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Yoo MY, Lee J, Chung JI, Yeo Y, Cho IY. The Association between Serum Vitamin D Concentration and Colon Polyp: A Cross-Sectional Study Using Health Care Screening Database in a Tertiary Hospital in Korea. Korean J Fam Med 2021; 42:303-309. [PMID: 34320798 PMCID: PMC8321912 DOI: 10.4082/kjfm.20.0181] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Accepted: 12/03/2020] [Indexed: 12/31/2022] Open
Abstract
Background As indoor activity increases with modern lifestyles changes, reduced exposure to sunlight may lead to reduced vitamin D synthesis. Previous studies demonstrated that increased vitamin D level is associated with decreased risk of colon cancer; therefore, this study attempted to determine the association between vitamin D and colon polyps, which may be precancerous lesions, in participants who underwent colonoscopy exams. Methods A total of 31,004 participants who underwent routine health checkups, including vitamin D level and colonoscopy, at Samsung Medical Center in South Korea from 2010 to 2018 were included in the study. Colorectal polyps were diagnosed through biopsy after performing colonoscopy exams. Participants were categorized into three groups according to level of vitamin D (deficient: <20 ng/mL), insufficient: 20≤ vitamin D <30 ng/mL, and sufficient: ≥30 ng/mL). We analyzed the presence of colorectal polyps according to vitamin D level, and performed multiple logistic regression analyses for the association between vitamin D level and colorectal polyps. Results About 50% of participants had colorectal polyps (hyperplastic polyp, n=4,864; adenomatous polyp, n=10,470; adenocarcinoma, n=24). There were no significant associations between vitamin D categories and colorectal polyp and colorectal cancer. However, when further analyzing by type of polyp, the risk of hyperplastic polyps significantly decreased with increasing vitamin D levels (P for trend=0.006). Conclusion We did not find evidence for an association between vitamin D and overall colorectal polyps; however, we observed a trend for decreased odds of hyperplastic polyps with increased vitamin D levels in comparison to vitamin D deficient subjects.
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Affiliation(s)
- Mun Young Yoo
- Department of Family Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jungkwon Lee
- Department of Family Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Ji In Chung
- Department of Health Promotion Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Yohwan Yeo
- Department of Family Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - In Young Cho
- Department of Family Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
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2
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Sengupta T, Majumder R, Majumder S. Role of vitamin D in treating COVID-19-associated coagulopathy: problems and perspectives. Mol Cell Biochem 2021; 476:2421-2427. [PMID: 33604809 PMCID: PMC7891480 DOI: 10.1007/s11010-021-04093-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Accepted: 01/29/2021] [Indexed: 12/26/2022]
Abstract
Aggressive inflammatory response leading to hypercoagulability has been found to be associated with disease severity in COVID-19 patients and portends bad treatment outcome. A state of acute disseminated intravascular coagulation (DIC), along with pulmonary embolism and/or deep vein thrombosis, has been observed in critically ill ICU patients. Autopsy reports of COVID-19 patients demonstrated microthrombi in lungs and in other organs, as well as marked inflammatory changes, characteristic clinicopathological features that exacerbate disease severity. Vitamin D supplementation was recommended by many clinicians across the globe to improve clinical symptoms of COVID-19 patients, mainly because of its immunomodulatory roles on immune cells. Furthermore, vitamin D and its associated molecules are also known to directly or indirectly regulate various thrombotic pathways. We propose that vitamin D supplementation not only attenuates the risk of Acute Respiratory Disease Syndrome (ARDS) but it also may have a role in reducing coagulation abnormalities in critically ill COVID-19 patients. The overarching goal of this review is to discuss the effects of vitamin D on coagulation pathways and other intertwined processes leading to thrombosis. Many clinical trials are currently investigating the efficacy of vitamin D supplementation in reducing the risk of COVID-19 infection. However, randomized placebo control clinical trials are also necessary to ascertain the effect of vitamin D supplementation on reducing the risk of coagulopathy in COVID-19 patients.
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Affiliation(s)
- Tanusree Sengupta
- Department of Chemistry, Sri Sivasubramaniya Nadar College of Engineering, Chennai, India.
| | - Rinku Majumder
- Department of Biochemistry & Molecular Biology, LSU Health Science Center, New Orleans, USA
| | - Samarpan Majumder
- Department of Genetics, LSU Health Science Center, New Orleans, USA.
