Vitamin D3 (Cholecalciferol)

INTRODUCTION: Hip fractures have a huge impact in reducing the quality of life and increasing mortality. This review aims to assess the impact of daily oral supplementation of vitamin D3 plus calcium on the incidence of hip fracture in people over 65 years. METHODS: PRISMA guidelines were followed and RCTs that evaluated the effectiveness of daily oral supplementation of vitamin D3 plus calcium in preventing hip fracture in adults over 65 years were included in the study. The databases such as Cochrane Library, Embase, Medline, PubMed, CINAHL, Web of Science and Scopus were searched from October 2019- January 2020.The Cochrane risk of bias tool was used to check the quality of the included studies. A meta-analysis with fixed effect model using Review Manager (Revman 5.3) was used to analyse the data. RESULTS: The meta-analysis of seven RCTs on vitamin D3 plus calcium supplementation and hip fracture (n = 12,620) identified odds ratio (OR) of 0.75; 95% Confidence interval (CI): 0.64, 0.87; p = .0003. Daily oral supplementation of 800 IU of Vitamin D3 plus 1200 mg of calcium was found more effective (n = 5676 participants; OR = 0.69; 95% CI: 0.58, 0.82; p < .0001) than daily oral supplementation of 800 IU of Vitamin D3 plus 1000 mg of calcium (n = 6555,OR = 1.08; 95% CI: 0.74, 1.56; p = .70) in reducing hip fracture. A meta-analysis of the seven RCTs to identify the incidence of non-vertebral fracture gave the OR of 0.80; 95% CI: 0.72, 0.89; p < .0001. A meta-analysis of three RCTs on femoral neck bone mineral density (BMD) (n = 483) gave a mean difference of 1.21; 95% CI: -0.79, 3.20; p = .24. CONCLUSION: Daily oral supplementation 800 IU of vitamin D3 plus 1200 mg of calcium reduces hip fracture and non-vertebral fracture in older people. Administering vitamin D3 and calcium supplements had no effect in increasing the femoral neck BMD. IMPLICATIONS FOR PRACTICE: Even though it is evident from the review that optimal daily intake of vitamin D3 plus calcium supplementation help in the prevention of fracture, it is only one essential element in fracture prevention. Also, people who are on dietary supplements should be compliant with same for better result. Efforts

BACKGROUND: Sickle cell disease (SCD) is a genetic chronic haemolytic and pro-inflammatory disorder. With increased catabolism and deficits in energy and nutrient intake, individuals with SCD suffer multiple macro- and micro-nutritional deficiencies, including vitamin D deficiency. This is an update of a previous review. OBJECTIVES: To investigate the effects of vitamin D supplementation in children and adults with SCD and to compare different dose regimens. To determine the effects of vitamin D supplementation on general health (e.g. growth status and health-related quality of life), on musculoskeletal health (including bone mineral density, pain crises, bone fracture and muscle health), on respiratory health (including lung function, acute chest syndrome, acute exacerbation of asthma and respiratory infections) and the safety of vitamin D supplementation. SEARCH METHODS: We searched the Cochrane Haemoglobinopathies Trials Register, compiled from electronic database searches and handsearching of journals and conference abstract books. Date of last search: 19 March 2020. We also searched database such as PubMed, clinical trial registries and the reference lists of relevant articles and reviews. Date of last search: 14 January 2020. SELECTION CRITERIA: Randomised controlled trials (RCTs) and quasi-RCTs comparing oral administration of any form of vitamin D supplementation at any dose and for any duration to another type or dose of vitamin D or placebo or no supplementation in people with SCD, of all ages, gender, and phenotypes. DATA COLLECTION AND ANALYSIS: Two authors independently extracted the data and assessed the risk of bias of the included studies. They used the GRADE guidelines to assess the quality of the evidence. MAIN RESULTS: Vitamin D versus placebo One double-blind RCT (n = 39) compared oral vitamin D3 (cholecalciferol) supplementation (20 participants) to placebo (19 participants) for six weeks. Only 25 participants completed the full six months of follow-up. The study had a high risk of bias due to incomplete outcome data, but a low risk of bias for randomisation, allocation concealment, blinding (of participants, personnel and outcome assessors)

Vitamin D plays a key role in mineral metabolism and its deficiency is often noted in patients on dialysis for end-stage renal disease (ESRD). We evaluated the efficacy and responses to vitamin D3 (cholecalciferol) in patients undergoing dialysis for ESRD. Randomized controlled trials or prospective studies comparing vitamin D3 supplementation to placebo in patients with ESRD on dialysis were searched from medical databases using the terms, 'Calcitriol/Cholecalciferol, vitamin D, chronic kidney disease, hemodialysis, serum calcium, parathyroid hormones (PTH), phosphorus, 25(OH)D, and 1,25(OH)2D'. The outcomes analyzed were serum calcium, PTH, phosphorus, 25(OH)D, and 1,25(OH) 2D levels. Of the 259 records identified, 9 studies with a total of 368 patients were chosen for the current meta-analysis. The number of patients, age, and gender distribution among the groups were comparable. Results reveal a greater increase in both 25(OH)D (Pooled difference in means=0.434, 95% CI 0.174 to 0.694, p=0.001) and 1,25(OH) 2D (Pooled difference in means=0.978, 95% CI 0.615 to 1.34, p<0.001) in the treatment arm, as compared to the placebo. There was no difference in the serum calcium or PTH among the two groups. However, patients in the treatment arm had a significant increase in phosphorus levels (Pooled difference in means=0.434, 95% CI 0.174 to 0.694, p=0.001). Vitamin D supplementation facilitated the maintenance of increased levels of 25(OH) D and 1,25(OH) 2D in patients undergoing dialysis for ESRD. This increase in vitamin D was not associated with hypercalcemia or significant changes in PTH levels.

