Enhancing the Design of Nutrient Clinical Trials for Disease Prevention—A Focus on Vitamin D: A Systematic Review

Nutrition Reviews, Journal Year: 2025, Volume and Issue: unknown

Published: Jan. 9, 2025

This systematic review (SR) highlights principles for nutrient clinical trials and explore the diverse physiological functions of vitamin D beyond its traditional role in musculoskeletal system related to study designs. Thousands published research articles have investigated benefits (a example taken this SR) system, including immune, pulmonary, cardiovascular systems; pregnancy; autoimmune disorders; cancer. They illustrated D's molecular mechanisms, interactions, genomic nongenomic actions. SR was designed identify shortcomings designs, statistical methods, data interpretation that led inconsistent findings D-related publications. also examples insights into avoiding design errors future studies, randomized controlled (RCTs). The adheres latest PRISMA statement, guidelines, PICOS process. Inappropriate or flawed designs were frequent trials. Major failures discussed here include too short duration, inadequate infrequent doses, insufficient power, failure measure baseline achieved levels, recruiting D-sufficient participants. These misleading interpretations. Thus, conclusions from such studies should not be generalized used recommendations, policymaking. Adequately powered epidemiological RCTs with sufficient duration individuals deficiency reported favorable outcomes, enriching literature, enabling understand physiology mechanisms. Proper rigorous methodologies cautious outcomes are crucial advancing field. apply only D, but other micro-nutrients nutraceutical research. Adhering them enhances credibility reliability trials, SRs, meta-analysis outcomes. emphasizes importance focused, hypothesis-driven, well-designed, statistically nutrients, conducted index deficient participants, avoidance errors. Findings incorporated practice, policymaking, public health improving nation reducing healthcare costs.

Language: Английский

---

Micronutrients at Supplemental Levels, Tight Junctions and Epithelial Barrier Function: A Narrative Review

International Journal of Molecular Sciences, Journal Year: 2024, Volume and Issue: 25(6), P. 3452 - 3452

Published: March 19, 2024

Disease modifiers, whether from cancer, sepsis, systemic inflammation, or microbial pathogens, all appear to induce epithelial barrier leak, with induced changes of the Tight Junctional (TJ) complex being pivotal process. This leak-and ensuant breakdown compartmentation-plays a central role in disease morbidity on many levels. Accumulation lung water luminal compartment airways was major driver and mortality COVID-19 is an excellent example phenomenon. Increasing awareness ability micronutrients improve basal function reduce compromise pathophysiology may prove be low-cost, safe, easily administered prophylactic and/or therapeutic option amenable large populations. The growing appreciation clinical utility supplemental doses Vitamin D but one example. narrative review intended propose general theory how why micronutrients-at levels above normal dietary intake-successfully remodel TJs function. It discusses key difference between dietary/Recommended Daily Allowance (RDA) versus levels, latter are needed situations. advances hypothesis for signal transduction regulation require these higher achieve TJ remodeling other element that clinically beneficial.

Language: Английский

---

Targeting the AMPK/Nrf2 Pathway: A Novel Therapeutic Approach for Acute Lung Injury

Journal of Inflammation Research, Journal Year: 2024, Volume and Issue: Volume 17, P. 4683 - 4700

Published: July 1, 2024

ALI(acute lung injury) is a severe respiratory dysfunction caused by various intrapulmonary and extrapulmonary factors. It primarily characterized oxidative stress affects the integrity of pulmonary barrier. In cases, ALI can progress to ARDS(acute distress syndrome), condition that poses serious threat lives affected patients. To date, etiological mechanisms underlying remain elusive, available therapeutic options are quite limited. AMPK(AMP-activated protein kinase), an essential serine/threonine kinase, performs pivotal function in regulation cellular energy levels regulatory mechanisms, including detection redox signals mitigating stress. Meanwhile, Nrf2(nuclear factor erythroid 2-related 2), critical transcription factor, alleviates inflammation responses interacting with multiple signaling pathways contributing modulation enzymes associated programmed cell death. Indeed, AMPK induces dissociation Nrf2 from Keap1(kelch-like ECH-associated protein-1) facilitates its translocation into nucleus trigger downstream antioxidant genes, ultimately suppressing expression inflammatory cells lungs. Given their roles, hold promise as novel treatment targets for ALI. This study aimed summarise current status research on AMPK/Nrf2 pathway ALI, encompassing recently reported natural compounds drugs activate alleviate injury, provide theoretical reference early intervention injury future protection.

