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Schiza S, Bouloukaki I, Kaditis A, Lombardi C, Bonsignore MR. Vitamin D deficiency: A forgotten aspect in sleep disorders? A critical update. Sleep Med 2024; 121:77-84. [PMID: 38941960 DOI: 10.1016/j.sleep.2024.06.023] [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: 03/17/2024] [Revised: 05/28/2024] [Accepted: 06/23/2024] [Indexed: 06/30/2024]
Abstract
Over the past few years, there has been a surge in interest regarding the connection between sleep duration and quality, sleep disorders, mainly Obstructive sleep apnoea (OSA) and Vitamin D. There is growing evidence to support a new role of Vitamin D in the maintenance and regulation of optimal sleep. Furthermore, a notable link has been identified between OSA and a decrease in serum Vitamin D levels, which appears to intensify as the severity of sleep apnea worsens. Vitamin D status could also potentially serve as a mediator or provide an explanation for the association between OSA and cardiometabolic morbidity, but the current state of research in this area is inadequate. Studies have indicated that the supplementation of Vitamin D can optimize sleep quality, presenting more proof of the connection between insufficient vitamin D levels and sleep disorders. However, it is unclear whether low serum Vitamin D levels are a contributing factor to OSA development or if OSA predisposes individuals to Vitamin D deficiency. As a result, various studies have endeavored to examine the complex relationship between OSA and Vitamin D deficiency. In children and adolescents, while data is limited, there seems also to be a link between sleep disorders and Vitamin D levels. Therefore, the objective of this review is to provide a comprehensive overview of the current evidence on the association between Vitamin D and sleep disorders in both adults and children.
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Affiliation(s)
- Sophia Schiza
- Sleep Disorders Center, Department of Respiratory Medicine, School of Medicine, University of Crete, Heraklion, Greece.
| | - Izolde Bouloukaki
- Sleep Disorders Center, Department of Respiratory Medicine, School of Medicine, University of Crete, Heraklion, Greece
| | - Athanasios Kaditis
- Division of Pediatric Pulmonology and Cystic Fibrosis Center, Department of Child Health, University of Missouri School of Medicine, MUHC Children's Hospital, Columbia, MO, USA; Child Health Research Institute, University of Missouri School of Medicine, Columbia, MO, USA
| | - Carolina Lombardi
- Istituto Auxologico Italiano, IRCCS, Department of Cardiovascular, Neural and Metabolic Sciences, St. Luke Hospital, Milan, Italy
| | - Maria R Bonsignore
- Division of Respiratory Medicine, PROMISE Dept, University of Palermo, Palermo, Italy; IBIM CNR, Palermo, Italy
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De Luca P, D'Ascanio L, Cingolani C, Latini G, Grigaliute E, Di Mauro P, Ralli M, La Mantia I, Di Stadio A. A Supplement with Ribes Nigrum, Boswellia Serrata, Bromelain and Vitamin D to Stop Local Inflammation in Chronic Sinusitis: A Case-Control Study. J Clin Med 2023; 12:jcm12082929. [PMID: 37109265 PMCID: PMC10142908 DOI: 10.3390/jcm12082929] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 03/31/2023] [Accepted: 04/15/2023] [Indexed: 04/29/2023] Open
Abstract
Although chronic sinusitis widely affects the adult population, the treatments currently used did not always satisfactorily solve the symptoms. Traditional therapy with steroids and antibiotics presents risks and benefits and the new drugs, i.e., monoclonal antibody, are valid solutions despite being quite expensive. Natural molecules could be a valid treatment that combines good efficacy and low price. We conducted a case -control study to evaluate the benefit of an oral supplement with Ribes nigrum, Boswellia serrata, Bromelain and Vitamin D on chronic sinusitis symptoms. 60 patients were randomly assigned to one of the three groups: control using nasal steroids only, treatment 1 using nasal steroid and 1 dose of the oral supplement for 30 days and treatment 2 in which patients used nasal steroid and two oral supplement doses daily for 15 days. Conditions of the nasal mucosa and a blood sample (WBC, IgE and CRP) were analyzed at T0, T1 (15 days after treatment) and T2 (30 days after treatment. Patients treated with the supplement improved their nasal findings (hyperemia of mucosa and rhinorrhea) with statistically significant differences from the control. Our preliminary data suggest that the addition of supplement containing Ribes nigrum, Boswellia serrata, Vitamin D and Bromelain to the traditional local therapy (nasal spray with cortisone) can be a supporting therapy to modulate the local inflammation in the nose in patients affected by chronic sinusitis.
