Vitamin D Immune-Mediated Responses and SARS-CoV-2 Infection: Clinical Implications in COVID-19

Active vitamin D is a true steroid hormone with pleiotropic biological effects that go beyond the classical concept of bone metabolism regulation. In fact, adequate serum levels of 25-hydroxyvitamin D (>40 ng/mL) are required to support several biological functions, including the control of innate and adaptive immunity in course of infectious, inflammatory and autoimmune diseases. SARS-CoV-2 is responsible for the COVID-19 pandemic and deficient/insufficient serum levels of 25-hydroxyvitamin D are reported in very large cohorts of patients. Of note, vitamin D is involved in different pathophysiological processes, such as expression of SARS-CoV-2 receptor (ACE2), activation of innate (neutrophils with their extracellular traps, monocytes/macrophages, dendritic cells, natural killer cells) and adaptive (T and B lymphocytes) immune cells and clinical manifestations, such as coagulation/thrombotic disorders and acute respiratory distress syndrome. Randomized clinical trials regarding vitamin D supplementation in COVID-19 patients have shown favorable effects on the control of inflammation markers, arterial oxygen saturation/inspired fraction of oxygen ratio, admission to hospital intensive care units and mortality. A target of serum 25-hydroxyvitamin D > 50 ng/mL has been identified as protective for the course of COVID-19, potentially playing an ancillary role in the treatment of the disease.

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AB0800 CLINICAL ASSOCIATION BETWEEN URIC ACID/25-HYDROXYVITAMIN D SERUM LEVELS RATIO IN PATIENTS WITH PSORIATIC ARTHRITIS

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2020-eular.2909 ◽

2020 ◽

Vol 79 (Suppl 1) ◽

pp. 1699.1-1700

Author(s):

F. Masini ◽

K. Gjeloshi ◽

E. Pinotti ◽

F. Danzo ◽

F. Guarino ◽

...

Keyword(s):

Vitamin D ◽

Uric Acid ◽

Psoriatic Arthritis ◽

Disease Activity ◽

Activity Index ◽

Univariate Analysis ◽

Disease Activity Index ◽

Serum Levels ◽

Hydroxyvitamin D ◽

25 Hydroxyvitamin D

Background:The association between hyperuricemia and psoriatic arthritis (PsA) is actually generally accepted. Previous studies have demonstrated that uric acid suppress 25(OH)D metabolism [1]. More evidence is required to demonstrate the immune modulatory effects in psoriasis, psoriatic arthritis and other autoimmune diseases. In particular, the potential association between 25-hydroxyvitamin D serum levels and PsA still remains unknown.Objectives:To assess a clinical association between uric acid/25(OH)D serum levels ratio related to PASI, BASDAI and DAPSA, if any, in patients with psoriatic arthritis.Methods:We retrospectively observed 61 patients with psoriatic arthritis referred to our outpatients clinic, independently from already being on therapy or naïve. All selected patients underwent only conventional non-biological therapy at baseline and none received vitamin D supplementation and either allopurinol or febuxostat previously. Blood samples were drawn from all participants for assessment of 25-hydroxyvitamin D and uric acid serum levels. Disease activity of psoriasis and psoriatic arthritis were assessed by the Psoriasis Area and Severity Index (PASI), the Disease Activity Index for Psoriatic Arthritis (DAPSA) and the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI). We assessed the covariates of interest by the Wilcoxon non parametric test, through the SPSS 24 Software.Results:We observed 61 patients, mainly females (83.6%). At the univariate analysis, the uric acid/25(OH)D serum levels ratio revealed significantly associated with DAPSA and BASDAI indexes (p<0.001 and p<0.001, respectively), whilst no significant association emerged with the PASI index (p=0.462).Conclusion:Data in the literature about these associations in the context of psoriatic arthritis are really poor. As a consequence, our findings, though preliminary, suggest us to hypothesize a potential role of uric acid/25(OH)D serum levels ratio as potential inflammation marker in order to better assess the disease activity. However, future larger studies are needed to investigate more in depth this association.[1]Charoenngam N, Ponvilawan B, Ungprasert P. Vitamin D insufficiency and deficiency are associated with a higher level of serum uric acid: A systematic review and meta-analysis. Mod Rheumatol. 2019 Mar 4:1-6.Disclosure of Interests:None declared