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Muthuvattur Pallath M, Ahirwar AK, Chandra Tripathi S, Asia P, Sakarde A, Gopal N. COVID-19 and nutritional deficiency: a review of existing knowledge. Horm Mol Biol Clin Investig 2021; 42:77-85. [PMID: 33544528 DOI: 10.1515/hmbci-2020-0074] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Accepted: 01/20/2021] [Indexed: 12/22/2022]
Abstract
COVID-19 has resulted in an ongoing global pandemic, which spread largely among people who have had close contact with the infected person. The immunopathology of the SARS-CoV-2 virus includes the production of an excess amount of pro-inflammatory cytokines "a cytokine-storm". The respiratory system (main), cardiovascular system and the gastrointestinal tract are the most affected body systems during viral infection. It has been found that most of the patients who require admission to hospital are elderly or have chronic underlying diseases. Higher cases of malnutrition and co-morbidities like diabetes mellitus and cardiovascular diseases are reported in elderly patients due to which, the immune system weakens and hence, the response to the virus is diminished in magnitude. A deficiency of micronutrients results in impaired immune responses leading to improper secretion of cytokines, alterations in secretory antibody response and antibody affinity which increases susceptibility to viral infection. The deficiency of various micronutrients in COVID-19 patient can be treated by appropriate nutritional supplements, prescribed after evaluating the patients' nutritional status. Here we aim to highlight the role of a few particular nutrients namely Vitamin D, Vitamin C, Omega-3 fatty acids, Zinc and Magnesium along with the synergistic roles they play in enhancing immunity and thus, maintaining homeostasis.
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Affiliation(s)
| | - Ashok Kumar Ahirwar
- Department of Biochemistry, All India Institute of Medical Sciences, Nagpur, Maharashtra, India
| | | | - Priyanka Asia
- Department of Biochemistry, All India Institute of Medical Sciences, Nagpur, Maharashtra, India
| | - Apurva Sakarde
- Department of Biochemistry, All India Institute of Medical Sciences, Nagpur, Maharashtra, India
| | - Niranjan Gopal
- Department of Biochemistry, All India Institute of Medical Sciences, Nagpur, Maharashtra, India
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4
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L Bishop E, Ismailova A, Dimeloe S, Hewison M, White JH. Vitamin D and Immune Regulation: Antibacterial, Antiviral, Anti-Inflammatory. JBMR Plus 2021; 5:e10405. [PMID: 32904944 PMCID: PMC7461279 DOI: 10.1002/jbm4.10405] [Citation(s) in RCA: 126] [Impact Index Per Article: 42.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Accepted: 08/05/2020] [Indexed: 02/06/2023] Open
Abstract
Regulation of immune function continues to be one of the most well-recognized extraskeletal actions of vitamin D. This stemmed initially from the discovery that antigen presenting cells such as macrophages could actively metabolize precursor 25-hydroxyvitamin D (25D) to active 1,25-dihydroxyvitamin D (1,25D). Parallel observation that activated cells from the immune system expressed the intracellular vitamin D receptor (VDR) for 1,25D suggested a potential role for vitamin D as a localized endogenous modulator of immune function. Subsequent studies have expanded our understanding of how vitamin D exerts effects on both the innate and adaptive arms of the immune system. At an innate level, intracrine synthesis of 1,25D by macrophages and dendritic cells stimulates expression of antimicrobial proteins such as cathelicidin, as well as lowering intracellular iron concentrations via suppression of hepcidin. By potently enhancing autophagy, 1,25D may also play an important role in combatting intracellular pathogens such as M. tuberculosis and viral infections. Local synthesis of 1,25D by macrophages and dendritic cells also appears to play a pivotal role in mediating T-cell responses to vitamin D, leading to suppression of inflammatory T helper (Th)1 and Th17 cells, and concomitant induction of immunotolerogenic T-regulatory responses. The aim of this review is to provide an update on our current understanding of these prominent immune actions of vitamin D, as well as highlighting new, less well-recognized immune effects of vitamin D. The review also aims to place this mechanistic basis for the link between vitamin D and immunity with studies in vivo that have explored a role for vitamin D supplementation as a strategy for improved immune health. This has gained prominence in recent months with the global coronavirus disease 2019 health crisis and highlights important new objectives for future studies of vitamin D and immune function. © 2020 The Authors. JBMR Plus published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research.
