The Effect of Circulating Zinc, Selenium, Copper and Vitamin K1 on COVID-19 Outcomes: A Mendelian Randomization Study

Background & Aims: Previous results from observational, interventional studies and in vitro experiments suggest that certain micronutrients possess anti-viral and immunomodulatory activities. In particular, it has been hypothesized that zinc, selenium, copper and vitamin K1 have strong potential for prophylaxis and treatment of COVID-19. We aimed to test whether genetically predicted Zn, Se, Cu or vitamin K1 levels have a causal effect on COVID-19 related outcomes, including risk of infection, hospitalization and critical illness. Methods: We employed a two-sample Mendelian Randomization (MR) analysis. Our genetic variants derived from European-ancestry GWAS reflected circulating levels of Zn, Cu, Se in red blood cells as well as Se and vitamin K1 in serum/plasma. For the COVID-19 outcome GWAS, we used infection, hospitalization or critical illness. Our inverse-variance weighted (IVW) MR analysis was complemented by sensitivity analyses including a more liberal selection of variants at a genome-wide sub-significant threshold, MR-Egger and weighted median/mode tests. Results: Circulating micronutrient levels show limited evidence of association with COVID-19 infection, with the odds ratio [OR] ranging from 0.97 (95% CI: 0.87–1.08, p-value = 0.55) for zinc to 1.07 (95% CI: 1.00–1.14, p-value = 0.06)—i.e., no beneficial effect for copper was observed per 1 SD increase in exposure. Similarly minimal evidence was obtained for the hospitalization and critical illness outcomes with OR from 0.98 (95% CI: 0.87–1.09, p-value = 0.66) for vitamin K1 to 1.07 (95% CI: 0.88–1.29, p-value = 0.49) for copper, and from 0.93 (95% CI: 0.72–1.19, p-value = 0.55) for vitamin K1 to 1.21 (95% CI: 0.79–1.86, p-value = 0.39) for zinc, respectively. Conclusions: This study does not provide evidence that supplementation with zinc, selenium, copper or vitamin K1 can prevent SARS-CoV-2 infection, critical illness or hospitalization for COVID-19.

Relationship between Structure and Biological Activity of Various Vitamin K Forms

Vitamin K is involved many biological processes, such as the regulation of blood coagulation, prevention of vascular calcification, bone metabolism and modulation of cell proliferation. Menaquinones (MK) and phylloquinone vary in biological activity, showing different bioavailability, half-life and transport mechanisms. Vitamin K1 and MK-4 remain present in the plasma for 8–24 h, whereas long-chain menaquinones can be detected up to 96 h after administration. Geometric structure is also an important factor that conditions their properties. Cis-phylloquinone shows nearly no biological activity. An equivalent study for menaquinone is not available. The effective dose to decrease uncarboxylated osteocalcin was six times lower for MK-7 than for MK-4. Similarly, MK-7 affected blood coagulation system at dose three to four times lower than vitamin K1. Both vitamin K1 and MK-7 inhibited the decline in bone mineral density, however benefits for the occurrence of cardiovascular diseases have been observed only for long-chain menaquinones. There are currently no guidelines for the recommended doses and forms of vitamin K in the prevention of osteoporosis, atherosclerosis and other cardiovascular disorders. Due to the presence of isomers with unknown biological properties in some dietary supplements, quality and safety of that products may be questioned.

Vitamin K Effects on Gas6 and Soluble Axl Receptors in Intensive Care Patients: An Observational Screening Study