Language: Английский

---

Positionspapier zum Post-COVID-Syndrom

Deleted Journal, Journal Year: 2025, Volume and Issue: unknown

Published: Feb. 3, 2025

---

Exploring the Potential of Dietary Supplements to Alleviate Pain Due to Long COVID

Nutrients, Journal Year: 2025, Volume and Issue: 17(7), P. 1287 - 1287

Published: April 7, 2025

Long COVID, characterized by persistent symptoms following COVID-19 infection, significantly impacts individuals' health and daily functioning due to fatigue pain. Focusing on pain, this review addresses nociplastic chronic pain conditions. Interventions designed reduce inflammation, oxidative stress, enhance vagal activity may offer a promising approach managing post-pandemic This presents individual components of food supplements with demonstrated efficacy in one or more conditions, focusing their proposed mechanisms clinical including use post-COVID-19 when available. Many these substances have long history safe an alternative long-term analgesic drug treatment, which is often associated potential side effects. also explores the for synergistic effects combining each other conventional analgesics, considering advantages both patients healthcare system using as adjunctive primary therapies related COVID. While preclinical scientific literature provides mechanistic basis action several control signaling pathways, experience, particularly field COVID-associated still limited. However, reviewed strongly suggests that attainable goal, provided rigorous trials are conducted.

Language: Английский

---

“Inflammatory Pathways in Patients with Post-acute Sequelae of COVID-19 – The Role of the Clinical Immunologist”

Annals of Allergy Asthma & Immunology, Journal Year: 2024, Volume and Issue: 133(5), P. 507 - 515

Published: Aug. 23, 2024

Language: Английский

---

Effects of an 8‐week high‐dose vitamin D supplementation on fatigue and neuropsychiatric manifestations in post‐COVID syndrome: A randomized controlled trial

Psychiatry and Clinical Neurosciences, Journal Year: 2024, Volume and Issue: unknown

Published: July 28, 2024

Aim This study evaluated the effectiveness of high‐dose vitamin D supplementation in alleviating fatigue and neuropsychiatric symptoms post‐COVID syndrome. Methods In an 8‐week, double‐blind, randomized, placebo‐controlled trial, 80 patients with or were enrolled. Participants randomly assigned to receive either 60,000 IU weekly ( n = 40) a placebo for 8 weeks. Clinical outcomes assessed using 11‐item Chalder Fatigue Scale (CFQ‐11); 21‐item Depression, Anxiety, Stress (DASS‐21); Pittsburgh Sleep Quality Index (PSQI); Addenbrooke's Cognitive Examination III (ACE); Trail Making Test A B (TMT‐A TMT‐B). Baseline 8‐week measurements inflammatory markers, including interleukin 6 (IL‐6) C‐reactive protein (CRP), also collected. Results Significant improvements found group CFQ (coefficient −3.5, P 0.024), DASS‐anxiety (−2.0, 0.011), ACE (2.1, 0.012). No significant differences observed PSQI, DASS‐depression, TMT, IL‐6, CRP levels. The incidence adverse events was comparable between groups, no serious reported. Conclusion High‐dose may benefit syndrome by reducing fatigue, anxiety, improving cognitive symptoms, minimal side effects.

Language: Английский

---

SARS-CoV-2 Infection and Multiple Sclerosis: Proactive Approach in a Vulnerable Patient Group through Daily Vitamin D Supplementation?

