greenmedinfo--2020-09-09--High prevalence of hypovitaminosis D was found in COVID-19 patients with acute respiratory failure,

PURPOSE : Hypovitaminosis D is a highly spread condition correlated with increased risk of respiratory tract infections .
Nowadays , the world is in the grip of the Coronavirus disease 19 ( COVID 19 ) pandemic .
In these patients , cytokine storm is associated with disease severity .
In consideration of the role of vitamin D in the immune system , aim of this study was to analyse vitamin D levels in patients with acute respiratory failure due to COVID-19 and to assess any correlations with disease severity and prognosis .
METHODS : In this retrospective , observational study @ @ @ @ @ @ @ laboratory data of 42 patients with acute respiratory failure due to COVID-19 , treated in Respiratory Intermediate Care Unit ( RICU ) of the Policlinic of Bari from March , 11 to April 30 , 2020 .
RESULTS : Eighty one percent of patients had hypovitaminosis D. Based on vitamin D levels , the population was stratified into four groups : no hypovitaminosis D , insufficiency , moderate deficiency , and severe deficiency .
No differences regarding demographic and clinical characteristics were found .
A survival analysis highlighted that , after 10 days @ @ @ @ @ @ @ patients had a 50 % mortality probability , while those with vitamin D ≥ 10 ng/mL had a 5 % mortality risk ( p = 0.019 ) .
CONCLUSIONS : High prevalence of hypovitaminosis D was found in COVID-19 patients with acute respiratory failure , treated in a RICU .
Patients with severe vitamin D deficiency had a significantly higher mortality risk .
Severe vitamin D deficiency may be a marker of poor prognosis in these patients , suggesting that adjunctive treatment might improve disease outcomes .

PURPOSE: Hypovitaminosis D is a highly spread condition correlated with increased risk of respiratory tract infections. Nowadays, the world is in the grip of the Coronavirus disease 19 (COVID 19) pandemic. In these patients, cytokine storm is associated with disease severity. In consideration of the role of vitamin D in the immune system, aim of this study was to analyse vitamin D levels in patients with acute respiratory failure due to COVID-19 and to assess any correlations with disease severity and prognosis.
METHODS: In this retrospective, observational study, we analysed demographic, clinical and laboratory data of 42 patients with acute respiratory failure due to COVID-19, treated in Respiratory Intermediate Care Unit (RICU) of the Policlinic of Bari from March, 11 to April 30, 2020.
RESULTS: Eighty one percent of patients had hypovitaminosis D. Based on vitamin D levels, the population was stratified into four groups: no hypovitaminosis D, insufficiency, moderate deficiency, and severe deficiency. No differences regarding demographic and clinical characteristics were found. A survival analysis highlighted that, after 10 days of hospitalization, severe vitamin D deficiency patients had a 50% mortality probability, while those with vitamin D ≥ 10 ng/mL had a 5% mortality risk (p = 0.019).
CONCLUSIONS: High prevalence of hypovitaminosis D was found in COVID-19 patients with acute respiratory failure, treated in a RICU. Patients with severe vitamin D deficiency had a significantly higher mortality risk. Severe vitamin D deficiency may be a marker of poor prognosis in these patients, suggesting that adjunctive treatment might improve disease outcomes.


greenmedinfo--2020-09-09--SARS-CoV-2 seroprevalence among parturient women in Philadelphia.

Limited data are available for pregnant women affected by SARS-CoV-2 .
Serological tests are critically important for determining SARS-CoV-2 exposures @ @ @ @ @ .
We validated a SARS-CoV-2 spike receptor binding domain serological test using 834 pre-pandemic samples @ @ @ @ @ recovered donors .
We then completed SARS-CoV-2 serological testing of 1,293 parturient women at two @ @ @ @ @ 4 to June 3 , 2020 .
We found 80/1,293 ( 6.2 % ) of @ @ @ @ @ IgM SARS-CoV-2-specific antibodies .
We found race/ethnicity differences in seroprevalence rates , with higher rates @ @ @ @ @ .
Of the 72 seropositive women who also received nasopharyngeal polymerase chain reaction testing during @ @ @ @ @ % ) were positive .
Continued serologic surveillance among pregnant women may inform perinatal clinical @ @ @ @ @ used to estimate exposure to SARS-CoV-2 within the community .

Limited data are available for pregnant women affected by SARS-CoV-2. Serological tests are critically important for determining SARS-CoV-2 exposures within both individuals and populations. We validated a SARS-CoV-2 spike receptor binding domain serological test using 834 pre-pandemic samples and 31 samples from COVID-19 recovered donors. We then completed SARS-CoV-2 serological testing of 1,293 parturient women at two centers in Philadelphia from April 4 to June 3, 2020. We found 80/1,293 (6.2%) of parturient women possessed IgG and/or IgM SARS-CoV-2-specific antibodies. We found race/ethnicity differences in seroprevalence rates, with higher rates in Black/non-Hispanic and Hispanic/Latino women. Of the 72 seropositive women who also received nasopharyngeal polymerase chain reaction testing during pregnancy, 46 (64%) were positive. Continued serologic surveillance among pregnant women may inform perinatal clinical practices and can potentially be used to estimate exposure to SARS-CoV-2 within the community.


greenmedinfo--2020-09-09--Population point prevalence of SARS-CoV-2 infection based on a statewide random sample - Indiana, Ap

Population point prevalence of SARS-CoV-2 infection based on a statewide random sample - Indiana, April 25–29, 2020.

Population prevalence of persons infected with SARS-CoV-2 , the virus that causes coronavirus disease 2019 ( COVID-19 ) , varies by subpopulation and locality .
U.S. studies of SARS-CoV-2 infection have examined infections in nonrandom samples ( 1 ) or seroprevalence in specific populations* ( 2 ) , which are limited in their generalizability and can not be used to accurately calculate infection-fatality rates .
During April 25-29 , 2020 , Indiana conducted statewide random sample testing of persons aged≥12 years to assess prevalence of active infection and presence of antibodies to SARS-CoV-2 ; additional nonrandom sampling was conducted in @ @ @ @ @ @ @ understand the impact of the virus in certain racial and ethnic minority populations .
Estimates were adjustedfor nonresponse to reflect state demographics using an iterative proportional fitting method .
Among 3,658 noninstitutionalized participants in the random sample survey , the estimated statewide point prevalence of active SARS-CoV-2 infection confirmed by reverse transcription-polymerase chain reaction ( RT-PCR ) testing was 1.74 % ( 95 % confidence interval [ CI ] = 1.10-2.54 ) ; 44.2 % of these persons reported no symptoms during the 2 weeks before testing .
The prevalence of immunoglobulin G @ @ @ @ @ @ @ infection , was 1.09 % ( 95 % CI = 0.76-1.45 ) .
The overall prevalence of current and previous infections of SARS-CoV-2 in Indiana was 2.79 % ( 95 % CI = 2.02-3.70 ) .
In the random sample , higher overall prevalences were observed among Hispanics and those who reported having a household contact who had previously been told by a health care provider that they had COVID-19 .
By late April , an estimated 187,802 Indiana residents were currently or previously infected with SARS-CoV-2 ( 9.6 times higher than the @ @ @ @ @ @ @ ) ( 3 ) , and 1,099 residents died ( infection-fatality ratio = 0.58 % ) .
The number of reported cases represents only a fraction of the estimated total number of infections .
Given the large number of persons who remain susceptible in Indiana , adherence to evidence-based public health mitigation and containment measures ( e.g.
, social distancing , consistent and correct use of face coverings , and hand hygiene ) is needed to reduce surge in hospitalizations and prevent morbidity and mortality from COVID-19 .

Population prevalence of persons infected with SARS-CoV-2, the virus that causes coronavirus disease 2019 (COVID-19), varies by subpopulation and locality. U.S. studies of SARS-CoV-2 infection have examined infections in nonrandom samples (1) or seroprevalence in specific populations* (2), which are limited in their generalizability and cannot be used to accurately calculate infection-fatality rates. During April 25-29, 2020, Indiana conducted statewide random sample testing of persons aged≥12 years to assess prevalence of active infection and presence of antibodies to SARS-CoV-2; additional nonrandom sampling was conducted in racial and ethnic minority communities to better understand the impact of the virus in certain racial and ethnic minority populations. Estimates were adjustedfor nonresponse to reflect state demographics using an iterative proportional fitting method. Among 3,658 noninstitutionalized participants in the random sample survey, the estimated statewide point prevalence of active SARS-CoV-2 infection confirmed by reverse transcription-polymerase chain reaction (RT-PCR) testing was 1.74% (95% confidence interval [CI] = 1.10-2.54); 44.2% of these persons reported no symptoms during the 2 weeks before testing. The prevalence of immunoglobulin G (IgG) seropositivity, indicating past infection, was 1.09% (95% CI = 0.76-1.45). The overall prevalence of current and previous infections of SARS-CoV-2 in Indiana was 2.79% (95% CI = 2.02-3.70). In the random sample, higher overall prevalences were observed among Hispanics and those who reported having a household contact who had previously been told by a health care provider that they had COVID-19. By late April, an estimated 187,802 Indiana residents were currently or previously infected with SARS-CoV-2 (9.6 times higher than the number of confirmed cases [17,792]) (3), and 1,099 residents died (infection-fatality ratio = 0.58%). The number of reported cases represents only a fraction of the estimated total number of infections. Given the large number of persons who remain susceptible in Indiana, adherence to evidence-based public health mitigation and containment measures (e.g., social distancing, consistent and correct use of face coverings, and hand hygiene) is needed to reduce surge in hospitalizations and prevent morbidity and mortality from COVID-19.


greenmedinfo--2020-09-09--Seroprevalence of antibodies to SARS-CoV-2 in 10 sites in the United States, March 23-May 12, 2020.

Importance : Reported cases of severe acute respiratory syndrome coronavirus 2 ( SARS-CoV-2 ) infection likely underestimate the prevalence of infection in affected communities .
Large-scale seroprevalence studies provide better estimates of the proportion of the population previously infected .
Objective : To estimate prevalence of SARS-CoV-2 antibodies in convenience samples from several geographic sites in the US .
Design , Setting , and Participants : This cross-sectional study performed serologic testing on a convenience sample of residual sera obtained from persons of all ages .
The serum was collected from March 23 through May 12 , 2020 , for @ @ @ @ @ @ @ companies .
Sites of collection were San Francisco Bay area , California ; Connecticut ; south Florida ; Louisiana ; Minneapolis-St Paul-St Cloud metro area , Minnesota ; Missouri ; New York City metro area , New York ; Philadelphia metro area , Pennsylvania ; Utah ; and western Washington State .
Main Outcomes and Measures : The presence of antibodies to SARS-CoV-2 spike protein was estimated using an enzyme-linked immunosorbent assay , and estimates were standardized to the site populations by age and sex .
Estimates were adjusted for test performance characteristics @ @ @ @ @ @ @ specificity ) .
The number of infections in each site was estimated by extrapolating seroprevalence to site populations ; estimated infections were compared with the number of reported coronavirus disease 2019 ( COVID-19 ) cases as of last specimen collection date .
Results : Serum samples were tested from 16 025 persons , 8853 ( 55.2 % ) of whom were women ; 1205 ( 7.5 % ) were 18 years or younger and 5845 ( 36.2 % ) were 65 years or older .
Most specimens from each site had no evidence @ @ @ @ @ @ @ of the proportion of persons seroreactive to the SARS-CoV-2 spike protein antibodies ranged from 1.0 % in the San Francisco Bay area ( collected April 23-27 ) to 6.9 % of persons in New York City ( collected March 23-April 1 ) .
The estimated number of infections ranged from 6 to 24 times the number of reported cases ; for 7 sites ( Connecticut , Florida , Louisiana , Missouri , New York City metro area , Utah , and western Washington State ) , an estimated greater than 10 times more @ @ @ @ @ @ @ reported cases .
Conclusions and Relevance : During March to early May 2020 , most persons in 10 diverse geographic sites in the US had not been infected with SARS-CoV-2 virus .
The estimated number of infections , however , was much greater than the number of reported cases in all sites .
The findings may reflect the number of persons who had mild or no illness or who did not seek medical care or undergo testing but who still may have contributed to ongoing virus transmission in the population .

