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Rathmann AM, Seifert R. Vitamin A-containing dietary supplements from German and US online pharmacies: market and risk assessment. NAUNYN-SCHMIEDEBERG'S ARCHIVES OF PHARMACOLOGY 2024; 397:6803-6820. [PMID: 38546747 DOI: 10.1007/s00210-024-03050-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Accepted: 03/12/2024] [Indexed: 09/25/2024]
Abstract
Vitamin A supplements are used by many people, and the number of newly registered dietary supplements is continuously increasing. The preparations fall under food law and are not subject to the strict controls of pharmaceuticals. Risk indications and maximum quantity recommendations, e.g., from the Bundesinstitut für Risikobewertung (BfR) and the U.S. Food and Drug Administration (FDA) are not binding, which means that overdoses and potentially serious health problems can easily occur. The hepatotoxicity and teratogenicity of vitamin A are well documented, and other negative effects of high doses of vitamin A are also being discussed. Nevertheless, preparations with exorbitantly high doses are freely available for sale and unrestricted. In this study, 75 supplements containing vitamin A available in Germany and 26 available in the USA were critically examined on the basis of various parameters such as the recommended daily dose according to the manufacturer, daily therapy costs (DTC), the presence of warnings about overdose, use during pregnancy and breastfeeding, and information on adverse effects/interactions. The aim was to gain insights into their risk potential and to examine the need for closer monitoring and stricter guidelines for these preparations. The results show some considerable country-specific differences. Overall, there are serious deficiencies in compliance with the labeling requirements for both the German and the US preparations, and the dosages are often far too high in view of the applicable expert recommendations. Overall, these deficits can pose a risk for consumers that is difficult to assess in its entirety, especially for vulnerable consumer groups. It should be noted that the US preparations perform better overall than the German preparations. This suggests better regulation of dietary supplements in the US market. Based on the available data and literature research, it is doubtful whether the intake of vitamin A-containing preparations, without a diagnosed vitamin A deficiency, has a positive health benefit. Furthermore, it should be examined whether vitamin A should continue to be offered over-the-counter as a food supplement.
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Affiliation(s)
| | - Roland Seifert
- Institute of Pharmacology, Hannover Medical School, D-30625, Hannover, Germany.
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2
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Garabedian C, Sibiude J, Anselem O, Attie-Bittach T, Bertholdt C, Blanc J, Dap M, de Mézerac I, Fischer C, Girault A, Guerby P, Le Gouez A, Madar H, Quibel T, Tardy V, Stirnemann J, Vialard F, Vivanti A, Sananès N, Verspyck E. [Fetal death: Expert consensus from the College of French Gynecologists and Obstetricians]. GYNECOLOGIE, OBSTETRIQUE, FERTILITE & SENOLOGIE 2024:S2468-7189(24)00261-7. [PMID: 39153884 DOI: 10.1016/j.gofs.2024.07.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/19/2024]
Abstract
Fetal death is defined as the spontaneous cessation of cardiac activity after fourteen weeks of amenorrhea. In France, the prevalence of fetal death after 22 weeks is between 3.2 and 4.4/1000 births. Regarding the prevention of fetal death in the general population, it is not recommended to counsel for rest and not to prescribe vitamin A, vitamin D nor micronutrient supplementation for the sole purpose of reducing the risk of fetal death (Weak recommendations; Low quality of evidence). It is not recommended to prescribe aspirin (Weak recommendation; Very low quality of evidence). It is recommended to offer vaccination against influenza in epidemic periods and against SARS-CoV-2 (Strong recommendations; Low quality of evidence). It is not recommended to systematically look for nuchal cord encirclements during prenatal screening ultrasounds (Strong Recommendation; Low Quality of Evidence) and not to perform systematic antepartum monitoring by cardiotocography (Weak Recommendation; Very Low Quality of Evidence). It is not recommended to ask women to perform an active fetal movement count to reduce the risk of fetal death (Strong Recommendation; High Quality of Evidence). Regarding evaluation in the event of fetal death, it is suggested that an external fetal examination be systematically offered (Expert opinion). It is recommended that a fetopathological and anatomopathological examination of the placenta be carried out to participate in cause identification (Strong Recommendation. Moderate quality of evidence). It is recommended that chromosomal analysis by microarray testing be performed rather than conventional karyotype, in order to be able to identify a potentially causal anomaly more frequently (Strong Recommendation, moderate quality of evidence); to this end, it is suggested that postnatal sampling of the placental fetal surface for genetic purposes be preferred (Expert Opinion). It is suggested to test for antiphospholipid antibodies and systematically perform a Kleihauer test and a test for irregular agglutinins (Expert opinion). It is suggested to offer a summary consultation, with the aim of assessing the physical and psychological status of the parents, reporting the results, discussing the cause and providing information on monitoring for a subsequent pregnancy (Expert opinion). Regarding announcement and support, it is suggested to announce fetal death without ambiguity, using simple words and adapting to each situation, and then to support couples with empathy in the various stages of their care (Expert opinion). Regarding management, it is suggested that, in the absence of a situation at risk of disseminated intravascular coagulation or maternal vitality, the patient's wishes should be taken into account when determining the time between the diagnosis of fetal death and induction of birth. Returning home is possible if it's the patient wish (Expert opinion). In all situations excluding maternal life-threatening emergencies, the preferred mode of delivery is vaginal delivery, regardless the history of cesarean section(s) history (Expert opinion). In the event of fetal death, it is recommended that mifepristone 200mg be prescribed at least 24hours before induction, to reduce the delay between induction and delivery (Low recommendation. Low quality of evidence). There are insufficient data in the literature to make a recommendation regarding the route of administration (vaginal or oral) of misoprostol, neither the type of prostaglandin to reduce induction-delivery time or maternal morbidity. It is suggested that perimedullary analgesia be introduced at the start of induction if the patient asks, regardless of gestational age. It is suggested to prescribe cabergoline immediately in the postpartum period in order to avoid lactation, whatever the gestational age, after discussing the side effects of the treatment with the patient (Expert opinion). The risk of recurrence of fetal death after unexplained fetal death does not appear to be increased in subsequent pregnancies, and data from the literature are insufficient to make a recommendation on the prescription of aspirin. In the event of a history of fetal death due to vascular issues, low-dose aspirin is recommended to reduce perinatal morbidity, and should not be combined with heparin therapy (Low recommendation, very low quality of evidence). It is suggested not to recommend an optimal delay before initiating another pregnancy just because of the history of fetal death. It is suggested that the woman and co-parent be informed of the possibility of psychological support. Fetal heart rate monitoring is not indicated solely because of a history of fetal death. It is suggested that delivery not be systematically induced. However, induction can be considered depending on the context and parental request. The gestational age will be discussed, taking into account the benefits and risks, especially before 39 weeks. If a cause of fetal death is identified, management will be adapted on a case-by-case basis (expert opinion). In the event of fetal death occurring in a twin pregnancy, it is suggested that the surviving twin be evaluated as soon as the diagnosis of fetal death is made. In the case of dichorionic pregnancy, it is suggested to offer ultrasound monitoring on a monthly basis. It is suggested not to deliver prematurely following fetal death of a twin. If fetal death occurs in a monochorionic twin pregnancy, it is suggested to contact the referral competence center, in order to urgently look for signs of acute fetal anemia on ultrasound in the surviving twin, and to carry out weekly ultrasound monitoring for the first month. It is suggested not to induce birth immediately.
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Affiliation(s)
| | - Jeanne Sibiude
- Service de gynécologie-obstétrique, hôpital Trousseau, AP-HP, Paris, France
| | - Olivia Anselem
- Maternité Port-Royal, groupe hospitalier Paris Centre, AP-HP, 75014 Paris, France
| | | | - Charline Bertholdt
- Pôle de gynécologie-obstétrique, pôle laboratoires, CHRU de Nancy, université de Lorraine, 54000 Nancy, France
| | - Julie Blanc
- Service de gynécologie-obstétrique, hôpital Nord, hôpitaux universitaires de Marseille, AP-HM, Marseille, France
| | - Matthieu Dap
- Pôle de gynécologie-obstétrique, pôle laboratoires, CHRU de Nancy, université de Lorraine, 54000 Nancy, France
| | | | - Catherine Fischer
- Service d'anesthésie, maternité Port-Royal, groupe hospitalier Paris Centre, AP-HP, Paris, France
| | - Aude Girault
- Maternité Port-Royal, groupe hospitalier Paris Centre, AP-HP, 75014 Paris, France
| | - Paul Guerby
- Service de gynécologie-obstétrique, CHU de Toulouse, Toulouse, France
| | - Agnès Le Gouez
- Service d'anesthésie, hôpital Antoine-Béclère, AP-HP, université Paris Saclay, Clamart, France
| | - Hugo Madar
- Service de gynécologie-obstétrique, CHU de Bordeaux, 33000 Bordeaux, France
| | - Thibaud Quibel
- Service de gynécologie-obstétrique, CHI de Poissy Saint-Germain-en-Laye, Poissy, France
| | - Véronique Tardy
- Direction des plateaux médicotechniques, hospices civils de Lyon, Lyon, France; Département de biochimie biologie moléculaire, université Claude-Bernard Lyon, Lyon, France
| | - Julien Stirnemann
- Service de gynécologie-obstétrique, hôpital Necker, AP-HP, Paris, France
| | - François Vialard
- Département de génétique, CHI de Poissy Saint-Germain-en-Laye, Poissy, France
| | - Alexandre Vivanti
- Service de gynécologie-obstétrique, DMU santé des femmes et des nouveau-nés, hôpital Antoine-Béclère, AP-HP, université Paris Saclay, Clamart, France
| | - Nicolas Sananès
- Service de gynécologie-obstétrique, hôpital américain, Neuilly-sur-Seine, France
| | - Eric Verspyck
- Service de gynécologie-obstétrique, CHU Charles-Nicolle, Rouen, France
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Lapauw B, Laurent MR, Rozenberg S, Body JJ, Bruyère O, Gielen E, Goemaere S, Iconaru L, Cavalier E. When and How to Evaluate Vitamin D Status? A Viewpoint from the Belgian Bone Club. Nutrients 2024; 16:2388. [PMID: 39125269 PMCID: PMC11313844 DOI: 10.3390/nu16152388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2024] [Revised: 07/09/2024] [Accepted: 07/11/2024] [Indexed: 08/12/2024] Open
Abstract
Low serum vitamin D levels have been associated with a variety of health conditions which has led the medical community but also the general population to evaluate vitamin D status quite liberally. Nevertheless, there remain questions about the efficacy and cost-effectiveness of such a broad and untargeted approach. This review therefore aims to summarize the current evidence and recommendations on when and how to evaluate vitamin D status in human health and disease. For the general population, most guidelines do not recommend universal screening but suggest a targeted approach in populations at risk. Also, some guidelines do not even recommend evaluating vitamin D status when vitamin D substitution is indicated anyway, such as in children or patients receiving anti-osteoporosis drugs. In those guidelines that recommend the screening of vitamin D status, serum 25(OH)D levels are universally proposed as the preferred screening tool. However, little attention is given to analytical considerations and almost no guidelines discuss the timing and frequency of screening. Finally, there is the known variability in diagnostic thresholds for defining vitamin D insufficiency and deficiency. Overall, the existing guidelines on the evaluation of vitamin D status differ broadly in screening strategy and screening implementation, and none of these guidelines discusses alternative screening modes, for instance, the vitamin metabolic ratio. Efforts to harmonize these different guidelines are needed to enhance their efficacy and cost-effectiveness.