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Analysis of Suicidal Behavior and Chronicity of Depressive Symptoms in the Presence of Hypovitaminosis D

Current Psychiatry Research and Reviews ◽

10.2174/2666082217666211122155401 ◽

2021 ◽

Vol 17 ◽

Author(s):

Catarina Magalhães Porto ◽

Natalia Santos Barbosa da Silva ◽

Cecília Magalhães Porto Lira ◽

Rayana Porpino Magalhães ◽

José Luiz Oliveira Magalhães ◽

...

Keyword(s):

Vitamin D ◽

Depressive Symptoms ◽

Suicidal Ideation ◽

Depressive Disorder ◽

Suicidal Behavior ◽

Suicide Risk ◽

Hypovitaminosis D ◽

Serum Levels ◽

Hydroxyvitamin D ◽

25 Hydroxyvitamin D

Background: One of the risk factors for suicide includes the presence of depressive disorder and symptoms, which may be related to the reduction of 25-hydroxyvitamin D serum levels. In this scenario, evidence shows vitamin D deficiency as an important aspect, directly related to depressive disorder chronicity. Objective: To assess the association between Vitamin D serum levels and the intensity of depressive symptoms and suicidal behavior in a clinical sample of depressed patients. Methods: A cross-sectional study with 146 patients aged between 18 and 59, seen in two psychiatry ambulatories. Data collection involved measurement of serum 25-hydroxyvitamin D levels and assessment of the intensity of depressive symptoms and suicide risk. Results: In the sample, 35% presented low Vitamin D serum levels and, in these individuals, the incidence of family history of Depressive Disorder (95.2%) and chronicity of severe depressive symptoms (47.8%) was higher. As to suicidal behavior, both groups presented high active suicide risk, with higher rates in the group with hypovitaminosis D. Only suicidal ideation was linked to lower Vitamin D levels (67.4% p= 0,005). Conclusion: In this study, hypovitaminosis D was associated with negative mental health outcomes, such as more severe chronicity of depressive symptoms and suicidal behavior, characterized by active suicidal ideation.

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25-Hydroxyvitamin D levels in serum at the onset of multiple sclerosis

Multiple Sclerosis Journal ◽

10.1191/1352458505ms1157oa ◽

2005 ◽

Vol 11 (3) ◽

pp. 266-271 ◽

Cited By ~ 157

Author(s):

M Soilu-Hänninen ◽

L Airas ◽

I Mononen ◽

A Heikkilä ◽

M Viljanen ◽

...

Keyword(s):

Vitamin D ◽

Bone Metabolism ◽

Sun Exposure ◽

Serum Levels ◽

Vitamin D Supplementation ◽

Hydroxyvitamin D ◽

Normal Bone ◽

Vitamin D Levels ◽

25 Hydroxyvitamin D ◽

Lower Vitamin

Past sun exposure and vitamin D supplementation have been associated with a reduction in the risk of MS. We measured the serum concentration of 25-hydroxyvitamin D (25[OH]D) at the time of MS diagnosis in 40 MS patients and 40 controls. We found no difference in the serum levels of 25(OH)D between MS patients and controls when all samples or samples obtained during winter months were compared, but MS patients had significantly lower serum 25(OH)D concentrations in June to September than the controls. The vitamin D stores were adequate for bone metabolism (> 37 nmol/L) in 70% of MS patients throughout the year and within the hypovitaminosis level (< 37 nmol/L) in 30% of MS patients at some time of the year. During MS-relapses, 25(OH)D levels were lower than in remission, but mostly within the reference range observed in relation with normal bone metabolism. We conclude that the vitamin D stores in most MS patients are adequate for their normal bone metabolism. However, lower vitamin D levels during MS relapses than in remission suggest that vitamin D could be involved in the regulation of the clinical disease activity of MS. The optimal serum levels of vitamin D for the regulation of immune responses remain to be determined.