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Affiliation(s)
- Emma L Bishop
- Institute of Immunology and ImmunotherapyUniversity of BirminghamBirminghamUK
| | - Aiten Ismailova
- Department of PhysiologyMcGill UniversityMontrealQuebecCanada
| | - Sarah Dimeloe
- Institute of Immunology and ImmunotherapyUniversity of BirminghamBirminghamUK
- Metabolism and Systems ResearchUniversity of BirminghamBirminghamUK
| | - Martin Hewison
- Metabolism and Systems ResearchUniversity of BirminghamBirminghamUK
| | - John H White
- Department of PhysiologyMcGill UniversityMontrealQuebecCanada
- Department of MedicineMcGill UniversityMontrealQuebecCanada
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Lahoor Basha S, Suresh S, Ashok Reddy V, Surya Teja SP. Is the shielding effect of cholecalciferol in SARS CoV-2 infection dependable? An evidence based unraveling. CLINICAL EPIDEMIOLOGY AND GLOBAL HEALTH 2021; 9:326-331. [PMID: 33102933 PMCID: PMC7576325 DOI: 10.1016/j.cegh.2020.10.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Revised: 10/06/2020] [Accepted: 10/12/2020] [Indexed: 01/08/2023] Open
Abstract
Despite being announced as a global health concern and emergency in January by WHO, designing specific treatment for SARS-CoV-2 is still a summit yet to be conquered. Currently, many drugs are being tested in the clinical scenario and vitamins play a significant role in therapeutic management. Based on the available evidence, we postulate that maintaining normal vitamin D3 levels may reduce severity, mortality risk of COVID-19. This review elucidates the alarming need for randomized clinical trials to determine the role of vitamin D in patient prognosis in COVID-19 infection and on latitude bases epidemiological outcome.
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Affiliation(s)
- Shaik Lahoor Basha
- Department of Medical Affairs, HealthMinds, Bengaluru, Karnataka, 560038, India
| | - Sake Suresh
- Department of General Medicine, Andaman & Nicobar Health Services, Port Blair, 744104, India
| | - V.V. Ashok Reddy
- Department of Emergency Medicine, Pushpagiri Institute of Medical Sciences, Tiruvalla, Kerala, India
| | - S P Surya Teja
- Health Minds Consulting Pvt Ltd, Bengaluru, India,Corresponding author
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Grant WB, Lahore H, McDonnell SL, Baggerly CA, French CB, Aliano JL, Bhattoa HP. Evidence that Vitamin D Supplementation Could Reduce Risk of Influenza and COVID-19 Infections and Deaths. Nutrients 2020; 12:nu12040988. [PMID: 32252338 PMCID: PMC7231123 DOI: 10.3390/nu12040988] [Citation(s) in RCA: 1049] [Impact Index Per Article: 262.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Revised: 03/30/2020] [Accepted: 03/31/2020] [Indexed: 02/06/2023] Open
Abstract
The world is in the grip of the COVID-19 pandemic. Public health measures that can reduce the risk of infection and death in addition to quarantines are desperately needed. This article reviews the roles of vitamin D in reducing the risk of respiratory tract infections, knowledge about the epidemiology of influenza and COVID-19, and how vitamin D supplementation might be a useful measure to reduce risk. Through several mechanisms, vitamin D can reduce risk of infections. Those mechanisms include inducing cathelicidins and defensins that can lower viral replication rates and reducing concentrations of pro-inflammatory cytokines that produce the inflammation that injures the lining of the lungs, leading to pneumonia, as well as increasing concentrations of anti-inflammatory cytokines. Several observational studies and clinical trials reported that vitamin D supplementation reduced the risk of influenza, whereas others did not. Evidence supporting the role of vitamin D in reducing risk of COVID-19 includes that the outbreak occurred in winter, a time when 25-hydroxyvitamin D (25(OH)D) concentrations are lowest; that the number of cases in the Southern Hemisphere near the end of summer are low; that vitamin D deficiency has been found to contribute to acute respiratory distress syndrome; and that case-fatality rates increase with age and with chronic disease comorbidity, both of which are associated with lower 25(OH)D concentration. To reduce the risk of infection, it is recommended that people at risk of influenza and/or COVID-19 consider taking 10,000 IU/d of vitamin D3 for a few weeks to rapidly raise 25(OH)D concentrations, followed by 5000 IU/d. The goal should be to raise 25(OH)D concentrations above 40-60 ng/mL (100-150 nmol/L). For treatment of people who become infected with COVID-19, higher vitamin D3 doses might be useful. Randomized controlled trials and large population studies should be conducted to evaluate these recommendations.
