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Introduction The physiologic vitamin D (VD), 1[alpha],25(OH).sub.2D.sub.3 (1,25D) is a local paracrine/autocrine effecter of fetal lung maturation. By stimulating alveolar type II cell and lipofibroblast proliferation and differentiation, parenterally administered 1,25D has been shown to enhance neonatal lung maturation; but due to the potential systemic side effects of the parenteral route, the translational value of these findings might be limited. To minimize the possibility of systemic toxicity, we examined the effects of VD on neonatal lung maturation, when delivered directly to lungs via nebulization. Methods One-day-old rat pups were administered three different doses of 1,25D and its physiologic precursor 25(OH)D (25D), or the diluent, via nebulization daily for 14 days. Pups were sacrificed for lung, kidneys, and blood collection to determine markers of lung maturation, and serum 25D and calcium levels. Results Compared to controls, nebulized 25D and 1,25D enhanced lung maturation as evidenced by the increased expression of markers of alveolar epithelial (SP-B, leptin receptor), mesenchymal (PPAR[gamma], C/EBP[alpha]), and endothelial (VEGF, FLK-1) differentiation, surfactant phospholipid synthesis, and lung morphology without any significant increases in serum 25D and calcium levels. Conclusions Inhaled VD is a potentially safe and effective novel strategy to enhance neonatal lung maturation., Author(s): Sneha K. Taylor[sup.1] , Reiko Sakurai[sup.1] , Tokusho Sakurai[sup.1] , Virender K. Rehan[sup.1] Author Affiliations: (1) Department of Pediatrics, Los Angeles Biomedical Research Institute at Harbor UCLA Medical Center, [...]

Preeclampsia is a common complication of pregnancy that is associated with an increased risk of maternal and neonatal morbidity and mortality. Currently, delivery is the only cure for preeclampsia; therefore, effective prevention and treatment options for this condition are sorely needed. In the current issue of the JCI, Mirzakhani et al. report the findings of the Vitamin D Antenatal Asthma Reduction Trial (VDAART), a well-conducted large, randomized, double-blind, placebo-controlled trial of vitamin D supplementation for the prevention of preeclampsia. Though vitamin D supplementation had no effect on the risk of preeclampsia, reduced maternal serum vitamin D levels did correlate with preeclampsia risk. Mirzakhani and colleagues identified a number of gene pathways that are differentially regulated among women with low serum vitamin D levels who develop preeclampsia. These results indicate that further research on the role of vitamin D in preeclampsia is warranted., Preeclampsia and the burden of disease Preeclampsia is a disorder that is unique to human pregnancy, and the only known cure for this complication is delivery. Preeclampsia affects approximately 4% [...]

Background Vitamin D deficiency may contribute to osteoporosis in nephrotic syndrome (NS). Methods A cross-sectional case-control study was performed to investigate 25 hydroxycholecalciferol [25(OH)D] status in 40 patients with NS in remission and 40 healthy controls. Serumlevelsof25(OH)D, calcium, phosphate, alkaline phosphatase (ALP) and intact parathyroid hormone (PTH) were assayed. NS patients were segregated by age at onset, current age, type and duration of NS, months since relapse and current drug therapy. Results Levels of 25(OH)D showed a positive correlation with months elapsed since last NS relapse ([r.sub.s]=+0.4, p= 0.012) and were lower in NS patients within 3 months of relapse but similar to that of controls in patients in remission for >3 months [median 14.23 (interquartile range 12.19-17.63) vs. 19.75 (14.04-28.38) ng/ml, respectively; p= 0.039]. There was no correlation of 25(OH)D levels with other disease characteristics or drug therapy. ALP levels were also lowest after relapse ([r.sub.s]=+0.34, p=0.036). Overall, 25(OH)D levels of Conclusions In our patients with NS, vitamin D stores remained low for 3 months after NS relapse but showed an increase with longer remission time to control levels. Vitamin D stores were not influenced by disease characteristics or therapy. Longitudinal studies are required to confirm these findings and evaluate the effect of vitamin D on bones, particularly in frequent relapsers. Keywords Vitamin D * 25 hydroxycholecalciferol * Nephrotic Syndrome * Parathyroid hormone * Alkaline phosphatase, Introduction Vitamin D is a vital component of bone metabolism and calcium homeostasis, and its deficiency is known to cause rickets, osteomalacia and hypocalcemia. Additionally, its deficiency has been associated [...]