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Affiliation(s)
- Bruno Lapauw
- Department of Endocrinology, Unit for Osteoporosis and Metabolic Bone Diseases, Ghent University Hospital, 9052 Ghent, Belgium;
- Department of Internal Medicine and Pediatrics, Ghent University, 9052 Ghent, Belgium
| | - Michaël R. Laurent
- Geriatrics Department, Imelda Hospital, 2820 Bonheiden, Belgium
- Centre for Metabolic Bone Diseases, University Hospitals Leuven, 3000 Leuven, Belgium;
| | - Serge Rozenberg
- Department of Obstetrics and Gynecology, CHU St Pierre, Brussels & Université Libre de Bruxelles, 1000 Bruxelles, Belgium;
| | - Jean-Jacques Body
- Department of Medicine, CHU Brugmann, Université Libre de Bruxelles, 1020 Brussels, Belgium; (J.-J.B.); (L.I.)
| | - Olivier Bruyère
- WHO Collaborating Center for Public Health Aspects of Musculoskeletal Health and Ageing, Research Unit in Public Health, Epidemiology and Health Economics, Department of Sport and Rehabilitation Sciences, University of Liège, 4000 Liège, Belgium;
| | - Evelien Gielen
- Centre for Metabolic Bone Diseases, University Hospitals Leuven, 3000 Leuven, Belgium;
- Geriatrics & Gerontology, Department of Public Health and Primary Care, KU Leuven, 3000 Leuven, Belgium
- Department of Geriatric Medicine, University Hospitals Leuven, 3000 Leuven, Belgium
| | - Stefan Goemaere
- Department of Endocrinology, Unit for Osteoporosis and Metabolic Bone Diseases, Ghent University Hospital, 9052 Ghent, Belgium;
- Department of Internal Medicine and Pediatrics, Ghent University, 9052 Ghent, Belgium
| | - Laura Iconaru
- Department of Medicine, CHU Brugmann, Université Libre de Bruxelles, 1020 Brussels, Belgium; (J.-J.B.); (L.I.)
| | - Etienne Cavalier
- Department of Clinical Chemistry, University of Liège, CIRM, CHU de Liège, 4000 Liège, Belgium;
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Turck D, Bohn T, Castenmiller J, de Henauw S, Hirsch‐Ernst K, Knutsen HK, Maciuk A, Mangelsdorf I, McArdle HJ, Pentieva K, Siani A, Thies F, Tsabouri S, Vinceti M, Lietz G, Passeri G, Craciun I, Fabiani L, Horvath Z, Valtueña Martínez S, Naska A. Scientific opinion on the tolerable upper intake level for preformed vitamin A and β-carotene. EFSA J 2024; 22:e8814. [PMID: 38846679 PMCID: PMC11154838 DOI: 10.2903/j.efsa.2024.8814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2024] Open
Abstract
Following two requests from the European Commission, the EFSA Panel on Nutrition, Novel Foods and Food Allergens (NDA) was asked to deliver a scientific opinion on the revision of the tolerable upper intake level (UL) for preformed vitamin A and β-carotene. Systematic reviews of the literature were conducted for priority adverse health effects of excess vitamin A intake, namely teratogenicity, hepatotoxicity and endpoints related to bone health. Available data did not allow to address whether β-carotene could potentiate preformed vitamin A toxicity. Teratogenicity was selected as the critical effect on which to base the UL for preformed vitamin A. The Panel proposes to retain the UL for preformed vitamin A of 3000 μg RE/day for adults. This UL applies to men and women, including women of child-bearing age, pregnant and lactating women and post-menopausal women. This value was scaled down to other population groups using allometric scaling (body weight0.75), leading to ULs between 600 μg RE/day (infants 4-11 months) and 2600 μg RE/day (adolescents 15-17 years). Based on available intake data, European populations are unlikely to exceed the UL for preformed vitamin A if consumption of liver, offal and products thereof is limited to once per month or less. Women who are planning to become pregnant or who are pregnant are advised not to consume liver products. Lung cancer risk was selected as the critical effect of excess supplemental β-carotene. The available data were not sufficient and suitable to characterise a dose-response relationship and identify a reference point; therefore, no UL could be established. There is no indication that β-carotene intake from the background diet is associated with adverse health effects. Smokers should avoid consuming food supplements containing β-carotene. The use of supplemental β-carotene by the general population should be limited to the purpose of meeting vitamin A requirements.
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5
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Ishaq MU, Kunwar D, Qadeer A, Komel A, Safi A, Malik A, Malik L, Akbar A. Effect of vitamin A on maternal, fetal, and neonatal outcomes: An overview of deficiency, excessive intake, and intake recommendations. Nutr Clin Pract 2024; 39:373-384. [PMID: 38030585 DOI: 10.1002/ncp.11096] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 10/29/2023] [Accepted: 11/05/2023] [Indexed: 12/01/2023] Open
Abstract
Vitamin A imbalance during pregnancy and lactation is a global public health concern with potentially negative consequences for fetuses and neonates. Inadequate vitamin A intake during this critical period can lead to anemia, weakened immune function, night blindness, and increased susceptibility to infections. Conversely, excessive intake of vitamin A can result in birth defects, hypercalcemia, and psychiatric symptoms. This review aims to identify risk factors contributing to vitamin A deficiency in pregnant women and its impact on maternal, fetal, and neonatal outcomes. It also examines the effects of high-dose vitamin A supplementation during pregnancy on offspring health. By analyzing existing literature and recommendations, the review emphasizes the significance of vitamin A in the development of various body systems and organs. It provides a comprehensive overview of the effects of vitamin A during pregnancy and lactation, encompassing deficiencies, excessive intake, and supplementation guidelines. The need for further research in this field is highlighted. In conclusion, maintaining a balanced vitamin A status is crucial during pregnancy to promote better outcomes for fetuses and newborns. Effective monitoring and intervention strategies are essential to address vitamin A deficiency and excess in pregnant women, thereby improving fetal and neonatal health.
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Affiliation(s)
| | - Digbijay Kunwar
- Department of Medicine, Nishtar Medical University, Multan, Pakistan
| | - Abdul Qadeer
- Department of Medicine, Nishtar Medical University, Multan, Pakistan
| | - Aqsa Komel
- Department of Medicine, Nishtar Medical University, Multan, Pakistan
| | - Adnan Safi
- Department of Medicine, Lahore General Hospital, Lahore, Pakistan
| | - Aqsa Malik
- Department of Medicine, Fatima Memorial College of Medicine and Dentistry, Lahore, Pakistan
| | - Linta Malik
- Department of Medicine, Nishtar Medical University, Multan, Pakistan
| | - Anum Akbar
- Department of Pediatrics, University of Nebraska Medical Centre, Omaha, Nebraska, USA
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6
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Hawkey AB, Shekey N, Dean C, Asrat H, Koburov R, Holloway ZR, Kullman SW, Levin ED. Developmental exposure to pesticides that disrupt retinoic acid signaling causes persistent retinoid and behavioral dysfunction in zebrafish. Toxicol Sci 2024; 198:246-259. [PMID: 38237923 DOI: 10.1093/toxsci/kfae001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/27/2024] Open
Abstract
Early developmental exposure to environmental toxicants may play a role in the risk for developing autism. A variety of pesticides have direct effects on retinoic acid (RA) signaling and as RA signaling has important roles in neurodevelopment, such compounds may cause developmental neurotoxicity through an overlapping adverse outcome pathway. It is hypothesized that a pesticide's embryonic effects on retinoid function may correspond with neurobehavioral disruption later in development. In the current studies, we determined the effects of RA-acting pesticides on neurobehavioral development in zebrafish. Buprofezin and imazalil caused generalized hypoactivity in the larval motility test, whereas chlorothalonil and endosulfan I led to selective hypoactivity and hyperactivity, respectively. With buprofezin, chlorothalonil, and imazalil, hypoactivity and/or novel anxiety-like behaviors persisted in adulthood and buprofezin additionally decreased social attraction responses in adulthood. Endosulfan I did not produce significant adult behavioral effects. Using qPCR analyses of adult brain tissue, we observed treatment-induced alterations in RA synthesis or catabolic genes, indicating persistent changes in RA homeostasis. These changes were compound-specific, with respect to expression directionality, and potential patterns of homeostatic disruption. Results suggest the likely persistence of disruptions in RA signaling well into adulthood and may represent compensatory mechanisms following early life stage exposures. This study demonstrates that early developmental exposure to environmental toxicants that interfere with RA signaling causes short as well as long-term behavioral disruption in a well-established zebrafish behavioral model and expand upon the meaning of the RA adverse outcome pathway, indicating that observed effects likely correspond with the nature of underlying homeostatic effects.
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Affiliation(s)
- Andrew B Hawkey
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina 27710, USA
- Department of Biomedical Sciences, Midwestern University, Downers Grove, Illinois 60515, USA
| | - Nathan Shekey
- Toxicology Program, North Carolina State University, Raleigh, North Carolina 27606, USA
| | - Cassandra Dean
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina 27710, USA
| | - Helina Asrat
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina 27710, USA
| | - Reese Koburov
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina 27710, USA
| | - Zade R Holloway
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina 27710, USA
| | - Seth W Kullman
- Toxicology Program, North Carolina State University, Raleigh, North Carolina 27606, USA
| | - Edward D Levin
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina 27710, USA
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Loser V, Baumgartner T, Legardeur H, Panchaud A, Théaudin M. Patisiran exposure in early pregnancy: a case report. Ther Adv Neurol Disord 2024; 17:17562864241239755. [PMID: 38532802 PMCID: PMC10964446 DOI: 10.1177/17562864241239755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Accepted: 02/28/2024] [Indexed: 03/28/2024] Open
Abstract
We describe here the first case of exposure to patisiran treatment, a small interfering RNA molecule, during early pregnancy of a 36-year-old woman with symptomatic hereditary transthyretin-related amyloidosis. There were no major complications during pregnancy and delivery, except for a postpartum hemorrhage due to uterine atony. Vitamin A levels had to be closely monitored during pregnancy, and vitamin A substitution adapted accordingly. There was no sign of minor or major congenital abnormalities of the baby. One month after delivery, the patient showed slight clinical and electrophysiological signs of neuropathy progression due to patisiran treatment withdrawal. Patisiran infusions were resumed 3 months after delivery. Due to the unknown teratogenic potential of patisiran, the risk of neuropathy worsening associated with withholding treatment must of course be weighed against a potential teratogenic risk of treatment during pregnancy. Vitamin A levels need to be closely assessed, and substitution must be adapted accordingly, to avoid embryofetal adverse outcome due to vitamin A deficiency or toxicity.
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Affiliation(s)
- Valentin Loser
- Service of Neurology, Department of Clinical Neurosciences, Lausanne University Hospital, University of Lausanne, Rue du Bugnon 44, Lausanne 1011, Switzerland
| | - Thomas Baumgartner
- Service of Neurology, Department of Clinical Neurosciences, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland
| | - Hélène Legardeur
- Woman–Mother–Child Department, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland
| | - Alice Panchaud
- Service of Pharmacy, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland
- Institute of Primary Health Care, University of Bern, Bern, Switzerland
| | - Marie Théaudin
- Service of Neurology, Department of Clinical Neurosciences, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland
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Forsby M, Winkvist A, Bärebring L, Augustin H. Supplement use in relation to dietary intake in pregnancy: an analysis of the Swedish GraviD cohort. Br J Nutr 2024; 131:256-264. [PMID: 37565530 PMCID: PMC10751946 DOI: 10.1017/s0007114523001794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 07/28/2023] [Accepted: 08/07/2023] [Indexed: 08/12/2023]
Abstract
We aimed to study supplement use in relation to dietary intake among pregnant women in Sweden, and adherence to the Nordic Nutrition Recommendations among supplement and non-supplement users. Pregnant women were recruited at registration to antenatal care in 2013–2014. In third trimester, supplement use was collected using a questionnaire, and dietary intake was collected using a FFQ. The majority (64 %) of the 1044 women reported use of one or more supplements. Among all, 0–23 % reported dietary intakes above recommended intake (RI) of vitamin D, folate, Fe and Se. Median dietary intakes of thiamine (1·4 v. 1·3 mg P = 0·013), phosphorus (1482 v. 1440 mg P = 0·007), folate (327 v. 316 µg P = 0·02), Fe (12 v. 11·5 mg P = 0·009), Mg (361 v. 346 mg P < 0·001) and Zn (10·7 v. 10·4 mg P = 0·01) were higher among supplement users compared with non-users. Larger proportions of supplement users than non-users adhered to RI of dietary intakes of thiamine (42 % v. 35 % P = 0·04) and Mg (75 % v. 69 % P = 0·05). Among non-users, a minority had dietary intakes above RI for vitamin D (6 %), folate (10 %) and Fe (21 %). The majority (75–100 %) of supplement users had total intakes above RI for most nutrients. In conclusion, supplement use contributed substantially to reaching RI for vitamin D, folate and Fe. Supplement users had a higher dietary intake of several nutrients than non-users. This highlights that non-supplement users are at risk of inadequate nutrient intakes during pregnancy, suggesting a need for heightened awareness of nutritional adequacy for pregnant women.
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Affiliation(s)
- Mathilda Forsby
- Institute of Medicine, University of Gothenburg, Gothenburg40530, Sweden
| | - Anna Winkvist
- Institute of Medicine, University of Gothenburg, Gothenburg40530, Sweden
| | - Linnea Bärebring
- Institute of Medicine, University of Gothenburg, Gothenburg40530, Sweden
| | - Hanna Augustin
- Institute of Medicine, University of Gothenburg, Gothenburg40530, Sweden
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9
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Maslin K, Hart KH, Shawe J. Tackling the dual burden of malnutrition in pregnancy - pregnancy after weight loss surgery. Proc Nutr Soc 2024:1-9. [PMID: 38240086 DOI: 10.1017/s0029665124000077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2024]
Abstract
The dual burden of malnutrition is characterised by the coexistence of undernutrition alongside overweight/obesity and diet-related noncommunicable diseases. It is a paradox which disproportionately affects women and is applicable to those who become pregnant after weight loss surgery. Obesity before and during pregnancy is associated with increased risk of adverse perinatal outcomes in both mother and child. Overall lifestyle interventions targeting weight loss in the preconception period have not proven effective, with people, and women in particular, increasingly seeking weight loss surgery. In women with severe obesity, surgery may normalise hormonal abnormalities and improve fertility. In those who become pregnant after surgery, evidence suggests a better overall obstetric outcome compared to those with severe obesity managed conservatively; however, there is heightened risk of maternal nutritional deficiencies and infants born small for gestational age. Specifically, pregnancy soon after surgery, in the catabolic phase when rapid weight loss is occurring, has the potential for poor outcomes. Lifelong micronutrient supplementation is required, and there is considerable risk of malnutrition if nutritional aftercare guidelines are not adhered to. It is therefore recommended that pregnancy is delayed until a stable weight is achieved and is supported by individualised advice from a multidisciplinary team. Further research is required to better understand how weight loss surgery affects the chances of having a healthy pregnancy and to ultimately improve nutritional management and patient care. In this review, we aim to summarise the evidence and guidance around nutrition during pregnancy after weight loss surgery.