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Affiliation(s)
- Pietro De Luca
- Department of Otolaryngology, San Giovanni-Addolorata Hospital, 00100 Rome, Italy
| | - Luca D'Ascanio
- Otolaryngology Department, AORMN (Azienda Ospedali Riuniti Marche Nord), 61032 Fano, Italy
| | - Cristina Cingolani
- Otolaryngology Department, AORMN (Azienda Ospedali Riuniti Marche Nord), 61032 Fano, Italy
| | - Gino Latini
- Otolaryngology Department, AORMN (Azienda Ospedali Riuniti Marche Nord), 61032 Fano, Italy
| | - Egle Grigaliute
- Department GF Ingrassia, Otolaryngology, University of Catania, 95131 Catania, Italy
| | - Paola Di Mauro
- Department GF Ingrassia, Otolaryngology, University of Catania, 95131 Catania, Italy
| | - Massimo Ralli
- Organ of Sense Department, University La Sapienza, 00185 Rome, Italy
| | - Ignazio La Mantia
- Department GF Ingrassia, Otolaryngology, University of Catania, 95131 Catania, Italy
| | - Arianna Di Stadio
- Department GF Ingrassia, Otolaryngology, University of Catania, 95131 Catania, Italy
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De Luca P, Di Stadio A, Marra P, Atturo F, Scarpa A, Cassandro C, La Mantia I, Della Volpe A, de Campora L, Tassone D, Camaioni A, Cassandro E. Vitamin D Deficit as Inducer of Adenotonsillar Hypertrophy in Children with Obstructive Sleep Apnea-A Prospective Case-Control Study. CHILDREN (BASEL, SWITZERLAND) 2023; 10:children10020274. [PMID: 36832406 PMCID: PMC9955224 DOI: 10.3390/children10020274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/07/2023] [Revised: 01/28/2023] [Accepted: 01/30/2023] [Indexed: 02/04/2023]
Abstract
(1) Objective: This prospective case-control study aimed to assess the level of serum vitamin D comparing pediatric non-allergic patients with obstructive sleep apnea (OSA) and healthy controls. (2) Methods: The period of the enrollment was from November 2021 to February 2022. Children with uncomplicated OSA caused by adenotonsillar hypertrophy (ATH) were recruited. Allergy was excluded by skin prick test (SPT), and the determination of serum IgE level using ELISA test. Plasma concentration of 25-hydroxy vitamin D (25-OHD) was quantitatively determined; then, the vitamin D concentration in patients was compared with healthy controls matched for sex, age, ethnicity, and characteristics. (3) Results: Plasma 25-OHD levels were significantly lower in patients than in healthy subjects (mean 17 ng/mL, 6.27 DS, range 6-30.7 ng/mL, vs. mean 22 ng/mL, 9.45 DS, range 7-41.2 ng/ ml; p < 0.0005). The prevalence of children with vitamin D deficiency was significantly higher in the ATH group than controls. The plasma 25-OHD level did not change following the ATH clinical presentation (III or IV grade according to the Brodsky scale), while the different categories of 25-OHD status (insufficiency, deficiency, and adequacy) in the ATH group were statistically significantly different (p < 0.001) from healthy controls. (4) Conclusions: This study identified statistically significant differences between the ATH group and control regarding the plasma concentration of vitamin D; this data, despite not being directly linkable to the lymphoid tissue hypertrophy (p-value not significant), might suggest a negative effect of vitamin D deficit on the immune system.