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Effect of smoking on the serum levels of 25-hydroxyvitamin D depends on the assay employed

Acta Endocrinologica ◽

10.1530/eje-10-0150e ◽

2010 ◽

Vol 163 (6) ◽

pp. 965 ◽

Cited By ~ 2

Author(s):

Guri Grimnes ◽

Bjørg Almaas ◽

Anne Elise Eggen ◽

Nina Emaus ◽

Yngve Figenschau ◽

...

Keyword(s):

Vitamin D ◽

Vitamin D3 ◽

Serum Levels ◽

Ultraviolet B ◽

Vitamin D2 ◽

Vitamin D and Calcitonin Treatment in Patients with Femoral Neck Fracture: A Prospective Controlled Clinical Study

Journal of International Medical Research ◽

10.1177/030006058901700305 ◽

1989 ◽

Vol 17 (3) ◽

pp. 226-242 ◽

Cited By ~ 9

Author(s):

E. Harju ◽

R. Punnonen ◽

R. Tuimala ◽

J. Salmi ◽

I. Paronen

Keyword(s):

Vitamin D ◽

Parathyroid Hormone ◽

Serum Levels ◽

Serum Calcitonin ◽

Hydroxyvitamin D ◽

Dihydroxyvitamin D ◽

1,25 Dihydroxyvitamin D ◽

Age Related ◽

Neck Fracture ◽

25 Hydroxyvitamin D

The effects on general and bone metabolism of femoral neck fracture patients of 0.25 μg α-calcoid given orally twice daily ( n=9) and 25 μg calcitonin given subcutaneously 30 times ( n=10) in 10 weeks were studied against a control ( n=ll). Bone histology and histomorphometry showed non-age related osteoporosis in 30% and osteomalacia in 22% of the patients studied. Impaired serum vitamin D status was found in 47 – 88% of patients, secondary hyperparathyroidism and increased serum parathyroid hormone in 59% and decreased serum calcitonin levels in 69%. On histology, normal findings and non-age related osteoporosis on histology were associated with low serum levels of 25-hydroxyvitamin D3,1,25- and 24,25-dihydroxy vitamin D3. Very high serum levels of 1,25-dihydroxyvitamin D3 and low levels of 25-hydroxyvitamin D3 occurred in fracture patients with osteomalacia. Calcitonin improved calcium balance, reduced osteoporosis and increased the serum 1,25- and 24,25-dihydroxyvitamin D3 levels but had no effect on osteomalacia. Vitamin D reduced osteomalacia, slightly increased the serum 1,25-dihydroxyvitamin D3 concentration and decreased serum levels of parathyroid hormone. Both treatments gave a similar slight decrease in serum calcitonin concentrations. A mechanism of action for the treatments is suggested.

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Serum vitamin D content in children with SARS-CoV-2 infection

Siberian medical review ◽

10.20333/25000136-2021-6-79-82 ◽

2021 ◽

Vol 6 ◽

pp. 79-82

Author(s):

V.N. Peregoedova ◽

◽

I.K. Bogomolova ◽

Keyword(s):