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Affiliation(s)
- Kate Maslin
- School of Nursing and Midwifery, University of Plymouth, Plymouth, Devon, UK
- Musgrove Park Hospital, Taunton & Somerset NHS Foundation Trust, Taunton, UK
| | - Kathryn H Hart
- School of Biosciences, University of Surrey, Guildford, UK
| | - Jill Shawe
- School of Nursing and Midwifery, University of Plymouth, Plymouth, Devon, UK
- Royal Cornwall Hospitals NHS Trust, Truro, Cornwall, UK
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10
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Bohn T, Böhm V, Dulińska-Litewka J, Landrier JF, Bánáti D, Kucuk O, Borel P, Canas JA, Rühl R. Is vitamin A an antioxidant? INT J VITAM NUTR RES 2023; 93:481-482. [PMID: 35291873 DOI: 10.1024/0300-9831/a000752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
- Torsten Bohn
- Nutrition and Health Research Group, Department of Precision Health, Luxembourg Institute of Health, Strassen, Luxembourg
| | - Volker Böhm
- Institute of Nutritional Sciences, Friedrich Schiller University Jena, Germany
| | | | | | - Diána Bánáti
- Faculty of Engineering, University of Szeged, Hungary
| | - Omer Kucuk
- Department of Hematology and Medical Oncology, Emory University School of Medicine, Atlanta, Georgia
- Winship Cancer Institute of Emory University, Druid Hills, Georgia, USA
| | - Patrick Borel
- C2VN, INRAE, INSERM, Aix-Marseille University, Marseille, France
| | - Jose A Canas
- Division of Pediatric Endocrinology, John's Hopkins All Children's Hospital, Saint Petersburg, Florida, USA
| | - Ralph Rühl
- Paprika Bioanalytics BT, Debrecen, Hungary
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11
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Jyothish A, George A, Narayanan PV, Krishnamurthy RG. MSX1 Gene Polymorphisms in Patients with non-Syndromic Cleft lip and Palate: A Tertiary Care Centre Based Case-Control Study from Central Kerala. Cleft Palate Craniofac J 2023:10556656231214131. [PMID: 37968856 DOI: 10.1177/10556656231214131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2023] Open
Abstract
OBJECTIVE The purpose of this study was to investigate the contribution of MSX1 gene polymorphisms to the risk of developing NSCLP. DESIGN Case-Control Study. SETTING A tertiary care centre. PATIENTS/PARTICIPANTS The sample consisted of 200 subjects (100 cases and 100 controls). INTERVENTIONS None. MAIN OUTCOME MEASURE(S) Genotyping was performed by restriction fragment length polymorphism. Allele and genotype frequencies were calculated between patients and controls and analyzed using online Web Tools such as SISA and SNPstats. The MSX1 gene polymorphisms c. 799 GT, c.458 CA can be risk factors in the development of orofacial clefts. RESULTS In the cases, an association was found between NSCLP and c.799 and c.458 of the MSX1 gene when compared with the control. The dominant and overdominant models, c. 799 GT, c.458 CA genotypes and c. 799 T, c.458 A alleles in the population are said to be the main risk factors to develop the NSCLP in our study population. The genotype variation of c 799 G/T and c.458 C/A are revealed to be specifically contributing to an NSCLP-type Cleft lip and Palate. It is worth noting that NSCLP females in the study population showed a stronger association with heterozygous genotypes of c.799 and c.458. However, further investigation with a larger cohort is necessary to confirm these findings. CONCLUSION Overall the results of the study revealed that MSX1 c 799 G > T and c.458 C > A can be considered as one of the genetic risk factors in the formation of Non-Syndromic Cleft Lip and Palate in the study population.
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Affiliation(s)
- Arun Jyothish
- School of Biotechnology, National Institute of Technology Calicut, Calicut, Kerala, India
| | - Alex George
- Jubilee Centre for Medical Research, JMMC&RI, Thrissur, Kerala, India
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12
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Kolvenbach CM, Shril S, Hildebrandt F. The genetics and pathogenesis of CAKUT. Nat Rev Nephrol 2023; 19:709-720. [PMID: 37524861 DOI: 10.1038/s41581-023-00742-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/29/2023] [Indexed: 08/02/2023]
Abstract
Congenital anomalies of the kidney and urinary tract (CAKUT) comprise a large variety of malformations that arise from defective kidney or urinary tract development and frequently lead to kidney failure. The clinical spectrum ranges from severe malformations, such as renal agenesis, to potentially milder manifestations, such as vesicoureteral reflux. Almost 50% of cases of chronic kidney disease that manifest within the first three decades of life are caused by CAKUT. Evidence suggests that a large number of CAKUT are genetic in origin. To date, mutations in ~54 genes have been identified as monogenic causes of CAKUT, contributing to 12-20% of the aetiology of the disease. Pathogenic copy number variants have also been shown to cause CAKUT and can be detected in 4-11% of patients. Furthermore, environmental and epigenetic factors can increase the risk of CAKUT. The discovery of novel CAKUT-causing genes is challenging owing to variable expressivity, incomplete penetrance and variable genotype-phenotype correlation. However, such a discovery could ultimately lead to improvements in the accurate molecular genetic diagnosis, assessment of prognosis and multidisciplinary clinical management of patients with CAKUT, potentially including personalized therapeutic approaches.
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Affiliation(s)
- Caroline M Kolvenbach
- Department of Medicine, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Shirlee Shril
- Department of Medicine, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Friedhelm Hildebrandt
- Department of Medicine, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
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13
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Song C, Li T, Zhang C, Li S, Lu S, Zou Y. RA-induced prominence-specific response resulted in distinctive regulation of Wnt and osteogenesis. Life Sci Alliance 2023; 6:e202302013. [PMID: 37541848 PMCID: PMC10403638 DOI: 10.26508/lsa.202302013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2023] [Revised: 07/24/2023] [Accepted: 07/27/2023] [Indexed: 08/06/2023] Open
Abstract
Proper retinoic acid (RA) signaling is essential for normal craniofacial development. Both excessive RA and RA deficiency in early embryonic stage may lead to a variety of craniofacial malformations, for example, cleft palate, which have been investigated extensively. Dysregulated Wnt and Shh signaling were shown to underlie the pathogenesis of RA-induced craniofacial defects. In our present study, we showed a spatiotemporal-specific effect of RA signaling in regulating early development of facial prominences. Although inhibited Wnt activities was observed in E12.5/E13.5 mouse palatal shelves, early exposure of excessive RA induced Wnt signaling and Wnt-related gene expression in E11.5/E12.5 mouse embryonic frontonasal/maxillary processes. A conserved regulatory network of miR-484-Fzd5 was identified to play critical roles in RA-regulated craniofacial development using RNA-seq. In addition, subsequent osteogenic/chondrogenic differentiation were differentially regulated in discrete mouse embryonic facial prominences in response to early RA induction, demonstrated using both in vitro and in vivo analyses.
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Affiliation(s)
- Chao Song
- The Key Laboratory of Virology of Guangzhou, Jinan University, Guangzhou, China
| | - Ting Li
- The Key Laboratory of Virology of Guangzhou, Jinan University, Guangzhou, China
| | - Chunlei Zhang
- First Affiliated Hospital, Jinan University, Guangzhou, China
| | - Shufang Li
- The Key Laboratory of Virology of Guangzhou, Jinan University, Guangzhou, China
| | - Songhui Lu
- Southern Marine Science and Engineering Guangdong Laboratory (Zhuhai), Zhuhai, China
| | - Yi Zou
- The Key Laboratory of Virology of Guangzhou, Jinan University, Guangzhou, China
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14
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Kawai S, Pak K, Iwamoto S, Kawakami C, Inuzuka R, Maeda J, Furutani Y, Kamisago M, Takatsuki S, Uyeda T, Yamagishi H, Ito S, Kobayashi T. Association Between Maternal Factors in Early Pregnancy and Congenital Heart Defects in Offspring: The Japan Environment and Children's Study. J Am Heart Assoc 2023; 12:e029268. [PMID: 37642029 PMCID: PMC10547327 DOI: 10.1161/jaha.122.029268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2023] [Accepted: 08/01/2023] [Indexed: 08/31/2023]
Abstract
Background Many prenatal factors are reported to be associated with congenital heart defects (CHD) in offspring. However, these associations have not been adequately examined using large-scale birth cohorts. Methods and Results We evaluated a data set of the Japan Environmental and Children's Study. The primary outcome was a diagnosis of CHD by age 2 years. We defined the following variables as exposures: maternal baseline characteristics, fertilization treatment, maternal history of diseases, socioeconomic status, maternal alcohol intake, smoking, tea consumption, maternal dietary intake, and maternal medications and supplements up to 12 weeks of gestation. We used multivariable logistic regression analysis to assess the associations between various exposures and CHD in offspring. A total of 91 664 singletons were included, among which 1264 (1.38%) had CHD. In multivariable analysis, vitamin A supplements (adjusted odds ratio [aOR], 5.78 [95% CI, 2.30-14.51]), maternal use of valproic acid (aOR, 4.86 [95% CI, 1.51-15.64]), maternal use of antihypertensive agents (aOR, 3.80 [95% CI, 1.74-8.29]), maternal age ≥40 years (aOR, 1.59 [95% CI, 1.14-2.20]), and high maternal hemoglobin concentration in the second trimester (aOR, 1.10 per g/dL [95% CI, 1.03-1.17]) were associated with CHD in offspring. Conclusions Using a Japanese large-scale birth cohort study, we found 6 maternal factors to be associated with CHD in offspring.
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Affiliation(s)
- Shun Kawai
- Department of PediatricsYokohama City UniversityYokohamaJapan
| | - Kyongsun Pak
- Biostatistics Unit, Department of Data ScienceNational Center for Child Health and DevelopmentTokyoJapan
| | - Shintaro Iwamoto
- Biostatistics Unit, Department of Data ScienceNational Center for Child Health and DevelopmentTokyoJapan
| | | | - Ryo Inuzuka
- Department of PediatricsThe University of Tokyo HospitalTokyoJapan
| | - Jun Maeda
- Department of CardiologyTokyo Metropolitan Children’s Medical CenterTokyoJapan
| | - Yoshiyuki Furutani
- Department of Pediatric Cardiology and Adult Congenital CardiologyTokyo Women’s Medical UniversityTokyoJapan
| | - Mitsuhiro Kamisago
- Department of PediatricsNippon Medical School Tama Nagayama HospitalTokyoJapan
| | | | - Tomomi Uyeda
- Department of Pediatric CardiologySakakibara Heart InstituteTokyoJapan
| | | | - Shuichi Ito
- Department of PediatricsYokohama City UniversityYokohamaJapan
| | - Tohru Kobayashi
- Department of Data ScienceNational Center for Child Health and DevelopmentTokyoJapan
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15
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Holla S, Zamil DH, Paidisetty PS, Wang LK, Katta R. Using Artificial Intelligence to Assess the Teratogenic Risk of Vitamin A Supplements. Cureus 2023; 15:e45931. [PMID: 37885558 PMCID: PMC10599455 DOI: 10.7759/cureus.45931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/25/2023] [Indexed: 10/28/2023] Open
Abstract
Vitamin A in high doses has been found to be highly teratogenic, leading to severe fetal abnormalities if exposure occurs during pregnancy. Hence, prescription vitamin A acne medications like isotretinoin are highly regulated via programs such as iPledge, which intend to avert fetal exposure to isotretinoin and to educate healthcare providers, pharmacists, and patients about the significant risks associated with isotretinoin and its appropriate usage conditions. However, over-the-counter (OTC) vitamin A supplements are not subject to these requirements, and calculating the vitamin A content of these supplements can be difficult due to the lack of Food and Drug Administration (FDA) regulations and inconsistencies in labeling. If the necessary information is provided, ChatGPT, a generative artificial intelligence (AI) tool, can help the general public calculate the vitamin A content of supplements. Nonetheless, supplement manufacturers do not always provide the data necessary for these calculations.