In order to minimize complications on the skeleton and to prevent extraskeletal calcifications, the specific aims of the management of chronic kidney disease mineral and bone disorder (CKD-MBD) are to maintain blood levels of serum calcium and phosphorus as close to the normal range as possible, thereby maintaining serum parathyroid hormone (PTH) at levels appropriate for CKD stage, preventing hyperplasia of the parathyroid glands, avoiding the development of extra-skeletal calcifications, and preventing or reversing the accumulation of toxic substances such as aluminum and [β.sub.2]-microglobulin. In order to limit cardiovascular calcification, daily intake of elemental calcium, including from dietary sources and from phosphate binders, should not exceed twice the daily recommended intake for age and should not exceed 2.5 g/day. Calcium-free phosphate binders, such as sevelamer hydrochloride and sevelamer carbonate, are safe and effective alternatives to calcium-based binders, and their use widens the margin of safety for active vitamin D sterol therapy. Vitamin D deficiency is highly prevalent across the spectrum of CKD, and replacement therapy is recommended in vitamin D-deficient and insufficient individuals. Therapy with active vitamin D sterols is recommended after correction of the vitamin D deficiency state and should be titrated based on target PTH levels across the spectrum of CKD. Although the use of calcimimetic drugs has been proven to effectively control the biochemical features of secondary hyperparathyroidism, there is very limited experience with the use of such agents in pediatric patients and especially during the first years of life. Studies are needed to further define the role of such agents in the treatment of pediatric CKD-MBD. Keywords Parathyroid hormone * Bonehistomorphometry * Fibroblast growth factor 23 * Vitamin D, Introduction 'Chronic kidney disease mineral and bone disorder' (CKDMBD) is a systemic disorder of mineral and bone metabolism due to CKD that is manifested by either one or a combination [...]

Background/Objectives: Preterm infants are at risk for low vitamin D but documentation on late-preterm infants is sparse. This prospective study monitored longitudinally vitamin D and parathormone (PTH) levels in late-preterm formula fed infants during the first year of life, taking into consideration in utero and postnatal growth, and season and diet. Subjects/Methods: The study population comprised 128 infants of gestational age (GA) 32-36 weeks, of which 102 were appropriate (AGA) and the remaining 26 were small for GA (SGA). Serum levels of vitamin D (25(OH)D), PTH calcium, phosphate (P) and alkaline phosphate were estimated at 2 and 6 weeks, and at 3, 6, 9 and 12 months of age. Results: The 25(OH)D levels were relatively low at 2 and 6 weeks in both AGA and SGA infants (21 ± 11, 20 ± 7ng/ml and 25 [+ or -] 16, 23 ± 8ng/ml, respectively), but increased at 6 months (45 [+ or -] 14, 47 ± 10ng/ml) and remained stable thereafter. SGA infants had lower 25(OH)D levels at 9 and 12 months (AGA 45 ± 14, 47 ± 18ng/ml vs SGA 38 ± 13, 37 ± 13ng/ml, P Conclusions: Late-preterm, formula fed infants may have suboptimal vitamin D levels and elevated PTH, especially, during the first 3 months. Those born SGA may have lower vitamin D levels up to the end of the first year of life. European Journal of Clinical Nutrition (2012) 66, 224-230; doi: 10.1038/ejcn.2011.158; published online 7 September 2011 Keywords: vitamin D; parathormone; late-preterm infant; small for gestational age; catch-up growth, Introduction Most of the studies on vitamin D status in infants have focused on full-term, exclusively breast-fed infants and the American Academy of Pediatrics has recently increased the recommended vitamin [...]

BACKGROUND: Sunlight contains ultraviolet B (UVB) radiation (290-315 nm) that affects human health in both detrimental (skin cancers) and beneficial (vitamin D3) ways. Serum 25-hydroxy-vitamin D concentrations from young Americans [...]

ARTICLE INFO Keywords: Genistein aglycone BMD CTX b-ALP OPG sRANKL ABSTRACT Genistein aglycone (GEN) has a favorable effect on bone loss. We investigated the effects of GEN alone or in [...]