Centre for Reproductive Health , Royal Infirmary of Edinburgh , Edinburgh , UK
| | - Ruridh M Allen
- b Department of Gastroenterology, Division of Medicine , Royal Infirmary of Edinburgh , Edinburgh , UK
| | - Ronald F Lamont
- c Division of Surgery , University College London, Northwick Park Institute of Medical Research Campus , London , UK.,d Institute of Clinical Research , University of Southern Denmark , Odense , Denmark
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Ciebiera M, Wojtyła C, Łukaszuk K, Zgliczyńska M, Zaręba K, Rawski W, Jakiel G. The role of vitamin D in perinatology. An up-to-date review. Arch Med Sci 2019; 17:992-1005. [PMID: 34336027 PMCID: PMC8314414 DOI: 10.5114/aoms.2019.81747] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2018] [Accepted: 07/05/2018] [Indexed: 02/06/2023] Open
Abstract
The role of vitamin D in perinatology is a subject of major interest in current medicine. There is growing evidence about the role of maternal vitamin D levels in pregnancy outcomes. The aim of this review is to summarize the current literature about the role of vitamin D in perinatology. Evidence from this review suggests associations between low levels of maternal vitamin D and higher risk of certain obstetrical complications. Vitamin D has been found to be related to preeclampsia, gestational diabetes mellitus, low birth weight, and preterm birth. The current literature supports vitamin D supplementation in pregnant women, but more high-quality data are necessary. The problem that remains is how to achieve an optimal 25-hydroxyvitamin D level. To determine the real benefits of vitamin D supplementation in pregnancy, we need high-quality trials in larger groups.
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Affiliation(s)
- Michał Ciebiera
- Second Department of Obstetrics and Gynecology, Center of Postgraduate Medical Education, Warsaw, Poland
| | - Cezary Wojtyła
- First Department of Obstetrics and Gynecology, Center of Postgraduate Medical Education, Warsaw, Poland
- European Observatory of Health Inequalities, State University of Applied Sciences, Kalisz, Poland
| | - Krzysztof Łukaszuk
- Department of Obstetrics and Gynecological Nursing, Faculty of Health Sciences, Medical University of Gdansk, Gdansk, Poland
| | - Magdalena Zgliczyńska
- Students’ Scientific Association at the First Department of Obstetrics and Gynecology, Medical University of Warsaw, Warsaw, Poland
| | - Kornelia Zaręba
- First Department of Obstetrics and Gynecology, Center of Postgraduate Medical Education, Warsaw, Poland
| | - Wojciech Rawski
- First Department of Obstetrics and Gynecology, Center of Postgraduate Medical Education, Warsaw, Poland
| | - Grzegorz Jakiel
- First Department of Obstetrics and Gynecology, Center of Postgraduate Medical Education, Warsaw, Poland
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Martínez-Domínguez SJ, Tajada M, Chedraui P, Pérez-López FR. Systematic review and meta-analysis of Spanish studies regarding the association between maternal 25-hydroxyvitamin D levels and perinatal outcomes. Gynecol Endocrinol 2018; 34:987-994. [PMID: 29842806 DOI: 10.1080/09513590.2018.1472761] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/16/2022] Open
Abstract
Objective: This systematic review and meta-analysis of Spanish studies assessed the association of maternal 25-hydroxyvitamin D [25(OH)D] levels on perinatal outcomes. Methods: PubMed, Cochrane Library, Embase, Scielo, Scopus, and Web of Science research databases were searched from inception through December 30 2017 using the terms 'vitamin D', 'pregnancy', and 'Spain'. Studies that compared first or second half of pregnancy normal 25(OH)D (≥30.0 ng/mL) versus insufficient (20.0-29.9 ng/mL) or deficient (<20.0 ng/mL) circulating levels and perinatal outcomes were systematically extracted. Data are presented as pooled odds ratios and their 95% confidence intervals (CIs) for categorical variables or mean differences and CIs for continuous variables. Risk of bias was evaluated with the Newcastle-Ottawa Scale. Results: Five cohort studies met inclusion criteria. The risk of gestational diabetes mellitus, preeclampsia, preterm birth, and small-for-gestational-age infants, and birthweight was not influenced by first half of pregnancy maternal 25(OH)D levels. In addition, second half of pregnancy 25(OH) levels did not affect birthweight. Conclusion: Maternal 25(OH)D levels during pregnancy did not affect studied perinatal outcomes and birthweight.
