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Aims Methods Results Conclusion The reference nutrient intake for vitamin D in people aged ≥4 years is 10 μg/day (400 IU/day) in the UK, but the recommended daily allowance is 15 μg/day (600 IU/day) for people aged 1–70 years in the USA. Here, we aim to compare the 25‐hydroxyvitamin D (25(OH)D) serum concentration profiles between the 2 doses.With world‐wide trial data of adults aged ≥18 years, 45–93 kg, we constructed a minimal physiologically based pharmacokinetics model of serum concentrations of vitamin D and 25(OH)D using nonlinear mixed effects modelling. We used this model to forecast the mean, 2.5th and 97.5th percentiles for serum 25(OH)D concentrations in British adults aged ≥16 years.Our final model used bodyweight to adjust volume of each compartment and maximum clearance of 25(OH)D. No other covariate was identified. The model accurately predicted independent data from trials of a broad range of dosing regimens. We simulated British adults and showed that circulating 25(OH)D concentrations in 95% of people taking 10 μg/day for a year is predicted to reach 50 nmol/L in 32 weeks, while 97.5% of those on 15 μg/day were predicted to attain this threshold within 28 weeks.Both doses are efficacious in >95% of the British population. The daily dose of 15 μg can help 97.5% of the British adults achieve 50 nmol/L serum 25(OH)D and reach the 25 nmol/L threshold in 4 weeks. [ABSTRACT FROM AUTHOR]

Limited guidelines exist regarding osteoporosis prevention in the general population. Despite being a subject of controversy, the majority of research suggests that decreased vitamin D levels correlate with increased bone turnover, that is, an important risk factor for osteoporosis development. In most guidelines, daily vitamin D supplementation is recommended. In persons with epilepsy (PWE), the situation is more complex, as other factors can increase the chance of being vitamin D deficient. Currently, there are no internationally accepted guidelines regarding monitoring bone health in PWE. Our aim was to review the existing evidence in PWE on: (1) risk factors for vitamin D deficiency, (2) the identification of higher risk groups, and (3) the optimal ways to monitor bone health. Our narrative review shows that: (1) anti‐seizure medication (ASM) use, especially enzyme‐inducing ASM (EIASM) and valproic acid, is identified as an important risk factor for impaired bone health (e.g., increased risk for osteoporosis/fractures and/or vitamin D deficiency); (2) higher risk groups within the PWE population are present: intellectual or physical disability, institutionalized patients, puberty, early onset epilepsy and developmental epileptic encephalopathies, postmenopausal women, and use of multiple ASM/concomitant drugs (e.g. corticosteroids); and (3) a monitoring scheme can be suggested including laboratory tests, bone density measurements, managing of risk factors, and/or vitamin D supplementation. Overall, regular vitamin D measurement in PWE is a cost‐effective and practical method for monitoring vitamin D deficiency, whereas in high‐risk patients the combination of vitamin D measurement and bone densitometry is recommended. There is not enough evidence to advocate continuous vitamin D supplementation in all PWE. Children with epilepsy should receive the recommended daily intake of vitamin D for age and additional monitoring and supplementation if at higher risk of deficiency. There is a need for prospective trials exploring the potential benefit of vitamin D supplementation in PWE. [ABSTRACT FROM AUTHOR]

Colorectal cancer (CRC) is one of the most life‐threatening neoplasias in terms of incidence and mortality worldwide. Vitamin D deficiency has been associated with an increased risk of CRC. 1α,25‐Dihydroxyvitamin D3 [1,25(OH)2D3], the most active vitamin D metabolite, is a pleiotropic hormone that, through its binding to a transcription factor of the nuclear receptor superfamily, is a major regulator of the human genome. 1,25(OH)2D3 acts on colon carcinoma and stromal cells and displays tumor protective actions. Here, we review the variety of molecular mechanisms underlying the effects of 1,25(OH)2D3 in CRC, which affect multiple processes that are dysregulated during tumor initiation and progression. Additionally, we discuss the epidemiological data that associate vitamin D deficiency and CRC, and the most relevant randomized controlled trials of vitamin D3 supplementation conducted in both healthy individuals and CRC patients. [ABSTRACT FROM AUTHOR]

Cover IllustrationThe vitamin D endocrine system and colorectal cancer. Image provided by Antonio Barbáchano, José Manuel González‐Sancho, authors of the State‐of‐the‐Art Review included in this issue, pages 2485–2518.. [Extracted from the article]

Aim: Manipulation of the intestinal microbiome and supplying vitamin D can attenuate psychiatric symptoms in schizophrenic patients. The current study tried to evaluate the effects of probiotic/vitamin D supplementation on the cognitive function and disease severity of schizophrenic patients. Methods: In the present study, 70 patients (aged 18–65) with schizophrenia were recruited. Participants were randomly allocated to the placebo (n = 35) and intervention (probiotic supplements+400 IU vitamin D, n = 35) groups. Severity of disease and cognitive function (primary outcomes) were evaluated by Positive and Negative Syndrome Scale (PANSS) and Montreal Cognitive Assessment (MoCA) tests, respectively. Moreover, lipid profile, body mass index (BMI), gastrointestinal (GI) problems, serum C‐reactive protein (CRP), and erythrocyte sedimentation rate (ESR) were evaluated as secondary outcomes. Results: A total of 69 patients completed the study. The MoCA score was increased by 1.96 units in the probiotic‐containing supplement group compared to the placebo (p = 0.004). Also, the percentage of subjects with MoCA score ≥ 26 rose significantly in the intervention group (p = 0.031). Moreover, TC (p = 0.011), FBS (p = 0.009), and CRP (p < 0.001) significantly decreased in the supplement group compared to the placebo. Although the probiotic supplement reduced PANSS score by 2.82 units, the difference between the study groups was not statistically significant (p = 0.247). Conclusion: Co‐administration of probiotics and vitamin D has beneficial effects on the improvement of cognitive function in schizophrenic patients. [ABSTRACT FROM AUTHOR]

Intestinal stem cells (ISCs) are known for their remarkable proliferative capacity, making them one of the most active cell populations in the body. However, a high turnover rate of intestinal epithelium raises the likelihood of dysregulated homeostasis, which is known to cause various diseases, including cancer. Maintaining precise control over the homeostasis of ISCs is crucial to preserve the intestinal epithelium's integrity during homeostasis or stressed conditions. Recent research has indicated that nutrients and metabolic pathways can extensively modulate the fate of ISCs. This review will explore recent findings concerning the influence of various nutrients, including lipids, carbohydrates, and vitamin D, on the delicate balance between ISC proliferation and differentiation. [ABSTRACT FROM AUTHOR]

Renin–angiotensin system activation contributes to skeletal muscle atrophy in aging individuals with chronic diseases. We aimed to explore the effects of cholecalciferol (VD3) and calcitriol (1,25VD3) on signaling of muscle proteolysis and oxidative stress in myotubes challenged with angiotensin II (AII). The mouse C2C12 myotubes were assigned to vehicle, AII, AII + VD3, AII + 1,25VD3, and AII + losartan groups. The expression levels of muscle‐specific E3 ubiquitin ligase proteins, autophagy‐related proteins, and oxidative stress markers were investigated. We demonstrated the diverse effects of VD3 and 1,25VD3 on AII‐induced myotube atrophy. The myotube diameter was preserved by treatment with 100 nM VD3 and losartan, while 1 and 10 nM 1,25VD3 increased levels of FoxO3a, MuRF1, and atrogin‐1 protein expression in myotubes exposed to AII. Treatment with AII + 10 nM 1,25VD3 resulted in the upregulation of LC3B‐II, LC3B‐II/LC3B‐I, and mature cathepsin L, which are autophagic marker proteins. The p62/SQSTM1 protein was downregulated and vitamin D receptor was upregulated after treatment with AII + 10 nM 1,25VD3. A cellular redox imbalance was observed as AII + 10 nM 1,25VD3‐induced reactive oxygen species and NADPH oxidase‐2 overproduction, and these changes were associated with an inadequate response of antioxidant superoxide dismutase‐1 and catalase proteins. Collectively, these findings provide a translational perspective on the role of vitamin D3 in alleviating muscle atrophy related to high levels of AII. [ABSTRACT FROM AUTHOR]

