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Alharthi GNA, Alzarei A. The Correlation Between Vitamin D Deficiency and Chronic Rhinosinusitis: A Systematic Review. Cureus 2024; 16:e55955. [PMID: 38601384 PMCID: PMC11005879 DOI: 10.7759/cureus.55955] [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] [Accepted: 03/11/2024] [Indexed: 04/12/2024] Open
Abstract
Chronic rhinosinusitis (CRS) is marked by inflammation of the paranasal sinuses and mucosal lining of the nose. CRS can be classified as CRS with nasal polyps or CRS without polyps. In recent years, there has been increased attention on the immunological role of vitamin D in treating CRS, coupled with the observation of vitamin D deficiency among CRS patients. Vitamin D is acknowledged for its immunomodulatory properties, especially in allergic conditions. Recent studies suggest that individuals with CRS, especially those with CRS with nasal polyps, frequently demonstrate lower than normal levels of vitamin D. We conducted searches across various databases, including PubMed, Web of Science, ScienceDirect, and the Cochrane Library, both electronically and manually, to identify pertinent studies. Studies from 2003 to 2023 were included. Deficiency of vitamin D was considered with levels of vitamin D less than 30 ng/mL, and only original studies were included. Studies including patients taking vitamin D supplementation previously and patients with chronic kidney and liver diseases were excluded. We included nine studies that recruited 1,042 patients in total. More than half of the studies reported the presence of nasal polyps in CRS, and participants from four studies had CRS without nasal polyps. All of the included studies reported a negative correlation between levels of vitamin D and CRS. The majority of the studies depicted quite low levels of vitamin D among CRS patients. The degree of CRS severity as measured by endoscopic and radiological scores is moderately inversely correlated with vitamin D intake. Therefore, it is recommended that the relationship between various serum vitamin D concentrations and the severity of CRS be investigated in detail, along with an understanding of the cellular effects of vitamin D levels on the nasal mucosa.
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Affiliation(s)
| | - Ali Alzarei
- Otolaryngology - Head and Neck Surgery, Aseer Central Hospital, Abha, SAU
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Pantazidou G, Papaioannou I, Skoulakis C, Petinaki E, Hajiioannou J. Vitamin D Levels in Chronic Rhinosinusitis in Patients With or Without Nasal Polyposis: A Systematic Review. Cureus 2023; 15:e46275. [PMID: 37908960 PMCID: PMC10615355 DOI: 10.7759/cureus.46275] [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] [Accepted: 09/30/2023] [Indexed: 11/02/2023] Open
Abstract
Chronic rhinosinusitis (CRS) is a large group of heterogeneous diseases characterized by extensive inflammation of the nasal mucosa and sinuses. Vitamin D (VD), as an immunoregulatory hormone, may play an important role in the pathophysiology of CRS. The purpose of this study is to review the existing literature that correlates VD levels with CRS with or without nasal polyps. A systematic manual search was conducted in the PubMed and Google Scholar databases up to July 2023. Articles from PubMed and the first 100 articles from Google Scholar were recorded for our research. Keywords used were the following: vitamin D, chronic rhinosinusitis, and nasal polyps. Among the 134 articles retrieved, only 18 were eligible. The other 116 studies were excluded as they related VD levels with other conditions (e.g., allergic rhinitis) and for other reasons. However, we identified two more eligible records through the manual research of the above-mentioned 132 studies, and finally, 20 records were included in the current review. The review concerned case-control studies, prospective, retrospective, and cross-sectional studies. Based on our review, we concluded that CRS patients are correlated with the lowest VD levels, accompanied by increased severity of the disease, especially in those with nasal polyposis. Patients can benefit from appropriate VD supplementation, and serum VD levels should be included in the laboratory assessment of CRS. However, due to the heterogeneity of the individuals involved, more well-designed clinical trials as well as randomized clinical trials should be conducted for further validation of the above findings in the general population in the future.