Vitamin D ◽

Serum Level ◽

Clinical Symptoms ◽

Serum Vitamin ◽

Serum Levels ◽

Control Group ◽

Immunochemical Method ◽

Hydroxyvitamin D ◽

Serum Vitamin D ◽

25 Hydroxyvitamin D

Aim of study. To study the total level of 25-hydroxyvitamin D in children with SARS-CoV-2 infection (COVID-19). Material and мethods. A total of 82 children aged 0-17 diagnosed with SARS-CoV-2 infection were enrolled. Depending on the severity of clinical symptoms, all children were divided into three groups according to the COVID-19 severity: asymptomatic, mild and moderate. The serum level of vitamin D in all patients was tested via the immunochemical method. Results. It was found that children with SARS-CoV-2 infection had lower serum level of vitamin D (29.92 [22.22; 28.07] ng/ml) as compared with the control group (36.43 [32.05; 44.08] ng/ml; p<0.001). A total of 90% of the children with SARS-CoV-2 infection were diagnosed with insufficiency or deficiency of vitamin D (<30 ng/ml). Only 10 % of the patients had normal levels of vitamin D. The insufficiency of vitamin D was found more often amongst children aged 0-11 and deficiency of total 25-hydroxyvitamin D was more common for children aged 12-17. The difference in serum levels of vitamin D depending on the severity of SARS-CoV-2 infection was not found. Male children with SARS-CoV-2 infection showed lower levels of vitamin D (p=0.013). Conclusion. A total of 90 % of the children with SARS-CoV-2 infection had insufficiency or deficiency of vitamin D regardless of the severity of clinical symptoms.

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Vitamin D Supplementation in Tuberculosis Patients: A Cross Sectional Study

Journal of Endocrinology, Tropical Medicine, and Infectiouse Disease (JETROMI) ◽

10.32734/jetromi.v1i1.1265 ◽

2019 ◽

Vol 1 (1) ◽

Author(s):

Dina Keumala Sari ◽

Nurfida Khairina Arrasyid ◽

Y. S. Harahap

Keyword(s):

Vitamin D ◽

Serum Level ◽

Serum Levels ◽

Cross Sectional Study ◽

Vitamin D Supplementation ◽

Sectional Study ◽

Cross Sectional ◽

Tuberculosis Patients ◽

Hydroxyvitamin D ◽

25 Hydroxyvitamin D

Previous studies have not been able to show with certainty the effect of vitamin D supplementation in tuberculosis patients. The objective of this study is to determine whether vitamin D supplementation to patients with tuberculosis could influence 25-hydroxyvitamin D (25(OH)D) and calcium serum levels. The results, after 28 days, the vitamin D supplementation showed significant increase of 25(OH)D serum level at the end point (p=0.001), but not for the calcium serum level (p=0.3). The Conclusions is supplementation with 1,000 IU vitamin D per day increased the 25(OH)D serum level but there was no association with the calcium serum level.

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Vitamin D in Follicular Fluid Correlates With the Euploid Status of Blastocysts in a Vitamin D Deficient Population

Frontiers in Endocrinology ◽

10.3389/fendo.2020.609524 ◽

2021 ◽

Vol 11 ◽

Author(s):

Ana Arnanz ◽

Neelke De Munck ◽

Ibrahim El Khatib ◽

Aşina Bayram ◽

Andrea Abdala ◽

...

Keyword(s):