To investigate the potential functional properties and added value of okra seed oil and provide a scientific basis for further industrial development and production of okra seed oil, its fatty acid profile, total phenolic, fat‐soluble vitamin composition, mineral element composition, and antioxidant activities were examined in this study. Also, correlations between bioactive components and the antioxidant activities of okra seed oil were explored. The study results show that okra seed oil contains 12 types of fatty acids, 65.22% of which are unsaturated acids, and among these unsaturated acids, linoleic acid (43%) and oleic acid (20.16%) are two dominant acid types. Compared with walnut oil and peanut oil, okra seed oil contains relatively high total phenols, fat‐soluble vitamins, and a variety of essential mineral nutrients, with a total phenolic content (TPC) of 959.65 μg/mL, a total tocopherol content of 742.71 μg/mL, a vitamin A content of 0.0017 μg/100 mL, a vitamin D content of 1.44 μg/100 mL, and a vitamin K1 content of 52.54 ng/100 mg. Also, okra seed oil exhibits better scavenging activities on hydroxyl (IC50 = 0.50 mg/mL) and ammonium salt (ABTS) free radicals (IC50 = 6.46 mg/mL) and certain reducing power (IC50 = 17.22 mg/mL) at the same concentration. The scavenging activities of okra seed oil on hydroxyl radicals and ABTS radicals, as well as its reducing power, are significantly correlated with its contents of total phenol, total tocopherol, α‐tocopherol, and γ‐tocopherol (p <.01). These results show that okra seed oil is rich in bioactive substances, thus presenting great nutritional potential. [ABSTRACT FROM AUTHOR]

Ultraviolet (UV) radiation, a component of sunlight, holds both advantageous anddetrimental effects on human health. While shorter wavelengths of UV radiationaid in melanin and vitamin D synthesis, longer wavelengths pose risks like skincancer and premature aging due to DNA damage. To combat such stress, cellsemploy various mechanisms, including the heat shock response (HSR). Activation of this response involves a highly regulated transcriptional processorchestrated by heat shock factors (HSFs). While HSF1 has been observed as a keytranscription factor for HSR, other HSFs are also found to be associated withdiverse cellular functions, including stress responses. Here, we discuss arecent study by Feng et al., published in Clinical and Translational Medicine, shedding light on the novel function of HSF4 in regulating inflammation and senescence following UV exposure. The researchers observed acomplex of HSF4 and the cofactor COIL (Coilin) at R‐loops–aberrant DNA‐RNAhybrid structures arising from UV‐induced DNA damage in human skin cells. Inthe study, they proposed the HSF4‐COIL complex at R‐loops as a potential therapeutic target to mitigate UV‐induced skin damage. [ABSTRACT FROM AUTHOR]

Vitamin D3 replacement in older insufficient adults significantly improves their antigen‐specific varicella zoster virus (VZV) cutaneous immunity. However, the mechanisms involved in this enhancement of cutaneous immunity are not known. Here, we show for the first time that vitamin D3 blocks the senescence‐associated secretory phenotype (SASP) production by senescent fibroblasts by partially inhibiting the p38 MAPK pathway. Furthermore, transcriptomic analysis of skin biopsies from older subjects after vitamin D3 supplementation shows that vitamin D3 inhibits the same inflammatory pathways in response to saline as the specific p38 inhibitor, losmapimod, which also enhances immunity in the skin of older subjects. Vitamin D3 supplementation therefore may enhance immunity during ageing in part by blocking p38 MAPK signalling and in turn inhibit SASP production from senescent cells in vivo. [ABSTRACT FROM AUTHOR]

This article discusses the use of vitamin D as a potential treatment for warts. Warts are difficult to treat, and current treatment options are not always effective. Vitamin D has been shown to have immune therapeutic properties and can inhibit keratinocyte proliferation, which is a therapeutic goal in managing warts. Studies have demonstrated the beneficial effects of intralesional and topical vitamin D in treating resistant warts. However, the efficacy of vitamin D treatment can vary depending on the specific subtype of HPV involved and other factors such as dose and duration of treatment. Further research is needed to fully understand the potential of vitamin D in wart management. [Extracted from the article]

Introduction: Sufficient levels of vitamin D have been associated with higher chances for both clinical pregnancy and live birth among women undergoing assisted reproductive techniques, whereas low levels of maternal vitamin D have been associated with preeclampsia and late miscarriage. In Denmark, subgroups at risk for low vitamin D levels, including neonates and toddlers, are recommended to use supplementation. The aim was to study the level of vitamin D3 among neonates born after in vitro fertilization compared with neonates from the general population. Material and methods: In this cohort study a random sample of 1326 neonates representing the general population and 1200 neonates conceived by in vitro fertilization born in Denmark from 1995 to 2002 were identified from registries covering the whole Danish population. Information on use of assisted reproduction was collected from the Danish In Vitro Fertilization register, ICD‐10 code: DZ358F. 25‐Hydroxyvitamin D was measured from dried blood spots routinely collected by heel prick 48–72 h after birth and corrected according to the hematocrit fraction for capillary blood of neonates. Linear regression analysis was performed, both crude and adjusted, for predefined putative confounders, identified through directed acyclic graphs. Results: Vitamin D3 analysis could be performed from a total of 1105 neonates from the general population and 1072 neonates conceived by in vitro fertilization that were subsequently included in the study. The median vitamin D3 was 24.0 nmol/L (interquartile range [IQR] 14.1–39.3) and 33.0 nmol/L (IQR 21.3–48.8) among neonates from the general population and neonates conceived by in vitro fertilization, respectively. The adjusted mean difference between neonates from the general population and those conceived by in vitro fertilization was 6.1 nmol/L (95% confidence interval 4.1–8.1). Conclusions: In this study, children born after in vitro fertilization have a higher vitamin D3 than a random sample of neonates in Denmark. [ABSTRACT FROM AUTHOR]

The efficacy of administering high doses of vitamin D to patients diagnosed with COVID‐19 remains uncertain. We conducted a comprehensive search across multiple databases (PubMed, EMBASE, Cochrane Library, and ISI Web of Science) from inception until August 2022, with no limitations on language, to locate randomized controlled trials (RCTs) that investigated the impact of high‐dose vitamin D supplementation (defined as a single dose of ≥100,000 IU or daily dose of ≥10,000 IU reaching a total dose of ≥100,000 IU) on COVID‐19 patients. Risk ratios (RR) with 95% confidence intervals (CI) and weighted mean differences (WMD) with 95% CI were calculated. Our meta‐analysis included 5 RCTs with a total of 834 patients. High‐dose vitamin D supplementation did not show any significant benefits for mortality (I2 = 0.0%, p =.670; RR 1.092, 95% CI 0.685–1.742, p =.711) or intensive care unit (ICU) admission (I2 = 0.0%, p =.519; RR 0.707, 95% CI 0.454–1.102, p =.126) in COVID‐19 patients compared to the control group. However, it was found to be safe and well‐tolerated (I2 = 0.0%, p =.887; RR 1.218, 95% CI 0.930–1.594, p =.151). Subgroup analysis also showed no benefits in overall mortality, including for patients with vitamin D deficiency (I2 = 0.0%, p =.452; RR 2.441, 95% CI 0.448–13.312, p =.303) or compared to the placebo (I2 = 0.0%, p =.673; RR 1.666, 95% CI 0.711–3.902, p =.240). Our research indicates that there is no evidence to support the efficacy of high‐dose vitamin D supplementation in improving clinical outcomes among individuals with COVID‐19, in line with previous studies focused on contexts including rickets. Considering the limitations of the study, additional research may be required. [ABSTRACT FROM AUTHOR]