BACKGROUND: The evidence on whether vitamin D supplementation is effective in decreasing cancers is contradictory. OBJECTIVES: To assess the beneficial and harmful effects of vitamin D supplementation for prevention of cancer in adults. SEARCH METHODS: We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, LILACS, Science Citation Index Expanded, and the Conference Proceedings Citation Index-Science to February 2014. We scanned bibliographies of relevant publications and asked experts and pharmaceutical companies for additional trials. SELECTION CRITERIA: We included randomised trials that compared vitamin D at any dose, duration, and route of administration versus placebo or no intervention in adults who were healthy or were recruited among the general population, or diagnosed with a specific disease. Vitamin D could have been administered as supplemental vitamin D (vitamin D₃ (cholecalciferol) or vitamin D₂ (ergocalciferol)), or an active form of vitamin D (1α-hydroxyvitamin D (alfacalcidol), or 1,25-dihydroxyvitamin D (calcitriol)). DATA COLLECTION AND ANALYSIS: Two review authors extracted data independently. We conducted random-effects and fixed-effect model meta-analyses. For dichotomous outcomes, we calculated the risk ratios (RRs). We considered risk of bias in order to assess the risk of systematic errors. We conducted trial sequential analyses to assess the risk of random errors. MAIN RESULTS: Eighteen randomised trials with 50,623 participants provided data for the analyses. All trials came from high-income countries. Most of the trials had a high risk of bias, mainly for-profit bias. Most trials included elderly community-dwelling women (aged 47 to 97 years). Vitamin D was administered for a weighted mean of six years. Fourteen trials tested vitamin D₃, one trial tested vitamin D₂, and three trials tested calcitriol supplementation. Cancer occurrence was observed in 1927/25,275 (7.6%) recipients of vitamin D versus 1943/25,348 (7.7%) recipients of control interventions (RR 1.00 (95% confidence interval (CI) 0.94 to 1.06); P = 0.88; I² = 0%; 18 trials; 50,623 participants; moderate quality evidence according to the

BACKGROUND: Available evidence on the effects of vitamin D on mortality has been inconclusive. In a recent systematic review, we found evidence that vitamin D3 may decrease mortality in mostly elderly women. The present systematic review updates and reassesses the benefits and harms of vitamin D supplementation used in primary and secondary prophylaxis of mortality. OBJECTIVES: To assess the beneficial and harmful effects of vitamin D supplementation for prevention of mortality in healthy adults and adults in a stable phase of disease. SEARCH METHODS: We searched The Cochrane Library, MEDLINE, EMBASE, LILACS, the Science Citation Index-Expanded and Conference Proceedings Citation Index-Science (all up to February 2012). We checked references of included trials and pharmaceutical companies for unidentified relevant trials. SELECTION CRITERIA: Randomised trials that compared any type of vitamin D in any dose with any duration and route of administration versus placebo or no intervention in adult participants. Participants could have been recruited from the general population or from patients diagnosed with a disease in a stable phase. Vitamin D could have been administered as supplemental vitamin D (vitamin D3 (cholecalciferol) or vitamin D2 (ergocalciferol)) or as an active form of vitamin D (1α-hydroxyvitamin D (alfacalcidol) or 1,25-dihydroxyvitamin D (calcitriol)). DATA COLLECTION AND ANALYSIS: Six review authors extracted data independently. Random-effects and fixed-effect meta-analyses were conducted. For dichotomous outcomes, we calculated the risk ratios (RRs). To account for trials with zero events, we performed meta-analyses of dichotomous data using risk differences (RDs) and empirical continuity corrections. We used published data and data obtained by contacting trial authors.To minimise the risk of systematic error, we assessed the risk of bias of the included trials. Trial sequential analyses controlled the risk of random errors possibly caused by cumulative meta-analyses. MAIN RESULTS: We identified 159 randomised clinical trials. Ninety-four trials reported no mortality, and nine trials reported mortality but did not report in which intervention gr

INTRODUCTION: Achieving a pCR serves as a biomarker indicating enhanced overall survival for breast cancer patients undergoing NST. Vitamin D enhances the antitumor effect of chemotherapeutics as demonstrated in cancer cells and animal models. In this prospective randomized clinical study, we aim to investigate the effect of oral vitamin D supplementation during neoadjuvant systemic therapy (NST) on pathologic complete response (pCR). METHODS: Between June 2019 and June 2023, an oral form of 50,000 IU vitamin D3 (cholecalciferol) replacement was administered once a week during NST for the study group. RESULTS: There were 114 (50.2%) cases in the study group and 113 (49.8%) in the control group (totally 227 cases). Factors that positively influenced pCR were higher clinical T stage, higher AJCC clinical stage, Estrogen receptor negativity, progesterone receptor negativity, human epidermal growth factor receptor 2 positivity, high Ki-67 expression (≥ 20%), hormone negative molecular subtypes, and vitamin D intake in univariate analysis. In the multivariate analysis, factors significantly affecting pCR were vitamin D intake (OR: 2.33, 95% CI 1.20-4.53; p = 0.013), hormone receptor negativity (OR: 2.22, 95% CI 1.11-4.43; p = 0.024), and Ki-67 ≥ 20% (OR: 3.27, 95% CI 1.03-10.34; p = 0.044). CONCLUSIONS: This is the first and only study to compare the effect of oral vitamin D supplementation on pCR during NST. Vitamin D supplementation during NST has a significant effect on pCR in breast cancer patients. Although this effect is not significant for axillary pCR, there is an almost significant correlation. TRIAL REGISTRATION: ClinicalTrials.gov (Identifier: NCT03986268). © 2025 The Author(s). World Journal of Surgery published by John Wiley & Sons Ltd on behalf of International Society of Surgery/Société Internationale de Chirurgie (ISS/SIC).