Vitamin D ◽

Follicular Fluid ◽

Serum Levels ◽

Human Reproduction ◽

Serum Samples ◽

Preimplantation Genetic Testing ◽

Hydroxyvitamin D ◽

25 Hydroxyvitamin D ◽

Metabolite Measurement ◽

Deficient Group

ContextThe widespread distribution of the Vitamin D (VitD) receptor in reproductive tissues suggests an important role for VitD in human reproduction. The assessment of patient´s VitD is based on the 25-hydroxyvitamin D (25(OH)D) metabolite measurement. However, most of the circulating 25(OH)D is bound to either VitD-binding protein (VDBP) (88%) or albumin (12%) and less than 1% circulates free.ObjectiveTo determine a possible correlation between VitD levels in serum (S) and follicular fluid (FF) and blastocyst ploidy status in patients undergoing infertility treatment.MethodsA prospective observational study was performed including couples planned for preimplantation genetic testing for aneuploidies (PGT-A) from ART Fertility Clinics. Patients were classified according to their 25(OH)D-Serum levels: VitD deficient group <20 ng/ml and insufficient/replete ≥20 ng/ml defined as VitD non-deficient group.ResultsSerum samples and 226 FF from individual follicles were collected for 25(OH)D, bioavailable 25(OH)D, free 25(OH)D, and % free 25(OH)D measurement. 25(OH)D-Serum in VitD deficient and non-deficient were 13.2±4.0 ng/ml vs 32.3±9.2 ng/ml; p<0.001. FF from 40 and 74 biopsied blastocysts was analysed of which 52.5 and 60.8% were euploid (p = 0.428), respectively. In VitD deficient patients, mean 25(OH)D-FF, bioavailable 25(OH)D-FF, and free 25(OH)D-FF were higher in euploid vs aneuploid blastocysts (18.3±6.3 ng/ml vs 13.9±4.8 ng/ml; p = 0.040; 1.5±0.5 ng/ml vs 1.1±0.4 ng/ml; p = 0.015; 0.005±0.002 ng/ml vs 0.003±0.001 ng/ml; p = 0.023, respectively), whilst no differences were found in VitD non-deficient patients (37.9±12.3 ng/ml vs 40.6±13.7 ng/ml; p = 0.380; 3.1±1.1 ng/ml vs 3.3±1.2 ng/ml; p = 0.323; 0.01±0.003 ng/ml vs 0.01±0.004 ng/ml; p = 0.319, respectively).ConclusionVitD non-deficient patients have a significantly higher probability of obtaining a euploid blastocyst compared to VitD deficient patients (OR:33.36, p = 0.002).

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Association of 25-hydroxyvitamin D, Cyclooxygenase-2 and Prostaglandin E2 Serum Levels in Breast Cancer Patients

The Indonesian Biomedical Journal ◽

10.18585/inabj.v13i4.1684 ◽

2021 ◽

Vol 13 (4) ◽

pp. 426-32

Author(s):

Theresia Ilyan ◽

Dwi Retnoningrum ◽

Meita Hendrianingtyas ◽

Dian Widyaningrum ◽

Banundari Rachmawati

Keyword(s):

Breast Cancer ◽

Vitamin D ◽

Serum Level ◽

Prostaglandin E2 ◽

Serum Vitamin ◽

Serum Levels ◽

Cyclooxygenase 2 ◽

Hydroxyvitamin D ◽

Serum Vitamin D ◽

25 Hydroxyvitamin D

BACKGROUND: Serum levels of 25-hydroxyvitamin D (25(OH)D), prostaglandin E2 (PGE2), and cyclooxygenase 2 (COX2) expression differ between breast cancer stages. Since, previous studies showed mixed results, in this study, we aimed to analyze vitamin D levels related to breast cancer stages and serum levels of COX2 and PGE2 in Indonesia.METHODS: This was a cross sectional study involving 75 breast cancer patients. Subjects were divided into 3 groups, namely operable early stage (K1), locally advanced stage (K2), and advanced stage (K3). Venous blood samples were taken from each subject, then were analyzed for the 25(OH)D, COX2, and PGE2 serum levels by enzyme-linked immunosorbent assay (ELISA) method.RESULTS: There were significant differences in 25(OH)D among groups (p=0.012); between K1 and K2 (p=0.009) and between K1 and K3 (p=0.023). However, there was no significant difference in serum COX2 level (p=0.328). There were significant differences of PGE2 among groups (p=0.002); between K1 and K2 (p=0.036) and between K1 and K3 (p=0.001). Correlation test showed that there were differences between 25(OH)D serum levels and PGE2 serum level (r=0.306, p=0.008) and also between 25(OH)D serum level and breast cancer stage (r=-0.229; p=0.048).CONCLUSION: There were differences in serum Vitamin D and PGE2 levels at various stages of breast cancer. Serum 25(OH)D levels had weak correlation with breast cancer stage and PGE2 serum level. Serum vitamin D level in advanced breast cancer were lower than early stage breast cancer and indicate a poor prognosis.KEYWORDS: breast cancer, 25-hydroxyvitamin D, cyclooxygenase 2, prostaglandin E2

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