Background: The impact of non‐pharmacological interventions (NPIs) on asthma prevention and management is insufficiently examined. We aim to comprehensively evaluate and synthesize existing evidence regarding the effectiveness of various NPIs throughout the life course. Methods: We conducted a systematic search and screening of reviews that examined the effectiveness of various NPIs on asthma prevention and control in the Cochrane Library, PubMed, Embase, and Ovid databases. Data extraction was performed by considering the type of NPIs and the life course stages of the target population. Recommendations were provided by considering the quality of review assessed using the AMSTAR2 tool and the consistency of findings across reviews. Results: We identified 145 reviews and mapped the evidence on the impact of 25 subtypes of NPIs on asthma prevention and control based on five stages of life course. Reviews indicated a shift of focus and various impacts of major NPIs on asthma prevention and control across life courses, while a few types of NPIs, such as physical exercise, appeared to be beneficial in children, adolescents and adults. Consistent and high‐level evidence was observed only for psychological intervention on asthma control and quality of life among adults and older adults. Potential benefit with high‐level evidence was reported on certain NPIs, such as vitamin D in reducing risk of developing asthma in offsprings in the prenatal stage, digital health interventions in improving asthma control from childhood to older adulthood, and breathing exercise in improving quality of life, asthma‐related symptoms and lung function in adulthood and older adulthood. Conclusion: This study emphasizes the significance of delivering NPIs to improve asthma prevention and management and highlights the heterogeneity regarding the impact of NPIs across life courses. High‐quality research is urgently needed to further strengthen the evidence base of NPIs and tailored interventions should be considered in guideline development. [ABSTRACT FROM AUTHOR]

Purpose: Vitiligo is a disease of acquired depigmentation characterized by the destruction of melanocytes. A theoretical association between low level of 25‐hydroxyvitamin D [25(OH)D] and vitiligo has been previously suggested. The objective of this study was to determine the efficacy of intramuscular injection of cholecalciferol with excimer laser compared with the excimer laser alone for vitiligo treatment. Methods: This study included 26 patients diagnosed with non‐segmental vitiligo and low serum 25(OH)D levels (<20 ng/mL). The participants were randomly divided into two groups through randomization. The treatment using a 308‐nm excimer laser was administered to both groups, and the study group additionally received cholecalciferol injection. Results: The Vitiligo Area Scoring Index (VASI) scores showed an 83.6% improvement over the initial score in the study group, whereas the control group showed a 54.7% improvement after 6 months of treatment. After 6 months of treatment, the study group showed a significantly higher proportion of patients who achieved VASI50 and VASI75 compared with the control group. Conclusion: Intramuscular injection of cholecalciferol can be a supplemental option for the treatment of vitiligo patients with vitamin D deficiency with excimer laser therapy. [ABSTRACT FROM AUTHOR]

Background: Alopecia areata (AA) is an autoimmune condition characterized by sudden and unpredictable hair loss, with a lifetime incidence of 2%. AA can be divided into three categories: patchy alopecia, alopecia totalis, and alopecia universalis. It can affect a person's psychological health and overall quality of life. Elevated C‐reactive protein (CRP) levels in the liver may indicate an inflammatory response in autoimmune diseases. Vitamin D, essential for immune system control and skin health, may be related to AA. Hair follicles contain vitamin D receptors, which control immunological responses in the skin. However, no study has found a relationship between CRP and vitamin D in AA patients in our region. Subjects and Methods: An analytical cross‐sectional study with a case‐control design research investigation of 82 AA patients and 81 healthy controls was carried out. Both groups' medical histories were taken. Biochemical analysis was done for both groups as well as the serum vitamin D levels, and CRP. Genetic analysis for CDX2 rs11568820 variant detected by PCR (T‐ARMS‐PCR) method and vitamin D receptor (VDR) gene expression measured by real‐time PCR analysis for both patients and healthy subjects. Results: CRP levels are higher in AA patients, AA patients with G/G genotypes exhibited higher concentrations of CRP when compared to those with A/A and A/G genotypes while patients with A/A genotypes have higher levels of Serum vitamin D as compared to the A/G and G/G genotypes. G allele was more abundant in AA patients. VDR gene expression was lower in AA compared to control and lower in ophiasis compared to localized and multiple patchy AA. An important inverse linear correlation was observed between vitamin D and CRP levels in ophiasis AA. Conclusion: CRP concentrations were found to be elevated in AA patients. The considerable accuracy of CRP in the diagnosis of AA is substantiated by a statistically significant al. A noteworthy inverse linear association was observed between serum vitamin D and CRP concentrations in ophiasis AA. [ABSTRACT FROM AUTHOR]

Obstructive sleep apnea and vitamin D deficiency are associated with multiple complications with increased morbidity and mortality. However, the relationship between these two entities remains unclear, with clinical studies demonstrating contradictory results. This narrative review aims to present the current evidence and understanding of this relationship and discuss the possible mechanisms linking these two disease entities. Finally, we summarize and propose areas of opportunity for future research. [ABSTRACT FROM AUTHOR]

Objective: In this study, we investigated the development of the Wnt signaling pathway in vitamin D (VitD) to improve systemic lupus erythematosus in mice to breakthrough clinical treatment approaches. Methods: Body weight changes were recorded during rearing. Antinuclear antibodies (ANA), anti-dsDNA, and anti-snRNP were detected in the mouse serum using an enzyme-linked immunosorbent assay. Apoptosis of Th1 and Th2 immune cells in mice was detected using flow cytometry. Reverse transcription polymerase chain reaction was used to detect the expression of T-bet, GATA3, and Wnt3a mRNA in the spleens of each group. Western blot analysis was performed to detect the expression of Wnt1, p-β-catenin, β-catenin, glycogen synthase kinsase3β (GSK-3β), Wnt3a, c-myc, and cyclin D1 protein in mice spleens. β-catenin in mice spleen was visualized using immunohistochemistry. Results: VitD did not substantial reduce the body weight of MRL/LPR mice, whereas the inhibitor did. VitD notably decreased the concentrations of ANA, anti-double-stranded DNA, and anti-snRNP in the serum of MRL/LPR mice and alleviated apoptosis of Th1 and Th2 cells. VitD markedly increased the expression of T-bet and GATA mRNA in the spleen of MRL/LPR mice and consequently increased the levels of Wnt3a and β-catenin. Western blot analysis revealed that the levels of GSK-3β, p-β-catenin, Wnt1, Wnt3a, c-myc, and cyclin D1 could be reduced by VitD, compared with MRL/LPR. Immunohistochemistry demonstrated that the expression of β-catenin was the most pronounced in the spleen of MRL/LPR mice, and the expression level of β-catenin decreased substantially after VitD intervention. Conclusions: VitD can further inhibit the nuclear translocation of β-catenin by downregulating the expression of Wnt ligands (Wnt1 and Wnt3a), which reduces the expression of the downstream target gene cyclin D1. Systemic lupus erythematosus in mice was improved by inhibiting the activation of Wnt/β-catenin signal pathway. [ABSTRACT FROM AUTHOR]

This article addresses the bioactive components in coffee aroma, their metabolism, and the mechanism of action in lowering the risk of various potential health problems. The main bioactive components involved in the perceived aroma of coffee and its related health benefits are caffeine, chlorogenic acid (CGA), trigonelline, diterpenes, and melanoids. These compounds are involved in various physiological activities. Caffeine has been shown to have anticancer properties, as well as the ability to prevent the onset and progression of hepatocellular carcinoma and to be anti‐inflammatory. CGA exhibits antioxidant action and is implicated in gut health, neurodegenerative disease protection, type 2 diabetes, and cardiovascular disease prevention. Furthermore, together with diterpenes, CGA has been linked to anticancer activity. Trigonelline, on the other side, has been found to lower oxidative stress by increasing antioxidant enzyme activity and scavenging reactive oxygen species. It also prevents the formation of kidney stones. Diterpenes and melanoids possess anti‐inflammatory and antioxidant properties, respectively. Consuming three to four cups of filtered coffee per day, depending on an individual's physiological condition and health status, has been linked to a lower risk of several degenerative diseases. Despite their health benefits, excessive coffee intake above the recommended daily dosage, calcium and vitamin D deficiency, and unfiltered coffee consumption all increase the risk of potential health concerns. In conclusion, moderate coffee consumption lowers the risk of different noncommunicable diseases. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the effect of vitamin D supplementation on the recurrence rate of benign paroxysmal positional vertigo (BPPV). Methods: A single‐center, prospective, double‐blind, placebo‐controlled, parallel‐group randomized controlled trial was conducted between November 2018 and May 2020. After successful treatment with canalith repositioning maneuvers, patients diagnosed with BPPV were randomized to either the vitamin D (n = 20) or placebo (n = 18) group. Only patients with serum vitamin D levels <20 ng mL−1 were included. The vitamin D group received 7000 IU of vitamin D weekly for a year, while the placebo group received a matching placebo drug. The final endpoint was the BPPV recurrence rate and correlation with serum vitamin D levels after 6 and 12 months in both groups. Results: Among 38 patients, 37 were followed up for 6 months and 30 for 12 months. Significantly higher serum vitamin D levels were observed in the vitamin D group compared to the placebo group at both the 6‐month and 1‐year follow‐ups (p <.001 at each timepoint). The recurrence rate was lower in the vitamin D group than in the placebo group after 6 months (p =.008) and 1 year (p =.003). Conclusion: Vitamin D supplementation, in the absence of calcium, may be beneficial for patients prone to recurrent BPPV episodes, particularly when serum vitamin D levels are suboptimal (PRE20181024‐001, Clinical Research Information Service, South Korea). Level of Evidence: 1b. [ABSTRACT FROM AUTHOR]