BACKGROUND: We aimed to assess serum 25-hydroxyvitamin D3 (25(OH)D3) concentrations in extrapulmonary tuberculosis (EPTB) patients and to evaluate the effect of vitamin D3 supplementation on their treatment course. METHODS: Serum 25(OH)D3concentrations were measured in 47 newly diagnosed EPTB patients and 42 controls. Vitamin D-deficient EPTB patients were randomly assigned to receive 50,000 IU of vitamin D3 (cholecalciferol) orally once a week for 6 weeks (total 300,000 IU), followed by maintenance doses of 1000 IU a day besides anti-TB drugs or the first line anti-TB treatment only. Follow up serum 25(OH)D3 concentrations were measured after 3 months of starting vitamin D3 supplementation. Both groups were evaluated for clinical, laboratory, and radiological outcomes after treatment. RESULTS: Serum 25(OH)D3 concentrations were significantly lower among TB cases (17.1 ± 5.5 nmol/L) compared to healthy controls (51.8 ± 27.3 nmol/L), and vitamin D deficiency was observed in all EPTB patients (n = 47). Patients in VD3 supplementation group had significantly higher weight gain and serum albumin level at 2 months and end of treatment, higher hemoglobin concentration at the end of treatment, significantly lower CRP and ESR at 2 months and at the end of treatment. In cases with TB pleurisy, a significant higher rate of full resolution of pleural fluid after 6 months of anti-TB treatment and shorter treatment duration were noted compared to the other group. CONCLUSIONS: Vitamin D deficiency is prevalent in EPTB patients, in whom, vitamin D supplementation is a useful adjunctive therapy to anti-TB drugs and improves treatment course. © 2024. The Author(s).

OBJECTIVE: This study was undertaken to assess the effect of treatment of vitamin D deficiency in drug-resistant epilepsy. METHODS: We conducted a multicenter, double-blind, placebo-controlled, randomized clinical trial, including patients aged ≥15 years with drug-resistant focal or generalized epilepsy. Patients with 25-hydroxyvitamin D (25[OH]D) < 30 ng/mL were randomized to an experimental group (EG) receiving vitamin D3 (cholecalciferol, 100 000 IU, five doses in 3 months) or a control group (CG) receiving matched placebo. During the open-label study, EG patients received 100 000 IU/month for 6 months, whereas CG patients received five doses in 3 months then 1/month for 3 months. Monitoring included seizure frequency (SF), 25(OH)D, calcium, albumin, creatinine assays, and standardized scales for fatigue, anxiety-depression, and quality of life (Modified Fatigue Impact Scale [M-FIS], Hospital Anxiety and Depression Scale, Quality of Life in Epilepsy [QOLIE-31]) at 3, 6, and 12 months. The primary efficacy outcome was the percentage of SF reduction compared to the reference period and CG at 3 months. Secondary outcomes were SF and bilateral tonic-clonic seizure (BTCS) reduction, scale score changes, and correlations with 25(OH)D during the follow-up. RESULTS: Eighty-eight patients were enrolled in the study (56 females, aged 17-74 years), with median baseline SF per 3 months = 16.5 and ≥2 antiseizure medications in 88.6%. In 75 patients (85%), 25(OH)D was <30 ng/mL; 40 of them were randomly assigned to EG and 34 to CG. After the 3-month blinded period, SF reduction did not significantly differ between groups. However, during the open-label period, SF significantly decreased (30% median SF reduction, 33% responder rate at 12 months). BTCSs were reduced by 52%. M-FIS and QOLIE-31 scores were significantly improved at the whole group level. SF reduction correlated with 25(OH)D > 30 ng/mL for >6 months. SIGNIFICANCE: Despite no proven effect after the 3-month blinded period, the open-label study suggests that long-term vitamin D3 supplementation with optimal 25(OH)D may reduce SF and BTCSs, with a positive effect on fatigue and quality of life. These findings need