Importance: Reported cases of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection likely underestimate the prevalence of infection in affected communities. Large-scale seroprevalence studies provide better estimates of the proportion of the population previously infected.
Objective: To estimate prevalence of SARS-CoV-2 antibodies in convenience samples from several geographic sites in the US.
Design, Setting, and Participants: This cross-sectional study performed serologic testing on a convenience sample of residual sera obtained from persons of all ages. The serum was collected from March 23 through May 12, 2020, for routine clinical testing by 2 commercial laboratory companies. Sites of collection were San Francisco Bay area, California; Connecticut; south Florida; Louisiana; Minneapolis-St Paul-St Cloud metro area, Minnesota; Missouri; New York City metro area, New York; Philadelphia metro area, Pennsylvania; Utah; and western Washington State.
Exposures: Infection with SARS-CoV-2.
Main Outcomes and Measures: The presence of antibodies to SARS-CoV-2 spike protein was estimated using an enzyme-linked immunosorbent assay, and estimates were standardized to the site populations by age and sex. Estimates were adjusted for test performance characteristics (96.0% sensitivity and 99.3% specificity). The number of infections in each site was estimated by extrapolating seroprevalence to site populations; estimated infections were compared with the number of reported coronavirus disease 2019 (COVID-19) cases as of last specimen collection date.
Results: Serum samples were tested from 16 025 persons, 8853 (55.2%) of whom were women; 1205 (7.5%) were 18 years or younger and 5845 (36.2%) were 65 years or older. Most specimens from each site had no evidence of antibodies to SARS-CoV-2. Adjusted estimates of the proportion of persons seroreactive to the SARS-CoV-2 spike protein antibodies ranged from 1.0% in the San Francisco Bay area (collected April 23-27) to 6.9% of persons in New York City (collected March 23-April 1). The estimated number of infections ranged from 6 to 24 times the number of reported cases; for 7 sites (Connecticut, Florida, Louisiana, Missouri, New York City metro area, Utah, and western Washington State), an estimated greater than 10 times more SARS-CoV-2 infections occurred than the number of reported cases.
Conclusions and Relevance: During March to early May 2020, most persons in 10 diverse geographic sites in the US had not been infected with SARS-CoV-2 virus. The estimated number of infections, however, was much greater than the number of reported cases in all sites. The findings may reflect the number of persons who had mild or no illness or who did not seek medical care or undergo testing but who still may have contributed to ongoing virus transmission in the population.


greenmedinfo--2020-09-09--Vitamin D supplementation may serve as a viable alternative for curtailing acute respiratory distres

Vitamin D supplementation may serve as a viable alternative for curtailing acute respiratory distress syndrome.

BACKGROUND : Coronavirus disease 2019 ( COVID-19 ) has infected more than 4.4 million people and caused more than 300,000 deaths partly through acute respiratory distress syndrome with propensity to affect African American and Hispanic communities disproportionately .
Patients with worse outcomes have exhibited higher blood plasma levels of proinflammatory cytokines .
Activation of the vitamin D receptor expressed on immune cells has been shown to directly reduce the secretion of inflammatory cytokines , such as interleukin-6 , and indirectly affect C-reactive protein .
AREAS OF UNCERTAINTY : The significance of the vitamin D pathway in patients diagnosed with COVID-19 @ @ @ @ @ @ @ in patients after diagnosis of COVID-19 .
PATIENTS AND PHARMACOLOGICAL INTERVENTIONS : We report 4 vitamin D deficient patients diagnosed with COVID-19 in April 2020 who were provided with either cholecalciferol of 1000 IU daily ( standard dose ) or ergocalciferol 50,000 IU daily for 5 days ( high dose ) as part of supplementation .
CLINICAL OUTCOMES : Patients that received a high dose of vitamin D supplementation achieved normalization of vitamin D levels and improved clinical recovery evidenced by shorter lengths of stay , lower oxygen requirements , and a reduction @ @ @ @ @ @ @ Vitamin D supplementation may serve as a viable alternative for curtailing acute respiratory distress syndrome in patients in underserved communities where resources to expensive and sought-after medications may be scarce .
Randomized clinical trials will serve as an appropriate vessel to validate the efficacy of the therapeutic regimen and dissection of the pathway .

BACKGROUND: Coronavirus disease 2019 (COVID-19) has infected more than 4.4 million people and caused more than 300,000 deaths partly through acute respiratory distress syndrome with propensity to affect African American and Hispanic communities disproportionately. Patients with worse outcomes have exhibited higher blood plasma levels of proinflammatory cytokines. Activation of the vitamin D receptor expressed on immune cells has been shown to directly reduce the secretion of inflammatory cytokines, such as interleukin-6, and indirectly affect C-reactive protein.
AREAS OF UNCERTAINTY: The significance of the vitamin D pathway in patients diagnosed with COVID-19.
THERAPEUTIC INNOVATION: Vitamin D supplementation in patients after diagnosis of COVID-19.
PATIENTS AND PHARMACOLOGICAL INTERVENTIONS: We report 4 vitamin D deficient patients diagnosed with COVID-19 in April 2020 who were provided with either cholecalciferol of 1000 IU daily (standard dose) or ergocalciferol 50,000 IU daily for 5 days (high dose) as part of supplementation.
CLINICAL OUTCOMES: Patients that received a high dose of vitamin D supplementation achieved normalization of vitamin D levels and improved clinical recovery evidenced by shorter lengths of stay, lower oxygen requirements, and a reduction in inflammatory marker status.
CONCLUSIONS: Vitamin D supplementation may serve as a viable alternative for curtailing acute respiratory distress syndrome in patients in underserved communities where resources to expensive and sought-after medications may be scarce. Randomized clinical trials will serve as an appropriate vessel to validate the efficacy of the therapeutic regimen and dissection of the pathway.


greenmedinfo--2020-09-09--Vitamin D can be effective on the prevention of COVID-19 complications.

The widespread COVID-19 pandemic has been , currently , converted to a catastrophic human health challenge .
Vitamin D ( VD ) and its metabolites have been used as a palliative treatment for chronic inflammatory and infectious diseases from ancient times .
In the current study , some molecular aspects of the potential effects of VD against COVID-19 side-effects have been discussed .
An arguable role in autophagy or apoptosis control has been suggested for VD through calcium signaling at the mitochondrial and ER levels .
1,25 ( OH ) 2D3 is also an immunomodulator that affects the development of @ @ @ @ @ @ @ in both innate and acquired immunity .
The production of some anti-microbial molecules such as defensins and cathelicidins is also stimulated by VD .
The overexpression of glutathione , glutathione peroxidase , and superoxide dismutase , and down-regulation of NADPH oxidase are induced by VD to reduce the oxidative stress .
Moreover , the multi-organ failure due to a cytokine storm induced by SARS-CoV2 in COVID-19 may be prevented by the immunomodulatory effects of VD .
It can also downregulate the renin-angiotensin system which has a protective role against cardiovascular complications induced by @ @ @ @ @ @ @ molecular evidences due to the potential protective effects of VD on the prevention of the COVID-19-induced morbidities , a VD supplementation is suggested to prevent the lethal side-effects of the infection .
It is particularly recommended in VD-deficient patients or those at greater risk of serious or critical effects of COVID-19 , including the elderly , and patients with pre-existing chronic diseases , especially those in nursing homes , care facilities , and hospitals .

The widespread COVID-19 pandemic has been, currently, converted to a catastrophic human health challenge. Vitamin D (VD) and its metabolites have been used as a palliative treatment for chronic inflammatory and infectious diseases from ancient times. In the current study, some molecular aspects of the potential effects of VD against COVID-19 side-effects have been discussed. An arguable role in autophagy or apoptosis control has been suggested for VD through calcium signaling at the mitochondrial and ER levels. 1,25(OH)2D3 is also an immunomodulator that affects the development of B-cells, T-cells, and NK cells in both innate and acquired immunity. The production of some anti-microbial molecules such as defensins and cathelicidins is also stimulated by VD. The overexpression of glutathione, glutathione peroxidase, and superoxide dismutase, and down-regulation of NADPH oxidase are induced by VD to reduce the oxidative stress. Moreover, the multi-organ failure due to a cytokine storm induced by SARS-CoV2 in COVID-19 may be prevented by the immunomodulatory effects of VD. It can also downregulate the renin-angiotensin system which has a protective role against cardiovascular complications induced by COVID-19. Given the many experimental and molecular evidences due to the potential protective effects of VD on the prevention of the COVID-19-induced morbidities, a VD supplementation is suggested to prevent the lethal side-effects of the infection. It is particularly recommended in VD-deficient patients or those at greater risk of serious or critical effects of COVID-19, including the elderly, and patients with pre-existing chronic diseases, especially those in nursing homes, care facilities, and hospitals.


greenmedinfo--2020-09-09--Vitamin D insufficiency and deficiency are common and account for a large proportion of respiratory

Vitamin D insufficiency and deficiency are common and account for a large proportion of respiratory disease mortality in older adults.

The COVID-19 pandemic goes along with increased mortality from acute respiratory disease .
It has been suggested that vitamin Dsupplementation might help to reduce respiratory disease mortality .
We assessed the prevalence of vitamin D insufficiency and deficiency , defined by 25-hydroxyvitamin D ( 25 ( OH ) D ) blood levels of 30-50 and < 30 nmol/L , respectively , and their association with mortality from respiratory diseases during 15 years of follow-up in a cohort of 9548 adults aged 50-75 years from Saarland , Germany .
Vitamin D insufficiency and deficiency were common ( 44 % and 15 @ @ @ @ @ @ @ those with sufficient vitamin D status , participants with vitamin D insufficiency and deficiency had strongly increased respiratory mortality , with adjusted hazard ratios ( 95 % confidence intervals ) of 2.1 ( 1.3-3.2 ) and 3.0 ( 1.8-5.2 ) overall , 4.3 ( 1.3-14.4 ) and 8.5 ( 2.4-30.1 ) among women , and 1.9 ( 1.1-3.2 ) and 2.3 ( 1.1-4.4 ) among men .
Overall , 41 % ( 95 % confidence interval : 20-58 % ) of respiratory disease mortality was statistically attributable to vitamin D insufficiency or deficiency @ @ @ @ @ @ @ common and account for a large proportion of respiratory disease mortality in older adults , supporting the hypothesis that vitamin Dsupplementation could be helpful to limit the burden of the COVID-19 pandemic , particularly among women .