Key Clinical Message: Any pregnant or lactating woman with severe constant back pain, PLO must be kept in mind due to its effect on the quality of life of the mother and her child. A 22‐year‐old woman, who delivered her first child 5 months ago and is now breastfeeding her baby, presented with mid‐back pain. After investigations, including laboratory tests, X‐rays, and bone density measurements, the diagnosis was PLO. The patient is being treated with calcium, vitamin D, and alendronate besides discontinuation of lactation. [ABSTRACT FROM AUTHOR]

Observational studies have confirmed that 25‐hydroxyvitamin D (25(OH)D) is associated with pulmonary hypertension (PH), but the causal association between each other is unclear. Therefore, Mendelian randomization (MR) method was performed to validate the causal association between PH and serum 25(OH)D levels. The summary data for 25(OH)D and PH were from the National Human Genome Research Institute‐European Bioinformatics Institute. Catalog of human genome‐wide association studies and FinnGen biobank consortium. MR analysis was utilized to explore the potential causal association between PH and 25(OH)D. To evaluate this association, inverse variance weighting was considered as the primary method. Cochran's Q test, MR‐Egger intercept test, and "leave‐one‐out" sensitivity analyses were utilized to control the pleiotropy and heterogeneity in the study. Two‐sample MR analysis revealed an inverse causal relationship between 25(OH)D and PH (odds ratio: 0.376, 95% confidence interval: 0.162–0.876, p = 2.334 × 10−2). There was no significant heterogeneity and pleiotropy. The present study confirmed the inverse causal relationship between 25(OH)D and PH. This pathway may provide another treatment pathway in PH. Further studies to elucidate this pathway is indicated. [ABSTRACT FROM AUTHOR]

As dysbiosis of gut microbiota is recognized as a major risk factor for malnutrition in hemodialysis (HD) patients, we aimed to assess the effects of fortified synbiotic dessert on malnutrition, oxidative stress, inflammation, and quality of life in patients undergoing hemodialysis. A total of 50 hemodialysis patients were randomized into two groups of intervention and control to consume either 50 g of synbiotic dessert fortified with vitamin D (1000 IU) and calcium (500 mg) (FSD) or 50 g of control dessert (CD) for 8 weeks, respectively. Changes in nutritional status [Subjective Global Assessment (SGA)], anthropometric measures, malondialdehyde (MDA), total antioxidant capacity (TAC), high‐sensitivity C‐reactive protein (hs‐CRP), ferritin, biochemistry [serum albumin, vitamin D, creatinine, blood urea nitrogen (BUN), complete blood count (CBC), and electrolytes], and quality of life were assessed before and at the end of the trial. The SGA scores and serum ferritin levels decreased significantly in the FSD group compared to the control group (p =.01 and p =.03, respectively). Regarding other markers, no statistically significant changes were found comparing the two groups. This novel fortified synbiotic dessert as a functional food may be effective in reducing the severity of malnutrition by improving SGA score in short term in hemodialysis patients. Thus, it is suggested to do further studies to elucidate the possible mechanisms related to the effects of this dessert on microbiota, skeletal muscle mass, and inflammation in HD in long term. [ABSTRACT FROM AUTHOR]

Phase angle and vitamin D can reflect the state of the body cells, and the two may interact with each other. Therefore, this study was conducted to find out the relationship between PA and vitamin D. Taking women in early pregnancy as our study subjects, we found that PA had a positive effect on vitamin D levels. Body composition phase angle, as a noninvasive, easy‐to‐operate, and easy‐to‐monitor indicator, can be used an early screening index for vitamin D nutrition levels in early pregnancy, and the cutoff value was 4.95°. [ABSTRACT FROM AUTHOR]

Background: Vitamin D is essential for skeletal health, calcium homeostasis and general health. The major and more stable form of vitamin D in circulation is 25‐hydroxyvitamin D (25‐OH‐D); this is the most valuable indicator of vitamin D status. There are studies on laboratory and zoo‐housed chimpanzees; however, serum vitamin D status has not been documented in chimpanzees in range countries. Objectives: (1) Determine the range of circulating 25‐OH‐D concentrations in chimpanzees in range countries. (2) Assess the influence of age, sex, and sun exposure on 25‐OH‐D serum concentrations. Methods: Opportunistic blood samples were obtained from 127 clinically healthy chimpanzees. Serum 25‐OH‐D concentration was measured with a commercially available competitive ELISA. Results: The median overall 25‐OH‐D concentration for chimpanzees in range countries was 46.24 nmol/L (range: 17.10–109.23 nmol/L). Males had a significantly lower concentration (40.15 nmol/L) than females (49.61 nmol/L), and infants (37.99 nmol/L) had a significantly lower concentration than adults (46.04 nmol/L). Concentrations of 25‐OH‐D in chimpanzees in sunnier habitats were significantly higher compared to thick tropical forest habitat. Conclusion: The present constitutes a large dataset of serum 25‐OH‐D concentrations in range country sanctuary chimpanzees and contributes to document normal ranges. Age, sex, and sun exposure influenced serum concentrations of 25‐OH‐D in sanctuary chimpanzees. [ABSTRACT FROM AUTHOR]

Introduction: Alopecia areata (AA) is an autoimmune non‐scarring hair loss. The role of micronutrients such as iron, zinc, and vitamins, especially vitamin D, on the natural hair cycle is well defined in literature. This study aims to evaluate the correlation between vitamin D and CRP levels in patients with alopecia areata. Methods: This cross‐sectional study was performed from beginning of October 2020 until end of December 2021. Alopecia areata patients over 18 years of age gave their written consent to participate in the study. The severity of the patients' disease was assessed using the Severity of Alopecia Tool. Serum vitamin D and CRP levels were measured and CBC and LFT were also performed. Results: There were significant differences between the patients with the localized form of AA and its universal form in the following variables: Vitamin D levels, SALT score, WBC, ALKP, and CRP. There was also a significant inverse correlation between CRP and vitamin D levels (p < 0.0001). Conclusion: Vitamin D deficiency is associated with higher CRP levels, and patients with low serum vitamin D and high CRP levels are at a higher risk of developing the universalis form of AA; therefore, these patients should undergo more aggressive treatments. [ABSTRACT FROM AUTHOR]

Background and aims: Psoriasis is a chronic, non‐contagious autoimmune condition marked by dry, itchy,erythematous and scaly plaques. From modest, localized plaques to total body coverage, the severity of psoriasis varies. Plaque, guttate, inverted, pustular, and erythrodermic psoriasis are the five primary kinds. About 90% of cases are of plaque psoriasis, commonly known as psoriasis vulgaris. Study aims to determine the impact of an rs2228570 (FokI) variant and an rs11568820 (CDX2) variant on serum vitamin D levels (SVD) in patients with psoriasis, and the correlation between the two variants and disease severity. Methods: A case‐control study consisting of 95 psoriasis vulgaris patients and 84 healthy controls. The clinical investigation, molecular genetics analysis, and biochemical analysis were done for both groups. Results: SVD levels were significantly decreased in psoriasis patients group. FokI genotypes analysis, we found no significant variance between groups. CDX2 G/G genotype is more prevalent in patients than controls. Moderate psoriasis vulgaris patients with CDX2 G/G genotypes have higher SVD levels than CDX2 G/A, and CDX2 A/A p = 0.003. Conclusion: The study found a difference in vitamin D levels between patients and healthy subjects, as well as a difference in vitamin D levels with different FoKI and CDX2 genotypes. [ABSTRACT FROM AUTHOR]