Comment in J Clin Endocrinol Metab. 2024 Dec 18;110(1):e186-e187. doi: 10.1210/clinem/dgae345. CONTEXT: Declining muscle strength and performance in older adults are associated with falls, fractures, and premature death. OBJECTIVE: This work aimed to determine whether supplementation with vitamin D3 or omega-3 fatty acids vs placebo for 2 years improves physical performance measures. METHODS: VITamin D and OmegA-3 TriaL (VITAL) was a double-blinded, placebo-controlled randomized trial of supplemental vitamin D3 and/or omega-3 fatty acids vs placebo in the prevention of cancer and cardiovascular disease in 25 871 US adults. This ancillary study was completed in a New England subcohort that had in-person evaluations at baseline and 2-year follow-up. This study was conducted with 1054 participants (age: men ≥50 and women ≥55 years) at the Center for Clinical Investigations in Boston. Interventions included a 2 × 2 factorial design of supplemental vitamin D3 (cholecalciferol, 2000 IU/day) and/or marine omega-3 fatty acids (1 g/day). Main outcome measures included 2-year changes in physical performance measures of grip strength, walking speed, standing balance, repeated chair stands, and Timed-up and Go (TUG). RESULTS: At 2 years, all randomized groups showed worsening walking speeds and TUG. There were no differences in changes in grip strength, walking speeds, Short Physical Performance Battery (composite of walking speed, balance, and chair stands), and TUG between the vitamin D3-treated and the placebo-treated groups and between the omega-3-treated and the placebo-treated groups. Effects overall did not vary by sex, age, body mass index, or baseline measures of total or free 25-hydroxyvitamin D (25[OH]D) or plasma omega-3 index; TUG slightly worsened with vitamin D supplementation, compared to placebo, in participants with baseline total 25(OH)D levels above the median (P = .01; P for interaction = .04). CONCLUSION: Neither supplemental vitamin D3 nor marine omega-3 fatty acids for 2 years improved physical performance in this generally healthy adult population. © The Author(s) 2024. Published by Oxford University Press on behalf of the Endocrine Society. All r

Vitamin D (VD) deficiency (serum 25(OH)D < 50 nmol/L) affects 27.3% of preschool children in Mexico. The purpose of this study was to assess the effect of vitamin D supplementation at different doses on serum 25(OH)D concentrations in preschool children. In a randomized control trial, 222 children 12-30 months old were randomly assigned to one of four treatment groups: (1) Vitamin D2 (Ergocalciferol) 400 IU/day (n = 56); (2) Vitamin D2 (Ergocalciferol) 800 IU/day (n = 55); (3) Vitamin D3 (Cholecalciferol) 1000 IU/day (n = 56); or (4) multiple micronutrients (MM) non-VD (n = 55). Supplements were given five days/wk for three months. Serum 25(OH)D was measured at baseline and after three months. At baseline, mean serum 25(OH)D was 58.9 ± 12.6 nmol/L and 23.4% were VD-deficient. There was a statistically significant increase in serum concentrations of 25(OH)D (range across groups: +8.2 to +17.3 nmol/L). Additionally, the prevalence of vitamin D deficiency decreased after three months: for D2 400 IU, -9.0%; for D2 800 IU, -11.0%; for D3 1000 IU, -18.0%; and for MM non-VD, -2.8% (p < 0.05). No adverse effects were observed. VD supplementation for three months was effective for increasing serum 25(OH)D concentrations and for reducing VD deficiency in preschool children. The highest efficacy was observed by giving 1000 IU D3/d.

BACKGROUND: Previous studies have reported that vitamin D supplement could improve fracture healing, but evidence regarding the role of vitamin D supplements in spinal fusion was limited. Thus, this study aimed to evaluate the effectiveness of oral vitamin D supplements on fusion outcomes in patients undergoing lumbar spinal fusion. METHODS: This randomized, double-blind, parallel-designed, active-control trial included the patients who planned for elective lumbar spinal fusion. Eligible patients were randomly assigned to receive either daily vitamin D3 (cholecalciferol) 800 IU and daily calcium citrate 600 mg (experimental group) or only daily calcium citrate 600 mg (control group). All supplements were given from postoperative day 1 and lasted for 3 months. Primary outcome was postoperative 1-year fusion rate, and secondary outcomes included time to fusion, Oswestry Disability Index (ODI), and visual analogue scale (VAS) for pain. RESULTS: Among the included 34 patients (21 in the experimental group and 13 in the control group), baseline 25-hydroxyvitamin D (25[OHVitD) level was 26.7 (10.4) ng/ml. Preoperative prevalence of vitamin D deficiency and insufficiency were 23.5% and 47.1%, respectively. Postoperative 1-year fusion rate was not significantly different between the two groups (95.2% vs. 84.6%, P = 0.544). The experimental group had significantly shorter time to fusion (Kaplan-Meier estimated: 169 days vs. 185 days [interquartile range: 88-182 days vs. 176-324 days], log-rank test: P = 0.028), lower postoperative 6-month ODI (P < 0.001), and lower postoperative 6-month VAS (P < 0.001) than the control group. Time to fusion was significantly and negatively correlated with preoperative, postoperative 3-month, and 6-month 25(OH)VitD levels (all P < 0.01). CONCLUSION: The patient with vitamin D supplements had shorter time to fusion, better spinal function and less pain after elective spinal fusion. Further research is warranted to identify the patients who can benefit the most from vitamin D supplements and the appropriate dose of vitamin D supplements. TRIAL REGISTRATION: ClinicalTrials.gov, NCT05023122. Registered 20 August 2021. Retrospectively register