Published: Feb. 10, 2024

VitD deficiency-risk factor pathologyHans-Klaus Goischke (2024) SARS-CoV-2 Infection and Multiple Sclerosis: Proactive Approach in a Vulnerable Patient Group through Daily Vitamin D Supplementation?rate was significantly lower than with values below or deficiency [17].Current data suggest protective role for VitD, particularly risk of intensive care unit admission reduced death [18,19].In addition, the occurrence Long-Covid is an aspect implementing this simple, effective, safe costeffective therapy broad therapeutic window prevention treatment .Although there still no indisputable evidence that Vit supplementation (VitD suppl.)reduces SARSCov-2 infection healthy individuals, collective it benefits vulnerable individuals [23].PwMS comorbidities, psychiatric illnesses, hypertension, obesity (an increased BMI may correlate severe course Covid-19), age > 50 years, disability methylprednisolone boost as well some DMTs (disease-modifying therapies) have higher COVID-19 courses [24-26].Infections (SARS-COV-2) can increase MS symptoms (pseudo-relapses) cause real relapses [27].In post-COVID syndrome (Long Covid), one eight patients presents such fatigue, shortness breath, cough, joint pain, chest muscle headache paresthesia limbs after at least 3 months.The latter also occur PwMS per se [28,29].If vitamin administration results infection, severity illness to people risk, occurs less frequently [18,19,21,22,30-33], not ethically justifiable withhold high dose vitamin-D from risk. Mechanisms Action COVID-19Barrea et al. list detail 14 mechanisms described by suppl. be sufficient Covid 19 vaccination supported [19,29,32,[34][35][36][37][38].Vit its metabolites inactivate viruses (increase antimicrobial peptide cathelicidin, defensins), lead reduction cytokine storm, reduce matrix metalloproteinase-9 concentration thereby host's metabolic tolerance damage, pneumonia myocarditis, pro-inflammatory cytokines, especially interleukin 6 (IL-6), which promotes permeability BBB, leads potentiation CNS damage PwMS, serious [29,[39][40][41][42]. enables neuroprotection reducing inflammation oxidative stress.Low 25(OH)D levels were inversely correlated IL-6 independent predictors mortality [43].1,25(OH)2D3 inhibits immunoglobulin synthesis, regulates B cell activity reduces auto-Ab production.It converts cells into plasma [18].Vit EBV [29].Current studies show chronic Long Covid-19 reactivation latent Epstein-Barr virus (EBV) worsening health status [44-48].In MS, level molecular mimicry between transcription EBNA-1 protein GlialCAM (glial adhesion molecule central nervous system [49].Bernal able detect detecting DNA antibodies against EBV-lytic genes [50].

Language: Английский

---

Vitamin D in the critically ill – update 2024

Current Opinion in Clinical Nutrition & Metabolic Care, Journal Year: 2024, Volume and Issue: unknown

Published: Aug. 27, 2024

Purpose of review This aims to summarize the latest publications on vitamin D focused critically ill patients. Recent findings Vitamin deficiency is common in patients (children and adults) associated with a higher risk for mortality morbidity as well sepsis, acute respiratory failure, renal failure prolonged ICU stay. As it an inexpensive substance wide safety margin, treatment form loading dose addition ongoing maintenance therapy interesting option ICU. The potential benefit native (biologically inactive) has not fully been answered but even small survival demonstrable very large analyses could be relevant critical care. To date, less than 5000 cumulative have enrolled randomized controlled trials concerning D, substantial heterogeneity trial design regarding population (with or without deficiency, coronavirus disease 2019, different age groups, underlying illnesses), metabolite, dosing, outcome, more. Summary More research needed, supplementation represents simple intervention excellent profile. adequate essential health multiple organ systems, rapid normalization states translate benefits across range diagnoses dysfunctions experienced setting. minimum, we recommend administering standard daily D3 patient.

Language: Английский

---

Impact of vitamin D on COVID-19 and other viral diseases

World Journal of Virology, Journal Year: 2024, Volume and Issue: 13(4)

Published: Oct. 18, 2024

This editorial aims to elucidate the intricate relationship between vitamin D and viral pathogenesis. It explores anticipated role of as a modulator in immune response against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) other pathogens. The comments are based on review article by Engin et al . potential modulating responses has been highlighted several studies, suggesting that it may influence both risk severity infections. Vitamin receptors present immunocompetent cells, which indicates can potentially modulate innate adaptive responses. context is relevant pathophysiology disease 2019 (COVID-19), where virus significantly impact progression outcome. immunomodulatory effects protect SARS-CoV-2 infection enhancing also maintains integrity body's physical barriers modulates inflammatory responses, thereby preventing entry replication virus. Many studies have suggested adequate levels help alleviate morbidity mortality associated with COVID-19. Furthermore, supplementation linked lower COVID-19 patients, particularly those deficiency during seasons less sunlight exposure.

Language: Английский

---