Background and purpose: People with multiple sclerosis (pwMS) report reduced quality of life (QoL). Engagement with healthy lifestyle behaviours, including consuming a healthy diet, regular physical activity, and adequate vitamin D exposure, is associated with higher QoL. We aim to assess whether individual lifestyle behaviours are more beneficial to QoL than others, and whether there are additive benefits to QoL by engaging in multiple healthy behaviours concurrently. Methods: Data from pwMS who completed an online survey at baseline, and at 2.5‐, 5‐ and 7.5‐year follow‐up, were analysed. Behaviours assessed were consumption of a no‐meat/dairy‐plus‐omega‐3 supplementation diet, meditation practice, physical activity, non‐smoking, and vitamin D exposure. Mental QoL (mQoL) and physical QoL (pQoL) were assessed by the Multiple Sclerosis Quality of Life (MSQOL‐54) questionaire. Linear regression analyses were performed to assess associations of individual behaviours at baseline and follow‐up time points with QoL, as well as between number of behaviours and QoL. Results: At baseline, healthy diet and regular physical activity were associated with higher mQoL (5.3/100 and 4.0/100) and higher pQoL (7.8/100 and 6.7/100). Prospectively, diet was positively associated with mQoL, and physical activity with both mQoL and pQoL. At baseline, engagement with ≥3 behaviours was positively associated with mQoL and pQoL, with additive positive associations for each additional behaviour. Prospectively, engagement with ≥3 behaviours was positively associated with mQoL and pQoL, with strongest associations observed with engagement with five behaviours. Conclusion: Consumption of a healthy diet, and regular physical activity, are both potential interventions to improve QoL. Engagement with multiple lifestyle behaviours may provide additional benefits and should be encouraged and supported for multiple sclerosis management. [ABSTRACT FROM AUTHOR]

Hypoxia pulmonary hypertension (PH) belongs to the third major category in PH classification. Chronic obstructive pulmonary disease (COPD) is a common cause of hypoxia PH. Low serum vitamin D concentration is considered to be a possible risk factor for chronic lung disease; epidemiological studies have found that vitamin D deficiency increases pulmonary artery pressure. Therefore, this study aimed to explore the role of vitamin D levels in COPD and chronic hypoxic PH. This retrospective study selected three groups of people as research subjects, including: Group N: normal control group (people without any chronic lung disease or PH); Group C: patients with COPD, but without PH; Group C + PH: patients with COPD and PH. Vitamin D levels and pulmonary artery pressure were observed in the three groups. Vitamin D levels of the three groups showed statistical differences in every pairwise comparison; the vitamin D level of Group C (20.27 ng/mL) was lower than Group N (23.48 ng/mL), Group C+ PH was the lowest (14.92 ng/mL). The levels of vitamin D in the three groups in this study were generally low. Vitamin D is negatively correlated with pulmonary artery systolic blood pressure. Low vitamin D levels may have a certain relationship with the occurrence and development of COPD. Further reductions in vitamin D levels may influence the development of PH in COPD. [ABSTRACT FROM AUTHOR]

Introduction: Effect of booster vaccination and vitamin D status on antibody production of Omicron variant‐infected adults need to be further explored. Methods: A retrospective, longitudinal, real‐world cohort study was performed. All included cases were divided into vitamin D deficiency (VDD) and non‐VDD (control) groups according to baseline serum 25‐hydroxyvitamin D [25(OH)D] concentration and then into unvaccinated, routinely vaccinated, and booster vaccinated VDD and control subgroups according to vaccination status. Antibody dynamics were observed within six time periods during hospitalization. Results: A total of 204 adult cases were included, of which 121 (59%) were males; 23 (11%), 31 (15%), and 26 (13%) or 50 (25%), 35 (17%), and 39 (19%) were unvaccinated, routinely vaccinated, and booster vaccinated VDD cases or controls, respectively. The median (interquartile range) for age and baseline 25(OH)D concentration was 42.5 (31–53.5) years and 21.5 (18–25.4) ng/mL, respectively. The IgM titers within 3 to 7 days and 7 to 14 days increased rapidly to 1.8‐fold (P < 0.001) and 3.6‐fold (P < 0.001) those within the first day; the IgG titers increased to 5.8‐fold (P < 0.001) and 10.9‐fold (P < 0.001). Booster vaccinated controls had higher first IgG titers compared with unvaccinated controls (3.1‐fold; P = 0.001) or booster vaccinated VDD cases (2.1‐fold; P = 0.02). Conclusions: Booster vaccination and non‐VDD status may have an interactive boosting effect on IgG production of Omicron variant‐infected adults. Further randomized clinical trials may be needed to determine whether booster vaccination combined with VDD correction improves the humoral immunity to Omicron variants. [ABSTRACT FROM AUTHOR]

Treatment adherence is an underestimated determinant of treatment success. Poor treatment adherence can also affect the efficacy of clinical trials. A combination of multiple adherence‐monitoring methods is required to ensure robustness. We investigated whether multiple adherence‐monitoring methods, including a novel smartwatch‐based monitoring method, would yield reliable and concordant results. In this open, randomized, decentralized clinical trial, vitamin D‐deficient individuals were randomized to an App − only group (an electronic medication diary) or an App + Watch group (i.e., App and smartwatch‐based monitoring) groups after a week run‐in period. The participants received vitamin D supplements (1000 IU) for 12 weeks (two consecutive periods of 6 weeks) with two pill counts (at the sixth week) and biweekly blood samplings for serum 25(OH) vitamin D concentration. Adherence was assessed and compared between the methods. Sixteen participants were enrolled, of which 13 completed the study. Serum 25(OH) vitamin D levels comparably increased in both groups until the first 7 weeks but trended higher in the App + Watch group in the second period. The number of doses recorded by the pill count and App did not differ significantly between the run‐in and Period 1 (p = 0.5534) but became significantly discrepant in Period 2 (p = 0.0225). In contrast, the concordance for smartwatch‐based monitoring was consistent in either period (p = 0.5898 and p = 0.5839, respectively). We explored multiple adherence‐monitoring methods in this pilot feasibility clinical study. Smartwatch‐based adherence monitoring may be an objective and sensitive method for measuring treatment adherence. [ABSTRACT FROM AUTHOR]

Calcium is imperative in maintaining a quality life, particularly during later ages. Its deficiency results in a wide range of metabolic disorders such as dental changes, cataracts, alterations in brain function, and osteoporosis. These deficiencies are more pronounced in females due to increased calcium turnover throughout their life cycle, especially during pregnancy and lactation. Vitamin D perform a central role in the metabolism of calcium. Recent scientific interventions have linked calcium with an array of metabolic disorders in females including hypertension, obesity, premenstrual dysphoric disorder, polycystic ovary syndrome (PCOS), multiple sclerosis, and breast cancer. This review encompasses these female metabolic disorders with special reference to calcium and vitamin D deficiency. This review article aims to present and elaborate on available data regarding the worldwide occurrence of insufficient calcium consumption in females and allied health risks, to provide a basis for formulating strategies and population‐level scientific studies to adequately boost calcium intake and position where required. [ABSTRACT FROM AUTHOR]

Previous studies have suggested that vitamin D has a protective effect on allergic diseases, while an individual's sex may have a moderating effect on the relationship between vitamin D and allergic‐related immunity. This study aimed to determine the role of vitamin D in children with coexisting allergic diseases in the context of sex differences and to explore the behavioral profiles of these patients. We recruited a total of 103 children with atopic diseases and divided them into four groups: males with one allergic disease (MA1, n = 20), males with two or more allergic diseases (MA2, n = 26), females with one allergic disease (FA1, n = 30), and females with two or more allergic diseases (FA2, n = 27). We measured serum calcium levels using the colorimetric method and serum 25‐OH vitamin D total levels using electrochemiluminescence immunoassay. We found that MA2 had significantly lower vitamin D levels than MA1 and FA2. The levels of IgE were negatively correlated with vitamin D in females, whereas the levels of IgE were not significantly correlated with vitamin D in males. Furthermore, serum IgE was significantly correlated with children's adaptive skills, and different sexes were associated with different aspects of adaptive skills. Our findings suggest a protective role of vitamin D in the development of one allergic disease against the coexistence of allergic diseases in males, as well as extend the evidence for sex differences in immunity by demonstrating a sex‐different correlation between IgE and vitamin D and the relationship between IgE and children's adaptive skills. [ABSTRACT FROM AUTHOR]