BACKGROUND: Low 25-hydroxyvitamin D (25OHD) levels are common in patients with chronic heart failure (HF) and are associated with increased mortality risk. This study aimed to establish the safety and efficacy of oral vitamin D3 (cholecalciferol) supplementation and its effect on endothelial and ventricular function in patients with stable HF. METHODS: This study was an investigator-initiated, multicenter, prospective, randomized, placebo-controlled trial. Seventy-three HF patients with 25OHD levels < 75 nmol/L (30 ng/mL) were randomized to receive 4000 IU vitamin D daily or a placebo for 6 months. The primary endpoint was a change in endothelial function between the baseline and after 6 months as assessed using EndoPAT. Secondary endpoints included changes in echocardiographic parameters and differences in quality of life (6-min walking test and New York Heart Association functional status) at 6 months. RESULTS: There were no adverse events in either group during the study period. Vitamin D supplementation did not improve endothelial dysfunction (EndoPAT: baseline, 1.19 ± 0.4 vs 6 months later, 1.22 ± 0.3, P = .65). However, patients' blood pressure, 6-min walking distance, and EQ-5D questionnaire scores improved after vitamin D treatment. In addition, a significant reduction in the left atrial diameter was observed. CONCLUSION: A daily vitamin D dose of 4000 IU for chronic HF appears to be safe. This dosage did not improve endothelial function but did improve the 6-min walk distance, symptoms, and left atrial diameter at 6 months.

Background. Chronic foot ulcers are a major cause of morbidity in people with diabetes with a lifetime risk of 25%. Treatment is challenging and the recurrence rates of foot ulcers are >50% after 3 years. Vitamin D deficiency is more common in people with diabetes with chronic foot ulcers, compared to both people without diabetes as well as people with diabetes but without foot ulcers. Purpose/aim of study. To assess the efficacy of high-dose compared to low-dose Cholecalciferol vitamin D3 on healing of chronic diabetic foot ulcers. Materials and methods. We included people with diabetes with one or more foot ulcers lasting for more than 6 weeks. Patients were randomly allocated to either a daily oral intake of high-dose (170 μg) or low-dose (20 μg) vitamin D3 (Cholecalciferol). We saw patients in the outpatient clinic after 4, 12, 24, 36, and 48 weeks. At each visit, we measured the ulcer with a specialized camera, and associated software and the area (cm2) was calculated. Patients and assessors were blinded to treatment allocation. We followed all patients for 48 weeks or until wound healing or surgical treatment. Findings/results. We included 48 patients in the analysis (24 in each group), with a total of 64 ulcers. Among them 41 ulcers were followed until healing or 48-week follow-up and 20 ulcers were surgically treated during the study period. Three patients were lost for follow-up. The intention-to-treat analysis showed a significantly higher rate of ulcer healing in the high-dose group with 21 of 30 (70%) healed ulcers compared to 12 of 34 (35%) in the low-dose group (P = .012). Median ulcer reduction at final follow-up was 100% (interquartile range [IQR]: 72-100) in the high-dose group and 57% (IQR: -28 to 100) in the low-dose group. Furthermore, we found a significant effect of high-dose vitamin D on ulcer reduction in the repeated measures analysis of variance. Conclusions. We found high-dose vitamin D3 to be efficient, compared to low-dose vitamin D3, in promoting healing in chronic diabetic foot ulcers.

Biofilm formed by Pseudomonas aeruginosa is a three dimensional microbial matrix that confers multidrug resistance properties along with the proficiency to evade the host immune system. The present study aims to determine the combinatorial effects of vitamin D3 (cholecalciferol) with two already reported antibiofilm agents: streptomycin and thymoquinone separately against P. aeruginosa biofilms. The minimum inhibitory concentration of streptomycin, thymoquinone and D3 was found to be 20, 10 and 100 μg/mL respectively. The inhibition of biofilm formation and pre-formed biofilm disintegration properties of streptomycin and thymoquinone alone or in combination with D3 at their sub-MIC concentration was determined by crystal violet staining and confocal laser scanning microscopy. A significant inhibition of metabolic activities like oxygen consumption rate and reduction in quorum sensing related cellular activities like swarming motilities, pyocyanin production and extracellular protease secretion by P. aeruginosa were also observed as a result of this combinatorial effect. Both of these combinatorial applications were found to accumulate ROS in bacterial cells, which has been proved to be one of the main causes of their antibiofilm activity. Effect of these two drug combinations on bacterial lettuce leaf infection was also evaluated. Molecular docking analysis indicated that thymoquinone combined D3 can interact more efficiently with the quorum sensing proteins LasI and LasR. The host cell cytotoxicity of these two combinations was found to be negligible on the murine macrophage cell line. These findings suggest that D3 potentiates the antimicrobial and antibiofilm efficacy of both streptomycin and thymoquinone against P. aeruginosa. Although both combinations have shown significant antibiofilm and antimicrobial potential, combinatorial performances of D3 combined thymoquinone were found to be more promising. © 2025. The Author(s), under exclusive licence to Springer Nature B.V.