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Affiliation(s)
- Swathi Holla
- Dermatology, Baylor College of Medicine, Houston, USA
| | - Dina H Zamil
- Dermatology, Baylor College of Medicine, Houston, USA
| | - Praneet S Paidisetty
- Dermatology, McGovern Medical School, The University of Texas Health Science Center, Houston, USA
| | - Leonard K Wang
- Dermatology, John Sealy School of Medicine, The University of Texas Medical Branch, Galveston, USA
| | - Rajani Katta
- Dermatology, McGovern Medical School, The University of Texas Health Science Center, Houston, USA
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16
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Akbar A, Duvall S, VanOrmer M, Slotkowski R, Hahka T, Genaro-Mattos T, Korade Z, Hanson C, Anderson Berry A, Thoene M. Plasma Retinol Concentrations and Dietary Intakes of Mother-Infant Sets in Singleton versus Twin Pregnancy. Nutrients 2023; 15:nu15112553. [PMID: 37299515 DOI: 10.3390/nu15112553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 05/26/2023] [Accepted: 05/29/2023] [Indexed: 06/12/2023] Open
Abstract
Vitamin A (retinol) is essential for normal fetal development, but the recommendation for maternal dietary intake (Retinol Activity Equivalent, RAE) does not differ for singleton vs. twin pregnancy, despite the limited evaluation of retinol status. Therefore, this study aimed to evaluate plasma retinol concentrations and deficiency status in mother-infant sets from singleton vs. twin pregnancies as well as maternal RAE intake. A total of 21 mother-infant sets were included (14 singleton, 7 twin). The HPLC and LC-MS/HS evaluated the plasma retinol concentration, and data were analyzed using the Mann-Whitney U test. Plasma retinol was significantly lower in twin vs. singleton pregnancies in both maternal (192.2 vs. 312.1 vs. mcg/L, p = 0.002) and umbilical cord (UC) samples (102.5 vs. 154.4 vs. mcg/L, p = 0.002). The prevalence of serum-defined vitamin A deficiency (VAD) <200.6 mcg/L was higher in twins vs. singletons for both maternal (57% vs. 7%, p = 0.031) and UC samples (100% vs. 0%, p < 0.001), despite a similar RAE intake (2178 vs. 1862 mcg/day, p = 0.603). Twin pregnancies demonstrated a higher likelihood of vitamin A deficiency in mothers, with an odds ratio of 17.3 (95% CI: 1.4 to 216.6). This study suggests twin pregnancy may be associated with VAD deficiency. Further research is needed to determine optimal maternal dietary recommendations during twin gestation.
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Affiliation(s)
- Anum Akbar
- Department of Pediatrics, University of Nebraska Medical Center, Omaha, NE 68198, USA
| | - Sarah Duvall
- College of Allied Health Professions, University of Nebraska Medical Center, Omaha, NE 68198, USA
| | - Matthew VanOrmer
- Department of Pediatrics, University of Nebraska Medical Center, Omaha, NE 68198, USA
| | - Rebecca Slotkowski
- Department of Pediatrics, University of Nebraska Medical Center, Omaha, NE 68198, USA
| | - Taija Hahka
- Department of Pediatrics, University of Nebraska Medical Center, Omaha, NE 68198, USA
| | - Thiago Genaro-Mattos
- Munroe Meyer Institute, University of Nebraska Medical Center, Omaha, NE 68198, USA
| | - Zeljka Korade
- Department of Pediatrics, University of Nebraska Medical Center, Omaha, NE 68198, USA
| | - Corrine Hanson
- College of Allied Health Professions, University of Nebraska Medical Center, Omaha, NE 68198, USA
| | - Ann Anderson Berry
- Department of Pediatrics, University of Nebraska Medical Center, Omaha, NE 68198, USA
| | - Melissa Thoene
- Department of Pediatrics, University of Nebraska Medical Center, Omaha, NE 68198, USA
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17
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Tan KML, Chee J, Lim KLM, Ng M, Gong M, Xu J, Tin F, Natarajan P, Lee BL, Ong CN, Tint MT, Kee MZL, Müller-Riemenschneider F, Gluckman PD, Meaney MJ, Kumar M, Karnani N, Eriksson JG, Nandanan B, Wyss A, Cameron-Smith D. Safety, Tolerability, and Pharmacokinetics of β-Cryptoxanthin Supplementation in Healthy Women: A Double-Blind, Randomized, Placebo-Controlled Clinical Trial. Nutrients 2023; 15:nu15102325. [PMID: 37242207 DOI: 10.3390/nu15102325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 05/04/2023] [Accepted: 05/09/2023] [Indexed: 05/28/2023] Open
Abstract
BACKGROUND β-cryptoxanthin is a dietary carotenoid for which there have been few studies on the safety and pharmacokinetics following daily oral supplementation. METHODS 90 healthy Asian women between 21 and 35 years were randomized into three groups: 3 and 6 mg/day oral β-cryptoxanthin, and placebo. At 2, 4, and 8 weeks of supplementation, plasma carotenoid levels were measured. The effects of β-cryptoxanthin on blood retinoid-dependent gene expression, mood, physical activity and sleep, metabolic parameters, and fecal microbial composition were investigated. RESULTS β-cryptoxanthin supplementation for 8 weeks (3 and 6 mg/day) was found to be safe and well tolerated. Plasma β-cryptoxanthin concentration was significantly higher in the 6 mg/day group (9.0 ± 4.1 µmol/L) compared to 3 mg/day group (6.0 ± 2.6 µmol/L) (p < 0.03), and placebo (0.4 ± 0.1 µmol/L) (p < 0.001) after 8 weeks. Plasma all-trans retinol, α-cryptoxanthin, α-carotene, β-carotene, lycopene, lutein, and zeaxanthin levels were not significantly changed. No effects were found on blood retinol-dependent gene expression, mood, physical activity and sleep, metabolic parameters, and fecal microbial composition. CONCLUSIONS Oral β-cryptoxanthin supplementation over 8 weeks lead to high plasma concentrations of β-cryptoxanthin, with no impact on other carotenoids, and was well tolerated in healthy women.
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Affiliation(s)
- Karen M L Tan
- Singapore Institute for Clinical Sciences, Agency for Science Technology and Research Singapore, Singapore 117609, Singapore
- Department of Laboratory Medicine, National University Hospital, Singapore 119074, Singapore
| | - Jolene Chee
- Singapore Institute for Clinical Sciences, Agency for Science Technology and Research Singapore, Singapore 117609, Singapore
| | - Kezlyn L M Lim
- Singapore Institute for Clinical Sciences, Agency for Science Technology and Research Singapore, Singapore 117609, Singapore
| | - Maisie Ng
- Singapore Institute for Clinical Sciences, Agency for Science Technology and Research Singapore, Singapore 117609, Singapore
- Bioinformatics Institute, Agency for Science Technology and Research Singapore, Singapore 138671, Singapore
| | - Min Gong
- Singapore Institute for Clinical Sciences, Agency for Science Technology and Research Singapore, Singapore 117609, Singapore
| | - Jia Xu
- Singapore Institute for Clinical Sciences, Agency for Science Technology and Research Singapore, Singapore 117609, Singapore
| | - Felicia Tin
- Singapore Institute for Clinical Sciences, Agency for Science Technology and Research Singapore, Singapore 117609, Singapore
| | - Padmapriya Natarajan
- Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, Singapore
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore 117549, Singapore
| | - Bee Lan Lee
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore 117549, Singapore
| | - Choon Nam Ong
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore 117549, Singapore
| | - Mya Thway Tint
- Singapore Institute for Clinical Sciences, Agency for Science Technology and Research Singapore, Singapore 117609, Singapore
- Human Potential Translational Research Program, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, Singapore
| | - Michelle Z L Kee
- Singapore Institute for Clinical Sciences, Agency for Science Technology and Research Singapore, Singapore 117609, Singapore
| | - Falk Müller-Riemenschneider
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore 117549, Singapore
- Digital Health Centre, Berlin Institute of Health, Charité-Universitätsmedizin Berlin, 10179 Berlin, Germany
| | - Peter D Gluckman
- Singapore Institute for Clinical Sciences, Agency for Science Technology and Research Singapore, Singapore 117609, Singapore
- Liggins Institute, University of Auckland, Auckland 1023, New Zealand
| | - Michael J Meaney
- Singapore Institute for Clinical Sciences, Agency for Science Technology and Research Singapore, Singapore 117609, Singapore
- Douglas Mental Health University Institute, McGill University, Montreal, QC H4H 1R3, Canada
| | - Mukkesh Kumar
- Singapore Institute for Clinical Sciences, Agency for Science Technology and Research Singapore, Singapore 117609, Singapore
- Bioinformatics Institute, Agency for Science Technology and Research Singapore, Singapore 138671, Singapore
| | - Neerja Karnani
- Singapore Institute for Clinical Sciences, Agency for Science Technology and Research Singapore, Singapore 117609, Singapore
- Bioinformatics Institute, Agency for Science Technology and Research Singapore, Singapore 138671, Singapore
- Department of Biochemistry, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, Singapore
| | - Johan G Eriksson
- Singapore Institute for Clinical Sciences, Agency for Science Technology and Research Singapore, Singapore 117609, Singapore
- Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, Singapore
- Human Potential Translational Research Program, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, Singapore
- Department of General Practice and Primary Health Care, University of Helsinki, 00100 Helsinki, Finland
- Folkhälsan Research Center, 00250 Helsinki, Finland
| | | | - Adrian Wyss
- DSM Nutritional Products Ltd., 4001 Basel, Switzerland
| | - David Cameron-Smith
- Singapore Institute for Clinical Sciences, Agency for Science Technology and Research Singapore, Singapore 117609, Singapore
- School of Environmental and Life Sciences, University of Newcastle, Callaghan, NSW 2308, Australia
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18
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Chaves MA, Ferreira LS, Baldino L, Pinho SC, Reverchon E. Current Applications of Liposomes for the Delivery of Vitamins: A Systematic Review. NANOMATERIALS (BASEL, SWITZERLAND) 2023; 13:nano13091557. [PMID: 37177102 PMCID: PMC10180326 DOI: 10.3390/nano13091557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Revised: 04/27/2023] [Accepted: 05/02/2023] [Indexed: 05/15/2023]
Abstract
Liposomes have been used for several decades for the encapsulation of drugs and bioactives in cosmetics and cosmeceuticals. On the other hand, the use of these phospholipid vesicles in food applications is more recent and is increasing significantly in the last ten years. Although in different stages of technological maturity-in the case of cosmetics, many products are on the market-processes to obtain liposomes suitable for the encapsulation and delivery of bioactives are highly expensive, especially those aiming at scaling up. Among the bioactives proposed for cosmetics and food applications, vitamins are the most frequently used. Despite the differences between the administration routes (oral for food and mainly dermal for cosmetics), some challenges are very similar (e.g., stability, bioactive load, average size, increase in drug bioaccessibility and bioavailability). In the present work, a systematic review of the technological advancements in the nanoencapsulation of vitamins using liposomes and related processes was performed; challenges and future perspectives were also discussed in order to underline the advantages of these drug-loaded biocompatible nanocarriers for cosmetics and food applications.
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Affiliation(s)
- Matheus A Chaves
- Laboratory of Encapsulation and Functional Foods (LEnAlis), Department of Food Engineering, School of Animal Science and Food Engineering, University of São Paulo, Av. Duque de Caxias Norte, 225, Pirassununga 13635900, SP, Brazil
- Laboratory of Molecular Morphophysiology and Development (LMMD), Department of Veterinary Medicine, School of Animal Science and Food Engineering, University of São Paulo, Av. Duque de Caxias Norte, 225, Pirassununga 13635900, SP, Brazil
| | - Letícia S Ferreira
- Laboratory of Encapsulation and Functional Foods (LEnAlis), Department of Food Engineering, School of Animal Science and Food Engineering, University of São Paulo, Av. Duque de Caxias Norte, 225, Pirassununga 13635900, SP, Brazil
| | - Lucia Baldino
- Department of Industrial Engineering, University of Salerno, Via Giovanni Paolo II, 132, 84084 Fisciano, Italy
| | - Samantha C Pinho
- Laboratory of Encapsulation and Functional Foods (LEnAlis), Department of Food Engineering, School of Animal Science and Food Engineering, University of São Paulo, Av. Duque de Caxias Norte, 225, Pirassununga 13635900, SP, Brazil
| | - Ernesto Reverchon
- Department of Industrial Engineering, University of Salerno, Via Giovanni Paolo II, 132, 84084 Fisciano, Italy
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19
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Liu C, Wang D, Jin L, Zhang J, Meng W, Jin L, Shang X. The relationship between maternal periconceptional micronutrient supplementation and non-syndromic cleft lip/palate in offspring. Birth Defects Res 2023; 115:545-554. [PMID: 36595654 DOI: 10.1002/bdr2.2146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 12/12/2022] [Accepted: 12/21/2022] [Indexed: 01/05/2023]
Abstract
BACKGROUND This study aimed to explore the relationship between maternal periconceptional supplementation with folic acid only (FAO) or with multiple micronutrients containing folic acid (MMFA) and non-syndromic cleft lip/palate in offspring. METHOD The data came from a prenatal health care system and a birth defects surveillance system in Beijing, China, from 2013 to 2018. Information on maternal FAO/MMFA supplementation was collected by questionnaire in the first trimester, and data on cleft lip/palate were collected at delivery or termination of pregnancy. Inverse probability weighting (IPW) by the propensity score to adjust for the confounders and Poisson regression model was used to estimate risk ratios (RRs) and their 95% confidence intervals (CIs). RESULTS A total of 63,969 participants were included in the study. Compared to the no-supplementation group, the adjusted RR for the supplementation group was 0.51 (95% CI: 0.40, 0.64). And the adjusted RRs for FAO and MMFA compared to the no-supplementation group were 0.56 (95% CI: 0.40, 0.76) and 0.48 (95% CI: 0.35, 0.65), respectively. Compared to supplement FAO and MMFA with less than 8 days out of 10 days, the adjusted RRs for FAO and MMFA with 8 or more days out of 10 days were 1.17 (95% CI: 0.78, 1.75), and 2.05 (95% CI: 1.37, 3.31), respectively. CONCLUSION Maternal supplementation with micronutrients, either FAO or MMFA, during the periconceptional period can reduce the risk for non-syndromic cleft lip/palate in offspring. However, women should be more cautious with MMFA supplementation.
