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Zhang T, Zhong J, Ji X, Sun J, Cui Y, Wang S. Vitamin D add on the standard treatment for myasthenia gravis symptoms following total gastrectomy: a case report. BMC Neurol 2024; 24:188. [PMID: 38840065 PMCID: PMC11151543 DOI: 10.1186/s12883-024-03687-z] [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: 01/26/2024] [Accepted: 05/22/2024] [Indexed: 06/07/2024] Open
Abstract
BACKGROUND Myasthenia gravis (MG) is a long-term autoimmune disorder that affects the neuromuscular junction, causing muscle weakness and fatigue as its primary clinical features. Vitamin D is crucial for both the autoimmune response and skeletal muscle function. CASE PRESENTATION Here, we presented a case report documenting the substantial improvement in symptoms experienced by a patient who underwent subtotal gastrectomy for gastric cancer following high-dose Vitamin D supplementation. The patient developed generalized MG two months after the surgery and did not respond adequately to pyridostigmine therapy, experiencing a progressive deterioration of the condition. A significant reduction in vitamin D concentration was observed following subtotal gastrectomy. In response, high-dose vitamin D supplementation was administered to the patient. Within one week of treatment, swallowing symptoms improved, enabling the consumption of a small amount of liquid food. By the second week, substantial swallowing and neck function improvements were evident. After one month, the patient regained the ability to straighten the neck while walking and consumed a regular diet despite persistent difficulties chewing hard food. CONCLUSIONS This case underscores the therapeutic potential of vitamin D in alleviating MG symptoms, particularly in individuals with compromised vitamin D levels following gastrectomy. The observed improvements present a new perspective on the possible involvement of vitamin D supplementation in the management of postoperative MG cases.
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Affiliation(s)
- Tao Zhang
- Department of Acupuncture, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, No.23 Museum Back Street, Dongcheng District, Beijing, 100010, China
- Department of Neurology, Inner Mongolia Hospital affiliated to Beijing Hospital of Traditional Chinese Medicine, Bayannur city, Inner Mongolia Autonomous Region, 015000, China
| | - Junhong Zhong
- Department of Acupuncture, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, No.23 Museum Back Street, Dongcheng District, Beijing, 100010, China
| | - Xu Ji
- Department of Acupuncture, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, No.23 Museum Back Street, Dongcheng District, Beijing, 100010, China
| | - Jingqing Sun
- Department of Acupuncture, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, No.23 Museum Back Street, Dongcheng District, Beijing, 100010, China
| | - Yingxue Cui
- Department of Acupuncture, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, No.23 Museum Back Street, Dongcheng District, Beijing, 100010, China.
| | - Shaosong Wang
- Department of Acupuncture, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, No.23 Museum Back Street, Dongcheng District, Beijing, 100010, China.
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Peng J, Cai K, Chen G, Liu L, Peng L. Genetic evidence strengthens the bidirectional connection between gut microbiota and Shigella infection: insights from a two-sample Mendelian randomization study. Front Microbiol 2024; 15:1361927. [PMID: 38495509 PMCID: PMC10941758 DOI: 10.3389/fmicb.2024.1361927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Accepted: 02/21/2024] [Indexed: 03/19/2024] Open
Abstract
Background In recent investigations, substantial strides have been made in the precise modulation of the gut microbiota to prevent and treat a myriad of diseases. Simultaneously, the pressing issue of widespread antibiotic resistance and multidrug resistance resulting from Shigella infections demands urgent attention. Several studies suggest that the antagonistic influence of the gut microbiota could serve as a novel avenue for impeding the colonization of pathogenic microorganisms or treating Shigella infections. However, conventional research methodologies encounter inherent challenges in identifying antagonistic microbial agents against Shigella, necessitating a comprehensive and in-depth analysis of the causal relationship between Shigella infections and the gut microbiota. Materials and methods Utilizing the aggregated summary statistics from Genome-Wide Association Studies (GWAS), we conducted Mendelian Randomization (MR) analyses encompassing 18,340 participants to explore the interplay between the gut microbiota and Shigella infections. This investigation also involved 83 cases of Shigella infection patients and 336,396 control subjects. In the positive strand of our findings, we initially performed a preliminary analysis using the Inverse Variance Weighting (IVW) method. Subsequently, we undertook sensitivity analyses to assess the robustness of the results, addressing confounding factors' influence. This