The COVID-19 pandemic goes along with increased mortality from acute respiratory disease. It has been suggested that vitamin Dsupplementation might help to reduce respiratory disease mortality. We assessed the prevalence of vitamin D insufficiency and deficiency, defined by 25-hydroxyvitamin D (25(OH)D) blood levels of 30-50 and<30 nmol/L, respectively, and their association with mortality from respiratory diseases during 15 years of follow-up in a cohort of 9548 adults aged 50-75 years from Saarland, Germany. Vitamin D insufficiency and deficiency were common (44% and 15%, respectively). Compared to those with sufficient vitamin D status, participants with vitamin D insufficiency and deficiency had strongly increased respiratory mortality, with adjusted hazard ratios (95% confidence intervals) of 2.1 (1.3-3.2) and 3.0 (1.8-5.2) overall, 4.3 (1.3-14.4) and 8.5 (2.4-30.1) among women, and 1.9 (1.1-3.2) and 2.3 (1.1-4.4) among men. Overall, 41% (95% confidence interval: 20-58%) of respiratory disease mortality was statistically attributable to vitamin D insufficiency or deficiency. Vitamin D insufficiency and deficiency are common and account for a large proportion of respiratory disease mortality in older adults, supporting the hypothesis that vitamin Dsupplementation could be helpful to limit the burden of the COVID-19 pandemic, particularly among women.


greenmedinfo--2020-09-09--This review also discusses recommendations for Vitamin D dose required for healthy as well as COVID-

Coronavirus disease ( COVID-19 ) is a major pandemic and now a leading cause of death worldwide .
Currently , @ @ @ @ @ the treatment of this disease .
Future preventions and social distancing are the only ways @ @ @ @ @ community transmission .
Vitamin D is an important micronutrient and has been reported to improve @ @ @ @ @ illness .
This short review highlights the important scientific link between Vitamin D levels and @ @ @ @ @ .
This review also discusses recommendations for Vitamin D dose required for healthy as well @ @ @ @ @ protection and prevention .

Coronavirus disease (COVID-19) is a major pandemic and now a leading cause of death worldwide. Currently, no drugs/vaccine is available for the treatment of this disease. Future preventions and social distancing are the only ways to prevent this disease from community transmission. Vitamin D is an important micronutrient and has been reported to improve immunity and protect against respiratory illness. This short review highlights the important scientific link between Vitamin D levels and susceptibility to COVID-19 in patients. This review also discusses recommendations for Vitamin D dose required for healthy as well as COVID-19 susceptible patients for protection and prevention.


greenmedinfo--2020-09-09--Vitamin D in COVID - 19: Dousing the fire or averting the storm?

COVID-19 , the acute respiratory tract infection ( RTI ) caused by the Coronavirus , Sars-CoV-2 , has swept around the world .
No country has been spared from its onslaught .
Treatments that can reduce the risk of infection and mortality from the disease are desperately needed .
Though high quality randomized controlled trials are lacking , some observational and interventional studies that explore the link between vitamin D and RTIs exist .
Vitamin D modulates both innate as well as adaptive immunity and may potentially prevent or mitigate the complications associated with RTIs .
Evidence linking vitamin D @ @ @ @ @ @ @ in winter in the northern hemisphere at a time when vitamin D levels are lowest in resident populations , that blacks and minority ethnic individuals who are known to have lower levels of vitamin D appear to be disproportionately affected and have more severe complications from the disease , that vitamin D deficiency has been shown to contribute to acute respiratory distress syndrome and that case fatality rates increase with age and in populations with comorbid conditions such as diabetes , hypertension , and cardiovascular disease , all of which are associated with @ @ @ @ @ @ @ review summarizes the current knowledge about the epidemiology and pathophysiology of COVID-19 , the evidence linking vitamin D and RTIs , especially COVID-19 , the mechanistic reasons behind the possible protective effect of vitamin D in COVID-19 , and the evidence with regard to vitamin D supplementation in RTIs .
It concludes with some recommendations regarding supplementation of vitamin D in patients with COVID-19 .

COVID-19, the acute respiratory tract infection (RTI) caused by the Coronavirus, Sars-CoV-2, has swept around the world. No country has been spared from its onslaught. Treatments that can reduce the risk of infection and mortality from the disease are desperately needed. Though high quality randomized controlled trials are lacking, some observational and interventional studies that explore the link between vitamin D and RTIs exist. Vitamin D modulates both innate as well as adaptive immunity and may potentially prevent or mitigate the complications associated with RTIs. Evidence linking vitamin D to COVID-19 include that the outbreak occurred in winter in the northern hemisphere at a time when vitamin D levels are lowest in resident populations, that blacks and minority ethnic individuals who are known to have lower levels of vitamin D appear to be disproportionately affected and have more severe complications from the disease, that vitamin D deficiency has been shown to contribute to acute respiratory distress syndrome and that case fatality rates increase with age and in populations with comorbid conditions such as diabetes, hypertension, and cardiovascular disease, all of which are associated with lower vitamin D levels. This narrative review summarizes the current knowledge about the epidemiology and pathophysiology of COVID-19, the evidence linking vitamin D and RTIs, especially COVID-19, the mechanistic reasons behind the possible protective effect of vitamin D in COVID-19, and the evidence with regard to vitamin D supplementation in RTIs. It concludes with some recommendations regarding supplementation of vitamin D in patients with COVID-19.


greenmedinfo--2020-09-09--Inhibitory effects of Vitamin D on inflammation and IL-6 release. A further support for COVID-19 man

Inhibitory effects of Vitamin D on inflammation and IL-6 release. A further support for COVID-19 management?

The ongoing worldwide pandemic of Coronavirus disease 2019 ( COVID-19 ) , raised the urgency to address knowledge gaps and @ @ @ @ @ management and control of this viral infection .
Throughout a keen analysis of the World @ @ @ @ @ most updated data , a gender-specific difference in the occurrence of infection was determined , @ @ @ @ @ patient 's vitamin D status .
Therefore , our purpose is to provide insights into @ @ @ @ @ D for its immunomodulatory effect , in order to help counteracting the COVID-19 pandemic .
@ @ @ @ @ vitamin D , by inducing progesterone-induced blocking factor ( PIBF ) , might regulate the @ @ @ @ @ cytokine IL-6 , which appears to be increased in COVID-19 infections .
Therefore , in @ @ @ @ @ to prevent the infection , supplementation of vitamin D might be considered an approach to @ @ @ @ @ .

The ongoing worldwide pandemic of Coronavirus disease 2019 (COVID-19), raised the urgency to address knowledge gaps and to establish evidence for improving management and control of this viral infection. Throughout a keen analysis of the World Health Organization (WHO) most updated data, a gender-specific difference in the occurrence of infection was determined, which seems to correlate with patient's vitamin D status. Therefore, our purpose is to provide insights into the nutritional importance of vitamin D for its immunomodulatory effect, in order to help counteracting the COVID-19 pandemic. Novel interesting findings suggest that vitamin D, by inducing progesterone-induced blocking factor (PIBF), might regulate the immune response and also modulate cytokine IL-6, which appears to be increased in COVID-19 infections. Therefore, in addition to the standard recommendations to prevent the infection, supplementation of vitamin D might be considered an approach to help counteracting this global epidemic.


greenmedinfo--2020-09-09--Level 1 and 2 evidence supports the use of thiamine, vitamin C, and vitamin D in COVID-like respirat

There are limited proven therapeutic options for the prevention and treatment of COVID-19 .
The role of vitamin and mineral supplementation or '' immunonutrition '' has previously been explored in a number of clinical trials in intensive care settings , and there are several hypotheses to support their routine use .
The aim of this narrative review was to investigate whether vitamin supplementation is beneficial in COVID-19 .
A systematic search strategy with a narrative literature summary was designed , using the Medline , EMBASE , Cochrane Trials Register , WHO International Clinical Trial Registry , and Nexis media databases @ @ @ @ @ @ @ roles of vitamins A to E were explored and their potential role in the fight against COVID-19 was evaluated .
The major topics extracted for narrative synthesis were physiological and immunological roles of each vitamin , their role in respiratory infections , acute respiratory distress syndrome ( ARDS ) , and COVID-19 .
Vitamins A to E highlighted potentially beneficial roles in the fight against COVID-19 via antioxidant effects , immunomodulation , enhancing natural barriers , and local paracrine signaling .
Level 1 and 2 evidence supports the use of thiamine , vitamin @ @ @ @ @ @ @ respiratory diseases , ARDS , and sepsis .
Although there are currently no published clinical trials due to the novelty of SARS-CoV-2 infection , there is pathophysiologic rationale for exploring the use of vitamins in this global pandemic , supported by early anecdotal reports from international groups .
The final outcomes of ongoing trials of vitamin supplementation are awaited with interest .

There are limited proven therapeutic options for the prevention and treatment of COVID-19. The role of vitamin and mineral supplementation or"immunonutrition"has previously been explored in a number of clinical trials in intensive care settings, and there are several hypotheses to support their routine use. The aim of this narrative review was to investigate whether vitamin supplementation is beneficial in COVID-19. A systematic search strategy with a narrative literature summary was designed, using the Medline, EMBASE, Cochrane Trials Register, WHO International Clinical Trial Registry, and Nexis media databases. The immune-mediating, antioxidant and antimicrobial roles of vitamins A to E were explored and their potential role in the fight against COVID-19 was evaluated. The major topics extracted for narrative synthesis were physiological and immunological roles of each vitamin, their role in respiratory infections, acute respiratory distress syndrome (ARDS), and COVID-19. Vitamins A to E highlighted potentially beneficial roles in the fight against COVID-19 via antioxidant effects, immunomodulation, enhancing natural barriers, and local paracrine signaling. Level 1 and 2 evidence supports the use of thiamine, vitamin C, and vitamin D in COVID-like respiratory diseases, ARDS, and sepsis. Although there are currently no published clinical trials due to the novelty of SARS-CoV-2 infection, there is pathophysiologic rationale for exploring the use of vitamins in this global pandemic, supported by early anecdotal reports from international groups. The final outcomes of ongoing trials of vitamin supplementation are awaited with interest.


greenmedinfo--2020-09-09--The importance of vitamin d metabolism as a potential prophylactic, immunoregulatory and neuroprotec

The importance of vitamin d metabolism as a potential prophylactic, immunoregulatory and neuroprotective treatment for COVID-19.