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Affiliation(s)
- Chunyi Liu
- Institute of Reproductive and Child Health, National Health Commission Key Laboratory of Reproductive Health, Peking University, Beijing, China.,Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Di Wang
- Institute of Reproductive and Child Health, National Health Commission Key Laboratory of Reproductive Health, Peking University, Beijing, China.,Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Lei Jin
- Tongzhou Maternal and Child Health Hospital of Beijing, Beijing, China
| | - Jie Zhang
- Institute of Reproductive and Child Health, National Health Commission Key Laboratory of Reproductive Health, Peking University, Beijing, China.,Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Wenying Meng
- Tongzhou Maternal and Child Health Hospital of Beijing, Beijing, China
| | - Lei Jin
- Institute of Reproductive and Child Health, National Health Commission Key Laboratory of Reproductive Health, Peking University, Beijing, China.,Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Xuejun Shang
- Department of Andrology, Jinling Hospital, School of Medicine, Nanjing University, Nanjing, China.,Nanjing School of Clinical Medicine, Southern Medical University, Nanjing, China
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20
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Burlina S, Dalfrà MG, Lapolla A. Pregnancy after Bariatric Surgery: Nutrition Recommendations and Glucose Homeostasis: A Point of View on Unresolved Questions. Nutrients 2023; 15:nu15051244. [PMID: 36904243 PMCID: PMC10005384 DOI: 10.3390/nu15051244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 02/23/2023] [Accepted: 02/24/2023] [Indexed: 03/06/2023] Open
Abstract
Obesity is increasing in all age groups and, consequently, its incidence has also risen in women of childbearing age. In Europe, the prevalence of maternal obesity varies from 7 to 25%. Maternal obesity is associated with short- and long-term adverse outcomes for both mother and child, and it is necessary to reduce weight before gestation to improve maternal and fetal outcomes. Bariatric surgery is an important treatment option for people with severe obesity. The number of surgeries performed is increasing worldwide, even in women of reproductive age, because improving fertility is a motivating factor. Nutritional intake after bariatric surgery is dependent on type of surgery, presence of symptoms, such as pain and nausea, and complications. There is also a risk of malnutrition after bariatric surgery. In particular, during pregnancy following bariatric surgery, there is a risk of protein and calorie malnutrition and micronutrient deficiencies due to increased maternal and fetal demand and possibly due to reduction of food intake (nausea, vomiting). As such, it is necessary to monitor and manage nutrition in pregnancy following bariatric surgery with a multidisciplinary team to avoid any deficiencies in each trimester and to ensure the well-being of the mother and fetus.
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21
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Hvizdak M, Kandel SE, Work HM, Gracey EG, McCullough RL, Lampe JN. Per- and polyfluoroalkyl substances (PFAS) inhibit cytochrome P450 CYP3A7 through direct coordination to the heme iron and water displacement. J Inorg Biochem 2023; 240:112120. [PMID: 36638633 PMCID: PMC10016736 DOI: 10.1016/j.jinorgbio.2023.112120] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 12/17/2022] [Accepted: 01/01/2023] [Indexed: 01/05/2023]
Abstract
Per- and polyfluoroalkyl substances (PFAS) are a chemical class of highly stable, fluorinated compounds popular for use in a variety of consumer products. PFAS environmental persistence in drinking water contributes to acute exposure in humans and subsequent bioaccumulation of the compounds in the liver and lung tissue. Prenatal PFAS exposure has been associated with lowered birth weight, premature birth, and developmental defects including cranio-facial abnormalities. The cytochrome P450 enzyme CYP3A7 is responsible for facilitating a variety of reactions essential for proper fetal development in humans. In addition to drug metabolism, CYP3A7 is responsible for metabolizing endogenous ligands in the developing human liver, including the steroid precursor dehydroepiandrosterone 3-sulfate (DHEA-S), essential for estriol synthesis during pregnancy, along with the morphogen all-trans-retinoic acid (atRA). Interference with estriol synthesis during pregnancy, as well as atRA clearance, is known to result in similar effects associated with prenatal PFAS exposure including lowered birth weight, premature birth, and developmental defects. We hypothesized that PFAS compounds bind to the CYP3A7 enzyme resulting in its inhibition. We implemented a series of binding studies using spectral characterization of six PFAS compounds (PFOA, PFOS, GenX, PFNA, PFNS, and PFHxS), and evaluated their interactions with recombinant CYP3A7. In addition, we screened PFAS for their ability to inhibit CYP3A7 oxidative activity using dibenzylfluorescein, a fluorescent probe, and DHEA-S, an endogenous substrate of CYP3A7. Our data demonstrate that of the six PFAS tested, PFOA, PFOS, PFNA, and PFHxS bind to and inhibit CYP3A7.
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Affiliation(s)
- Michaela Hvizdak
- Department of Pharmaceutical Sciences, Skaggs School of Pharmacy and Pharmaceutical Sciences, University of Colorado Anschutz Medical Campus, Aurora, CO, United States of America
| | - Sylvie E Kandel
- Department of Pharmaceutical Sciences, Skaggs School of Pharmacy and Pharmaceutical Sciences, University of Colorado Anschutz Medical Campus, Aurora, CO, United States of America
| | - Hannah M Work
- Department of Pharmaceutical Sciences, Skaggs School of Pharmacy and Pharmaceutical Sciences, University of Colorado Anschutz Medical Campus, Aurora, CO, United States of America
| | - Emily G Gracey
- Department of Pharmaceutical Sciences, Skaggs School of Pharmacy and Pharmaceutical Sciences, University of Colorado Anschutz Medical Campus, Aurora, CO, United States of America
| | - Rebecca L McCullough
- Department of Pharmaceutical Sciences, Skaggs School of Pharmacy and Pharmaceutical Sciences, University of Colorado Anschutz Medical Campus, Aurora, CO, United States of America
| | - Jed N Lampe
- Department of Pharmaceutical Sciences, Skaggs School of Pharmacy and Pharmaceutical Sciences, University of Colorado Anschutz Medical Campus, Aurora, CO, United States of America; Structural Biology and Biochemistry Program, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, United States of America.
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22
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Kittleson MM, DeFilippis EM, Bhagra CJ, Casale JP, Cauldwell M, Coscia LA, D'Souza R, Gaffney N, Gerovasili V, Ging P, Horsley K, Macera F, Mastrobattista JM, Paraskeva MA, Punnoose LR, Rasmusson KD, Reynaud Q, Ross HJ, Thakrar MV, Walsh MN. Reproductive health after thoracic transplantation: An ISHLT expert consensus statement. J Heart Lung Transplant 2023; 42:e1-e42. [PMID: 36528467 DOI: 10.1016/j.healun.2022.10.009] [Citation(s) in RCA: 17] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Accepted: 10/10/2022] [Indexed: 11/16/2022] Open
Abstract
Pregnancy after thoracic organ transplantation is feasible for select individuals but requires multidisciplinary subspecialty care. Key components for a successful pregnancy after lung or heart transplantation include preconception and contraceptive planning, thorough risk stratification, optimization of maternal comorbidities and fetal health through careful monitoring, and open communication with shared decision-making. The goal of this consensus statement is to summarize the current evidence and provide guidance surrounding preconception counseling, patient risk assessment, medical management, maternal and fetal outcomes, obstetric management, and pharmacologic considerations.
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Affiliation(s)
- Michelle M Kittleson
- Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California.
| | - Ersilia M DeFilippis
- Division of Cardiology, New York Presbyterian-Columbia University Irving Medical Center, New York, New York
| | - Catriona J Bhagra
- Department of Cardiology, Cambridge University and Royal Papworth NHS Foundation Trusts, Cambridge, UK
| | - Jillian P Casale
- Department of Pharmacy Services, University of Maryland Medical Center, Baltimore, Maryland
| | - Matthew Cauldwell
- Department of Obstetrics, Maternal Medicine Service, St George's Hospital, London, UK
| | - Lisa A Coscia
- Transplant Pregnancy Registry International, Gift of Life Institute, Philadelphia, Pennsylvania
| | - Rohan D'Souza
- Division of Maternal and Fetal Medicine, Department of Obstetrics and Gynecology, McMaster University, Hamilton, Ontario, Canada
| | - Nicole Gaffney
- Lung Transplant Service, Alfred Hospital, Melbourne, Australia; Department of Medicine, Central Clinical School, Monash University, Melbourne, Australia
| | | | - Patricia Ging
- Department of Pharmacy, Mater Misericordiae University Hospital, Dublin, Ireland
| | - Kristin Horsley
- Department of Obstetrics and Gynecology, McMaster University, Hamilton, Ontario, Canada
| | - Francesca Macera
- De Gasperis Cardio Center and Transplant Center, Niguarda Hospital, Milan, Italy; Dept of Cardiology, Cliniques Universitaires de Bruxelles - Hôpital Erasme, Brussels, Belgium
| | - Joan M Mastrobattista
- Department of Obstetrics & Gynecology, Division of Maternal-Fetal Medicine, Baylor College of Medicine Houston, Texas
| | - Miranda A Paraskeva
- Lung Transplant Service, Alfred Hospital, Melbourne, Australia; Department of Medicine, Central Clinical School, Monash University, Melbourne, Australia
| | - Lynn R Punnoose
- Vanderbilt Heart and Vascular Institute, Vanderbilt University Medical Center, Nashville, Tennessee
| | | | - Quitterie Reynaud
- Cystic Fibrosis Adult Referral Care Centre, Department of Internal Medicine, Hospices civils de Lyon, Pierre Bénite, France
| | - Heather J Ross
- Peter Munk Cardiac Centre of the University Health Network, Toronto, Ontario, Canada; Ted Rogers Centre for Heart Research, Toronto, Ontario, Canada; University of Toronto, Toronto, Ontario, Canada
| | - Mitesh V Thakrar
- Department of Medicine, Division of Respirology, University of Calgary, Calgary, Alberta, Canada
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23
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Deepak Kumar K, Huntriss R, Green E, Bora S, Pettitt C. Development of a nutrition screening tool to identify need for dietetic intervention in female infertility. J Hum Nutr Diet 2023; 36:154-168. [PMID: 35762584 PMCID: PMC10087620 DOI: 10.1111/jhn.13055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Revised: 06/11/2022] [Accepted: 06/13/2022] [Indexed: 01/19/2023]
Abstract
BACKGROUND One in seven couples are impacted by infertility in the UK, and female infertility is often associated with several health conditions impacted by nutrition. Despite many studies aimed at identifying the critical role of nutrition in infertility, there is currently no screening tool that identifies nutritional risk factors for infertility. AIM To propose a self-administered screening tool to identify women who would benefit from nutritional intervention to promote fertility. METHODS A narrative review was carried out to identify and summarise modifiable nutritional risk factors that can influence female fertility, including comorbidities that can influence nutrition intake, absorption, and metabolism. KEY FINDINGS A nutrition screening tool outlining modifiable nutrition risk factors potentially improving female fertility has been proposed, comprising of BMI, medical history and quality of diet and lifestyle which would aid in designing evidence based dietetic services for female infertility.
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Affiliation(s)
| | | | | | | | - Claire Pettitt
- Nutrition and Dietetic Research Group, Faculty of Medicine, Imperial College London, UK
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24
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Meiss LN, Jain R, Kazmerski TM. Family Planning and Reproductive Health in Cystic Fibrosis. Clin Chest Med 2022; 43:811-820. [PMID: 36344082 DOI: 10.1016/j.ccm.2022.06.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Family planning in cystic fibrosis (CF) is an increasingly important aspect of care, as improvements in care and outcomes lead to a rise in the number of pregnancies and parenthood in people with CF. This article highlights: (1) Health considerations for people with CF related to pregnancy, contraception, and parenthood. (2) Facets of reproductive planning, fertility, and preconception counseling. (3) Relationship-centered reproductive health discussions.
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Affiliation(s)
- Lauren N Meiss
- Department of Obstetrics, Gynecology, and Reproductive Sciences, Yale School of Medicine, 20 York Street, New Haven, CT 06510, USA
| | - Raksha Jain
- Department of Medicine, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX 75390-8558, USA
| | - Traci M Kazmerski
- Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA; Center for Innovative Research on Gender Health Equity (CONVERGE), University of Pittsburgh, Pittsburgh, PA, USA.