Chronic administration of d‐galactose (d‐gal) in rodents reproduces the overproduction of reactive oxygen species of physiological aging. The present research shows for the first time distinct signatures on d‐gal‐induced aging (500 mg/kg, 6 weeks) and the preventive and protective potential of two vitamin D (50 IU) supplementation regimens (pre‐induction and simultaneous, respectively) in two vital organs (heart and brain). d‐gal‐induced notorious alterations in working memory, a strong increase in brain malondialdehyde (MDA) oxidative levels, and strong downregulation of sirtuin 1 (SIRT1) in the heart and hippocampus and of calstabin2 in the heart. Cardiac and brain superoxide dismutase (SOD) and glutathione peroxidase (GPx) enzymatic antioxidant capacities were damaged, brain calstabin2 was downregulated, and neuropathology was observed. Heart damage also included a moderate increase in MDA levels, serologic lactate dehydrogenase (LDH), total creatine kinase (CK) activities, and histopathological alterations. The used dose of vitamin D was enough to prevent cognitive impairment, avoid muscular damage, hamper cardiac and cerebral oxidative stress, and SIRT1 and calstabin2 downregulation. Most importantly, the potencies of the two preventive schedules depended on the tissue and level of study. The pre‐induction schedule prevented d‐gal‐induced aging by 1 order of magnitude higher than simultaneous administration in all the variables studied except for SIRT1, whose strong downregulation induced by d‐gal was equally prevented by both schedules. The benefits of vitamin D for oxidative stress were stronger in the brain than in the heart. Brain MDA levels were more sensitive to damage, while SOD and GPx antioxidant enzymatic activities were in the heart. In this order, the magnitude of SOD, MDA, and GPx oxidative stress markers was sensitive to prevention. In summary, the results unveiled distinct aging induction, preventive signatures, and sensitivity of markers depending on different levels of study and tissues, which are relevant from a mechanistic view and in the design of targeted interventions. [ABSTRACT FROM AUTHOR]

Background: 1,25‐Dihydroxyvitamin D (1,25(OH)2 D) is vital in the homeostasis of calcium and bone health as well as in the prevention of many disorders such as neoplasms. Epidemiological data show that low concentrations of both 1,25(OH)2D and its precursor 25(OH) vitamin D (25(OH)D) are associated with an increased risk of a variety of human tumours. Objectives: To investigate 25(OH)D, parathormone (PTH) and immunity marker concentrations in dogs with transmissible venereal tumour (TVT). Methods: 25(OH)D, PTH and various biochemical and immunity markers were evaluated in dogs with TVT (n = 26) and in healthy (n = 30) dogs. Results: 25(OH)D concentrations were significantly lower in dogs with TVT in comparison with healthy dogs. In contrast, PTH, immunoglobulin G and interleukin (IL)‐9 concentrations were higher in the dogs with TVT. Other variables, including IL‐10, interferon γ, calcium and inorganic phosphate, were not statistically different between the two groups. Conclusions: Decreased serum 25(OH)D concentration may be a risk factor for the development of canine TVT; however, cause‐and‐effect remains incompletely understood. Further studies are required to elucidate the exact role of 25(OH)D in canine TVT and whether vitamin D supplementation may be useful prophylactically or as an adjunct to chemotherapy. [ABSTRACT FROM AUTHOR]

Background: Minerals play vital roles in physiologic processes. Calcium, phosphorus and magnesium are common minerals. Secretion, absorption and homeostasis of these minerals are affected by associations between the active vitamin D and parathyroid hormone (PTH). Objective: The aim of this study was to assess concentrations of vitamin D, PTH and minerals, such as calcium, phosphorus and magnesium in horse sera, as well as associations of these values with lameness in horses. In the references, the reasons for lameness can be deficiency and imbalance of minerals, and clinical observations also confirm this and there is still not enough information regarding the relationship between mineral imbalance and lameness of horses. The prominent forms of lameness include navicular syndrome, back pain, splints, ring bone, side bone, non‐infectious arthritis and bucked shins. Deficiency and inadequacy of calcium, phosphorous and magnesium have been regarded as predisposing and aggravating factors of the aforementioned diseases. Materials and methods: This cross‐sectional study was carried out on 60 horses, including 30 lame and 30 healthy adult horses, summer to fall 2021. Levels of calcium, phosphorus, magnesium, vitamin D and PTH were assessed in sera using automatic analyser, atomic absorption spectroscopy and commercially available kits. Results: The average level of calcium was higher healthy horses than lame horses in the two seasons (p < 0.001). The average level of inorganic phosphorus in horses was higher in summer than autumn (p < 0.001). The mean magnesium concentration in healthy horses was greater than lame horses in the two seasons (p < 0.01). In this study, the mean PTH concentration in healthy horses was lower in fall than summer (p < 0.05). Conclusion: The low average levels of calcium and magnesium in lame horses in the two seasons indicate critical roles of calcium and magnesium in the normal function of the horse musculoskeletal system as well as prevention of lameness. [ABSTRACT FROM AUTHOR]

Background: Previous studies have documented vitamin D imbalance in dogs with acute pancreatitis (AP), but no studies have investigated serum vitamin D receptor (VDR) and vitamin D‐binding protein (VDBP) concentrations. Objectives: Compare serum 25‐hydroxyvitamin D (25[OH]D), VDR, and VDBP concentrations in healthy dogs and dogs with AP and identify correlations between these concentrations with ionized calcium, C‐reactive protein (CRP), and canine‐specific pancreatic lipase (Spec cPL) concentrations. Animals: Twenty‐two dogs with AP and 20 healthy control dogs. Methods: Prospective cross‐sectional study. Serum 25(OH)D concentrations were measured using a chemiluminescence immunoassay, and VDR and VDBP concentrations were measured using a ELISA kit designed for dogs. Results: Serum concentrations of 25(OH)D were lower in dogs with AP (mean ± SD, 66.1 ± 39.2 ng/mL) than in controls (96.8 ± 30.4 ng/mL; P =.01), and VDR concentrations were lower in dogs with AP (5.3 ± 3.5 ng/mL) than in controls (7.4 ± 2.5 ng/mL; P =.03). No difference was observed in serum VDBP concentrations between the groups. Serum VDR concentrations differed between survivors (median [interquartile range] = 6.6 [4.3‐8.2] ng/mL) and nonsurvivors (2.7 [0.5‐3.5] ng/mL; P =.01). Negative correlations were observed among serum VDR, CRP (rs = −0.55), and Spec cPL (rs = −0.47) concentrations in dogs with AP. Conclusions and Clinical Importance: Dogs with AP had lower serum 25(OH)D and VDR concentrations than controls. Additionally, our study suggests a potential role of VDR expression in the inflammatory process of AP in dogs. [ABSTRACT FROM AUTHOR]

Background: Depression is a common psychiatric comorbidity among chronic dermatology patients. There is extreme lacking in the research studying biomarkers responsible for it. Both brain‐derived neurotrophic factor (BDNF) and vitamin D have a significant role in the development of depression. Aim: To assess BDNF and vitamin D serum levels in different clinical verities of alopecia areata (AA) and vitiligo patients, correlating them with depression prevalence and quality of life. Methods: In all, 30 AA patients, 30 vitiligo patients, and 30 healthy volunteers were included. Both alopecia and vitiligo severity and activity were evaluated using the suitable clinical scores. Depression was assessed using Beck depression inventory (BDI) scale and quality of life was recorded using Dermatology Life Quality Index (DLQI). Both serum BDNF and vitamin D levels were investigated using ELISA. Results: In both alopecia and vitiligo patients, serum BDNF and serum vitamin D were significantly lower compared to controls (p = 0.001 for both). Both were associated and negatively correlated with BDI and DLQI. Regarding alopecia, they showed a significant decline in more sever disease and with longer disease duration. However, in vitiligo, BDNF (p = 0.001) and vitamin D (p = 0.03) correlated negatively with disease activity, but not with disease severity. Serum BDNF and vitamin D correlated positively with each other (p = 0.001) in both AA and vitiligo cases. Conclusion: The inverse association of both serum BDNF and vitamin D with depression, and the positive correlation noted between their serum levels, may indicate a potential combined effect of these two players on development of depression and its negative health‐related outcomes. [ABSTRACT FROM AUTHOR]