The coronavirus disease 2019 ( COVID-19 ) pandemic has led to a declaration of a Public Health Emergency of International Concern by the World Health Organization .
As of May 18 , 2020 , there have been more than 4.7 million cases and over 316,000 deaths worldwide .
COVID-19 is caused by a highly infectious novel coronavirus known as severe acute respiratory syndrome coronavirus-2 ( SARS-CoV-2 ) , leading to an acute infectious disease with mild-to-severe clinical symptoms such as flu-like symptoms , fever , headache , dry cough , muscle pain , loss of smell and taste , increased @ @ @ @ @ @ @ , conjunctivitis , acute respiratory distress syndromes , respiratory failure , cytokine release syndrome ( CRS ) , sepsis , etc .
While physicians and scientists have yet to discover a treatment , it is imperative that we urgently address 2 questions : how to prevent infection in immunologically naive individuals and how to treat severe symptoms such as CRS , acute respiratory failure , and the loss of somatosensation .
Previous studies from the 1918 influenza pandemic have suggested vitamin D 's non-classical role in reducing lethal pneumonia and case fatality rates @ @ @ @ @ @ @ vitamin D supplementation can reduce incidence of acute respiratory infection and the severity of respiratory tract diseases in adults and children .
According to our literature search , there are no similar findings of clinical trials that have been published as of July 1st , 2020 , in relation to the supplementation of vitamin D in the potential prevention and treatment for COVID-19 .
In this review , we summarize the potential role of vitamin D extra-renal metabolism in the prevention and treatment of the SARS-CoV-2 infection , helping to bring us slightly @ @ @ @ @ @ @ will focus on 3 major topics here : 1 .
Vitamin D might aid in preventing SARS-CoV-2 infection : Vitamin D : Overview of Renal and Extra-renal metabolism and regulation .
Vitamin D : Overview of molecular mechanism and multifaceted functions beyond skeletal homeostasis .
Vitamin D : Overview of local immunomodulation in human infectious diseases .
Anti-viral infection .
Anti-malaria and anti-systemic lupus erythematosus ( SLE ) .
2 .
Vitamin D might act as a strong immunosuppressant inhibiting cytokine release syndrome in COVID-19 : Vitamin D : Suppression of key pro-inflammatory @ @ @ @ @ @ @ NF-kB ) , interleukin-6 ( IL-6 ) , and tumor necrosis factor ( TNF ) .
3 .
Vitamin D might prevent loss of neural sensation in COVID-19 by stimulating expression of neurotrophins like Nerve Growth Factor ( NGF ) : Vitamin D : Induction of key neurotrophic factors .
.

The coronavirus disease 2019 (COVID-19) pandemic has led to a declaration of a Public Health Emergency of International Concern by the World Health Organization. As of May 18, 2020, there have been more than 4.7 million cases and over 316,000 deaths worldwide. COVID-19 is caused by a highly infectious novel coronavirus known as severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), leading to an acute infectious disease with mild-to-severe clinical symptoms such as flu-like symptoms, fever, headache, dry cough, muscle pain, loss of smell and taste, increased shortness of breath, bilateral viral pneumonia, conjunctivitis, acute respiratory distress syndromes, respiratory failure, cytokine release syndrome (CRS), sepsis, etc. While physicians and scientists have yet to discover a treatment, it is imperative that we urgently address 2 questions: how to prevent infection in immunologically naive individuals and how to treat severe symptoms such as CRS, acute respiratory failure, and the loss of somatosensation. Previous studies from the 1918 influenza pandemic have suggested vitamin D's non-classical role in reducing lethal pneumonia and case fatality rates. Recent clinical trials also reported that vitamin D supplementation can reduce incidence of acute respiratory infection and the severity of respiratory tract diseases in adults and children. According to our literature search, there are no similar findings of clinical trials that have been published as of July 1st, 2020, in relation to the supplementation of vitamin D in the potential prevention and treatment for COVID-19. In this review, we summarize the potential role of vitamin D extra-renal metabolism in the prevention and treatment of the SARS-CoV-2 infection, helping to bring us slightly closer to fulfilling that goal. We will focus on 3 major topics here: 1. Vitamin D might aid in preventing SARS-CoV-2 infection: Vitamin D: Overview of Renal and Extra-renal metabolism and regulation. Vitamin D: Overview of molecular mechanism and multifaceted functions beyond skeletal homeostasis. Vitamin D: Overview of local immunomodulation in human infectious diseases. Anti-viral infection. Anti-malaria and anti-systemic lupus erythematosus (SLE). 2. Vitamin D might act as a strong immunosuppressant inhibiting cytokine release syndrome in COVID-19: Vitamin D: Suppression of key pro-inflammatory pathways including nuclear factor kappa B (NF-kB), interleukin-6 (IL-6), and tumor necrosis factor (TNF). 3. Vitamin D might prevent loss of neural sensation in COVID-19 by stimulating expression of neurotrophins like Nerve Growth Factor (NGF): Vitamin D: Induction of key neurotrophic factors. .


greenmedinfo--2020-09-09--Older adults with vitamin D deficiency and COVID-19 may demonstrate worse morbidity outcomes.

PURPOSE : Older adults are more likely to be vitamin D deficient .
The aim of the study was to determine whether these patients have worse outcomes with COVID-19 .
METHODS : We conducted a prospective cohort study between 1 March and 30 April 2020 to assess the importance of vitamin D deficiency in older patients with COVID-19 .
The cohort consisted of patients aged≥65 years presenting with symptoms consistent with COVID-19 ( n=105 ) .
All patients were tested for serum 25-hydroxyvitamin D ( 25 ( OH ) D ) levels during acute illness .
Diagnosis of COVID-19 was @ @ @ @ @ @ @ or supporting radiological evidence .
COVID-19-positive arm ( n=70 ) was sub-divided into vitamin D-deficient ( ≤30 nmol/L ) ( n=39 ) and -replete groups ( n=35 ) .
Subgroups were assessed for disease severity using biochemical , radiological and clinical markers .
Primary outcome was in-hospital mortality .
Secondary outcomes were laboratory features of cytokine storm , thoracic imaging changes and requirement of non-invasive ventilation ( NIV ) .
RESULTS : COVID-19-positive arm demonstrated lower median serum 25 ( OH ) D level of 27 nmol/L ( IQR=20-47 nmol/L ) compared with @ @ @ @ @ @ @ 52 nmol/L ( IQR=31.5-71.5 nmol/L ) ( p value=0.0008 ) .
Among patients with vitamin D deficiency , there was higher peak D-dimer level ( 1914.00 μgFEU/L vs 1268.00 μgFEU/L ) ( p=0.034 ) and higher incidence of NIV support and high dependency unit admission ( 30.77 % vs 9.68 % ) ( p=0.042 ) .
No increased mortality was observed between groups .
CONCLUSION : Older adults with vitamin D deficiency and COVID-19 may demonstrate worse morbidity outcomes .
Vitamin D status may be a useful prognosticator .

PURPOSE: Older adults are more likely to be vitamin D deficient. The aim of the study was to determine whether these patients have worse outcomes with COVID-19.
METHODS: We conducted a prospective cohort study between 1 March and 30 April 2020 to assess the importance of vitamin D deficiency in older patients with COVID-19. The cohort consisted of patients aged≥65 years presenting with symptoms consistent with COVID-19 (n=105). All patients were tested for serum 25-hydroxyvitamin D (25(OH)D) levels during acute illness. Diagnosis of COVID-19 was confirmed via viral reverse transcriptase PCR swab or supporting radiological evidence. COVID-19-positive arm (n=70) was sub-divided into vitamin D-deficient (≤30 nmol/L) (n=39) and -replete groups (n=35). Subgroups were assessed for disease severity using biochemical, radiological and clinical markers. Primary outcome was in-hospital mortality. Secondary outcomes were laboratory features of cytokine storm, thoracic imaging changes and requirement of non-invasive ventilation (NIV).
RESULTS: COVID-19-positive arm demonstrated lower median serum 25(OH)D level of 27 nmol/L (IQR=20-47 nmol/L) compared with COVID-19-negative arm, with median level of 52 nmol/L (IQR=31.5-71.5 nmol/L) (p value=0.0008). Among patients with vitamin D deficiency, there was higher peak D-dimer level (1914.00 μgFEU/L vs 1268.00 μgFEU/L) (p=0.034) and higher incidence of NIV support and high dependency unit admission (30.77% vs 9.68%) (p=0.042). No increased mortality was observed between groups.
CONCLUSION: Older adults with vitamin D deficiency and COVID-19 may demonstrate worse morbidity outcomes. Vitamin D status may be a useful prognosticator.


greenmedinfo--2020-09-09--Vitamin D and Covid-19: From potential therapeutic effects to unanswered questions.

Evidence suggests that vitamin D supplementation could potentially be effective either in treatment or prevention of coronavirus disease 2019 ( @ @ @ @ @ several studies and trials have begun to investigate the impact of vitamin D supplementation on @ @ @ @ @ syndrome coronavirus 2 ( SARS-CoV-2 ) infection .
In this review , we focus on @ @ @ @ @ D in the pathogenesis of Covid-19 .
We consider whether deficiency of vitamin D may @ @ @ @ @ biological factors that could explain the excess mortality seen among non-Caucasians .
We also raise @ @ @ @ @ to be addressed to provide a clear picture of the extent to which vitamin D @ @ @ @ @ Covid-19 , particularly those with underlying risk factors .

Evidence suggests that vitamin D supplementation could potentially be effective either in treatment or prevention of coronavirus disease 2019 (Covid-19). Indeed, several studies and trials have begun to investigate the impact of vitamin D supplementation on patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. In this review, we focus on the potential mechanisms of vitamin D in the pathogenesis of Covid-19. We consider whether deficiency of vitamin D may be one of the underlying biological factors that could explain the excess mortality seen among non-Caucasians. We also raise several important questions which need to be addressed to provide a clear picture of the extent to which vitamin D supplementation may benefit patients with Covid-19, particularly those with underlying risk factors.


greenmedinfo--2020-09-09--The results indicated that the monthly average percent positive of four common coronaviruses was sig

Human coronaviruses are RNA viruses that are sensitive to ultraviolet ( UV ) radiation .
Sunlight contains UVA ( 320-400 nm ) , UVB ( 260-320 nm ) and UVC ( 200-260 nm ) action spectra .
UVC can inactivate coronaviruses , including severe acute respiratory syndrome-coronavirus-2 ( SARS-CoV-2 ) .
The incidence and mortality of coronavirus disease 2019 ( COVID-19 ) are considered to be correlated with vitamin D levels .
Vitamin Dsynthesis in human skin is closely related to exposure to UVB radiation .
Therefore , the incidence and mortality of COVID-19 are also considered to be correlated @ @ @ @ @ @ @ study , Spearman and Kendall rank correlation analysis tests were used to analyze the correlation between the average percent positive of five human coronaviruses ( SARS-CoV-2 , CoVHKU1 , CoVNL63 , CoVOC43 , and CoV229E ) in the U.S. and the corresponding sunlight UV radiation dose The results indicated that the monthly average percent positive of four common coronaviruses was significantly negatively correlated with the sunlight UV radiation dose .
The weekly percent positive of SARS-CoV-2 during April 17 , 2020 to July 10 , 2020 showed a significant negative correlation with the @ @ @ @ @ @ @ 1 and 2 of the U.S. while no statistical significance in the other regions .
Additionally , sunlight UV radiation also showed some negative effects with respect to the early SARS-CoV-2 transmission .