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25
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Paidisetty PS, Wang LK, Zamil DH, Fu S, Nawas ZY. Isotretinoin, Vitamin A Supplements, and Unintended Pregnancies in Post Roe v. Wade America. Cureus 2022; 14:e31442. [DOI: 10.7759/cureus.31442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/13/2022] [Indexed: 11/15/2022] Open
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26
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Zamil DH, Ameri M, Fu S, Abughosh FM, Katta R. Skin, hair, and nail supplements advertised on Instagram. Proc AMIA Symp 2022; 36:38-40. [PMID: 36578583 PMCID: PMC9762852 DOI: 10.1080/08998280.2022.2124767] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Teens and young adults increasingly utilize social media for health information. Dermatologic supplements, advertised on social media, may be pharmacologically active and risk adverse effects. Instagram was searched, and 100 posts from March 2021 were evaluated for ingredients, health claims, account verification status, and endorsements. Only 4% of posts were made by verified accounts, and 1% of posts contained a visible Supplement Facts label. The Food and Drug Administration does not regulate dietary supplements. Ingredients such as vitamin A found in posts can pose teratogenic risk. Other potentially dangerous ingredients included saw palmetto and biotin. To accurately counsel patients who may retrieve health information from Instagram, it is important for practitioners to be familiar with social media claims.
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Affiliation(s)
| | - May Ameri
- McGovern Medical School, The University of Texas Health Science Center, Houston, Texas
| | - Shangyi Fu
- Baylor College of Medicine, Houston, Texas
| | | | - Rajani Katta
- McGovern Medical School, The University of Texas Health Science Center, Houston, Texas,Corresponding author: Rajani Katta, MD, Katta Dermatology, 6750 West Loop South, Suite 695, Bellaire, TX77401 (e-mail: )
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27
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Nhieu J, Lin YL, Wei LN. CRABP1 in Non-Canonical Activities of Retinoic Acid in Health and Diseases. Nutrients 2022; 14:nu14071528. [PMID: 35406141 PMCID: PMC9003107 DOI: 10.3390/nu14071528] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 04/01/2022] [Accepted: 04/03/2022] [Indexed: 12/30/2022] Open
Abstract
In this review, we discuss the emerging role of Cellular Retinoic Acid Binding Protein 1 (CRABP1) as a mediator of non-canonical activities of retinoic acid (RA) and relevance to human diseases. We first discuss the role of CRABP1 in regulating MAPK activities and its implication in stem cell proliferation, cancers, adipocyte health, and neuro-immune regulation. We then discuss an additional role of CRABP1 in regulating CaMKII activities, and its implication in heart and motor neuron diseases. Through molecular and genetic studies of Crabp1 knockout (CKO) mouse and culture models, it is established that CRABP1 forms complexes with specific signaling molecules to function as RA-regulated signalsomes in a cell context-dependent manner. Gene expression data and CRABP1 gene single nucleotide polymorphisms (SNPs) of human cancer, neurodegeneration, and immune disease patients implicate the potential association of abnormality in CRABP1 with human diseases. Finally, therapeutic strategies for managing certain human diseases by targeting CRABP1 are discussed.
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Affiliation(s)
| | | | - Li-Na Wei
- Correspondence: ; Tel.: +1-612-6259-402
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28
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Maurya VK, Shakya A, Bashir K, Kushwaha SC, McClements DJ. Vitamin A fortification: Recent advances in encapsulation technologies. Compr Rev Food Sci Food Saf 2022; 21:2772-2819. [PMID: 35384290 DOI: 10.1111/1541-4337.12941] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 02/14/2022] [Accepted: 02/22/2022] [Indexed: 11/26/2022]
Abstract
Vitamin A is an essential micronutrient whose deficiency is still a major health concern in many regions of the world. It plays an essential role in human growth and development, immunity, and vision, but may also help prevent several other chronic diseases. The total amount of vitamin A in the human diet often falls below the recommended dietary allowance of approximately 900-1000 μ $ \umu $ g/day for a healthy adult. Moreover, a significant proportion of vitamin A may be degraded during food processing, storage, and distribution, thereby reducing its bioactivity. Finally, the vitamin A in some foods has a relatively low bioavailability, which further reduces its efficacy. The World Health Organization has recommended fortification of foods and beverages as a safe and cost-effective means of addressing vitamin A deficiency. However, there are several factors that must be overcome before effective fortified foods can be developed, including the low solubility, chemical stability, and bioavailability of this oil-soluble vitamin. Consequently, strategies are required to evenly disperse the vitamin throughout food matrices, to inhibit its chemical degradation, to avoid any adverse interactions with any other food components, to ensure the food is palatable, and to increase its bioavailability. In this review article, we discuss the chemical, physical, and nutritional attributes of vitamin A, its main dietary sources, the factors contributing to its current deficiency, and various strategies to address these deficiencies, including diet diversification, biofortification, and food fortification.
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Affiliation(s)
- Vaibhav Kumar Maurya
- Centre for Food Research and Analysis, National Institute of Food Technology Entrepreneurship and Management, Haryana, India
| | - Amita Shakya
- Agriculture and Environmental Sciences, National Institute of Food Technology Entrepreneurship and Management, Haryana, India.,Division of Biotechnology, Cytogene Research & Development, Lucknow, India
| | - Khalid Bashir
- Department of Food Technology, Jamia Hamdard, New Delhi, India
| | - Satish Chand Kushwaha
- Centre for Food Research and Analysis, National Institute of Food Technology Entrepreneurship and Management, Haryana, India
| | - David Julian McClements
- Department of Food Science, University of Massachusetts, Amherst, Massachusetts, USA.,Department of Food Science & Bioengineering, Zhejiang Gongshang University, Hangzhou, Zhejiang, China
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29
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O’Connor C, Varshosaz P, Moise AR. Mechanisms of Feedback Regulation of Vitamin A Metabolism. Nutrients 2022; 14:nu14061312. [PMID: 35334970 PMCID: PMC8950952 DOI: 10.3390/nu14061312] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 03/15/2022] [Accepted: 03/17/2022] [Indexed: 02/06/2023] Open
Abstract
Vitamin A is an essential nutrient required throughout life. Through its various metabolites, vitamin A sustains fetal development, immunity, vision, and the maintenance, regulation, and repair of adult tissues. Abnormal tissue levels of the vitamin A metabolite, retinoic acid, can result in detrimental effects which can include congenital defects, immune deficiencies, proliferative defects, and toxicity. For this reason, intricate feedback mechanisms have evolved to allow tissues to generate appropriate levels of active retinoid metabolites despite variations in the level and format, or in the absorption and conversion efficiency of dietary vitamin A precursors. Here, we review basic mechanisms that govern vitamin A signaling and metabolism, and we focus on retinoic acid-controlled feedback mechanisms that contribute to vitamin A homeostasis. Several approaches to investigate mechanistic details of the vitamin A homeostatic regulation using genomic, gene editing, and chromatin capture technologies are also discussed.
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Affiliation(s)
- Catherine O’Connor
- MD Program, Northern Ontario School of Medicine, 317-MSE Bldg., 935 Ramsey Lake Rd., Sudbury, ON P3E 2C6, Canada;
| | - Parisa Varshosaz
- Biology and Biomolecular Sciences Ph.D. Program, Northern Ontario School of Medicine, Laurentian University, Sudbury, ON P3E 2C6, Canada;
| | - Alexander R. Moise
- Medical Sciences Division, Northern Ontario School of Medicine, 317-MSE Bldg., 935 Ramsey Lake Rd., Sudbury, ON P3E 2C6, Canada
- Department of Chemistry and Biochemistry, Biology and Biomolecular Sciences Program, Laurentian University, Sudbury, ON P3E 2C6, Canada
- Correspondence: ; Tel.: +1-705-662-7253
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30
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Ayub A, Sadiq H, Ijaz R. Patterns of orofacial clefts and associated risk factors in Pakistan: An institutional experience. JOURNAL OF CLEFT LIP PALATE AND CRANIOFACIAL ANOMALIES 2022. [DOI: 10.4103/jclpca.jclpca_1_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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31
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Wang N, Xie M, Lei G, Zeng C, Yang T, Yang Z, Wang Y, Li J, Wei J, Tian J, Yang T. A Cross-Sectional Study of Association between Plasma Selenium Levels and the Prevalence of Osteoarthritis: Data from the Xiangya Osteoarthritis Study. J Nutr Health Aging 2022; 26:197-202. [PMID: 35166315 DOI: 10.1007/s12603-022-1739-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
OBJECTIVES Selenium plays an indispensable role in antioxidant and antiinflammation processes. Oxidative stress and inflammation have been hypothesized to be involved in the pathogenesis of cartilage degeneration. We sought to examine the association between plasma selenium levels and the prevalence of radiographic osteoarthritis (ROA). DESIGN A population-based cross-sectional study. SETTING AND PARTICIPANTS Individuals aged ≥ 50 years were retrieved from the Xiangya Osteoarthritis (XO) Study, a community-based study conducted among the residents of the rural areas of China. METHODS Plasma selenium concentration was measured by inductively coupled plasma-dynamic reaction cell-mass spectrometry. ROA was defined as Kellgren/Lawrence score ≥ 2 in at least one knee, hip or hand joint. The association between plasma selenium levels and ROA was evaluated by applying logistic and spline regression. RESULTS A total of 1,032 subjects (women: 52.5%; mean age: 63.1 years; ROA prevalence: 45.4%) were included. Compared with the highest tertile, the odds ratios (ORs) for ROA were 1.24 (95% confidence interval [CI]: 0.91 to 1.68) and 1.77 (95% CI: 1.31 to 2.40) in the middle and lowest tertile of plasma selenium, respectively (P for trend<0.05). The results were not changed materially with adjustment of potential confounders. In addition, subjects who had lower plasma selenium levels exhibited a higher prevalence of ROA in a dose-response relationship manner (P=0.005). CONCLUSION This study suggests that subjects with lower levels of plasma selenium exhibited a higher prevalence of ROA in a dose-response relationship manner. However, additional studies are still needed to verify the potential causal relationship.
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Affiliation(s)
- N Wang
- Tuo Yang, Health Management Center, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, Hunan, China, 410008, Tel: 18711019415, E-mail: ; Jian Tian, Department of Orthopaedics, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, Hunan, China, 410008, Tel: 15116331787, E-mail:
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32
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Barber MS, Barrett R, Bradley RD, Walker E. A naturopathic treatment approach for mild and moderate COVID-19: A retrospective chart review. Complement Ther Med 2021; 63:102788. [PMID: 34748955 PMCID: PMC8570825 DOI: 10.1016/j.ctim.2021.102788] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Revised: 10/08/2021] [Accepted: 11/03/2021] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVES The coronavirus disease 2019 (COVID-19) pandemic has led to significant morbidity and mortality. Although COVID-19 vaccination is available, therapeutic options are still needed. The goal of the present manuscript is to report on a treatment strategy used in a naturopathic medical practice for mild and moderate COVID-19. DESIGN A retrospective chart review was conducted of 30 consecutive patients diagnosed with mild and moderate COVID-19 who were provided multi-nutrient, herbal, and probiotic treatment in a rural, out-patient, naturopathic primary care setting. MAIN OUTCOMES MEASURES The primary outcome was treatment safety; secondary outcomes included changes in symptoms, progression to severe COVID-19, incidence of long COVID, and recovery time. RESULTS No side effects or adverse events were reported from treatment and all patients experienced resolution of symptoms presumed to be associated with COVID-19 infection. One patient who had been ill for 28 days prior to presentation was hospitalized. Five patients had an illness duration of more than one month. Time to treatment was correlated with duration of illness post-treatment (r = 0.63, p < 0.001) and more symptoms at presentation was correlated with a longer duration of illness (r = 0.52, p < 0.01). CONCLUSIONS In this retrospective chart review, a multi-nutrient, herbal, and probiotic therapeutic approach for mild and moderate COVID-19 appeared to be well-tolerated. Delay in seeking treatment after symptom onset, as well as more symptoms at presentation, were correlated with a longer duration of illness. This treatment strategy may have clinical benefit, warranting prospective clinical trials with confirmed COVID-19 cases.
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Affiliation(s)
- Melissa S Barber
- National University of Natural Medicine, Helfgott Research Institute, 2220 SW 1st Ave, Portland, OR, United States.
| | - Richard Barrett
- National University of Natural Medicine, Helfgott Research Institute, 2220 SW 1st Ave, Portland, OR, United States.
| | - Ryan D Bradley
- National University of Natural Medicine, Helfgott Research Institute, 2220 SW 1st Ave, Portland, OR, United States.
| | - Erin Walker
- Canby Clinic, 452 NW 1st Ave, Canby, OR, United States.
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Abstract
Vitamin and mineral supplement consumption is widespread. They are taken for a variety of conditions, including dermatologic disorders. Although consumers often assume these supplements are safe, excessive consumption of supplements may have deleterious effects. Such vitamin supplements include vitamin A, niacin, biotin, vitamin D, and vitamin E, and specific mineral supplements include zinc, copper, and iron. These supplements may have a number of potential adverse effects.
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Affiliation(s)
- Freidrich Anselmo
- Department of Dermatology, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Marcia S Driscoll
- Department of Dermatology, University of Maryland School of Medicine, Baltimore, Maryland, USA.