involved employing the Leave-One-Out method and scrutinizing funnel plots to ensure the reliability of the MR analysis outcomes. Conclusively, a reverse MR analysis was carried out, employing the Wald ratio method due to the exposure of individual Single Nucleotide Polymorphisms (SNPs). This was undertaken to explore the plausible associations between Shigella infections and genetically predicted compositions of the gut microbiota. Results In this study, we employed 2,818 SNPs associated with 211 species of gut microbiota as instrumental variables (IVs). Through IVW analysis, our positive MR findings revealed a significant negative correlation between the occurrence of Shigella infections and the phylum Tenericutes (OR: 0.18, 95% CI: 0.04-0.74, p = 0.02), class Mollicutes (OR: 0.18, 95% CI: 0.04-0.74, p = 0.02), genus Intestinimonas (OR: 0.16, 95% CI: 0.04-0.63, p = 0.01), genus Gordonibacter (OR: 0.39, 95% CI: 0.16-0.93, p = 0.03), and genus Butyrivibrio (OR: 0.44, 95% CI: 0.23-0.87, p = 0.02). Conversely, a positive correlation was observed between the occurrence of Shigella infections and genus Sutterella (OR: 10.16, 95% CI: 1.87-55.13, p = 0.01) and genus Alistipes (OR: 12.24, 95% CI: 1.71-87.34, p = 0.01). In sensitivity analyses, utilizing MR-Egger regression analysis and MR Pleiotropy Residual Sum and Outlier (MR-PRESSO) detection, all outcomes demonstrated robust stability. Simultaneously, in the reverse MR analysis, Shigella infections resulted in an upregulation of four bacterial genera and a downregulation of three bacterial genera. Conclusion In summation, the MR analysis outcomes corroborate the presence of bidirectional causal relationships between the gut microbiota and Shigella infections. This study not only unveils novel perspectives for the prevention and treatment of Shigella infections but also furnishes fresh insights into the mechanistic underpinnings of how the gut microbiota contributes to the pathogenesis of Shigella infections. Consequently, the established dual causal association holds promise for advancing our understanding and addressing the complexities inherent in the interplay between the gut microbiota and Shigella infections, thereby paving the way for innovative therapeutic interventions and preventive strategies in the realm of Shigella-related diseases.
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Affiliation(s)
- Jingyi Peng
- Guizhou University of Traditional Chinese Medicine, Guiyang, Guizhou, China
| | - Kun Cai
- Guizhou University of Traditional Chinese Medicine, Guiyang, Guizhou, China
| | - Guanglei Chen
- Guizhou University of Traditional Chinese Medicine, Guiyang, Guizhou, China
| | - Linxiao Liu
- Guizhou University of Traditional Chinese Medicine, Guiyang, Guizhou, China
| | - Lili Peng
- The First People’s Hospital of Hangzhou Lin’an District, Hangzhou, Zhejiang, China
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Wang W, Ge W, Feng J, Huang M, Zhang X, Xia J, Wang L, Li C. Mendelian randomization analyses of known and suspected risk factors and biomarkers for myasthenia gravis overall and by subtypes. BMC Neurol 2024; 24:33. [PMID: 38238684 PMCID: PMC10795466 DOI: 10.1186/s12883-024-03529-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Accepted: 01/05/2024] [Indexed: 01/22/2024] Open
Abstract
BACKGROUND Myasthenia gravis (MG) is an autoimmune disease that affects neuromuscular junction. The literature suggests the involvement of circulating cytokines (CK), gut microbiota (GM), and serum metabolites (SM) with MG. However, this research is limited to observational trials, and comprehensive causal relationship studies have not been conducted. Based on published datasets, this investigation employed Mendelian Randomization (MR) to analyze the known and suspected risk factors and biomarkers causal association of MG and its subtypes. METHODS This research used two-sample MR and linkage disequilibrium score (LDSC) regression of multiple datasets to aggregate datasets acquired from the genome-wide association studies (GWAS) to assess the association of MG with 41-CK, 221-GM, and 486-SM. For sensitivity analysis and to validate the robustness of the acquired data, six methods were utilized, including MR-Egger regression, inverse variance weighting (IVW), weighted median, and MR-PRESSO. RESULTS The MR method identified 20 factors significantly associated with MG, including 2 CKs, 6 GMs, and 9 SMs. Further analysis of the factors related to the two MG subtypes, early-onset MG (EOMG) and late-onset MG (LOMG), showed that EOMG had a high overlap with MG in the intestinal flora, while LOMG had a greater similarity in CKs and SMs. Furthermore, LDSC regression analysis indicated that Peptococcaceae, oxidized biliverdin, and Kynurenine had significant genetic correlations with general MG, whereas EOMG was highly correlated with Intestinibacter, while LOMG had significant genetic associations with Kynurenine and Glucose. CONCLUSION This research furnishes evidence for the potential causal associations of various risk factors with MG and indicates a heterogeneous relationship between CKs, GMs, and SMs with MG subtypes.