Human coronaviruses are RNA viruses that are sensitive to ultraviolet (UV) radiation. Sunlight contains UVA (320-400 nm), UVB (260-320 nm) and UVC (200-260 nm) action spectra. UVC can inactivate coronaviruses, including severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2). The incidence and mortality of coronavirus disease 2019 (COVID-19) are considered to be correlated with vitamin D levels. Vitamin Dsynthesis in human skin is closely related to exposure to UVB radiation. Therefore, the incidence and mortality of COVID-19 are also considered to be correlated with Vitamin D levels. In this study, Spearman and Kendall rank correlation analysis tests were used to analyze the correlation between the average percent positive of five human coronaviruses (SARS-CoV-2, CoVHKU1, CoVNL63, CoVOC43, and CoV229E) in the U.S. and the corresponding sunlight UV radiation dose The results indicated that the monthly average percent positive of four common coronaviruses was significantly negatively correlated with the sunlight UV radiation dose. The weekly percent positive of SARS-CoV-2 during April 17, 2020 to July 10, 2020 showed a significant negative correlation with the sunlight UV radiation dose in census regions 1 and 2 of the U.S. while no statistical significance in the other regions. Additionally, sunlight UV radiation also showed some negative effects with respect to the early SARS-CoV-2 transmission.


greenmedinfo--2020-09-09--The Brothers Grim: Bill and Mike’s Pandemic Panopticon

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Before beginning any type of @ @ @ @ @ treatment regimen , it is advisable to seek the advice of a licensed healthcare professional @

This website is for information purposes only. By providing the information contained herein we are not diagnosing, treating, curing, mitigating, or preventing any type of disease or medical condition. Before beginning any type of natural, integrative or conventional treatment regimen, it is advisable to seek the advice of a licensed healthcare professional.
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greenmedinfo--2020-09-09--Association of vitamin D with the modulation of the disease severity in COVID-19.

In late 2019 , SARS-CoV-2 started to spread throughout the world causing the COVID-19 that has taken a considerable number @ @ @ @ @ from several investigations have explained the virus origin , pathogenicity , and transmission .
Similar @ @ @ @ @ pulmonary angiotensin converting enzyme ( ACE ) 2 was introduced as the virus receptor for @ @ @ @ @ increased body of epidemiological and clinical evidences has shown modulating effects of vitamin D in @ @ @ @ @ .
Several clinical symptoms as well as molecular factors have shown to be related to @ @ @ @ @ .
In this study , vitamin D , ACE concentrations , and neutrophil to lymphocyte @ @ @ @ @ measured in patients with confirmed COVID-19 in comparison with control group .
Results demonstrated significant @ @ @ @ @ ACE levels as well as NLR in the patients ' group .
Contribution of those @ @ @ @ @ severity of the disease has been shown .

In late 2019, SARS-CoV-2 started to spread throughout the world causing the COVID-19 that has taken a considerable number of lives. Results obtained from several investigations have explained the virus origin, pathogenicity, and transmission. Similar to SARS coronavirus, the pulmonary angiotensin converting enzyme (ACE) 2 was introduced as the virus receptor for entering the cell. An increased body of epidemiological and clinical evidences has shown modulating effects of vitamin D in lung injuries through several mechanisms. Several clinical symptoms as well as molecular factors have shown to be related to the disease transmission and severity. In this study, vitamin D, ACE concentrations, and neutrophil to lymphocyte ratio (NLR) were measured in patients with confirmed COVID-19 in comparison with control group. Results demonstrated significant alterations in vitamin D and ACE levels as well as NLR in the patients' group. Contribution of those factors with the prognosis and severity of the disease has been shown.


greenmedinfo--2020-09-09--Vitamin D in prevention and treatment of COVID-19: Current perspective and future prospects.

Vitamin D deficiency ( VDD ) partly explains geographical differences in COVID-19 susceptibility , severity , and mortality .
VDD among African-Americans , diabetics , hypertensive , and aged populations possibly explain the higher death rate , aggravated by cocooning .
Vitamin D is pleiotropic , mediating bone metabolism , calcium homeostasis , and immune functions , whereas VDD is associated with inflammatory reactions and immune dysfunction , predisposing individuals to severe infections .
Vitamin D modulates innate and adaptive immunity via the expression of genes that code antimicrobial peptides ( AMPs ) .
And the expression of cluster of @ @ @ @ @ @ @ co-receptor for epidermal toll-like receptor ( TLR ) 4 .
AMPs stimulate TLR2 in macrophages , increasing the conversion of vitamin D into its active form by cytochrome P450 27B1 .
Antiviral properties of vitamin D-induced AMPs can shift the polarization of the adaptive immune response from helper T cells ( Th ) 1 to the more regulatory Th2 responses that suppress immune over-reactivity by preventing cytokine storm , which is already demonstrated during the Spanish flu episode .
Vitamin D induces antiviral effects by both direct and indirect mechanisms via AMPs , @ @ @ @ @ @ @ and viral elements , induction of autophagy and apoptosis , variation of genetic and epigenetic factors .
The crosstalk between vitamin D and intracellular signaling pathways may operate as a primary regulatory action on viral gene transcription .
VDD may increase the likelihood of infection with enveloped viruses , including retrovirus , hepatitis , and dengue .
Global data correlates severe VDD with COVID-19 associated coagulopathy , disrupted immune response and mortality , reduced platelet count , and prolonged prothrombin time , suggesting benefits from supplementation .
Key teaching points Vitamin D induces @ @ @ @ @ @ @ via AMPs , immunomodulation , induction of autophagy , etc .
Epidemiology of VDD partly explains geographical differences in COVID-19 susceptibility , severity , and mortality .
Global data correlates severe VDD with COVID-19 associated coagulopathy , disrupted immune response and mortality , reduced platelet count , and prolonged prothrombin time , together suggesting benefits from supplementation .
Many clinical trials are underway globally to delineate the role of vitamin D in both prevention and treatment of COVID-19 .

Vitamin D deficiency (VDD) partly explains geographical differences in COVID-19 susceptibility, severity, and mortality. VDD among African-Americans, diabetics, hypertensive, and aged populations possibly explain the higher death rate, aggravated by cocooning. Vitamin D is pleiotropic, mediating bone metabolism, calcium homeostasis, and immune functions, whereas VDD is associated with inflammatory reactions and immune dysfunction, predisposing individuals to severe infections. Vitamin D modulates innate and adaptive immunity via the expression of genes that code antimicrobial peptides (AMPs). And the expression of cluster of differentiation (CD)14, the co-receptor for epidermal toll-like receptor (TLR)4. AMPs stimulate TLR2 in macrophages, increasing the conversion of vitamin D into its active form by cytochrome P450 27B1. Antiviral properties of vitamin D-induced AMPs can shift the polarization of the adaptive immune response from helper T cells (Th)1 to the more regulatory Th2 responses that suppress immune over-reactivity by preventing cytokine storm, which is already demonstrated during the Spanish flu episode. Vitamin D induces antiviral effects by both direct and indirect mechanisms via AMPs, immunomodulation, the interplay between major cellular and viral elements, induction of autophagy and apoptosis, variation of genetic and epigenetic factors. The crosstalk between vitamin D and intracellular signaling pathways may operate as a primary regulatory action on viral gene transcription. VDD may increase the likelihood of infection with enveloped viruses, including retrovirus, hepatitis, and dengue. Global data correlates severe VDD with COVID-19 associated coagulopathy, disrupted immune response and mortality, reduced platelet count, and prolonged prothrombin time, suggesting benefits from supplementation. Key teaching points Vitamin D induces antiviral effects by direct and indirect mechanisms via AMPs, immunomodulation, induction of autophagy, etc. Epidemiology of VDD partly explains geographical differences in COVID-19 susceptibility, severity, and mortality. Global data correlates severe VDD with COVID-19 associated coagulopathy, disrupted immune response and mortality, reduced platelet count, and prolonged prothrombin time, together suggesting benefits from supplementation. Many clinical trials are underway globally to delineate the role of vitamin D in both prevention and treatment of COVID-19.


greenmedinfo--2020-09-09--Reasons to avoid vitamin D deficiency during COVID-19 pandemic.

The effects of vitamin D on the musculoskeletal system are well established .
Its deficiency causes osteomalacia , secondary hyperparathyroidism , and an increased risk for fractures and falls .
However , clinical and experimental evidence points to extra-skeletal actions of vitamin D , including on immune and respiratory systems .
Thus , during this COVID-19 pandemic , a possible deleterious role of vitamin D deficiency has been questioned .
This paper aims to present a brief review of the literature and discuss , based on evidence , the role of vitamin D in the lung function and in the @ @ @ @ @ @ @ were searched in the databases MEDLINE/PubMed and SciELO/LILACS .
The mechanisms of vitamin D action in the immune system response will be discussed .
Clinical data from systematic reviews and meta-analyses show benefits in the prevention of respiratory infections and improvement of pulmonary function when vitamin D-deficient patients are supplemented .
At the time of writing this paper , no published data on vitamin D supplementation for patients with COVID-19 have been found .
Vitamin D supplementation is recommended during this period of social isolation to avoid any deficiency , especially in the @ @ @ @ @ @ @ achieve normal values of 25 ( OH ) D. The prevention of respiratory infections and improvement of pulmonary function are additional benefits observed when vitamin D deficiency is treated .
Thus far , any protective effect of vitamin D specifically against severe COVID-19 remains unclear .
We also emphasize avoiding bolus or extremely high doses of vitamin D , which can increase the risk of intoxication without evidence of benefits .

The effects of vitamin D on the musculoskeletal system are well established. Its deficiency causes osteomalacia, secondary hyperparathyroidism, and an increased risk for fractures and falls. However, clinical and experimental evidence points to extra-skeletal actions of vitamin D, including on immune and respiratory systems. Thus, during this COVID-19 pandemic, a possible deleterious role of vitamin D deficiency has been questioned. This paper aims to present a brief review of the literature and discuss, based on evidence, the role of vitamin D in the lung function and in the prevention of respiratory infections. Relevant articles were searched in the databases MEDLINE/PubMed and SciELO/LILACS. The mechanisms of vitamin D action in the immune system response will be discussed. Clinical data from systematic reviews and meta-analyses show benefits in the prevention of respiratory infections and improvement of pulmonary function when vitamin D-deficient patients are supplemented. At the time of writing this paper, no published data on vitamin D supplementation for patients with COVID-19 have been found. Vitamin D supplementation is recommended during this period of social isolation to avoid any deficiency, especially in the context of bone outcomes, aiming to achieve normal values of 25(OH)D. The prevention of respiratory infections and improvement of pulmonary function are additional benefits observed when vitamin D deficiency is treated. Thus far, any protective effect of vitamin D specifically against severe COVID-19 remains unclear. We also emphasize avoiding bolus or extremely high doses of vitamin D, which can increase the risk of intoxication without evidence of benefits.


greenmedinfo--2020-09-09--Evidence for possible association of vitamin D status with cytokine storm and unregulated inflammati

Evidence for possible association of vitamin D status with cytokine storm and unregulated inflammation in COVID-19 patients.