Advanced glycation end products (AGEs) are formed through non-enzymatic glycation, that have been linked to various diseases, including polycystic ovarian syndrome (PCOS) playing a critical role leading to secondary comorbidities such as diabetes-related problems, cardiovascular complications, infertility, etc. As a result, there has been a lot of research into AGE-inhibiting phytochemicals for the remediation and obstruct progression of glycation-related illnesses. The current study is based on in-vitro protein model, in which human serum albumin have been used to investigate the cumulative effect of chlorogenic acid (CGA) and cholecalciferol (vitamin D) on glycation and evaluate their inhibitory impact on AGEs production in the presence of methylglyoxal. Through the application of several biochemical and biophysical techniques, we were able to examine the synergistic impact of both the compounds on albumin structure and its biochemical properties during different stages of glycation. According to Nitro-blue tetrazolium assay results indicate that CGA and vitamin D inhibited fructosamine (early glycation product) production. Moreover, free thiol and lysine residues were significantly increased whereas protein carbonyl levels were significantly decreased. Additive effect of CGA and vitamin D were associated with reduced AGEs fluorescence and increased tryptophan and tyrosine fluorescence. Amadori-albumin after treatment showed some evidence of regaining its alpha-helicity as measured by far-UV CD spectrum. Furthermore, secondary structural alterations were confirmed by Fourier transform infrared spectroscopy (FTIR). ANS (1-anilinonaphthalene-8-sulfonic acid) fluorescence spectra also displayed less revelation of hydrophobic patches. Bilirubin binding capacity was also restored which showed functional recovery of HSA. The electrophoretic mobility was also restored which is portrayed by SDS-PAGE. Additionally, to predict the anti-aggregation potential of CGA and vitamin D, congo red assay and ThT fluorescence was performed which reveal low aggregate formation after treatment. These results corroborated with scanning electron microscopy and confocal microscopy. Doc

BACKGROUND AND OBJECTIVES: Vitamin D3 (cholecalciferol) dose required to maintain sufficiency in non- Caucasian women with postmenopausal osteoporosis (PMO) inthe tropics has not been well studied. Some guidelines mandate 800-1000 IU vitamin D/day but the Endocrine Society (US) advocates 1500-2000 IU/day to maintain 25-hydroxyvitamin-D (25(OH)D) concentration at >75 nmol/L. We aimed to establish oral cholecalciferol dose required to maintain 25(OH)D concentration at >75 nmol/L in PMO Chinese Malaysian women, postulating lower dose requirements amongst light-skinned subjects in the tropics. METHODS AND STUDY DESIGN: 90 Chinese Malaysian PMO women in Kuala Lumpur, Malaysia (2°30'N) with baseline serum 25(OH)D levels >=50 nmol/L were recruited. Prior vitamin D supplements were discontinued and subjects randomized to oral cholecalciferol 25,000 IU/4-weekly (Group-A) or 50,000 IU/4-weekly (Group- B) for 16 weeks, administered under direct observation. Serum 25(OH)D, PTH, serum/urinary calcium were measured at baseline, 8 and 16 weeks. RESULTS: Baseline characteristics, including osteoporosis severity, sun exposure (~3 hours/week), and serum 25(OH)D did not differ between treatment arms. After 16 weeks, 91% of women sufficient at baseline, remained sufficient on 25,000 IU/4-weekly compared with 97% on 50,000 IU/4-weekly with mean serum 25(OH)D 108.1±20.4 and 114.7±18.4 SD nmol/L respectively (p=0.273). At trial's end, 39% and 80% of insufficient women at baseline attained sufficiency in Group A and Group B (p=0.057). Neither dose was associated with hyperparathyroidism or toxicity. CONCLUSIONS: Despite pretrial vitamin D supplementation and adequate sun exposure, 25.6% Chinese Malaysian PMO women were vitamin D insufficient indicating sunshine alone cannot ensure sufficiency in the tropics. Both ~900 IU/day and ~1800 IU/day cholecalciferol can safely maintain vitamin D sufficiency in >90% of Chinese Malaysian PMO women. Higher doses are required with baseline concentration <75 nmol/L.

OBJECTIVE: Observational studies suggest that vitamin D may lower the risk of type 2 diabetes. However, data from long-term trials are lacking. The Vitamin D and Type 2 Diabetes (D2d) study is a randomized clinical trial designed to examine whether a causal relationship exists between vitamin D supplementation and the development of diabetes in people at high risk for type 2 diabetes. RESEARCH DESIGN AND METHODS: D2d was designed with support from a U34 planning grant from the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). The final protocol was approved by the D2d Research Group, the data and safety monitoring board, and NIDDK. Key eligibility criteria are age ≥30 years, BMI of 24 (22.5 for Asian Americans) to 42 kg/m(2), increased risk for diabetes (defined as meeting two of three glycemic criteria for prediabetes established by the American Diabetes Association [fasting glucose 100-125 mg/dL (5.5-6.9 mmol/L), 2-h postload glucose after 75-g glucose load 140-199 mg/dL (7.7-11.0 mmol/L), hemoglobin A₁c 5.7-6.4% (39-46 mmol/mol)]), and no hyperparathyroidism, nephrolithiasis, or hypercalcemia. D2d participants are randomized to once-daily vitamin D₃ (cholecalciferol 4,000 IU) or placebo and followed for an average of 3 years. The primary end point is time to incident diabetes as assessed by laboratory criteria during the study or by adjudication if diagnosed outside of D2d. Recruitment was initiated at the end of 2013. CONCLUSIONS: D2d will test whether vitamin D supplementation is safe and effective at lowering the risk of progression to diabetes in people at high risk for type 2 diabetes. © 2014 by the American Diabetes Association. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered.

