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Giustina A, Bouillon R, Binkley N, Sempos C, Adler RA, Bollerslev J, Dawson-Hughes B, Ebeling PR, Feldman D, Heijboer A, Jones G, Kovacs CS, Lazaretti-Castro M, Lips P, Marcocci C, Minisola S, Napoli N, Rizzoli R, Scragg R, White JH, Formenti AM, Bilezikian JP. Controversies in Vitamin D: A Statement From the Third International Conference. JBMR Plus 2020; 4:e10417. [PMID: 33354643 PMCID: PMC7745884 DOI: 10.1002/jbm4.10417] [Citation(s) in RCA: 96] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2020] [Revised: 08/18/2020] [Accepted: 09/20/2020] [Indexed: 12/19/2022] Open
Abstract
The Third International Conference on Controversies in Vitamin D was held in Gubbio, Italy, September 10–13, 2019. The conference was held as a follow‐up to previous meetings held in 2017 and 2018 to address topics of controversy in vitamin D research. The specific topics were selected by the steering committee of the conference and based upon areas that remain controversial from the preceding conferences. Other topics were selected anew that reflect specific topics that have surfaced since the last international conference. Consensus was achieved after formal presentations and open discussions among experts. As will be detailed in this article, consensus was achieved with regard to the following: the importance and prevalence of nutritional rickets, amounts of vitamin D that are typically generated by sun exposure, worldwide prevalence of vitamin D deficiency, the importance of circulating concentrations of 25OHD as the best index of vitamin D stores, definitions and thresholds of vitamin D deficiency, and efficacy of vitamin D analogues in the treatment of psoriasis. Areas of uncertainly and controversy include the following: daily doses of vitamin D needed to maintain a normal level of 25OHD in the general population, recommendations for supplementation in patients with metabolic bone diseases, cutaneous production of vitamin D by UVB exposure, hepatic regulation of 25OHD metabolites, definition of vitamin D excess, vitamin D deficiency in acute illness, vitamin D requirements during reproduction, potential for a broad spectrum of cellular and organ activities under the influence of the vitamin D receptor, and potential links between vitamin D and major human diseases. With specific regard to the latter area, the proceedings of the conference led to recommendations for areas in need of further investigation through appropriately designed intervention trials. © 2020 The Authors. JBMR Plus published by Wiley Periodicals LLC. on behalf of American Society for Bone and Mineral Research.
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Affiliation(s)
- Andrea Giustina
- Institute of Endocrine and Metabolic Sciences, San Raffaele, Vita-Salute University and IRCCS Hospital Milan Italy
| | - Roger Bouillon
- Laboratory of Clinical and Experimental Endocrinology, Department of Chronic Diseases Metabolism and Ageing KU Leuven Leuven Belgium
| | - Neil Binkley
- Osteoporosis Clinical Research Program on Aging, University of Wisconsin Madison WI USA
| | | | - Robert A Adler
- McGuire Veterans Affairs Medical Center and Virginia Commonwealth University School of Medicine Richmond VA USA
| | - Jens Bollerslev
- Section of Specialized Endocrinology, Department of Endocrinology, Oslo University Hospital, Rikshospitalet, Oslo, Norway, and Faculty of Medicine University of Oslo Oslo Norway
| | - Bess Dawson-Hughes
- Jean Mayer USDA Nutrition Research Center on Aging Tufts University Boston MA USA
| | - Peter R Ebeling
- Department of Medicine, School of Clinical Sciences Monash University Calyton Victoria Australia
| | - David Feldman
- Department of Medicine Stanford University School of Medicine Stanford CA USA
| | - Annemieke Heijboer
- Endocrine Laboratory, Department of Clinical Chemistry Amsterdam UMC, Vrije Universiteit Amsterdam and University of Amsterdam, Amsterdam Gastroenterology & Metabolism Amsterdam The Netherlands
| | - Glenville Jones
- Department of Biomedical and Molecular Sciences Queen's University Kingston Ontario Canada
| | - Christopher S Kovacs
- Faculty of Medicine Memorial University of Newfoundland St. John's Newfoundland and Labrador Canada
| | - Marise Lazaretti-Castro