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Affiliation(s)
- Pietro De Luca
- Otolaryngology Department, San Giovanni-Addolorata Hospital, 00184 Rome, Italy
- Otolaryngology Department, AORN Moscati, 83100 Avellino, Italy
- Correspondence:
| | - Arianna Di Stadio
- Otolaryngology Department, University of Catania, 95124 Catania, Italy
| | - Pasquale Marra
- Otolaryngology Department, AORN Moscati, 83100 Avellino, Italy
| | - Francesca Atturo
- Otolaryngology Department, San Giovanni-Addolorata Hospital, 00184 Rome, Italy
| | - Alfonso Scarpa
- Department of Medicine, Surgery and Dentistry, University of Salerno, 84084 Salerno, Italy
| | - Claudia Cassandro
- Department of Surgical Sciences, University of Turin, 10124 Turin, Italy
| | - Ignazio La Mantia
- Otolaryngology Department, University of Catania, 95124 Catania, Italy
| | - Antonio Della Volpe
- Cochlear Implant and Middle Ear Unit, Santobono-Posilipon Hospital, 80122 Naples, Italy
| | - Luca de Campora
- Otolaryngology Department, San Giovanni-Addolorata Hospital, 00184 Rome, Italy
| | - Domenico Tassone
- Otolaryngology Department, San Giovanni-Addolorata Hospital, 00184 Rome, Italy
| | - Angelo Camaioni
- Otolaryngology Department, AORN Moscati, 83100 Avellino, Italy
| | - Ettore Cassandro
- Department of Medicine, Surgery and Dentistry, University of Salerno, 84084 Salerno, Italy
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Maselli del Giudice A, La Mantia I, Barbara F, Ciccarone S, Ragno MS, de Robertis V, Cariti F, Barbara M, D’Ascanio L, Di Stadio A. Use of Nutraceuticals in Elderly to Fight Inflammation and Immuno-Senescence: A Randomized Case-Control Study. Nutrients 2022; 14:3476. [PMID: 36079732 PMCID: PMC9459752 DOI: 10.3390/nu14173476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2022] [Revised: 08/11/2022] [Accepted: 08/22/2022] [Indexed: 11/16/2022] Open
Abstract
Elderly people are at high risk of suffering from infection and being affected by severe forms of disease because their immunosystem suffers from aging. The alteration of normal immune functions causes the increase of pro-inflammatory cytokines which can expose these people to increased risk of developing pathologies as cancer, diabetes, and/or arthritis. Some supplements could be helpful for restoring normal immune functions. We conducted a case-control study to evaluate the efficacy of a supplement containing Sambucus nigra, zinc, tyndallized Lactobacillus acidophilus (HA122), arabinogalactans, vitamin D, vitamin E, and vitamin C to improve the inflammatory levels (IL-6 and CRP) and to modulate the lymphocytes growth. Additionally, we analyzed wellness by self-questionnaire. This study had two control group: a young group and an elderly one. Our study showed that treating elderly patients with the supplement for 30 days improved IL-6, CRP, and lymphocytes levels; the result was independent from the dosage of the supplements used. Elderly patients, despite the improvement, were not able to reach the same conditions of young patients; however, most of the patients (>70%) claimed to “feel better” after the use of the supplement. The use of this supplement should be considered at a low dosage for a prolonged period to reduce inflammation and modulate immune senescence in patients over 60 years old.