Background: The human papillomavirus that causes warts is usually harmless, and it can infect any part of the skin or mucous membranes. Despite the availability of several treatments, warts often return, and scarring, pigmentation changes, and recurrence are all possible side effects. Aim: Intralesional vitamin D3 was employed as an immunotherapy for cutaneous warts in the current investigation. Materials and Methods: In Al‐Sadr Medical City in the city of Al‐Najaf Al‐Ashraf, a skin clinic conducted a therapeutic clinical experiment. A total of 204 cutaneous warts were examined in 40 patients (14 men and 26 females). Vitamin D3 solution of the dose (600 000 IU) was injected into the lesions' bases, with 0.2 mL per patient. Each session could only inject up to five warts. The injections were given every 2 weeks for a total of four times. Instructing patients to forego the use of any topical or oral medication was also a part of the protocol. Each patient was evaluated for recurrence risk before each therapy and then again 6 months later. Result and Discussion: There was a wide range of patient ages in this study, from 20 months to 52 years. About 65% of the cases included females. When looking at the many kinds of warts, the most prevalent was the common wart (71.6%). After four treatments, a positive response was considered to have occurred when all lesions had disappeared, a partial response when more than half of the lesions had disappeared, and no reaction when less than half of the lesions had disappeared. The final tally was 81.9% for those who responded in whole, 11.3% for those who responded partially, and 6.9% for those who did not respond at all. Next‐session complete response rates were 12.7%, 29.9%, 54.9%, and 81.9%, respectively. Thirteen people experienced adverse symptoms, most noticeably minor swelling and itching. Within 6 months of follow‐up, warts had completely disappeared for all patients with a partial or modest response except one who had no reaction. Conclusion: Vitamin D3 administered intralesional is an effective and low‐cost treatment for cutaneous warts. [ABSTRACT FROM AUTHOR]

Background: Vitamin D (Vit.D) has an important role in protecting COVID‐19 patients. This study investigated the changes in vitamin D receptor (VDR) expression and interleukin 6 levels in patients with COVID‐19. Materials and methods: 120 hospitalized patients and 120 healthy people participated in this study, both group adjusted by sex and age. Vit.D was measured with HPLC, the expression of VDR gene was done with Real‐time PCR, and IL‐6 was measured with ELISA assay. Results: Our findings showed no significant difference in the case of Vit.D (25‐OH‐D3) between the two studied groups, interestingly the expression of VDR was statistically lower in the patients with COVID‐19, p‐value = 0.003. VDR expression was lower in the patient with diabetes, hypertension and cardiovascular disease, significantly, p‐value = 0.002. The level of IL‐6 was statistically higher in the COVID‐19 group, p‐value = 0.003. Conclusion: Alongside the important role of 25‐OH‐D3 in COVID‐19 patients, the quality and quantity of the VDR expression and its role in the level of IL‐6 are the promising risk factors in the future. Further studies are needed to determine the factors increasing the expression level of VDR, especially in the patients with diabetes, hypertension and cardiovascular disease. [ABSTRACT FROM AUTHOR]

Key Clinical Message: Breast milk alone is a poor and inadequate source of vitamin D. Many guidelines suggest supplementation of vitamin D to the newborns to prevent vitamin D deficiency. However, due to practices of outdoor breastfeeding and sunbathing, vitamin D supplementation may not be routinely required in our settings. Overzealous use of vitamin D supplementation and over‐the‐counter prescription may result in hypervitaminosis D. [ABSTRACT FROM AUTHOR]

Rickets is a disorder of bone development and can be the result of either dietary or genetic causes. Here, related pugs from 2 litters were included. Three pugs had clinical signs including, lameness, bone deformities, and dyspnea. One other pug was found dead. Radiographs of 2 affected pugs, 5 and 6 months old, showed generalized widening, and irregular margination of the physes of both the appendicular and the axial skeleton with generalized decrease in bone opacity and bulbous swelling of the costochondral junctions. Two pugs had low serum calcium and 1,25 (OH)2D3 concentrations. Test results further indicated secondary hyperparathyroidism with adequate concentrations of 25‐hydroxyvitamin D. Necropsy revealed tongue‐like projections of cartilage extending into the metaphysis consistent with rickets, loss of metaphyseal mineralization and lung pathology. Vitamin D‐dependent rickets was diagnosed. A truncating mutation in the 1α‐hydroxylase gene (CYP27B1) was identified by genome sequence analysis of the pugs with VDDR type 1A. Vitamin D‐dependent rickets type 1A can occur in young pugs, and if left untreated is a life‐threatening condition. Early medical intervention can reverse clinical signs and should be instituted as soon as possible. [ABSTRACT FROM AUTHOR]

The variation in vitamin D status is still unclear. We aim to describe the vitamin D status among healthy infants and children in Shanghai (31° N latitude), one of the largest cities in China. We conducted a hospital‐based, 2‐year retrospective observational study and recruited children for health examination at the Tongren Hospital affiliated with Shanghai Jiao Tong University School of Medicine from January 2019 to December 2020. Serum 25‐hydroxyvitamin D (25(OH)D) levels were measured using an enzyme‐linked immunosorbent assay. A total of 6164 children aged 0–11 years were included. Of these, 94.4% of the serum 25(OH)D measurements at first assessment were within the range of 12–50 ng/mL. The median 25(OH)D level was 31.3 (IQR 25.6, 38.1) ng/mL, the percentages of 25(OH)D < 20 ng/mL and 25(OH)D < 30 ng/mL were 10.0% and 43.8%, respectively. Low vitamin D status (deficiency and insufficiency) differed significantly by age group (infants, toddlers, preschoolers, and schoolers) and seasonality (all p <.001), but not by gender. For the sub‐group (n = 855) of children with repeated assessments, their low 25(OH)D levels increased significantly whether after about a 7‐month (n = 351) or 12‐month (n = 504) interval, and the increments of median 25(OH)D levels were 8.1 ng/mL and 2.1 ng/mL respectively (p <.001). This study documents the vitamin D status in Shanghai, showing that low vitamin D status is common in infants and children and suggesting that the assessment of 25(OH)D level is necessary for individuals who are at risk for deficiency or excess. [ABSTRACT FROM AUTHOR]

Background: Many clinical features of psoriasis include a rash with itchy, scaly patches, most frequently on the knees, elbows, trunk, and scalp. By studying genes involved with psoriasis receptivity, the pathologic pathways of psoriasis become clearer and more understood. Aim: To predict the participation of rs1544410 in serum vitamin D levels (SDL) in psoriasis, psoriasis susceptibility, and severity. Patients/Methods: One hundred five patients with psoriasis were categorized by body surface area as mild, moderate, and severe. SDL and genetic analysis of rs1544410 were performed using polymerase chain reaction and standard Sanger methods. Result: Our findings revealed that SDL were higher in healthy subjects than in patients. The rs1544410 genotype TT was more prevalent in patients, while CT was more prevalent in controls. Our findings revealed that the T alleles were frequently more in the patient group than in the controls. (p ≤ 0.001). While in healthy normal individuals, the C alleles were frequently more (p ≤ 0.001). SDL are lower in patients with the TT genotype. Patients with moderate form of psoriasis have higher SDL than those with mild or severe form. Conclusion: rs1544410 polymorphism has been linked to a higher probability of psoriasis and SDL deficiency. However, grander scale studies in a larger number of people are necessary. [ABSTRACT FROM AUTHOR]