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Affiliation(s)
- Georgia Pantazidou
- Otolaryngology - Head and Neck Surgery, General Hospital of Patras, Patras, GRC
| | | | | | - Efthimia Petinaki
- Biopathology - Clinical Microbiology, University Hospital of Larisa, Larisa, GRC
| | - Jiannis Hajiioannou
- Otolaryngology - Head and Neck Surgery, University Hospital of Larisa, Larisa, GRC
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Shrestha P, Deepak R, Bhalla AS, Gupta Y, Sikka K, Irugu DVK, Bairwa M, Thakar A, Verma H. Vitamin D and Interleukins in Chronic Rhinosinusitis with Polyposis. Indian J Otolaryngol Head Neck Surg 2022; 74:4756-4760. [PMID: 36742814 PMCID: PMC9895733 DOI: 10.1007/s12070-022-03085-2] [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: 11/09/2021] [Accepted: 01/09/2022] [Indexed: 02/07/2023] Open
Abstract
Vitamin D is thought to play an inflammatory modulatory role in the pathogenesis of chronic rhinosinusitis with nasal polyposis (CRSwNP) & it also affects the severity of inflammation so the study was focused on the evaluation of serum vitamin D & interleukins in CRSwNP. The prospective study was conducted on clinic-radiological confirmed cases. The patients were not operated prior, clubbed under primary nasal polyposis (PNP) group and the patients were operated prior, clubbed under recurrent nasal polyposis (RNP) group. The subjective and objective severity of the disease was assessed by sino-nasal outcome score (SNOT 22) & NCCT PNS & orbit. Serum levels of cytokines (IL4, IL 5, and IL 13) were quantified using the ELISA method using the Human Interleukin antibody coated ELISA kit. Measurement of vitamin D was done by using recombinant ruthenium-labelled VDBP. There was a significant difference in Vitamin D, AEC, IL 4, IL 5, IL 13 levels in the disease groups compared to control group. Low vitamin D, high SNOT & high absolute eosinophil count (AEC) count was noticed in both disease groups. Vitamin D may play a significant role in nasal polyposis formation. For the establishment of interaction, a community based larger study is required as the prevalence of low vitamin D level is high in Indian population.
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Affiliation(s)
| | - Rakesh Deepak
- Department of Transplant Immunology and Immunogenetics, AIIMS, New Delhi, India
| | | | | | - Kapil Sikka
- Department of Otorhinolaryngology, AIIMS, 4065, ENT Office, New Delhi, 110029 India
| | - D. V. K. Irugu
- Department of Otorhinolaryngology, AIIMS, 4065, ENT Office, New Delhi, 110029 India
| | - Mohan Bairwa
- Centre for Community Medicine, AIIMS, New Delhi, India
| | - Alok Thakar
- Department of Otorhinolaryngology, AIIMS, 4065, ENT Office, New Delhi, 110029 India
| | - Hitesh Verma
- Department of Otorhinolaryngology, AIIMS, 4065, ENT Office, New Delhi, 110029 India
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Kowalik K, Waniewska-Leczycka M, Sarnowska E, Rusetska N, Ligaj M, Chrzan A, Popko M. The SWI/SNF complex in eosinophilic and non eosinophilic chronic rhinosinusitis. ACTA ACUST UNITED AC 2021; 41:159-167. [PMID: 34028461 PMCID: PMC8142725 DOI: 10.14639/0392-100x-n0760] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Accepted: 11/09/2020] [Indexed: 01/02/2023]
Abstract
Introduction Chronic rhinosinusitis (CRS) can be classified as eosinophilic (eCRS) or non-eosinophilic (neCRS) based on infiltration type. The SWI/SNF complex may be involved in the pathophysiology of CRS. Aim To assess the expression of the SWI/SNF complex in both CRS groups; to correlate blood eosinophil count (BEC), and histopathology eosinophil count (HPEC) with the SWI/SNF expression level in eCRS and neCRS. Materials and methods The study population consisted of 96 patients (68 eCRS, 28 neCRS). Immunohistochemical staining was performed on sinonasal mucosa for assessment of SWI/SNF protein expression. Type of tissue infiltration was assessed in samples obtained from examined groups (HPEC). The diagnostic value of eCRS was 10 cells/HPF (high power field). Complete blood count was analysed in order to calculate BEC. Results BEC and HPEC correlated negatively with all the SWI/SNF subunits. HPEC and BEC correlated positively with clinical findings (L-M and SNOT-22), while SWI/SNF correlated negatively with clinical findings (L-M and SNOT-22). Conclusions The SWI/SNF was observed in both eCRS and neCRS, with lower expression in former. The meaning of its negative correlation with BEC, HPEC and clinical findings in eCRS group remains to be understood.