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Affiliation(s)
| | - Ignazio La Mantia
- Department GF Ingrassia, University of Catania, 95123 Catania, Italy
| | - Francesco Barbara
- Department Otorhinolaryngology, University Hospital of Bari, 70126 Bari, Italy
| | - Silvana Ciccarone
- Department Otorhinolaryngology, Hospital of Barletta, 76121 Barletta (BT), Italy
| | - Maria Sterpeta Ragno
- Department Otorhinolaryngology, Hospital of Barletta, 76121 Barletta (BT), Italy
| | | | - Francesco Cariti
- Department Otorhinolaryngology, Hospital of Barletta, 76121 Barletta (BT), Italy
| | - Michele Barbara
- Department Otorhinolaryngology, Hospital of Barletta, 76121 Barletta (BT), Italy
| | - Luca D’Ascanio
- Department Otorhinolaryngology, Azienda Ospeliera Riunita Marche Nord (AORMN), 61032 Fano (PU), Italy
| | - Arianna Di Stadio
- Department GF Ingrassia, University of Catania, 95123 Catania, Italy
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Notarbartolo V, Montante C, Ferrante G, Giuffrè M. Antioxidant Effects of Dietary Supplements on Adult COVID-19 Patients: Why Do We Not Also Use Them in Children? Antioxidants (Basel) 2022; 11:antiox11091638. [PMID: 36139712 PMCID: PMC9495518 DOI: 10.3390/antiox11091638] [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: 06/29/2022] [Revised: 08/09/2022] [Accepted: 08/19/2022] [Indexed: 11/16/2022] Open
Abstract
Respiratory tract infections (RTIs) are very common in children, especially in the first five years of life, and several viruses, such as the influenza virus, Respiratory Syncytial Virus, and Rhinovirus, are triggers for symptoms that usually affect the upper airways. It has been known that during respiratory viral infections, a condition of oxidative stress (OS) occurs, and many studies have suggested the potential use of antioxidants as complementary components in prophylaxis and/or therapy of respiratory viral infections. Preliminary data have demonstrated that antioxidants may also interfere with the new coronavirus 2’s entry and replication in human cells, and that they have a role in the downregulation of several pathogenetic mechanisms involved in disease severity. Starting from preclinical data, the aim of this narrative review is to evaluate the current evidence about the main antioxidants that are potentially useful for preventing and treating Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection in adults and to speculate on their possible use in children by exploring the most relevant issues affecting their use in clinical practice, as well as the associated evidence gaps and research limitations.
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Affiliation(s)
- Veronica Notarbartolo
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialities, University of Palermo, 90128 Palermo, Italy
- Correspondence:
| | - Claudio Montante
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialities, University of Palermo, 90128 Palermo, Italy
| | - Giuliana Ferrante
- Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, Pediatric Division, University of Verona, 37134 Verona, Italy
| | - Mario Giuffrè
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialities, University of Palermo, 90128 Palermo, Italy
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Single-Center-Single-Blinded Clinical Trial to Evaluate the Efficacy of a Nutraceutical Containing Boswellia Serrata, Bromelain, Zinc, Magnesium, Honey, Tyndallized Lactobacillus Acidophilus and Casei to Fight Upper Respiratory Tract Infection and Otitis Media. Healthcare (Basel) 2022; 10:healthcare10081526. [PMID: 36011184 PMCID: PMC9408187 DOI: 10.3390/healthcare10081526] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 08/10/2022] [Accepted: 08/12/2022] [Indexed: 11/16/2022] Open
Abstract
Some nutraceuticals have been studied as supportive treatment for fighting upper respiratory tract infection and middle ear disease. Our study aims at evaluating the effect of a specific oral supplementation in the treatment of pediatric otits media. The subjects were randomly assigned by the physician (single-blinded study) to one of three groups: Control Group (CG), Treatment Group 1 (TG1), or Treatment Group 2 (TG2). Both TG were treated with Flogostop Duo (for 20 days—TG1 or 30 days—TG2) in combination with the standard treatment, while CG underwent standard treatment only. The standard treatment was nasal aerosol with Fluticasone and Mucolytic, and nasal washing with hypertonic solution. All patients were analyzed by otoscopy, impedance, fibroscopy, and pure auditory test at the baseline (T0), after 20 days (T1) and 35 days (T2). 120 children were included in the study, 40 in the CG, 40 in the TG1, and 40 in the TG2. Both TG1 and TG2 presented statistically significant differences with respect to controls in otoscopy, impedance, fibroscopy, and PTA at T2. The otoscopy improved at T2 with statistically significant value only in TG2. The impedance and fibroscopy improved at T1 both in TG1 and TG2 compared to CG. A statistically significant improvement was observed in TG2 at T2 in comparison to both CG and TG1. Statistically significant differences were observed in PTA at T2 only compared with controls. This study confirmed the efficacy of nutraceutical as supporting therapy in the upper respiratory tract infection in children. In particular, the supplement containing Boswellia serrata and Bromelain, which are molecules with strong anti-inflammatory and pain-control capacities, could add the benefit without the adverse effects which are related to NSAID use.