OBJECTIVES : We present evidence for a possible role of Vitamin D ( VitD ) deficiency in unregulated cytokine production and inflammation leading to complications in COVID-19 patients .
DESIGN : The time-adjusted case mortality ratio ( T-CMR ) was estimated as the ratio of deceased patients on day N to the confirmed cases on day N-8 .
The adaptive average of T-CMR ( A-CMR ) was calculated as a metric of COVID-19 associated mortality .
A model based on positivity change ( PC ) and an estimated prevalence of COVID-19 was used to determine countries with similar screening strategies @ @ @ @ @ @ @ the mean concentration of 25-hydroxyvitamin D ( 25 ( OH ) D ) in elderly individuals in countries with similar screening strategy was investigated .
We considered high C-reactive protein ( CRP ) in severe COVID-19 patients ( CRP ≥ 1 mg/dL ) as a surrogate of a cytokine storm .
We considered high-sensitivity CRP ( hs-CRP ) in healthy subjects as hs-CRP ≥ 0.2 mg/dL .
RESULTS : A link between 25 ( OH ) D and A-CMR in countries with similar screening strategy is evidence for VitD 's possible role in @ @ @ @ @ @ @ patients with severe COVID-19 .
We observed an odds ratio ( OR ) of 1.8 with 95 % confidence interval ( 95 % CI ) ( 1.2 to 2.6 ) and an OR of 1.9 with 95 % CI ( 1.4 to 2.7 ) for hs-CRP in VitD deficient elderly from low-income families and high-income families , respectively .
COVID-19 patient-level data show an OR of 3.4 with 95 % CI ( 2.15 to 5.4 ) for high CRP in severe COVID-19 patients .
CONCLUSION : We conclude that future studies on VitD @ @ @ @ @ @ @ COVID-19 mortality are warranted .

OBJECTIVES: We present evidence for a possible role of Vitamin D (VitD) deficiency in unregulated cytokine production and inflammation leading to complications in COVID-19 patients.
DESIGN: The time-adjusted case mortality ratio (T-CMR) was estimated as the ratio of deceased patients on day N to the confirmed cases on day N-8. The adaptive average of T-CMR (A-CMR) was calculated as a metric of COVID-19 associated mortality. A model based on positivity change (PC) and an estimated prevalence of COVID-19 was used to determine countries with similar screening strategies. A possible association of A-CMR with the mean concentration of 25-hydroxyvitamin D (25(OH)D) in elderly individuals in countries with similar screening strategy was investigated. We considered high C-reactive protein (CRP) in severe COVID-19 patients (CRP ≥ 1 mg/dL) as a surrogate of a cytokine storm. We considered high-sensitivity CRP (hs-CRP) in healthy subjects as hs-CRP ≥ 0.2 mg/dL.
RESULTS: A link between 25(OH)D and A-CMR in countries with similar screening strategy is evidence for VitD's possible role in reducing unregulated cytokine production and inflammation among patients with severe COVID-19. We observed an odds ratio (OR) of 1.8 with 95% confidence interval (95% CI) (1.2 to 2.6) and an OR of 1.9 with 95% CI (1.4 to 2.7) for hs-CRP in VitD deficient elderly from low-income families and high-income families, respectively. COVID-19 patient-level data show an OR of 3.4 with 95% CI (2.15 to 5.4) for high CRP in severe COVID-19 patients.
CONCLUSION: We conclude that future studies on VitD's role in reducing cytokine storm and COVID-19 mortality are warranted.


greenmedinfo--2020-09-09--Deficient vitamin D status was associated with increased COVID-19 risk.

Importance : Vitamin D treatment has been found to decrease the incidence of viral respiratory tract infection , especially in patients with vitamin D deficiency .
Whether vitamin D is associated with coronavirus disease 2019 ( COVID-19 ) incidence is unknown .
Objective : To examine whether the last vitamin D status before COVID-19 testing is associated with COVID-19 test results .
Design , Setting , and Participants : This retrospective cohort study at an urban academic medical center included patients with a 25-hydroxycholecalciferol or 1,25-dihydroxycholecalciferol level measured within 1 year before being tested for COVID-19 from March 3 to @ @ @ @ @ @ @ Vitamin D deficiency was defined by the last measurement of 25-hydroxycholecalciferol less than 20 ng/mL or 1,25-dihydroxycholecalciferol less than 18 pg/mL before COVID-19 testing .
Treatment changes were defined by changes in vitamin D type and dose between the date of the last vitamin D level measurement and the date of COVID-19 testing .
Vitamin D deficiency and treatment changes were combined to categorize the most recent vitamin D status before COVID-19 testing as likely deficient ( last level deficient and treatment not increased ) , likely sufficient ( last level not deficient @ @ @ @ @ @ @ 2 groups with uncertain deficiency ( last level deficient and treatment increased , and last level not deficient and treatment decreased ) .
Main Outcomes and Measures : The outcome was a positive COVID-19 polymerase chain reaction test result .
Multivariable analysis tested whether vitamin D status before COVID-19 testing was associated with testing positive for COVID-19 , controlling for demographic and comorbidity indicators .
Results : A total of 489 patients ( mean [ SD ] age , 49.2 [ 18.4 ] years ; 366 [ 75 % ] women ; and @ @ @ @ @ @ @ than White ) had a vitamin D level measured in the year before COVID-19 testing .
Vitamin D status before COVID-19 testing was categorized as likely deficient for 124 participants ( 25 % ) , likely sufficient for 287 ( 59 % ) , and uncertain for 78 ( 16 % ) .
Overall , 71 participants ( 15 % ) tested positive for COVID-19 .
In multivariate analysis , testing positive for COVID-19 was associated with increasing age up to age 50 years ( relative risk , 1.06 ; 95 % CI @ @ @ @ @ @ @ ; non-White race ( relative risk , 2.54 ; 95 % CI , 1.26-5.12 ; P = .009 ) , and likely deficient vitamin D status ( relative risk , 1.77 ; 95 % CI , 1.12-2.81 ; P = .02 ) compared with likely sufficient vitamin D status .
Predicted COVID-19 rates in the deficient group were 21.6 % ( 95 % CI , 14.0 % -29.2 % ) vs 12.2 % ( 95 % CI , 8.9 % -15.4 % ) in the sufficient group .
Conclusions and Relevance : In @ @ @ @ @ @ @ likely deficient vitamin D status was associated with increased COVID-19 risk , a finding that suggests that randomized trials may be needed to determine whether vitamin D affects COVID-19 risk .

Importance: Vitamin D treatment has been found to decrease the incidence of viral respiratory tract infection, especially in patients with vitamin D deficiency. Whether vitamin D is associated with coronavirus disease 2019 (COVID-19) incidence is unknown.
Objective: To examine whether the last vitamin D status before COVID-19 testing is associated with COVID-19 test results.
Design, Setting, and Participants: This retrospective cohort study at an urban academic medical center included patients with a 25-hydroxycholecalciferol or 1,25-dihydroxycholecalciferol level measured within 1 year before being tested for COVID-19 from March 3 to April 10, 2020.
Exposures: Vitamin D deficiency was defined by the last measurement of 25-hydroxycholecalciferol less than 20 ng/mL or 1,25-dihydroxycholecalciferol less than 18 pg/mL before COVID-19 testing. Treatment changes were defined by changes in vitamin D type and dose between the date of the last vitamin D level measurement and the date of COVID-19 testing. Vitamin D deficiency and treatment changes were combined to categorize the most recent vitamin D status before COVID-19 testing as likely deficient (last level deficient and treatment not increased), likely sufficient (last level not deficient and treatment not decreased), and 2 groups with uncertain deficiency (last level deficient and treatment increased, and last level not deficient and treatment decreased).
Main Outcomes and Measures: The outcome was a positive COVID-19 polymerase chain reaction test result. Multivariable analysis tested whether vitamin D status before COVID-19 testing was associated with testing positive for COVID-19, controlling for demographic and comorbidity indicators.
Results: A total of 489 patients (mean [SD] age, 49.2 [18.4] years; 366 [75%] women; and 331 [68%] race other than White) had a vitamin D level measured in the year before COVID-19 testing. Vitamin D status before COVID-19 testing was categorized as likely deficient for 124 participants (25%), likely sufficient for 287 (59%), and uncertain for 78 (16%). Overall, 71 participants (15%) tested positive for COVID-19. In multivariate analysis, testing positive for COVID-19 was associated with increasing age up to age 50 years (relative risk, 1.06; 95% CI, 1.01-1.09; P = .02); non-White race (relative risk, 2.54; 95% CI, 1.26-5.12; P = .009), and likely deficient vitamin D status (relative risk, 1.77; 95% CI, 1.12-2.81; P = .02) compared with likely sufficient vitamin D status. Predicted COVID-19 rates in the deficient group were 21.6% (95% CI, 14.0%-29.2%) vs 12.2%(95% CI, 8.9%-15.4%) in the sufficient group.
Conclusions and Relevance: In this single-center, retrospective cohort study, likely deficient vitamin D status was associated with increased COVID-19 risk, a finding that suggests that randomized trials may be needed to determine whether vitamin D affects COVID-19 risk.


greenmedinfo--2020-09-10--Eradication of H. pylori may lead to recovery of vitamin C secretion by gastric epithelium and enabl

Eradication of H. pylori may lead to recovery of vitamin C secretion by gastric epithelium and enable regression of premalignant gastric lesions.

is a class one carcinogen which causes chronic atrophic gastritis , gastric intestinal metaplasia , dysplasia and adenocarcinoma .
The mechanisms by whichinteracts with other risk and protective factors , particularly vitamin C in gastric carcinogenesis are complex .
Gastric carcinogenesis includes metabolic , environmental , epigenetic , genomic , infective , inflammatory and oncogenic pathways .
The molecular classification of gastric cancer subtypes has revolutionized the understanding of gastric carcinogenesis .
This includes the tumour microenvironment , germline mutations , and the role ofbacteria , virus and epigenetics in somatic mutations .
There is evidence that ascorbic acid , @ @ @ @ @ @ @ the risk of gastric cancer .
Gastric juice ascorbate levels depend on dietary intake of ascorbic acid but can also be decreased byinfection , CagA secretion , tobacco smoking , achlorhydria and chronic atrophic gastritis .
Ascorbic acid may be protective against gastric cancer by its antioxidant effect in gastric cytoprotection , regenerating active vitamin E and glutathione , inhibiting endogenous N-nitrosation , reducing toxic effects of ingested nitrosodimethylamines and heterocyclic amines , and preventinginfection .
The effectiveness of such cytoprotection is related tostrain virulence , particularly CagA expression .
The role of @ @ @ @ @ @ @ cancer is still evolving .
Other factors in conjunction with vitamin C also play a role in gastric carcinogenesis .
Eradication ofmay lead to recovery of vitamin C secretion by gastric epithelium and enable regression of premalignant gastric lesions , thereby interrupting the Correa cascade of gastric carcinogenesis .

is a class one carcinogen which causes chronic atrophic gastritis, gastric intestinal metaplasia, dysplasia and adenocarcinoma. The mechanisms by whichinteracts with other risk and protective factors, particularly vitamin C in gastric carcinogenesis are complex. Gastric carcinogenesis includes metabolic, environmental, epigenetic, genomic, infective, inflammatory and oncogenic pathways. The molecular classification of gastric cancer subtypes has revolutionized the understanding of gastric carcinogenesis. This includes the tumour microenvironment, germline mutations, and the role ofbacteria,virus and epigenetics in somatic mutations. There is evidence that ascorbic acid, phytochemicals and endogenous antioxidant systems can modify the risk of gastric cancer. Gastric juice ascorbate levels depend on dietary intake of ascorbic acid but can also be decreased byinfection,CagA secretion, tobacco smoking, achlorhydria and chronic atrophic gastritis. Ascorbic acid may be protective against gastric cancer by its antioxidant effect in gastric cytoprotection, regenerating active vitamin E and glutathione, inhibiting endogenous N-nitrosation, reducing toxic effects of ingested nitrosodimethylamines and heterocyclic amines, and preventinginfection. The effectiveness of such cytoprotection is related tostrain virulence, particularly CagA expression. The role of vitamin C in epigenetic reprogramming in gastric cancer is still evolving. Other factors in conjunction with vitamin C also play a role in gastric carcinogenesis. Eradication ofmay lead to recovery of vitamin C secretion by gastric epithelium and enable regression of premalignant gastric lesions, thereby interrupting the Correa cascade of gastric carcinogenesis.


greenmedinfo--2020-09-10--Apple polyphenol-rich drinks dose-dependently decrease early-phase postprandial glucose concentratio

Apple polyphenol-rich drinks dose-dependently decrease early-phase postprandial glucose concentrations following a high-carbohydrate meal.