- Division of Endocrinology Escola Paulista de Medicina-Universidade Federal de Sao Paulo (EPM-UNIFESP) São Paulo Brazil
| | - Paul Lips
- Department of Internal Medicine, Endocrine Section Amsterdam University Medical Center Amsterdam The Netherlands
| | - Claudio Marcocci
- Department of Clinical and Experimental Medicine University of Pisa Pisa Italy
| | - Salvatore Minisola
- Department of Internal Medicine and Medical Disciplines University of Rome "Sapienza" Rome Italy
| | - Nicola Napoli
- Unit of Endocrinology and Diabetes Campus Bio-Medico, University of Rome Rome Italy.,Division of Bone and Mineral Diseases Washington University in St. Louis St. Louis MO USA
| | - Rene Rizzoli
- Service of Bone Diseases Geneva University Hospitals and Faculty of Medicine Geneva Switzerland
| | - Robert Scragg
- School of Population Health University of Auckland Auckland New Zealand
| | - John H White
- Department of Physiology McGill University Montreal Quebec Canada
| | - Anna Maria Formenti
- Institute of Endocrine and Metabolic Sciences, San Raffaele, Vita-Salute University and IRCCS Hospital Milan Italy
| | - John P Bilezikian
- Department of Medicine, Endocrinology Division, College of Physicians and Surgeons Columbia University New York NY USA
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Picard S, Mayemba CN, Ung RV, Martel S, Mac-Way F. Division of an Iliac Crest Bone Biopsy Specimen to Allow Histomorphometry, Immunohistochemical, Molecular Analysis, and Tissue Banking: Technical Aspect and Applications. JBMR Plus 2020; 4:e10424. [PMID: 33354645 PMCID: PMC7745880 DOI: 10.1002/jbm4.10424] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 09/25/2020] [Accepted: 10/05/2020] [Indexed: 11/25/2022] Open
Abstract
The evaluation of bone complications in chronic kidney disease (CKD) often requires a bone biopsy, the analysis of which can refine the diagnosis of bone defects. Bone histomorphometry performed on sections of the iliac crest biopsy remains the reference procedure for the quantitative assessment of bone health in CKD patients, whereas immunohistochemistry and other molecular biology analyses are indispensable tools for studying the disrupted signaling pathways. Traditionally, the whole iliac crest biopsy was included in methyl‐methacrylate (MMA) and was exclusively used for bone histomorphometry to describe static, dynamic, and structural parameters. Therefore, further molecular analysis of the bone tissue or the need for tissue banking would require a second biopsy to be made, because inclusion in MMA prevents the extraction of good‐quality nucleic acids. In this work, we describe a simple approach to divide a single iliac crest bone biopsy into multiple parts. This allows for simultaneous assessments of histology, immunohistochemistry, biomolecular analysis, and tissue banking while preserving the same bone surface area for histomorphometry. © 2020 American Society for Bone and Mineral Research © 2020 The Authors. JBMR Plus published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research.
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Affiliation(s)
- Sylvain Picard
- Centre Hospitalier Universitaire (CHU) de Québec Research Center, L'Hôtel-Dieu de Québec Hospital, Endocrinology and Nephrology Axis, Faculty and Department of Medicine Université Laval Quebec City Quebec Canada
| | - Christian N Mayemba
- Centre Hospitalier Universitaire (CHU) de Québec Research Center, L'Hôtel-Dieu de Québec Hospital, Endocrinology and Nephrology Axis, Faculty and Department of Medicine Université Laval Quebec City Quebec Canada
| | - Roth-Visal Ung
- Centre Hospitalier Universitaire (CHU) de Québec Research Center, L'Hôtel-Dieu de Québec Hospital, Endocrinology and Nephrology Axis, Faculty and Department of Medicine Université Laval Quebec City Quebec Canada
| | - Simon Martel
- Centre Hospitalier Universitaire (CHU) de Québec Research Center, L'Hôtel-Dieu de Québec Hospital, Endocrinology and Nephrology Axis, Faculty and Department of Medicine Université Laval Quebec City Quebec Canada
| | - Fabrice Mac-Way
- Centre Hospitalier Universitaire (CHU) de Québec Research Center, L'Hôtel-Dieu de Québec Hospital, Endocrinology and Nephrology Axis, Faculty and Department of Medicine Université Laval Quebec City Quebec Canada
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