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Leszczyszyn A, Hnitecka S, Dominiak M. Could Vitamin D3 Deficiency Influence Malocclusion Development? Nutrients 2021; 13:nu13062122. [PMID: 34205632 PMCID: PMC8234332 DOI: 10.3390/nu13062122] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 06/18/2021] [Accepted: 06/18/2021] [Indexed: 11/16/2022] Open
Abstract
The abnormal growth of the craniofacial bone leads to skeletal and dental defects, which result in the presence of malocclusions. Not all causes of malocclusion have been explained. In the development of skeletal abnormalities, attention is paid to general deficiencies, including of vitamin D3 (VD3), which causes rickets. Its chronic deficiency may contribute to skeletal malocclusion. The aim of the study was to assess the impact of VD3 deficiency on the development of malocclusions. The examination consisted of a medical interview, oral examination, an alginate impression and radiological imaging, orthodontic assessment, and taking a venous blood sample for VD3 level testing. In about 42.1% of patients, the presence of a skeletal defect was found, and in 46.5% of patients, dentoalveolar malocclusion. The most common defect was transverse constriction of the maxilla with a narrow upper arch (30.7%). The concentration of vitamin 25 (OH) D in the study group was on average 23.6 ± 10.5 (ng/mL). VD3 deficiency was found in 86 subjects (75.4%). Our research showed that VD3 deficiency could be one of an important factor influencing maxillary development. Patients had a greater risk of a narrowed upper arch (OR = 4.94), crowding (OR = 4.94) and crossbite (OR = 6.16). Thus, there was a link between the deficiency of this hormone and the underdevelopment of the maxilla.
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Affiliation(s)
- Anna Leszczyszyn
- Oral Surgery Department, Wroclaw Medical University, 50-425 Wroclaw, Poland; (A.L.); (M.D.)
| | - Sylwia Hnitecka
- Maxillofacial Surgery Department, Wroclaw Medical University, 50-556 Wroclaw, Poland
- Correspondence:
| | - Marzena Dominiak
- Oral Surgery Department, Wroclaw Medical University, 50-425 Wroclaw, Poland; (A.L.); (M.D.)
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Di Stadio A, Costantini C, Renga G, Pariano M, Ricci G, Romani L. The Microbiota/Host Immune System Interaction in the Nose to Protect from COVID-19. Life (Basel) 2020; 10:life10120345. [PMID: 33322584 PMCID: PMC7763594 DOI: 10.3390/life10120345] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2020] [Revised: 12/03/2020] [Accepted: 12/10/2020] [Indexed: 12/12/2022] Open
Abstract
Coronavirus disease 2019 (COVID-19) is caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and is characterized by variable clinical presentation that ranges from asymptomatic to fatal multi-organ damage. The site of entry and the response of the host to the infection affect the outcomes. The role of the upper airways and the nasal barrier in the prevention of infection is increasingly being recognized. Besides the epithelial lining and the local immune system, the upper airways harbor a community of microorganisms, or microbiota, that takes an active part in mucosal homeostasis and in resistance to infection. However, the role of the upper airway microbiota in COVID-19 is not yet completely understood and likely goes beyond protection from viral entry to include the regulation of the immune response to the infection. Herein, we discuss the hypothesis that restoring endogenous barriers and anti-inflammatory pathways that are defective in COVID-19 patients might represent a valid strategy to reduce infectivity and ameliorate clinical symptomatology.
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Affiliation(s)
- Arianna Di Stadio
- Department of Otolaryngology, University of Perugia, 06132 Perugia, Italy;
- Correspondence: (A.D.S.); (L.R.)
| | - Claudio Costantini
- Department of Medicine and Surgery, University of Perugia, 06132 Perugia, Italy; (C.C.); (G.R.); (M.P.)
| | - Giorgia Renga
- Department of Medicine and Surgery, University of Perugia, 06132 Perugia, Italy; (C.C.); (G.R.); (M.P.)
| | - Marilena Pariano
- Department of Medicine and Surgery, University of Perugia, 06132 Perugia, Italy; (C.C.); (G.R.); (M.P.)
| | - Giampietro Ricci
- Department of Otolaryngology, University of Perugia, 06132 Perugia, Italy;
| | - Luigina Romani
- Department of Medicine and Surgery, University of Perugia, 06132 Perugia, Italy; (C.C.); (G.R.); (M.P.)
- Correspondence: (A.D.S.); (L.R.)
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