BACKGROUND : Previous research demonstrated that a high dose of phlorizin-rich apple extract ( AE ) can markedly inhibit early-phase postprandial glycemia , but efficacy of lower doses of the AE is unclear .
OBJECTIVE : To determine whether lower AE doses reduce early-phase postprandial glycemia in healthy adults and investigate mechanisms .
DESIGN : In a randomised , controlled , double-blinded , cross-over acute trial , drinks containing 1.8 g ( HIGH ) , 1.35 g ( MED ) , 0.9 g ( LOW ) , or 0 g ( CON ) of a phlorizin-rich AE were consumed before @ @ @ @ @ @ @ glucose , insulin , C-peptide , glucose-dependent insulinotropic polypeptide ( GIP ) and polyphenol metabolites concentrations were measured 0-240 min , acetaminophen concentrations to assess gastric emptying rate , and 24 h urinary glucose excretion .
Effects of AE on intestinal glucose transport were investigated in Caco-2/TC7 cells .
RESULTS : AE significantly reduced plasma glucose iAUC 0-30 min at all doses : mean differences ( 95 % CI ) relative to CON were-15.6 ( -23.3 , -7.9 ) , -11.3 ( -19.6 , -3.0 ) and-8.99 ( -17.3 , -0.7 ) mmol/L/min @ @ @ @ @ @ @ , delayed T ( HIGH , MEDIUM and LOW 45 min vs. CON 30 min ) , but did not lower C. Similar dose-dependent treatment effects were observed for insulin , C-peptide , and GIP .
Gastric emptying rates and urinary glucose excretion did not differ .
Serum phloretin , quercetin and epicatechin metabolites were detected postprandially .
A HIGH physiological AE dose equivalent decreased total glucose uptake by 48 % in Caco-2/TC7 cells .
CONCLUSIONS : Phlorizin-rich AE , even at a low dose , can slightly delay early-phase glycaemia without affecting @ @ @ @ @ @

BACKGROUND: Previous research demonstrated that a high dose of phlorizin-rich apple extract (AE) can markedly inhibit early-phase postprandial glycemia, but efficacy of lower doses of the AE is unclear.
OBJECTIVE: To determine whether lower AE doses reduce early-phase postprandial glycemia in healthy adults and investigate mechanisms.
DESIGN: In a randomised, controlled, double-blinded, cross-over acute trial, drinks containing 1.8 g (HIGH), 1.35 g (MED), 0.9 g (LOW), or 0 g (CON) of a phlorizin-rich AE were consumed before 75 g starch/sucrose meal. Postprandial blood glucose, insulin, C-peptide, glucose-dependent insulinotropic polypeptide (GIP) and polyphenol metabolites concentrations were measured 0-240 min, acetaminophen concentrations to assess gastric emptying rate, and 24 h urinary glucose excretion. Effects of AE on intestinal glucose transport were investigated in Caco-2/TC7 cells.
RESULTS: AE significantly reduced plasma glucose iAUC 0-30 min at all doses: mean differences (95% CI) relative to CON were-15.6 (-23.3, -7.9), -11.3 (-19.6, -3.0) and-8.99 (-17.3, -0.7) mmol/L/min for HIGH, MEDIUM and LOW respectively, delayed T(HIGH, MEDIUM and LOW 45 min vs. CON 30 min), but did not lower C. Similar dose-dependent treatment effects were observed for insulin, C-peptide, and GIP. Gastric emptying rates and urinary glucose excretion did not differ. Serum phloretin, quercetin and epicatechin metabolites were detected postprandially. A HIGH physiological AE dose equivalent decreased total glucose uptake by 48% in Caco-2/TC7 cells.
CONCLUSIONS: Phlorizin-rich AE, even at a low dose, can slightly delay early-phase glycaemia without affecting peak and total glycaemic response.


greenmedinfo--2020-09-10--Structural characterisation and immunomodulatory activity of polysaccharides from white asparagus sk

Structural characterisation and immunomodulatory activity of polysaccharides from white asparagus skin.

The physicochemical properties , structural features and immunomodulatory effects of the white asparagus ( Asparagus officinalis L. ) skin polysaccharides @ @ @ @ @ studied .
WASP showed a pectic-like structure with a relatively low degree of esterification ( @ @ @ @ @ ; the weight-average molecular weight ( Mw ) and intrinsic viscosity were 76.1 kDa and @ @ @ @ @ Structurally , the dominated sugar residue of WASP was 4-α-D-GalpA ( 39.7 mol % ) @ @ @ @ @ α-L-Araf , 3-α-L-Rhap , 2,4-α-L-Rhap , and 4-β-D-Galp were also detected with a comparable amount @ @ @ @ @ WASP was also presented .
Physiologically , WASP could modulate the immune response of RAW @ @ @ @ @ release of immune factors ( IL-6 , TNF-α and IL-10 ) and improving the expression @ @ @ @ @ , the pectic-like polysaccharides from white asparagus ( Asparagus officinalis L. ) skin could be @ @ @ @ @ agent in functional food .

The physicochemical properties, structural features and immunomodulatory effects of the white asparagus (Asparagus officinalis L.) skin polysaccharides (WASP) were systematically studied. WASP showed a pectic-like structure with a relatively low degree of esterification (DE, 18%); the weight-average molecular weight (Mw) and intrinsic viscosity were 76.1 kDa and 13 mL/g, respectively. Structurally, the dominated sugar residue of WASP was 4-α-D-GalpA (39.7 mol%), while other residues including α-L-Araf, 3-α-L-Rhap, 2,4-α-L-Rhap, and 4-β-D-Galp were also detected with a comparable amount. A proposed structure of WASP was also presented. Physiologically, WASP could modulate the immune response of RAW 264.7 macrophages through increasing the release of immune factors (IL-6, TNF-α and IL-10) and improving the expression of mRNA. To conclude, the pectic-like polysaccharides from white asparagus (Asparagus officinalis L.) skin could be potentially used as an immunomodulatory agent in functional food.


greenmedinfo--2020-09-10--Asparanin A from Asparagus officinalis L. induces G0/G1 cell cycle arrest and apoptosis in human end

Asparanin A from Asparagus officinalis L. induces G0/G1 cell cycle arrest and apoptosis in human endometrial carcinoma cells.

Asparanin A ( AA ) , a steroidal saponin fromL.
, has anticancer activity : however , its detailed molecular @ @ @ @ @ EC ) have not been studied so far .
We evaluated the anticancer activity and @ @ @ @ @ EC cell line Ishikawa in vitro and in vivo .
AA inhibited the Ishikawa cell @ @ @ @ @ alteration and cell cycle arrest in G0/G1 phase .
Moreover , it could induce apoptosis @ @ @ @ @ the deregulation of Bak/Bcl-xl ratio which led to the generation of ROS , up-regulation of @ @ @ @ @ ofΔψ , and activation of caspases , besides inhibition of the PI3K/AKT/mTOR pathway .
In @ @ @ @ @ of AA significantly inhibited the tumor tissue cell proliferation , reduced the tumor growth , @ @ @ @ @ .
AA can be a possible functional food ingredient to cure endometrial cancer followed by @ @ @

Asparanin A (AA), a steroidal saponin fromL., has anticancer activity: however, its detailed molecular mechanisms in endometrial cancer (EC) have not been studied so far. We evaluated the anticancer activity and underlying mechanism of AA on EC cell line Ishikawa in vitro and in vivo. AA inhibited the Ishikawa cell proliferation and caused cell morphology alteration and cell cycle arrest in G0/G1 phase. Moreover, it could induce apoptosis through mitochondrial pathway, including the deregulation of Bak/Bcl-xl ratio which led to the generation of ROS, up-regulation of cytochrome c followed by decrease ofΔψ, and activation of caspases, besides inhibition of the PI3K/AKT/mTOR pathway. In vivo data showed that administration of AA significantly inhibited the tumor tissue cell proliferation, reduced the tumor growth, and induced the apoptosis occurrence. AA can be a possible functional food ingredient to cure endometrial cancer followed by clinical trials.


greenmedinfo--2020-09-10--Polysaccharides from fermented Asparagus officinalis with Lactobacillus plantarum NCU116 alleviated

Polysaccharides from fermented Asparagus officinalis with Lactobacillus plantarum NCU116 alleviated liver injury via modulation of glutathione homeostasis, bile acid metabolism, and SCFA production.

Lactic acid bacteria strain ( LAB ) NCU116 fermented Asparagus officinalis polysaccharides ( FAOP ) have been proven to cause substantial changes in physicochemical properties such as monosaccharide composition and molecular weight , accounting for their enhanced immune activity than unprocessed Asparagus officinalis polysaccharides ( AOP ) .
In the current study , the hepatoprotective effects of FAOP in mice with cyclophosphamide ( CTX ) -induced hepatotoxicity were investigated .
FAOP were more effective than AOP in alleviating CTX-induced hepatic damage , including inhibition of hepatic biochemical markers ( ALT , AST , AKP and LDH ) and pro-inflammatory cytokines @ @ @ @ @ @ @ as reinforcement of antioxidant systems ( T-AOC , SOD , CAT , and MDA ) .
In particular , compared with AOP , FAOP showed superior performance by promoting GSH biosynthesis , and normalizing the expression level of bile acid receptors ( FXR and SHP ) and key enzymes in bile acid synthesis ( CYP7A1 , CYP8B1 and CYP27A1 ) .
Modulation of disordered homeostasis of bile acids by FAOP can be attributed to the upregulation of hepatic short chain fatty acid ( SCFA ) receptors GPR41 and GPR109A as well as intestinal @ @ @ @ @ @ @ study validated the hepatoprotective superiority of FAOP than AOP with evidence from variations in bile acid compositions and the construction of related metabolic pathways .
Therefore , LAB NCU116 fermentation of Asparagus officinalis was practical and effective to obtain promising hepatoprotective polysaccharides , which might arise from enhanced SCFA production than unprocessed AOP .