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Affiliation(s)
| | - Mauricio Tajada
- a Facultad de Medicina , Universidad de Zaragoza , Zaragoza , Spain
- b Obstetrics Service , Miguel Servet University Hospital , Zaragoza , Spain
| | - Peter Chedraui
- c Institute of Biomedicine, Research Area for Women's Health, Facultad de Ciencias Médicas , Universidad Católica de Santiago de Guayaquil , Guayaquil , Ecuador
- d Facultad de Ciencias de la Salud , Universidad Católica "Nuestra Señora de la Asunción" , Asunción , Paraguay
| | - Faustino R Pérez-López
- a Facultad de Medicina , Universidad de Zaragoza , Zaragoza , Spain
- e Department of Obstetrics and Gynecology , Lozano-Blesa University Hospital , Zaragoza , Spain
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Serum 25-Hydroxyvitamin D Level Is Not Related to Regulatory T Cells or Kidney Function in Renal Transplant Recipients. Transplant Proc 2018; 50:1802-1806. [PMID: 30056904 DOI: 10.1016/j.transproceed.2018.03.117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2017] [Revised: 03/15/2018] [Accepted: 03/23/2018] [Indexed: 10/17/2022]
Abstract
BACKGROUND Vitamin D and regulatory T cells (Tregs) are both involved in promoting peripheral tolerance and limiting chronic inflammatory diseases. Renal transplant recipients (RTRs) are likely to have low vitamin D levels, which may influence their immune status. AIM The aim of our study was to assess the usefulness of serum 25-hydroxyvitamin D (25(OH)D) and Tregs in estimation of the protolerogenic milieu in RTRs within 1 year after kidney transplantation. METHODS 26 RTRs (15M/11F, aged 49.1 ± 15.4 years) 3 to 13 months after kidney transplantation and 24 healthy volunteers were enrolled for the study. The serum level of 25(OH)D was measured with ELISA and peripheral blood immune cell populations (T lymphocytes, helper T lymphocytes, and Tregs) were assessed by flow cytometry. RESULTS Severe 25(OH)D deficiency (<10 ng/mL) was found in one RTR (3%) and moderate deficiency (<20 ng/mL) in 12 (46%), while vitamin D sufficiency was found in 6 patients (23%). The RTRs did not differ from the control group in observed 25(OH)D levels. None of the cell populations were related to the level of 25(OH)D in the control group. In RTRs, there was a negative association between 25(OH)D and total T lymphocyte count (rs = -0.45, P = .023), but 25(OH)D was not related to any other cell population or kidney function. CONCLUSION The results of our study suggest that serum 25(OH)D is not sufficiently reflective of vitamin D status to apply this measure in assessment of protolerogenic milieu in RTRs.
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Zhang M, Litonjua AA, Mueller NT. Maternal antibiotic use and child asthma: is the association causal? Eur Respir J 2018; 52:52/1/1801007. [PMID: 29973360 DOI: 10.1183/13993003.01007-2018] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Accepted: 06/23/2018] [Indexed: 01/03/2023]
Affiliation(s)
- Mingyu Zhang
- Dept of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.,Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins University, Baltimore, MD, USA
| | - Augusto A Litonjua
- Pediatric Pulmonary Division, Dept of Pediatrics, Golisano Children's Hospital at Strong, University of Rochester Medical Center, Rochester, NY, USA
| | - Noel T Mueller
- Dept of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.,Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins University, Baltimore, MD, USA
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