Dysmenorrhea, affecting approximately 80% of adolescents, significantly impairs quality of life, disrupts sleep patterns, and induces mood changes. Furthermore, its economic impact is substantial, accounting for an estimated $200 billion in the United States and $4.2 million in Japan annually. This review aimed to identify the effects of vitamin D and calcium on primary dysmenorrhea. We conducted a comprehensive literature search across Web of Science, PubMed, Scopus, and Science Direct, focusing on studies published from 2010 to 2020. Keywords included 'primary dysmenorrhea', 'vitamin D', '25-OH vitamin D3', 'cholecalciferol', and 'calcium'. The quality assessment of the articles was done using the Consolidated Standards of Reporting Trials (CONSORT) and the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklists, and the risk bias was assessed using the Cochrane assessment tool. Abnormal low Vit. D levels increased the severity of primary dysmenorrhea through increased prostaglandins and decreased calcium absorption. Vitamin D and calcium supplements could reduce the severity of primary dysmenorrhea and the need for analgesics. This systematic review found an inverse relation between the severity of dysmenorrhea and low serum Vit. D and calcium.. Vitamin D and calcium supplements could reduce the severity of primary dysmenorrhea and the need for analgesics. © 2023 The Author(s).

BACKGROUND: Sickle cell disease is a genetic chronic haemolytic and pro-inflammatory disorder. The clinical manifestations of sickle cell disease result from the presence of mutations on the beta globin genes that generate an abnormal haemoglobin product (called haemoglobin S) within the red blood cell. Sickle cell disease can lead to many complications such as acute chest syndrome, stroke, acute and chronic bone complications (including painful vaso-occlusive crisis, osteomyelitis, osteonecrosis and osteoporosis). With increased catabolism and deficits in energy and nutrient intake, individuals with sickle cell disease suffer multiple macro- and micro-nutritional deficiencies, including vitamin D deficiency. Since vitamin D maintains calcium homeostasis and is essential for bone mineralisation, its deficiency may worsen musculoskeletal health problems encountered in sickle cell disease. Therefore, there is a need to review the effects and the safety of vitamin D supplementation in sickle cell disease. OBJECTIVES: To investigate the hypothesis that vitamin D supplementation increases serum 25-hydroxyvitamin D level in children and adults with sickle cell disease.To determine the effects of vitamin D supplementation on general health such as growth status and health-related quality of life; on musculoskeletal health including bone mineral density, pain crises, bone fracture and muscle health; on respiratory health which includes lung function tests, acute chest syndrome, acute exacerbation of asthma and respiratory infections; and the safety of vitamin D supplementation in children and adults with sickle cell disease. SEARCH METHODS: We searched the Cochrane Haemoglobinopathies Trials Register, compiled from electronic database searches and handsearching of journals and conference abstract books. We also searched database such as PubMed, clinical trial registries and the reference lists of relevant articles and reviews.Date of last search: 15 December 2016. SELECTION CRITERIA: Randomised controlled studies and quasi-randomised controlled studies (controlled clinical studies) comparing oral administration of any form of vitamin D supplementation to another type of

Rickets are chronic bone disorders marked by impaired mineralization of the growing skeleton. While most cases arise from nutritional deficiencies, non-nutritional forms are frequently underrecognized. Subtle signs such as alopecia in vitamin D dependent rickets type 2A, cataract in Lowe syndrome, dental abscesses or sensorineural hearing loss in X-linked hypophosphatemia can prompt timely diagnosis and referral. A structured approach combining growth and skeletal assessment, targeted biochemistry (calcium, phosphate, alkaline phosphatase, parathyroid hormone, 25-hydroxyvitamin D, 1,25-dihydroxyvitamin D), radiography, and early genetic testing once nutritional deficiency or renal failure are excluded improves diagnostic accuracy. Molecular confirmation enables precise subclassification into hypophosphatemic and calciopenic rickets, supporting genotype-directed therapy, including burosumab for X-linked hypophosphatemia. Early, tailored treatment enhances radiographic healing, growth, and function. Emerging genotype-phenotype correlations further inform genetic counselling and prognosis, strengthening the multidisciplinary management of these complex disorders. ©Author(s) 2026.

Topical vitamin D analogs are well-established therapies for psoriasis, but their broader dermatologic potential increasingly depends not only on their biological activity but also on the ability of topical formulations to achieve effective and localized cutaneous delivery. This narrative review critically examines the emerging use of calcipotriol, tacalcitol, and calcitriol beyond psoriasis, with particular emphasis on formulation strategies, cutaneous drug delivery, and their relationship with clinical performance. Conventional topical dosage forms, including ointments, creams, and solutions, remain the principal delivery systems used in clinical studies. Their therapeutic performance is influenced by vehicle composition, skin-barrier integrity, local retention, application conditions, and the physicochemical properties of the vitamin D compound, which collectively determine cutaneous penetration, tolerability, and systemic exposure. Across the reviewed indications, formulations and treatment protocols vary considerably, contributing to heterogeneity in clinical outcomes. Vitiligo currently presents the strongest clinical evidence, particularly when topical vitamin D analogs are combined with narrowband ultraviolet B phototherapy, whereas encouraging results have been reported for morphea, acne vulgaris, and inherited ichthyoses. Evidence for atopic dermatitis, alopecia areata, and basal cell carcinoma remains limited or inconsistent. Beyond conventional vehicles, emerging delivery technologies including liposomes, nanoemulsions, solid lipid nanoparticles, nanostructured lipid carriers, polymeric nanoca

Paricalcitol (19-nor-1,25-dihydroxyvitamin D2) is a synthetic vitamin D receptor (VDR) agonist used for the treatment of secondary hyperparathyroidism mainly in chronic kidney disease (CKD), with a 10-times lower calcemic potential and 3-times less potent to the VDR than calcitriol. This narrative review examines the available preclinical and clinical evidence on the immunomodulatory actions of paricalcitol beyond mineral metabolism. Experimental studies show that paricalcitol can modulate immune-cell function, inflammatory signaling, oxidative stress and fibrosis through VDR-dependent pathways. Human evidence is derived mainly from patients with CKD and kidney transplantation, where reductions in inflammatory and oxidative stress markers have been reported; however, findings are not consistent across all studies. Evidence in other immune-mediated conditions, including IgA nephropathy, psoriasis, ato