Lactic acid bacteria strain (LAB) NCU116 fermented Asparagus officinalis polysaccharides (FAOP) have been proven to cause substantial changes in physicochemical properties such as monosaccharide composition and molecular weight, accounting for their enhanced immune activity than unprocessed Asparagus officinalis polysaccharides (AOP). In the current study, the hepatoprotective effects of FAOP in mice with cyclophosphamide (CTX)-induced hepatotoxicity were investigated. FAOP were more effective than AOP in alleviating CTX-induced hepatic damage, including inhibition of hepatic biochemical markers (ALT, AST, AKP and LDH) and pro-inflammatory cytokines (TNF-α and IL-1β) as well as reinforcement of antioxidant systems (T-AOC, SOD, CAT, and MDA). In particular, compared with AOP, FAOP showed superior performance by promoting GSH biosynthesis, and normalizing the expression level of bile acid receptors (FXR and SHP) and key enzymes in bile acid synthesis (CYP7A1, CYP8B1 and CYP27A1). Modulation of disordered homeostasis of bile acids by FAOP can be attributed to the upregulation of hepatic short chain fatty acid (SCFA) receptors GPR41 and GPR109A as well as intestinal SCFA production. Furthermore, serum metabolomics study validated the hepatoprotective superiority of FAOP than AOP with evidence from variations in bile acid compositions and the construction of related metabolic pathways. Therefore, LAB NCU116 fermentation of Asparagus officinalis was practical and effective to obtain promising hepatoprotective polysaccharides, which might arise from enhanced SCFA production than unprocessed AOP.


greenmedinfo--2020-09-10--These results demonstrate a possible protective potential of silver nanoparticles on renal toxicity

These results demonstrate a possible protective potential of silver nanoparticles on renal toxicity induced by acetaminophen.

Present study was planned to investigate the ameliorative effect of silver nanoparticles ( AgNPs ) on acetaminophen-induced nephrotoxicity .
Our @ @ @ @ @ AgNPs at three different doses ( 50 , 100 and 150 μg/kg once only ) @ @ @ @ @ g/kg once only ) induced acute renal toxicity .
AgNPs treated animals also show less @ @ @ @ @ in kidneys and corroborating the results of analysis of serum urea and creatinine .
In @ @ @ @ @ theacetaminophen-induced oxidative stress , which was confirmed by the alleviated lipid peroxidation , enhanced renal @ @ @ @ @ enzymatic activities of superoxide dismutase , catalase and adenosine triphosphatase in kidney .
Thus , @ @ @ @ @ protective potential of AgNPs on renal toxicity induced by acetaminophen .
This study will definitely @ @ @ @ @ therapeutic drug against nephrotoxicity , after further clinical and preclinical studies .

Present study was planned to investigate the ameliorative effect of silver nanoparticles (AgNPs) on acetaminophen-induced nephrotoxicity. Our results demonstrate that therapy of AgNPs at three different doses (50, 100 and 150 μg/kg once only) prevented the acetaminophen (2 g/kg once only) induced acute renal toxicity. AgNPs treated animals also show less intensity in the histological alterations in kidneys and corroborating the results of analysis of serum urea and creatinine. In addition, AgNPs therapy prevented theacetaminophen-induced oxidative stress, which was confirmed by the alleviated lipid peroxidation, enhanced renal reduced glutathione content and restored enzymatic activities of superoxide dismutase, catalase and adenosine triphosphatase in kidney. Thus, our results demonstrate a possible protective potential of AgNPs on renal toxicity induced by acetaminophen. This study will definitely lead to the development of therapeutic drug against nephrotoxicity, after further clinical and preclinical studies.


greenmedinfo--2020-09-10--Does vitamin D deficiency increase the severity of COVID-19?

The severity of coronavirus 2019 infection ( COVID-19 ) is determined by the presence of pneumonia , severe acute respiratory distress syndrome ( SARS-CoV-2 ) , myocarditis , microvascular thrombosis and/or cytokine storms , all of which involve underlying inflammation .
A principal defence against uncontrolled inflammation , and against viral infection in general , is provided by T regulatory lymphocytes ( Tregs ) .
Treg levels have been reported to be low in many COVID-19 patients and can be increased by vitamin D supplementation .
Low vitamin D levels have been associated with an increase in inflammatory cytokines and @ @ @ @ @ @ @ viral upper respiratory tract infections .
Vitamin D deficiency is associated with an increase in thrombotic episodes , which are frequently observed in COVID-19 .
Vitamin D deficiency has been found to occur more frequently in patients with obesity and diabetes .
These conditions are reported to carry a higher mortality in COVID-19 .
If vitamin D does in fact reduce the severity of COVID-19 in regard to pneumonia/ARDS , inflammation , inflammatory cytokines and thrombosis , it is our opinion that supplements would offer a relatively easy option to decrease the impact @ @ @ @

The severity of coronavirus 2019 infection (COVID-19) is determined by the presence of pneumonia, severe acute respiratory distress syndrome (SARS-CoV-2), myocarditis, microvascular thrombosis and/or cytokine storms, all of which involve underlying inflammation. A principal defence against uncontrolled inflammation, and against viral infection in general, is provided by T regulatory lymphocytes (Tregs). Treg levels have been reported to be low in many COVID-19 patients and can be increased by vitamin D supplementation. Low vitamin D levels have been associated with an increase in inflammatory cytokines and a significantly increased risk of pneumonia and viral upper respiratory tract infections. Vitamin D deficiency is associated with an increase in thrombotic episodes, which are frequently observed in COVID-19. Vitamin D deficiency has been found to occur more frequently in patients with obesity and diabetes. These conditions are reported to carry a higher mortality in COVID-19. If vitamin D does in fact reduce the severity of COVID-19 in regard to pneumonia/ARDS, inflammation, inflammatory cytokines and thrombosis, it is our opinion that supplements would offer a relatively easy option to decrease the impact of the pandemic.


greenmedinfo--2020-09-10--Possible role of vitamin D in Covid-19 infection in pediatric population.

PURPOSE : Covid-19 is a pandemic of unprecedented proportion , whose understanding and management is still under way .
In the emergency setting new or available therapies to contrast the spread of COVID-19 are urgently needed .
Elderly males , especially those affected by previous diseases or with comorbidities , are more prone to develop interstitial pneumonia that can deteriorate evolving to ARDS ( acute respiratory distress syndrome ) that require hospitalization in Intensive Care Units ( ICUs ) .
Even children and young patients are not spared by SARS-CoV 2 infection , yet they seem to develop a milder @ @ @ @ @ @ @ the immunomodulatory role of Vitamin D , should be further investigated .
METHODS : We reviewed the literature about the immunomodulatory role of Vitamin D collecting data from the databases Medline and Embase .
RESULTS : Vitamin D proved to interact both with the innate immune system , by activating Toll-like receptors ( TLRs ) or increasing the levels of cathelicidins andβ-defensins , and adaptive immune system , by reducing immunoglobulin secretion by plasma cells and pro-inflammatory cytokines production , thus modulating T cells function .
Promising results have been extensively described as @ @ @ @ @ @ @ respiratory tract infections , autoimmune diseases and even pulmonary fibrosis .
CONCLUSIONS : In this review , we suggest that vitamin D supplementation might play a role in the prevention and/or treatment to SARS-CoV-2 infection disease , by modulating the immune response to the virus both in the adult and pediatric population .

PURPOSE: Covid-19 is a pandemic of unprecedented proportion, whose understanding and management is still under way. In the emergency setting new or available therapies to contrast the spread of COVID-19 are urgently needed. Elderly males, especially those affected by previous diseases or with comorbidities, are more prone to develop interstitial pneumonia that can deteriorate evolving to ARDS (acute respiratory distress syndrome) that require hospitalization in Intensive Care Units (ICUs). Even children and young patients are not spared by SARS-CoV 2 infection, yet they seem to develop a milder form of disease. In this setting the immunomodulatory role of Vitamin D, should be further investigated.
METHODS: We reviewed the literature about the immunomodulatory role of Vitamin D collecting data from the databases Medline and Embase.
RESULTS: Vitamin D proved to interact both with the innate immune system, by activating Toll-like receptors (TLRs) or increasing the levels of cathelicidins andβ-defensins, and adaptive immune system, by reducing immunoglobulin secretion by plasma cells and pro-inflammatory cytokines production, thus modulating T cells function. Promising results have been extensively described as regards the supplementation of vitamin D in respiratory tract infections, autoimmune diseases and even pulmonary fibrosis.
CONCLUSIONS: In this review, we suggest that vitamin D supplementation might play a role in the prevention and/or treatment to SARS-CoV-2 infection disease, by modulating the immune response to the virus both in the adult and pediatric population.


greenmedinfo--2020-09-10--Vitamin D and inflammation: Potential implications for severity of covid-19.

Background Recent research has indicated that vitamin D may have immune supporting properties through modulation of both the adaptive and innate immune system through cytokines and regulation of cell signalling pathways .
We hypothesize that vitamin D status may influence the severity of responses to Covid-19 and that the prevalence of vitamin D deficiency in Europe will be closely aligned to Covid-19 mortality .
Methods We conducted a literature search on PubMed ( no language restriction ) of vitamin D status ( for older adults ) in countries/areas of Europe affected by Covid-19 infection .
Countries were selected by severity @ @ @ @ @ @ @ and were limited to national surveys or where not available , to geographic areas within the country affected by infection .
Covid-19 infection and mortality data was gathered from the World Health Organisation .
Results Counter-intuitively , lower latitude and typically 'sunny ' countries such as Spain and Italy ( particularly Northern Italy ) , had low mean concentrations of 25 ( OH ) D and high rates of vitamin D deficiency .
These countries have also been experiencing the highest infection and death rates in Europe .
The northern latitude countries ( @ @ @ @ @ @ @ receive less UVB sunlight than Southern Europe , actually had much higher mean 25 ( OH ) D concentrations , low levels of deficiency and for Norway and Finland , lower infection and death rates .
The correlation between 25 ( OH ) D concentration and mortality rate reached conventional significance ( P=0.046 ) by Spearman 's Rank Correlation .
Conclusions Optimising vitamin D status to recommendations by national and international public health agencies will certainly have benefits for bone health and potential benefits for Covid-19 .
There is a strong plausible biological @ @ @ @ @ @ @ role for vitamin D in Covid-19 .

Background Recent research has indicated that vitamin D may have immune supporting properties through modulation of both the adaptive and innate immune system through cytokines and regulation of cell signalling pathways. We hypothesize that vitamin D status may influence the severity of responses to Covid-19 and that the prevalence of vitamin D deficiency in Europe will be closely aligned to Covid-19 mortality. Methods We conducted a literature search on PubMed (no language restriction) of vitamin D status (for older adults) in countries/areas of Europe affected by Covid-19 infection. Countries were selected by severity of infection (high and low) and were limited to national surveys or where not available, to geographic areas within the country affected by infection. Covid-19 infection and mortality data was gathered from the World Health Organisation. Results Counter-intuitively, lower latitude and typically 'sunny' countries such as Spain and Italy (particularly Northern Italy), had low mean concentrations of 25(OH)D and high rates of vitamin D deficiency. These countries have also been experiencing the highest infection and death rates in Europe. The northern latitude countries (Norway, Finland, Sweden) which receive less UVB sunlight than Southern Europe, actually had much higher mean 25(OH)D concentrations, low levels of deficiency and for Norway and Finland, lower infection and death rates. The correlation between 25(OH)D concentration and mortality rate reached conventional significance (P=0.046) by Spearman's Rank Correlation. Conclusions Optimising vitamin D status to recommendations by national and international public health agencies will certainly have benefits for bone health and potential benefits for Covid-19. There is a strong plausible biological hypothesis and evolving epidemiological data supporting a role for vitamin D in Covid-19.