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Affiliation(s)
- Wenwen Wang
- Department of Health Statistics, School of Preventive Medicine, Fourth Military Medical University, No.169 Changlexilu Road, Xi'an, Shaanxi Province, 710042, P. R. China
| | - Wei Ge
- Department of Field and Disaster Nursing, Fourth Military Medical University, Xi'an, Shaanxi, 710032, China
| | - Junling Feng
- Department of Health Statistics, School of Preventive Medicine, Fourth Military Medical University, No.169 Changlexilu Road, Xi'an, Shaanxi Province, 710042, P. R. China
| | - Manli Huang
- Department of Health Statistics, School of Preventive Medicine, Fourth Military Medical University, No.169 Changlexilu Road, Xi'an, Shaanxi Province, 710042, P. R. China
| | - Xihua Zhang
- Department of Neurological Intensive Care Rehabilitation, Xi'an International Medical Center Hospital, Xi'an, Shaanxi Province, 710000, China
| | - Jielai Xia
- Department of Health Statistics, School of Preventive Medicine, Fourth Military Medical University, No.169 Changlexilu Road, Xi'an, Shaanxi Province, 710042, P. R. China
| | - Ling Wang
- Department of Health Statistics, School of Preventive Medicine, Fourth Military Medical University, No.169 Changlexilu Road, Xi'an, Shaanxi Province, 710042, P. R. China.
| | - Chen Li
- Department of Health Statistics, School of Preventive Medicine, Fourth Military Medical University, No.169 Changlexilu Road, Xi'an, Shaanxi Province, 710042, P. R. China.
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Di Molfetta IV, Bordoni L, Gabbianelli R, Sagratini G, Alessandroni L. Vitamin D and Its Role on the Fatigue Mitigation: A Narrative Review. Nutrients 2024; 16:221. [PMID: 38257114 PMCID: PMC10818509 DOI: 10.3390/nu16020221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 01/02/2024] [Accepted: 01/04/2024] [Indexed: 01/24/2024] Open
Abstract
Vitamin D has historically been associated with bone metabolism. However, over the years, a growing body of evidence has emerged indicating its involvement in various physiological processes that may influence the onset of numerous pathologies (cardiovascular and neurodegenerative diseases, rheumatological diseases, fertility, cancer, diabetes, or a condition of fatigue). This narrative review investigates the current knowledge of the pathophysiological mechanisms underlying fatigue and the ways in which vitamin D is implicated in these processes. Scientific studies in the databases of PubMed, Scopus, and Web of Science were reviewed with a focus on factors that play a role in the genesis of fatigue, where the influence of vitamin D has been clearly demonstrated. The pathogenic factors of fatigue influenced by vitamin D are related to biochemical factors connected to oxidative stress and inflammatory cytokines. A role in the control of the neurotransmitters dopamine and serotonin has also been demonstrated: an imbalance in the relationship between these two neurotransmitters is linked to the genesis of fatigue. Furthermore, vitamin D is implicated in the control of voltage-gated calcium and chloride channels. Although it has been demonstrated that hypovitaminosis D is associated with numerous pathological conditions, current data on the outcomes of correcting hypovitaminosis D are conflicting. This suggests that, despite the significant involvement of vitamin D in regulating mechanisms governing fatigue, other factors could also play a role.
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Affiliation(s)
- Ippolita Valentina Di Molfetta
- Chemistry Interdisciplinary Project, School of Pharmacy, University of Camerino, Via Madonna delle Carceri, 62032 Camerino, Italy; (I.V.D.M.); (L.A.)
| | - Laura Bordoni
- Unit of Molecular Biology and Nutrigenomics, School of Pharmacy, University of Camerino, Via Gentile III da Varano, 62032 Camerino, Italy; (L.B.); (R.G.)
| | - Rosita Gabbianelli
- Unit of Molecular Biology and Nutrigenomics, School of Pharmacy, University of Camerino, Via Gentile III da Varano, 62032 Camerino, Italy; (L.B.); (R.G.)
| | - Gianni Sagratini
- Chemistry Interdisciplinary Project, School of Pharmacy, University of Camerino, Via Madonna delle Carceri, 62032 Camerino, Italy; (I.V.D.M.); (L.A.)
| | - Laura Alessandroni
- Chemistry Interdisciplinary Project, School of Pharmacy, University of Camerino, Via Madonna delle Carceri, 62032 Camerino, Italy; (I.V.D.M.); (L.A.)
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Cutolo M, Gotelli E. The 2023's Growing Evidence Confirming the Relationship between Vitamin D and Autoimmune Diseases. Nutrients 2023; 15:4760. [PMID: 38004154 PMCID: PMC10675822 DOI: 10.3390/nu15224760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Revised: 11/05/2023] [Accepted: 11/09/2023] [Indexed: 11/26/2023] Open
Abstract
The second Special Issue of Nutrients dedicated to "Vitamin D, Immune Response, and Autoimmune Diseases" will include original data and recent achievements from authors who would like to participate in this research topic [...].
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Affiliation(s)
- Maurizio Cutolo
- Laboratory of Experimental Rheumatology and Academic Division of Clinical Rheumatology, Department of Internal Medicine and Specialties, University of Genova, 16132 Genova, Italy
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