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34
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Wiesinger A, Boink GJJ, Christoffels VM, Devalla HD. Retinoic acid signaling in heart development: Application in the differentiation of cardiovascular lineages from human pluripotent stem cells. Stem Cell Reports 2021; 16:2589-2606. [PMID: 34653403 PMCID: PMC8581056 DOI: 10.1016/j.stemcr.2021.09.010] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 09/16/2021] [Accepted: 09/17/2021] [Indexed: 11/29/2022] Open
Abstract
Retinoic acid (RA) signaling plays an important role during heart development in establishing anteroposterior polarity, formation of inflow and outflow tract progenitors, and growth of the ventricular compact wall. RA is also utilized as a key ingredient in protocols designed for generating cardiac cell types from pluripotent stem cells (PSCs). This review discusses the role of RA in cardiogenesis, currently available protocols that employ RA for differentiation of various cardiovascular lineages, and plausible transcriptional mechanisms underlying this fate specification. These insights will inform further development of desired cardiac cell types from human PSCs and their application in preclinical and clinical research.
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Affiliation(s)
- Alexandra Wiesinger
- Department of Medical Biology, Amsterdam University Medical Centers, Meibergdreef 9, 1105 AZ Amsterdam, the Netherlands
| | - Gerard J J Boink
- Department of Medical Biology, Amsterdam University Medical Centers, Meibergdreef 9, 1105 AZ Amsterdam, the Netherlands; Department of Cardiology, Amsterdam University Medical Centers, Meibergdreef 9, 1105 AZ Amsterdam, the Netherlands
| | - Vincent M Christoffels
- Department of Medical Biology, Amsterdam University Medical Centers, Meibergdreef 9, 1105 AZ Amsterdam, the Netherlands
| | - Harsha D Devalla
- Department of Medical Biology, Amsterdam University Medical Centers, Meibergdreef 9, 1105 AZ Amsterdam, the Netherlands.
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35
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Billiauws L, Ceccaldi PF, Joly F. Nutrition parentérale et grossesse. NUTR CLIN METAB 2021. [DOI: 10.1016/j.nupar.2021.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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36
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Li Y, Tajima A, Mattie FJ, Green MH, Ross AC. Pregnancy and Lactation Alter Vitamin A Metabolism and Kinetics in Rats under Vitamin A-Adequate Dietary Conditions. Nutrients 2021; 13:2853. [PMID: 34445012 PMCID: PMC8401525 DOI: 10.3390/nu13082853] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Revised: 08/13/2021] [Accepted: 08/18/2021] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Vitamin A (VA) plays critical roles in prenatal and postnatal development; however, limited information is available regarding maternal VA metabolism during pregnancy and lactation. OBJECTIVES We investigated the impact of pregnancy and lactation on VA metabolism and kinetics in rats, hypothesizing that changes in physiological status would naturally perturb whole-body VA kinetics. METHODS Eight-week old female rats (n = 10) fed an AIN-93G diet received an oral tracer dose of 3H-labeled retinol to initiate the kinetic study. On d 21 after dosing, six female rats were mated. Serial blood samples were collected from each female rat at selected times after dose administration until d 14 of lactation. Model-based compartmental analysis was applied to the plasma tracer data to develop VA kinetic models. RESULTS Our compartmental model revealed that pregnancy resulted in a gradual increase in hepatic VA mobilization, presumably to support different stages of fetal development. Additionally, the model indicates that during lactation, VA derived from dietary intake was the primary source of VA delivered to the mammary gland for milk VA secretion. CONCLUSION During pregnancy and lactation in rats with an adequate VA intake and previous VA storage, the internal redistribution of VA and increased uptake from diet supported the maintenance of VA homeostasis.
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Affiliation(s)
| | | | | | | | - A. Catharine Ross
- Department of Nutritional Sciences, The Pennsylvania State University, University Park, PA 16802, USA; (Y.L.); (A.T.); (F.J.M.); (M.H.G.)
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37
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Abstract
Importance Nutrition patterns in pregnancy play a decisive role in the well-being of the mother and the fetus. Objective The aim of this review was to summarize and compare guidelines and recommendations on nutrition in pregnancy. Evidence Acquisition A descriptive review of major guidelines on antenatal nutrition was conducted, including the most recently published guidelines, namely, by the Australian Government Department of Health (2018); the Canadian Nutrition Working Group and Society of Obstetricians and Gynaecologists of Canada (2016); the World Health Organization (2016); the Institute of Obstetricians and Gynaecologists, Royal College of Physicians of Ireland (2016); the International Federation of Gynecology and Obstetrics (2015); the Academy of Nutrition and Dietetics (2014); and the National Institute for Health and Care Excellence (2008). Results There is almost universal agreement regarding macronutrient requirements during pregnancy. The WHO, FIGO, and the NICE guidelines make no recommendation on fluid intake. Almost all guidelines state that weight gain during pregnancy should be closely monitored. Folic acid supplementation is universally recommended from the preconception period, but there are controversies regarding other vitamins' supplementation. Multiple micronutrient supplementation could be an option in specific settings according only to the FIGO. Probiotics are not routinely recommended in pregnancy. Conclusions There is wide agreement among the reviewed guidelines regarding nutrition in pregnancy, but still there are controversies. Evaluation and classification of influential guidelines can be beneficial for establishing a universal consensus on nutrition during pregnancy, in order to achieve more favorable perinatal outcomes.
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Zamil DH, Burns EK, Perez-Sanchez A, Parke MA, Katta R. Risk of Birth Defects From Vitamin A "Acne Supplements" Sold Online. Dermatol Pract Concept 2021; 11:e2021075. [PMID: 34123566 DOI: 10.5826/dpc.1103a75] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/07/2021] [Indexed: 01/15/2023] Open
Abstract
Background Dietary supplements are popular among US consumers and claim to address a variety of conditions, including acne. Acne supplements containing vitamin A are of particular interest, due to the potentially teratogenic effects of vitamin A doses over 10,000 IU. Objective This study examined dosage, pregnancy risks, and labeling of vitamin A-containing acne supplements available online. Methods An Internet search of acne supplements sold online was conducted between March and May 2020. Supplement labels and websites were analyzed for vitamin A content and pregnancy warnings, and then divided into categories based on dosage and teratogenic risk. Results A total of 49 acne supplements was found, and of these 26 (53%) contain vitamin A. Three supplements are likely teratogenic, 4 contain vitamin A doses exceeding the daily level of intake that meets the nutritional needs of most people, and 15 have an unknown teratogenic risk. Among the 6 supplements with over 10,000 IU vitamin A, 2 have no pregnancy warning at all, including the supplement with the highest vitamin A dose found in this study. Conclusions Dietary supplements are not subject to the same stringent regulations as drugs, and as such, consumers may be unaware of pregnancy risks. Furthermore, FDA requirements on labeling of vitamin A supplements may lead to consumer confusion regarding dosage. As such, we encourage stricter labeling requirements for vitamin A-containing supplements, including pregnancy warnings for high-dose supplements and clearer dosage labeling.
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Affiliation(s)
| | | | - Ariadna Perez-Sanchez
- Department of Internal Medicine, University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA
| | | | - Rajani Katta
- McGovern Medical School at University of Texas Health Science Center at Houston, Houston, Texas, USA
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Carazo A, Macáková K, Matoušová K, Krčmová LK, Protti M, Mladěnka P. Vitamin A Update: Forms, Sources, Kinetics, Detection, Function, Deficiency, Therapeutic Use and Toxicity. Nutrients 2021; 13:1703. [PMID: 34069881 PMCID: PMC8157347 DOI: 10.3390/nu13051703] [Citation(s) in RCA: 102] [Impact Index Per Article: 34.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 05/07/2021] [Accepted: 05/13/2021] [Indexed: 12/12/2022] Open
Abstract
Vitamin A is a group of vital micronutrients widely present in the human diet. Animal-based products are a rich source of the retinyl ester form of the vitamin, while vegetables and fruits contain carotenoids, most of which are provitamin A. Vitamin A plays a key role in the correct functioning of multiple physiological functions. The human organism can metabolize natural forms of vitamin A and provitamin A into biologically active forms (retinol, retinal, retinoic acid), which interact with multiple molecular targets, including nuclear receptors, opsin in the retina and, according to the latest research, also some enzymes. In this review, we aim to provide a complex view on the present knowledge about vitamin A ranging from its sources through its physiological functions to consequences of its deficiency and metabolic fate up to possible pharmacological administration and potential toxicity. Current analytical methods used for its detection in real samples are included as well.
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Affiliation(s)
- Alejandro Carazo
- Department of Pharmacology and Toxicology, Faculty of Pharmacy, Charles University, Akademika Heyrovského 1203, 500 05 Hradec Králové, Czech Republic;
| | - Kateřina Macáková
- Department of Pharmacognosy, Faculty of Pharmacy, Charles University, Akademika Heyrovského 1203, 500 05 Hradec Králové, Czech Republic;
| | - Kateřina Matoušová
- Department of Clinical Biochemistry and Diagnostics, University Hospital Hradec Králové, Sokolská 581, 500 05 Hradec Králové, Czech Republic; (K.M.); (L.K.K.)
| | - Lenka Kujovská Krčmová
- Department of Clinical Biochemistry and Diagnostics, University Hospital Hradec Králové, Sokolská 581, 500 05 Hradec Králové, Czech Republic; (K.M.); (L.K.K.)
- Department of Analytical Chemistry, Faculty of Pharmacy, Charles University, Akademika Heyrovského 1203, 500 05 Hradec Králové, Czech Republic
| | - Michele Protti
- The Department of Pharmacy and Biotechnology (FaBiT), Alma Mater Studiorum–University of Bologna, Via Belmeloro 6, 40126 Bologna, Italy;
| | - Přemysl Mladěnka
- Department of Pharmacology and Toxicology, Faculty of Pharmacy, Charles University, Akademika Heyrovského 1203, 500 05 Hradec Králové, Czech Republic;
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Vasistha NA, Khodosevich K. The impact of (ab)normal maternal environment on cortical development. Prog Neurobiol 2021; 202:102054. [PMID: 33905709 DOI: 10.1016/j.pneurobio.2021.102054] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 03/01/2021] [Accepted: 04/20/2021] [Indexed: 12/24/2022]
Abstract
The cortex in the mammalian brain is the most complex brain region that integrates sensory information and coordinates motor and cognitive processes. To perform such functions, the cortex contains multiple subtypes of neurons that are generated during embryogenesis. Newly born neurons migrate to their proper location in the cortex, grow axons and dendrites, and form neuronal circuits. These developmental processes in the fetal brain are regulated to a large extent by a great variety of factors derived from the mother - starting from simple nutrients as building blocks and ending with hormones. Thus, when the normal maternal environment is disturbed due to maternal infection, stress, malnutrition, or toxic substances, it might have a profound impact on cortical development and the offspring can develop a variety of neurodevelopmental disorders. Here we first describe the major developmental processes which generate neuronal diversity in the cortex. We then review our knowledge of how most common maternal insults affect cortical development, perturb neuronal circuits, and lead to neurodevelopmental disorders. We further present a concept of selective vulnerability of cortical neuronal subtypes to maternal-derived insults, where the vulnerability of cortical neurons and their progenitors to an insult depends on the time (developmental period), place (location in the developing brain), and type (unique features of a cell type and an insult). Finally, we provide evidence for the existence of selective vulnerability during cortical development and identify the most vulnerable neuronal types, stages of differentiation, and developmental time for major maternal-derived insults.
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Affiliation(s)
- Navneet A Vasistha
- Biotech Research and Innovation Centre (BRIC), Faculty of Health and Medical Sciences, University of Copenhagen, 2200, Copenhagen, Denmark.
| | - Konstantin Khodosevich
- Biotech Research and Innovation Centre (BRIC), Faculty of Health and Medical Sciences, University of Copenhagen, 2200, Copenhagen, Denmark.
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41
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Mahle AC, Morris BD, Frazer Z, Novak C. Severe vitamin deficiencies in pregnancy complicated by progressive familial intrahepatic cholestasis. BMJ Case Rep 2021; 14:e240248. [PMID: 33692058 PMCID: PMC7949387 DOI: 10.1136/bcr-2020-240248] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/10/2021] [Indexed: 01/17/2023] Open
Abstract
Progressive familial intrahepatic cholestasis (PFIC) is a rare disease of impaired bile acid excretion which can lead to nutritional deficiencies. Vitamin deficiencies during pregnancy can result in adverse maternal and fetal outcomes. A 20-year-old primiparous woman at 30 4/7 weeks with PFIC type 2 presented with worsening cholestasis, coagulopathy and fat-soluble vitamin deficiency. She developed visual deficits and was found to have severe vitamin A deficiency. Her coagulopathy and visual deficits improved following vitamin K and A supplementation, respectively. She delivered at 32 2/7 weeks following preterm labour. This case highlights several unique aspects in the care of pregnant women with liver disease. These patients are at risk for fat-soluble vitamin deficiencies which can result in significant coagulopathy and rarely, visual deficits due to vitamin A deficiency. Prompt treatment is necessary to prevent permanent sequelae.