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Affiliation(s)
- William B. Grant
- Sunlight, Nutrition, and Health Research Center, P.O. Box 641603, San Francisco, CA 94164-1603, USA
- Correspondence: ; Tel.: +1-415-409-1980
| | - Henry Lahore
- 2289 Highland Loop, Port Townsend, WA 98368, USA;
| | - Sharon L. McDonnell
- GrassrootsHealth, Encinitas, CA 92024, USA; (S.L.M.); (C.A.B.); (C.B.F.); (J.L.A.)
| | - Carole A. Baggerly
- GrassrootsHealth, Encinitas, CA 92024, USA; (S.L.M.); (C.A.B.); (C.B.F.); (J.L.A.)
| | - Christine B. French
- GrassrootsHealth, Encinitas, CA 92024, USA; (S.L.M.); (C.A.B.); (C.B.F.); (J.L.A.)
| | - Jennifer L. Aliano
- GrassrootsHealth, Encinitas, CA 92024, USA; (S.L.M.); (C.A.B.); (C.B.F.); (J.L.A.)
| | - Harjit P. Bhattoa
- Department of Laboratory Medicine, Faculty of Medicine, University of Debrecen, Nagyerdei Blvd 98, H-4032 Debrecen, Hungary;
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Grant WB, Lahore H, McDonnell SL, Baggerly CA, French CB, Aliano JL, Bhattoa HP. Evidence that Vitamin D Supplementation Could Reduce Risk of Influenza and COVID-19 Infections and Deaths. Nutrients 2020. [PMID: 32252338 DOI: 10.20944/preprints202003.0235.v2] [Citation(s) in RCA: 50] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
The world is in the grip of the COVID-19 pandemic. Public health measures that can reduce the risk of infection and death in addition to quarantines are desperately needed. This article reviews the roles of vitamin D in reducing the risk of respiratory tract infections, knowledge about the epidemiology of influenza and COVID-19, and how vitamin D supplementation might be a useful measure to reduce risk. Through several mechanisms, vitamin D can reduce risk of infections. Those mechanisms include inducing cathelicidins and defensins that can lower viral replication rates and reducing concentrations of pro-inflammatory cytokines that produce the inflammation that injures the lining of the lungs, leading to pneumonia, as well as increasing concentrations of anti-inflammatory cytokines. Several observational studies and clinical trials reported that vitamin D supplementation reduced the risk of influenza, whereas others did not. Evidence supporting the role of vitamin D in reducing risk of COVID-19 includes that the outbreak occurred in winter, a time when 25-hydroxyvitamin D (25(OH)D) concentrations are lowest; that the number of cases in the Southern Hemisphere near the end of summer are low; that vitamin D deficiency has been found to contribute to acute respiratory distress syndrome; and that case-fatality rates increase with age and with chronic disease comorbidity, both of which are associated with lower 25(OH)D concentration. To reduce the risk of infection, it is recommended that people at risk of influenza and/or COVID-19 consider taking 10,000 IU/d of vitamin D3 for a few weeks to rapidly raise 25(OH)D concentrations, followed by 5000 IU/d. The goal should be to raise 25(OH)D concentrations above 40-60 ng/mL (100-150 nmol/L). For treatment of people who become infected with COVID-19, higher vitamin D3 doses might be useful. Randomized controlled trials and large population studies should be conducted to evaluate these recommendations.
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Affiliation(s)
- William B Grant
- Sunlight, Nutrition, and Health Research Center, P.O. Box 641603, San Francisco, CA 94164-1603, USA
| | - Henry Lahore
- 2289 Highland Loop, Port Townsend, WA 98368, USA
| | | | | | | | | | - Harjit P Bhattoa
- Department of Laboratory Medicine, Faculty of Medicine, University of Debrecen, Nagyerdei Blvd 98, H-4032 Debrecen, Hungary
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