Growth arrest-specific gene 6 protein (Gas6) is avitamin K-dependent tissue bound protein. Gas6 has been shown to promote growth and therapy resistance among different types of cancer as well as thromboembolism. The aim of this prospective screening study: ClinicalTrials.gov; Identifier: NTC3782025, was to evaluate the effects of intravenously administered vitamin K1 on Gas6 and its soluble (s)Axl receptor plasma levels in intensive care patients. Vitamin K1 was intravenously injected in non-warfarin treated patients with prolonged Owren prothrombin time international normalized ratio (PT-INR) > 1.2 and blood samples were retrieved before and 20–28 h after injection. Citrate plasma samples from 52 intensive care patients were analysed for different vitamin K dependent proteins. There was a significant, but small increase in median Gas6. Only one patient had a large increase in sAxl, but overall, no significant changes in sAxl Gas6 did not correlate to PT-INR, thrombin generation assay, coagulation factors II, VII, IX and X, but to protein S and decarboxylated matrix Gla protein (dp-ucMGP). In conclusion, there was a small increase in Gas6 over 20–28 h. The pathophysiology and clinical importance of this remains to be investigated. To verify a true vitamin K effect, improvement of Gas6 carboxylation defects needs to be studied.

An Improved and Plant Viable Synthesis of Vitamin K1

An improved and simplified process of vitamin K1 preparation. The article confers the new reagent BF3. Acetic acid complex as a condensation reagent for phytol with compound III in vitamin K1 synthesis, which eludes the use of ethereal reagent and make the process hazard free. Further innovation presents base catalyzed synthesis of vitamin K1 which is an oxidative product of compound IV. Sodium methoxide base is used in synthesis which eliminates use of metal oxidant, costly and hazardous reagent. The new approach ensures the non-generation of epoxide impurity (V) which tends to form during Ag2O catalyzed synthesis. Finally, article also focused on formation and conformation of 7R and 11R diastereomeric centers and ensure the formation of vitamin k1 with desired stereochemistry also article submit proof of concept and supporting literature survey for desired stereochemistry.

Review on Evaluation of Physalis peruviana L.’s Antioxidant, Antimicrobial and Biochemical Activities

In this review, it was emphasized that natural and organic foods have a rich structure in terms of antimicrobial, antioxidant, and vitamin content. Physalis peruviana L., products contain minerals, amino acids, withanolides, flavonoids, and essential fatty acids, thus representing good sources of these compounds. These compounds have protective, regulatory, and nutritional roles in metabolism. Physalis peruviana L. is a wild fruit that has been widely used for centuries, mainly in folk medicine. The fruit and juice of Physalis peruviana L., contain high amounts of vitamin C, vitamin E, vitamin K1, and many other mineral substances. In addition, the ingredients in Physalis peruviana L., have antioxidant, antibacterial, antiviral, antiallergic, anti-inflammatory, and antineoplastic effects. The available evidence has demonstrated the nutritional value of different products of Physalis peruviana L., suggesting them to be potential candidates for use in the cosmetic industry, in the preparation of functional foods, and phytomedicine for the prevention.

An informatics consult approach for generating clinical evidence for treatment decisions

Background An Informatics Consult has been proposed in which clinicians request novel evidence from large scale health data resources, tailored to the treatment of a specific patient. However, the availability of such consultations is lacking. We seek to provide an Informatics Consult for a situation where a treatment indication and contraindication coexist in the same patient, i.e., anti-coagulation use for stroke prevention in a patient with both atrial fibrillation (AF) and liver cirrhosis. Methods We examined four sources of evidence for the effect of warfarin on stroke risk or all-cause mortality from: (1) randomised controlled trials (RCTs), (2) meta-analysis of prior observational studies, (3) trial emulation (using population electronic health records (N = 3,854,710) and (4) genetic evidence (Mendelian randomisation). We developed prototype forms to request an Informatics Consult and return of results in electronic health record systems. Results We found 0 RCT reports and 0 trials recruiting for patients with AF and cirrhosis. We found broad concordance across the three new sources of evidence we generated. Meta-analysis of prior observational studies showed that warfarin use was associated with lower stroke risk (hazard ratio [HR] = 0.71, CI 0.39–1.29). In a target trial emulation, warfarin was associated with lower all-cause mortality (HR = 0.61, CI 0.49–0.76) and ischaemic stroke (HR = 0.27, CI 0.08–0.91). Mendelian randomisation served as a drug target validation where we found that lower levels of vitamin K1 (warfarin is a vitamin K1 antagonist) are associated with lower stroke risk. A pilot survey with an independent sample of 34 clinicians revealed that 85% of clinicians found information on prognosis useful and that 79% thought that they should have access to the Informatics Consult as a service within their healthcare systems. We identified candidate steps for automation to scale evidence generation and to accelerate the return of results. Conclusion We performed a proof-of-concept Informatics Consult for evidence generation, which may inform treatment decisions in situations where there is dearth of randomised trials. Patients are surprised to know that their clinicians are currently not able to learn in clinic from data on ‘patients like me’. We identify the key challenges in offering such an Informatics Consult as a service.