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Affiliation(s)
- Amanda Caroline Mahle
- Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Bernard David Morris
- Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Zane Frazer
- Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Christopher Novak
- Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
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42
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Nasreddine G, El Hajj J, Ghassibe-Sabbagh M. Orofacial clefts embryology, classification, epidemiology, and genetics. MUTATION RESEARCH-REVIEWS IN MUTATION RESEARCH 2021; 787:108373. [PMID: 34083042 DOI: 10.1016/j.mrrev.2021.108373] [Citation(s) in RCA: 56] [Impact Index Per Article: 18.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 02/21/2021] [Accepted: 02/23/2021] [Indexed: 01/14/2023]
Abstract
Orofacial clefts (OFCs) rank as the second most common congenital birth defect in the United States after Down syndrome and are the most common head and neck congenital malformations. They are classified as cleft lip with or without cleft palate (CL/P) and cleft palate only (CPO). OFCs have significant psychological and socio-economic impact on patients and their families and require a multidisciplinary approach for management and counseling. A complex interaction between genetic and environmental factors contributes to the incidence and clinical presentation of OFCs. In this comprehensive review, the embryology, classification, epidemiology and etiology of clefts are thoroughly discussed and a "state-of-the-art" snapshot of the recent advances in the genetics of OFCs is presented.
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Affiliation(s)
- Ghenwa Nasreddine
- Department of Natural Sciences, School of Arts and Sciences, Lebanese American University, P.O. Box: 13-5053, Chouran, 1102 2801, Beirut, Lebanon.
| | - Joelle El Hajj
- Department of Natural Sciences, School of Arts and Sciences, Lebanese American University, P.O. Box: 13-5053, Chouran, 1102 2801, Beirut, Lebanon.
| | - Michella Ghassibe-Sabbagh
- Department of Natural Sciences, School of Arts and Sciences, Lebanese American University, P.O. Box: 13-5053, Chouran, 1102 2801, Beirut, Lebanon.
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43
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Zgliczynska M, Kosinska-Kaczynska K. Micronutrients in Multiple Pregnancies-The Knowns and Unknowns: A Systematic Review. Nutrients 2021; 13:nu13020386. [PMID: 33513722 PMCID: PMC7912422 DOI: 10.3390/nu13020386] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Revised: 01/22/2021] [Accepted: 01/23/2021] [Indexed: 12/12/2022] Open
Abstract
Maternal diet and nutritional status are of key importance with regard to the short- and long-term health outcomes of both the mother and the fetus. Multiple pregnancies are a special phenomenon in the context of nutrition. The presence of more than one fetus may lead to increased metabolic requirements and a faster depletion of maternal macro- and micro- nutrient reserves than in a singleton pregnancy. The aim of this systematic review was to gather available knowledge on the supply and needs of mothers with multiple pregnancies in terms of micronutrients and the epidemiology of deficiencies in that population. It was constructed in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses Statement (PRISMA). The authors conducted a systematic literature search with the use of three databases: PubMed/MEDLINE, Scopus and Embase. The last search was run on the 18 October 2020 and identified 1379 articles. Finally, 12 articles and 1 series of publications met the inclusion criteria. Based on the retrieved studies, it may be concluded that women with multiple pregnancies might be at risk of vitamin D and iron deficiencies. With regard to other microelements, the evidence is either inconsistent, scarce or absent. Further in-depth prospective and population studies are necessary to determine if nutritional recommendations addressed to pregnant women require adjustments in cases of multiple gestations.
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44
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Gkouskou KK, Grammatikopoulou MG, Vlastos I, Sanoudou D, Eliopoulos AG. Genotype-guided dietary supplementation in precision nutrition. Nutr Rev 2020; 79:1225-1235. [PMID: 33367884 DOI: 10.1093/nutrit/nuaa132] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Achieving adequate micronutrient status, while avoiding deficiencies, represents a challenge for people globally. Consequently, many individuals resort to oral nutrient supplementation (ONS) in order to correct suboptimal dietary intakes. Advances in the fields of nutrigenetics and nutritional genomics have identified differences in response to micronutrient supplementation according to genetic makeup, adding dietary supplement use to the clinician's toolkit in the precision nutrition era. This review focuses on published evidence linking genetic variants to the responses associated with some of the most popular dietary supplements. With an increasing number of health professionals becoming involved in the prescription of ONS, identifying and matching individuals to the appropriate dietary supplement according to their genotype is important for achieving optimal health benefits and micronutrient equilibrium, while reducing the adverse events and financial costs often associated with excessive ONS.
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Affiliation(s)
- Kalliopi K Gkouskou
- Department of Biology, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.,Embiodiagnostics, Biology Research Company, Heraklion, Crete, Greece
| | - Maria G Grammatikopoulou
- Department of Nutritional Sciences and Dietetics, Faculty of Health Sciences, International Hellenic University, Thessaloniki, Greece
| | - Ioannis Vlastos
- Department of Biology, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Despina Sanoudou
- Clinical Genomics and Pharmacogenomics Unit, 4th Department of Internal Medicine, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.,Center for New Biotechnologies and Precision Medicine, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.,Center of Basic Research, Biomedical Research Foundation of the Academy of Athens, Athens, Greece
| | - Aristides G Eliopoulos
- Department of Biology, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.,Center for New Biotechnologies and Precision Medicine, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.,Center of Basic Research, Biomedical Research Foundation of the Academy of Athens, Athens, Greece
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45
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Awasthi S, Awasthi A. Role of vitamin a in child health and nutrition. CLINICAL EPIDEMIOLOGY AND GLOBAL HEALTH 2020. [DOI: 10.1016/j.cegh.2020.03.016] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
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46
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Burns EK, Perez-Sanchez A, Katta R. Risks of Skin, Hair, and Nail Supplements. Dermatol Pract Concept 2020; 10:e2020089. [PMID: 33150030 DOI: 10.5826/dpc.1004a89] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/28/2020] [Indexed: 12/23/2022] Open
Abstract
Skin, hair, and nail supplements, sometimes referred to as "beauty supplements" or "ingestible skin care," are a large and growing industry. These products may contain vitamins and minerals, sometimes in very high doses. They may also contain herbs, hormones, microbes, or animal derivatives such as fish oils and collagen powders. Dietary supplements are regulated as foods, not as drugs, by the US Food and Drug Administration (FDA). Therefore, manufacturers do not need to provide any proof of safety, efficacy, or quality prior to sale. This is of serious concern, as many adverse effects due to supplement components have been reported. The potential risks cover multiple categories. These include acute toxicities, such as choking, as well as chronic toxicities, such as increased risk of diabetes. Teratogenicity and interactions with drugs and laboratory testing have been documented in research studies. Other risks include potentially increased risk of cancer with long-term use, allergic reactions, and others. It is vital that physicians educate their patients on these risks. As no post-marketing surveillance programs are required for supplements, our understanding of supplement risks is incomplete. Physicians should be wary of these risks and encourage further research and regulation.
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Affiliation(s)
| | - Ariadna Perez-Sanchez
- Department of Internal Medicine, University of Texas Health Science Center, San Antonio, TX, USA
| | - Rajani Katta
- Department of Dermatology, McGovern Medical School at UT Health, Houston, TX, USA
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47
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Garland MA, Reynolds K, Zhou CJ. Environmental mechanisms of orofacial clefts. Birth Defects Res 2020; 112:1660-1698. [PMID: 33125192 PMCID: PMC7902093 DOI: 10.1002/bdr2.1830] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2020] [Revised: 10/07/2020] [Accepted: 10/13/2020] [Indexed: 12/11/2022]
Abstract
Orofacial clefts (OFCs) are among the most common birth defects and impart a significant burden on afflicted individuals and their families. It is increasingly understood that many nonsyndromic OFCs are a consequence of extrinsic factors, genetic susceptibilities, and interactions of the two. Therefore, understanding the environmental mechanisms of OFCs is important in the prevention of future cases. This review examines the molecular mechanisms associated with environmental factors that either protect against or increase the risk of OFCs. We focus on essential metabolic pathways, environmental signaling mechanisms, detoxification pathways, behavioral risk factors, and biological hazards that may disrupt orofacial development.
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Affiliation(s)
- Michael A. Garland
- Department of Biochemistry and Molecular Medicine, University of California at Davis, School of Medicine, Sacramento, CA 95817
- Institute for Pediatric Regenerative Medicine of Shriners Hospitals for Children, University of California at Davis, School of Medicine, Sacramento, CA 95817
| | - Kurt Reynolds
- Department of Biochemistry and Molecular Medicine, University of California at Davis, School of Medicine, Sacramento, CA 95817
- Institute for Pediatric Regenerative Medicine of Shriners Hospitals for Children, University of California at Davis, School of Medicine, Sacramento, CA 95817
- Biochemistry, Molecular, Cellular, and Developmental Biology (BMCDB) graduate group, University of California, Davis, CA 95616
| | - Chengji J. Zhou
- Department of Biochemistry and Molecular Medicine, University of California at Davis, School of Medicine, Sacramento, CA 95817
- Institute for Pediatric Regenerative Medicine of Shriners Hospitals for Children, University of California at Davis, School of Medicine, Sacramento, CA 95817
- Biochemistry, Molecular, Cellular, and Developmental Biology (BMCDB) graduate group, University of California, Davis, CA 95616
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48
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Abstract
Pregnancy is a time where expectant mothers often focus on their diet to improve their own health and to preserve the future health of their children. There is much conflicting information in the public domain about the safety and/or efficacy of nutritional supplements during pregnancy. Despite this, the market for supplements is growing. This review discusses the roles of critical nutrients in pregnancy and the available evidence on the use of supplements to reduce risks and improve maternal and fetal outcomes. Recommendations are made for pregnant women, taking into account safety data and tolerable upper intakes set for pregnant women. It is important for dieticians, nutritionists, physicians, and other healthcare providers to be able to offer accurate and evidence-based advice on supplement use in pregnancy. Routine supplementation may not be necessary for all, but individuals at risk are identified.
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49
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Vitamin A as a Transcriptional Regulator of Cardiovascular Disease. HEARTS 2020. [DOI: 10.3390/hearts1020013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Vitamin A is a micronutrient and signaling molecule that regulates transcription, cellular differentiation, and organ homeostasis. Additionally, metabolites of Vitamin A are utilized as differentiation agents in the treatment of hematological cancers and skin disorders, necessitating further study into the effects of both nutrient deficiency and the exogenous delivery of Vitamin A and its metabolites on cardiovascular phenotypes. Though vitamin A/retinoids are well-known regulators of cardiac formation, recent evidence has emerged that supports their role as regulators of cardiac regeneration, postnatal cardiac function, and cardiovascular disease progression. We here review findings from genetic and pharmacological studies describing the regulation of both myocyte- and vascular-driven cardiac phenotypes by vitamin A signaling. We identify the relationship between retinoids and maladaptive processes during the pathological hypertrophy of the heart, with a focus on the activation of neurohormonal signaling and fetal transcription factors (Gata4, Tbx5). Finally, we assess how this information might be leveraged to develop novel therapeutic avenues.
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50
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Perez-Sanchez AC, Burns EK, Perez VM, Tantry EK, Prabhu S, Katta R. Safety Concerns of Skin, Hair and Nail Supplements in Retail Stores. Cureus 2020; 12:e9477. [PMID: 32874806 PMCID: PMC7455464 DOI: 10.7759/cureus.9477] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Background: Dietary supplements promoted for “skin, hair, and nail” health are becoming increasingly popular, although there is a lack of regulatory oversight. As no centralized database or repository for these supplements is available, the aim of this study was to provide an overview of supplements in a sample of retail stores, with a focus on safety concerns. Methods: Dermatology supplements were defined as those that featured the words “skin”, “hair”, “nails”, “beauty”, or “glow” in the product name or tagline. Seven stores including drug, grocery, department, and cosmetics stores were surveyed within a three-mile radius. Data were extracted from the Supplement Facts label of each product. Results: A total of 176 separate supplements were identified, containing a total of 255 distinct ingredients. These included vitamins, minerals, food extracts, botanicals, animal products (collagen, fish oils), amino acids, a hormone, and distinct microbial strains. Conclusion: This survey of “dermatology” supplements available in local retailers raised several safety concerns, including potential interactions, teratogenicity risks, a lack of independent third-party testing, lack of warning labels, and nutrient “overdosing”. Given limited regulation of dietary supplements, it is imperative that physicians educate patients on the potential risks. These include risks related to supplement ingredients and dosages, as well as risks related to the lack of regulatory oversight. Patients must also be educated about the multiple gaps in our knowledge of dietary supplements, especially in terms of efficacy and long-term safety.
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Affiliation(s)
- Ariadna C Perez-Sanchez
- Internal Medicine, University of Texas Health Science Center at San Antonio, San Antonio, USA
| | - Emily K Burns
- Dermatology, Baylor College of Medicine, Houston, USA
| | | | | | | | - Rajani Katta
- Dermatology, University of Texas Health Science Center at Houston, Houston, USA.,Internal Medicine, Baylor College of Medicine, Houston, USA
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