Background: Vitiligo is a depigmenting disorder caused by the destruction of melanocytes by various mechanisms which affect melanocyte function and survival. Different therapeutic approaches for vitiligo include nonsurgical and surgical methods but effective therapy is still challenging. There are few studies that suggest the role of vitamin D analogs in the repigmentation process with encouraging results. To our knowledge, this is the first study to evaluate the effect of topical vitamin D (cholecalciferol) combined with microneedling in the treatment of depigmented patches of vitiligo. Aim of the Work: Evaluate the effect of microneedling alone versus microneedling with topical vitamin D in the treatment of vitiligo. Patients and Methods: A prospective comparative clinical trial was carried out on 25 patients with stable vitiligo; every patient had at least two patches; the first patch was treated with microneedling alone. The other patch was treated with microneedling combined with topical cholecalciferol. Results: Good‐to‐excellent response was detected in 52% of the patches treated with microneedling topical cholecalciferol, while only in 40% of the patches treated with microneedling alone. The improvement was higher in combined treatment with no significant difference between both groups. Conclusion: Topical cholecalciferol is a relatively effective and safe alternative in the treatment of stable vitiligo and its combination with microneedling increases its efficacy. [ABSTRACT FROM AUTHOR]

Background: The coronavirus disease‐2019 (COVID‐19) has become a worldwide health issue with widespread hospitalization and dependence on the intensive care unit (ICU). Vitamin D has a key role in modulating immune cells and modulating the inflammatory responses. This study aimed to investigate the association of vitamin D supplementation with inflammatory, biochemical, and mortality indices in critically ill patients with COVID‐19. Methods: This case‐control study was conducted on critically ill COVID‐19 patients hospitalized in the ICU including the survived >30 day patients as the case group and dead patients as the control group. The status of vitamin D supplementation and inflammatory and biochemical indices of the patients were retrieved from the medical records. Logistic regression method was used to assess the association between 30 days survival and vitamin D supplement intake. Results: Compared to the group of COVID‐19 patients who died in <30 day, the survived patients had a lower eosinophile level (2.2 ± 0.5 vs. 6 ± 0.0, p <.001) and higher vitamin D supplementation duration (9 ± 4.4 vs. 3.3 ± 1.9 day, p =.001). Vitamin D supplementation had a positive association with survival in COVID‐19 patients (OR: 1.98, 95% CI: 1.15−3.40, p <.05). The association remained significant after adjustments fot age, sex, underlying diseases, and smoking. Conclusion: Vitamin D supplementation in critically ill patients with COVID‐19 has the potential to increase survivability within the first 30 days of hospitalization. [ABSTRACT FROM AUTHOR]

This technical report describes the collection of data and appraisal of scientific evidence in relation to the assessment of Tolerable Upper Intake Levels (UL) for vitamin D. Five systematic reviews (SR) were conducted following a tailored literature search, data extraction, evidence appraisal (i.e., risk of bias (RoB) assessment) and evidence synthesis. Narrative reviews were conducted to gather contextual evidence relevant to the interpretation of the main body of evidence (BoE). In the SR on bioavailability of calcidiol compared to native vitamin D3, 4304 records were identified and reduced to 12 individual records after screening for eligibility. The evidence appraisal revealed an overall low to high RoB of the individual studies. The available BoE demonstrated higher relative bioavailability of calcidiol compared to native vitamin D3 with a conversion factor of about 2 across baseline 25(OH)D concentrations of 30 to 55 nmol/L. In the SR on hypercalcaemia and hypercalciuria, 8277 records were identified and reduced to 37 individual records after screening for eligibility. The evidence appraisal revealed an overall low to high RoB of the individual studies. The available evidence demonstrated that occurrence of persistent hypercalcemia and hypercalciuria with high doses of vitamin D supplementation was rare. Nevertheless, increased risk of persistent hypercalciuria was observed with 250 μg/d of vitamin D supplementation. In the SRs on bone fractures, falls, bone mineral density (BMD), bone mineral content, and bone strength, 15 541 records were identified and reduced to 20 individual records after screening for eligibility. The evidence appraisal revealed an overall low to moderate RoB of the individual studies. No clear signs of adverse effects of high vitamin D intake were found in relation to bone fractures, falls, or areal BMD, but volumetric BMD was reduced with 100 and 250 μg/d of vitamin D. [ABSTRACT FROM AUTHOR]

Introduction: Alopecia areata (AA) is a challenging disease with variable treatment outcomes. Hair follicles express vitamin D receptors. Therefore, vitamin D3 may be promising for AA treatment through immunomodulatory mechanisms. The efficacy of bimatoprost in scalp AA treatment was reported by few studies. Objective: To evaluate the efficacy and safety of microneedling (MN) with topical vitamin D3 versus MN with bimatoprost in comparison with MN alone in the treatment of localized AA. Patients and Methods: Seventy‐five patients with localized AA were divided into three groups. The first group: 25 patients were treated with MN alone. The second group: 25 patients treated with MN combined with topical vitamin D3. The third group: 25 patients treated with MN combined with bimatoprost solution. The response was evaluated clinically and dermoscopically. Results: At the end of the study, all groups showed a statistically significant decrease in the SALT score compared to the baseline. The clinical response (regrowth scale): vitamin D and bimatoprost groups showed a statistically significant higher regrowth scale compared to MN alone group (p‐value = 0.000). After treatment, hair regrowth was significantly higher in MN combined with bimatoprost than in MN combined with topical vitamin D3. However, after 3 months of follow‐up, there was no statistically significant difference between both groups. Side effects were mild and transient in all groups. Conclusion: Topical vitamin D3 and bimatoprost combined with MN are safe and effective therapeutic options for localized AA. [ABSTRACT FROM AUTHOR]

Background: Alopecia areata (AA) is a common non‐scarring hair loss disorder that affects children and adults with a great psychological burden because of its recurrent and sometimes treatment‐refractory nature. Objective: To compare the efficacy of topical calcineurin inhibitor, topical potent steroid combined with vitamin D analogue versus topical superpotent steroid in treatment of localized AA. Patients and Methods: Sixty subjects with chronic (>1 year) localized (SALT score < 25%) AA, confirmed clinically and dermoscopically, were randomized into three groups. Group I used topical 0.03% tacrolimus (Tarolimus®), group II used topical potent steroid combined with vitamin D analogue (Daivobet®). and group III used topical superpotent steroid (Dermovate®). All patients continued a daily therapy for three successive months and were followed up for three other months. Assessment was done using PULL test, SALT score, and dermoscopic comparison before and after therapy. Results: Group II showed comparable statistical results to group III with lower values in a non‐statistically significant way. Group I achieved the least improvement among all groups. Conclusion: Combined vitamin D analogues with potent steroid appears to be a more convenient treatment for localized AA than superpotent steroids because of less side effects and comparable efficacy. Tacrolimus needs further research or formula customization to be used as a topical therapy for AA. [ABSTRACT FROM AUTHOR]

Bone remodeling is marked by bone synthesis and absorption balance, and any altered dynamic in this process leads to osteoporosis (OP). The interaction of hormonal, environmental and genetic factors regulate bone metabolism. Since vitamin D displays a classic role in bone metabolism regulation, acting through vitamin D receptor (VDR), the genetic variants within VDR were the first ones associated with bone density and remodelling. Therefore, we investigated whether three single nucleotide polymorphisms (SNPs) within VDR were associated with OP differential susceptibility and clinical profile from postmenopausal versus healthy women from Northeast Brazil. Genetic association study enrolling 146 postmenopausal osteoporotic women as the patient group and 95 healthy age‐matched women as the control group. We assessed three SNPs within VDR (rs11168268, rs1540339 and rs3890733), considering the clinical profile of all patients. Our results showed an association of rs11168268 G/G genotype with higher bone mineral density (BMD) mean for the total hip (A/A = 0.828 ± 0.09; A/G = 0.081 ± 0.13; G/G = 0.876 ± 0.12, p =.039), and the rs3890733 T/T genotype was associated with increased OP risk in patients below 60 years old (odds ratio [OR] = 5.12, 95% confidence interval [CI ]= 1.13–23.27, p =.012). The rs1540339 T/T genotype was associated with protection for individuals with low melanin deposition when compared to the high melanin deposition group (OR = 0.24, 95%CI = 0.06–0.94, p =.029). Additionally, 61% of patients presented deficient vitamin D serum levels. The SNP rs11168268 G/G was associated with a significantly increased mean total hip BMD in patients OP, highlighting this SNP and its relationship with BMD. [ABSTRACT FROM AUTHOR]