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Affiliation(s)
- Katarzyna Kowalik
- Department of Otorhinolaryngology, Faculty of Medicine and Dentistry, Medical University of Warsaw, Warsaw, Poland
| | - Martyna Waniewska-Leczycka
- Department of Otorhinolaryngology, Faculty of Medicine and Dentistry, Medical University of Warsaw, Warsaw, Poland
| | - Elzbieta Sarnowska
- Department of Molecular and Translational Oncology, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland
| | - Natalia Rusetska
- Department of Molecular and Translational Oncology, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland
| | - Marcin Ligaj
- Department of Pathology, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland
| | - Alicja Chrzan
- Department of Pathology, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland
| | - Mariola Popko
- Department of Otorhinolaryngology, Faculty of Medicine and Dentistry, Medical University of Warsaw, Warsaw, Poland
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Erdoğan M, Fındıklı HA. Novel biomarker for predicting sepsis mortality: vitamin D receptor. J Int Med Res 2021; 49:3000605211034733. [PMID: 34396836 PMCID: PMC8371733 DOI: 10.1177/03000605211034733] [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: 11/24/2022] Open
Abstract
Objective There are currently no studies on the role of vitamin D receptor (VDR) levels
as a cause of or risk factor for sepsis. We aimed to establish the
association between VDR levels and 28-day mortality in critically ill
patients with sepsis. Methods This prospective cross-sectional observational study included 148 patients
diagnosed with sepsis who were treated in the intensive care unit. We
measured VDR levels, laboratory characteristics, and health scores and
related them to survival. Results The 148 patients included 96 survivors and 52 non-survivors, with VDR levels
of 1.92 and 1.36 ng/mL, respectively. Baseline VDR was a significant
predictor of 28-day mortality, with an area under the curve of 0.778. A low
VDR level was significantly associated with lower overall survival in
patients with sepsis according to Kaplan–Meier curve analysis. VDR levels
were also negatively correlated with lactate, C-reactive protein, acute
physiological and clinical health evaluation (APACHE) II and sequential
organ failure assessment (SOFA) scores, and disease severity. Conclusions VDR levels were associated with high 28-day mortality and negatively
correlated with lactate, C-reactive protein, APACHE II and SOFA scores, and
disease severity in patients with sepsis. VDR levels can predict poor
outcomes in patients with sepsis.
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Affiliation(s)
- Murat Erdoğan
- Department of Internal Medicine Intensive Care Unit, University of Health Sciences - Adana Health Practice and Research Center, Adana, Turkey
| | - Hüseyin Avni Fındıklı
- Department of Internal Medicine, Kahramanmaraş Necip Fazıl City Hospital, Kahramanmaraş, Turkey
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Role of Vitamin D in the Clinical Course of Nasal Polyposis. Biomedicines 2021; 9:biomedicines9080855. [PMID: 34440059 PMCID: PMC8389619 DOI: 10.3390/biomedicines9080855] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 07/15/2021] [Accepted: 07/16/2021] [Indexed: 01/04/2023] Open
Abstract
Vitamin D is a lipo-soluble hormone well known for its effects on calcium homeostasis and bone metabolism. Recently, there has been growing interest in the extraskeletal effects of vitamin D. In particular, recent studies have highlighted how vitamin D plays a fundamental role in immunomodulation processes in the context of both innate and adaptive immunity, with consequent anti-inflammatory and anti-oxidant effect in different immune-mediated pathologies, such as systemic sclerosis, psoriasis, atopic dermatitis and rheumatoid arthritis; as well as in various pro-inflammatory processes affecting the airways, including chronic rhinosinusitis with (CRSwNP) or without (CRSsNP) nasal polyposis. We analyze the role of vitamin D in the genesis and progression of CRSwNP/sNP and its supplementation as a safe and valid therapeutic strategy capable of improving the clinical outcome of standard therapies.
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Relationship between the Severity of Inflammatory Changes in Chronic Sinusitis and the Level of Vitamin D before and after the FESS Procedure. J Clin Med 2021; 10:jcm10132836. [PMID: 34198970 PMCID: PMC8269335 DOI: 10.3390/jcm10132836] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Revised: 06/12/2021] [Accepted: 06/24/2021] [Indexed: 12/21/2022] Open
Abstract
There have been a few reports confirming that vitamin D (VD3) deficiency increases inflammation in the paranasal sinuses. The work brings new information that, despite the presence of inflammation before surgery, patients with higher vitamin D levels had less inflammation, and this has been proven on three levels. We show that vitamin D levels clearly correlate with the severity of the disease in chronic sinusitis. These results have been confirmed in imaging studies (Lund MacKay scale), endoscopy (Lund-Kennedy scale) and in the SNOT 20 questionnaire. 40 patients suffering from chronic sinusitis were divided into two equal groups: group 1: with less severe radiological changes (10 or less points on the Lund-Mackay scale), group 2: with a more advanced form (>10 points). The relationship between VD3 and the severity of the disease (clinical and nasal endoscopy) was assessed. The mean VD3 level in patients in group 2 before surgery was lower (23.01 ng/mL) than in group 1 (28.02 ng/mL) (p < 0.05). They presented a higher degree of advanced changes in all the above scales, i.e., before the SNOT 20 procedure, the mean was: group 1: 30.33, group 2: 31.80 (p < NS); Lund-Kennedy: group 1: 3.21, group 2: 6.30 (p < 0.05). After surgery an increase in VD3 levels was observed in both study groups: in group 1 to the value of 37.98 ng/mL (p < 0.002) and in group 2 to 27.67 ng/mL (p < 0.004). Lower VD3 levels were found in patients with a higher stage of the disease. Reduction of inflammation increases the level of VD3 and reduces subjective and objective symptoms of chronic inflammation.