Analysis of Lipophilic Antioxidants in the Leaves of Kaempferia parviflora Wall. Ex Baker Using LC–MRM–MS and GC–FID/MS

Lipophilic metabolites such as carotenoids, fatty acids, vitamin K1, phytosterols, and tocopherols are important antioxidants that are used in the cosmetics, foods, and nutraceutical industries. Recently, there has been a growing demand for the use of byproducts (wastes) as a potential source of industrially important compounds. The leaves of Kaempferia parviflora (black ginger) (KP-BG) are major byproducts of KP-BG cultivation and have been reported to contain several bioactive metabolites; however, the composition of lipophilic metabolites in KP-BG leaves has not been examined. In this study, the lipophilic antioxidant profile was analyzed in the leaves of KP-BG plants grown in vitro and ex vitro. Lipophilic compounds, namely carotenoids (80.40–93.84 µg/g fresh weight (FW)), tocopherols (42.23–46.22 µg/g FW), phytosterols (37.69–44.40 µg/g FW), and vitamin K1 (7.25–7.31 µg/g FW), were quantified using LC–MRM–MS. The fatty acid profile of the KP-BG leaves was identified using GC–FID/MS. The content of individual lipophilic compounds varied among the KP-BG leaves. Ex vitro KP-BG leaves had high levels of lutein (44.38 µg/g FW), α-carotene (14.79 µg/g FW), neoxanthin (12.30 µg/g FW), β-carotene (11.33 µg/g FW), violaxanthin (11.03 µg/g FW), α-tocopherol (39.70 µg/g FW), α-linolenic acid (43.12%), palmitic acid (23.78%), oleic acid (12.28%), palmitoleic acid (3.64%), total carotenoids (93.84 µg/g FW), and tocopherols (46.22 µg/g FW) compared with in vitro KP-BG leaves. These results indicate that ex-vitro-grown KP-BG leaves could be used as a valuable natural source for extracting important lipophilic antioxidants.

The effect of vitamin K1 on VEGF levels in chick embryos with type 1 diabetes and Diabetic Retinopathy induced by streptozotocin

Objective: Hyperglycemia caused by Diabetes Mellitus (DM) is associated with long-term dysfunction such as diabetic retinopathy (DRP). The most effective growth factor in the development of DRP is the vascular endothelial growth factor (VEGF). Vitamin K1 reduces hyperglycemia and prevents the development of DM. In this study, we aimed to create streptozotocin (STZ) induced DM and DRP in chick embryos and to show whether vitamin K1 can prevent early-stage DRP by measuring VEGF levels. Material and Methods: The 140 specific pathogen-free (SPF) fertilized chicken eggs were used in this study. Three different STZ doses were administered to 120 SPF eggs for an induced DM model. Three different vitamin K1 doses were administered in each STZ dose group. On the 12th day and 18th day the remaining 20 SPF eggs were separated as control groups. On the 18th-day, blood glucose, blood insulin and VEGF levels were measured. Results: 0.45 mg/egg STZ dose (STZ3) was determined as the optimal/ideal dose for the DM model. When the group-administered STZ3 and vitamin K1 were evaluated among themselves; it was determined that there were significant changes in blood glucose, blood insulin, VEGF levels of the STZ3+K1-3 group compared to the STZ3+K1-1 and STZ3+K1-2 groups (p<0.05). Conclusion: Vitamin K1 increases blood insulin levels and decreases blood glucose levels. When hyperglycemia reduces, the VEGF levels reduce. Vitamin K1 protects from DRP by reducing VEGF levels.