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The impact of vitamin D supplementation on VDR gene expression and body composition in monozygotic twins: randomized controlled trial. Sci Rep 2020; 10:11943. [PMID: 32686744 PMCID: PMC7371728 DOI: 10.1038/s41598-020-69128-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2020] [Accepted: 07/07/2020] [Indexed: 02/07/2023] Open
Abstract
Vitamin D supplementation is widely used. However, there is no consensus on the use and dosage of this supplement and the existing recommendations arise from studies based on the benefits that this nutrient can facilitate in bones. In addition, individual genetics can influence the response to supplementation, therefore, research involving monozygotic twins aims to reduce these differences in phenotypic responses. The objective of this randomised controlled study is to examine the effect of vitamin D supplementation on body composition and the expression of the vitamin D receptor (VDR) mRNA. An intervention was performed through supplementation with cholecalciferol at the concentration of 2000 IU in 90 healthy adult monozygotic twins (male or female pairs) for 2 months. The findings showed that serum vitamin D concentration increased by 65% and VDR gene expression sixty times (p = 0.001). Changes in body composition parameters were observed regarding body fat and lean mass. Our results indicate that an increase in serum vitamin D concentration may have potential therapeutic implications.
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Laulajainen-Hongisto A, Toppila-Salmi SK, Luukkainen A, Kern R. Airway Epithelial Dynamics in Allergy and Related Chronic Inflammatory Airway Diseases. Front Cell Dev Biol 2020; 8:204. [PMID: 32292784 PMCID: PMC7118214 DOI: 10.3389/fcell.2020.00204] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2019] [Accepted: 03/10/2020] [Indexed: 12/12/2022] Open
Abstract
Allergic rhinitis, chronic rhinosinusitis, and asthma are highly prevalent, multifactorial chronic airway diseases. Several environmental and genetic factors affect airway epithelial dynamics leading to activation of inflammatory mechanisms in the airways. This review links environmental factors to host epithelial immunity in airway diseases. Understanding altered homeostasis of the airway epithelium might provide important targets for diagnostics and therapy of chronic airway diseases.
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Affiliation(s)
- Anu Laulajainen-Hongisto
- Department of Otorhinolaryngology, Helsinki University Hospital, University of Helsinki, Helsinki, Finland.,Laboratory of Cellular and Molecular Immunology, Institute of Microbiology of the Czech Academy of Sciences, Prague, Czechia
| | - Sanna Katriina Toppila-Salmi
- Haartman Institute, Medicum, University of Helsinki, Helsinki, Finland.,Skin and Allergy Hospital, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Annika Luukkainen
- Haartman Institute, Medicum, University of Helsinki, Helsinki, Finland
| | - Robert Kern
- Department of Otolaryngology, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
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Pulvirenti G, Parisi GF, Manti S, Licari A, del Giudice MM, Salpietro C, Marseglia GL, Leonardi S. The Immunomodulatory Role of Vitamin D in Respiratory Diseases. CURRENT RESPIRATORY MEDICINE REVIEWS 2020. [DOI: 10.2174/1573398x15666191114144230] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
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The growing interest in the new role of vitamin D, particularly as an immunomodulatory
factor, has spurred basic research and the development of clinical trials to better understand the
influence of supplementation on various diseases. Vitamin D is an important nutrient factor in human
health due to its role in calcium metabolism regulation, cellular growth, differentiation and its
fundamental discovered activity in immune functions. It has influenced different diseases,
particularly inflammatory and autoimmune diseases, through immune response regulation,
modulating innate and adaptive immunity.
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The aim of this review was to explore the role of vitamin D in the main respiratory diseases in
children such as asthma, chronic rhinosinusitis, cystic fibrosis and recurrent respiratory infections.
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Affiliation(s)
- Giulio Pulvirenti
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Giuseppe Fabio Parisi
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Sara Manti
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Amelia Licari
- Department of Pediatrics, Fondazione IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy
| | - Michele Miraglia del Giudice
- Department of Woman, Child and General and Specialist Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy
| | | | - Gian Luigi Marseglia
- Department of Pediatrics, Fondazione IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy
| | - Salvatore Leonardi
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
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