Background/Objectives: Frontal fibrosing alopecia (FFA) and lichen planopilaris (LPP) are primary lymphocytic cicatricial alopecias with frequently reported systemic and dermatological comorbidities, although their prevalence and consistency across studies remain uncertain. Methods: We conducted a systematic review and random-effects prevalence meta-analysis following PRISMA 2020 and Joanna Briggs Institute guidance, prospectively registered in PROSPERO (CRD420250656067). MEDLINE, Embase, ClinicalTrials.gov, preprint sources, and reference lists were searched from inception to 18 June 2025 for observational studies reporting comorbidity prevalence in FFA and/or LPP. Results: Sixty studies comprising 4499 patients with FFA and 1370 with LPP were included. In FFA, the highest pooled prevalences among commonly reported conditions included androgenetic alopecia (31.9%), hypertension (23.6%), thyroid disorders (22.2%), hypothyroidism (20.6%), lichen planus pigmentosus (19.6%), and dyslipidemia (17.9%). In LPP, androgenetic alopecia (27.2%), hypertension (21.2%), hypothyroidism (18.7%), vitamin D deficiency (18.3%), dyslipidemia (16.0%), and thyroid disorders (14.5%) were prominent. Several estimates showed substantial between-study heterogeneity. Exploratory subgroup analyses identified study-level sources of heterogen

Alopecia areata (AA) is an immune-mediated non-scarring hair loss disorder. Severe forms, including alopecia totalis and alopecia universalis (AU), are rare in children and often refractory. Psychosocial stress has been implicated as a trigger, and pigmentary changes may occur during regrowth. We report a 9-year-old girl from Honduras with AU involving the scalp, eyebrows, eyelashes, and forearms, with nail pitting following a significant psychosocial stressor. Laboratory studies showed normal thyroid function and low vitamin D levels. Initial treatment included topical clobetasol propionate 0.05% for 6 months, topical minoxidil 5% for 12 months, and oral vitamin D supplementation for 6 months, with minimal response. Systemic therapy was initiated with oral corticosteroids (1 mg/kg/day) tapered over 4 months, followed by oral methotrexate (12 mg/m²/week) for 1 year; topical therapies were maintained concurrently throughout systemic treatment. Hair regrowth began at 3 months of methotrexate, initially as diffuse poliosis, followed by complete terminal hair regrowth and normalization of nail changes. Psychological support was provided throughout management. This case highlights psychosocial stress as a potential contributor in pediatric AU and supports a multidisciplinary approach. Methotrexate was effective and well tolerated, and poliosis may be a marker of follicular recovery.

Obesity and overweight are significant medical and social problems, and current approaches to their treatment, including hypocaloric diets, bariatric interventions, and pharmacotherapy, including incretin drugs (e.g., glucagon-like peptide-1 receptor agonists), can be accompanied by the development of diffuse hair loss. This article, prepared following a discussion at an expert council, systematizes current data on the prevalence and clinical and morphological variants of alopecia associated with weight loss. The main pathogenic mechanisms are discussed, including metabolic stress, protein-energy malnutrition, and micronutrient deficiencies.Special attention is paid to the role of biotin and vitamin D in maintaining hair follicle function, as well as to risk groups for alopecia in patients undergoing treatment for obesity. Approaches to the prevention, monitoring, and comprehensive management of such patients are presented, taking into account the need to maintain adherence to the main therapy.This article systematizes current data on the prevalence and clinical and morphological variants of alopecia associated with weight loss. It examines the main pathogenic mechanisms, including metabolic stress, protein-energy malnutrition, and micronutrient deficiencies. Special attention is paid to the role of biotin and vitamin D in maintaining hair follicle function, as well as to risk groups for alopecia in patient

INTRODUCTION: Alopecia areata is a non-scarring autoimmune disease that is usually characterized by patchy or diffuse hair loss. The collapse of the immunological privilege of hair follicles and activation of cytotoxic T-cell pathways, regulated by metabolic, psychological, and environmental variables, cause this disorder. Advances in the fields of immunology and regenerative medicine have identified new therapeutic targets and novel approaches. METHODS: Mechanistic studies, clinical trials, peer-reviewed articles, and epidemiological data have been combined into this review. A literature review of the pathophysiology of AA, environmental factors, traditional medicines, and newer therapeutic approaches, including biologics, metabolic regulators, regenerative therapies, and new drug delivery systems, was comprehensively reviewed and included. RESULTS: Activation of CD8⁷NKG2D⁷ T cells through IFN-γ and breaching of follicular immune privilege are the primary drivers of AA disease. Other factors contributing to disease development include stress, smoking, alcohol use, sleep disorders, obesity, vitamin D deficiency, alterations of the microbiota, virus infections, and medication exposure. The efficacy of conventional therapies, including topical corticosteroids, minoxidil, topical immunotherapy, glucocorticoids, cyclosporine, oral minoxidil, and JAK inhibitors, is variable. Novel treatments target the prostaglandin pathways, thyroid receptors, Wnt/β-catenin signaling, androgen receptors, LDH-driven metabolic activation, PDE4, and RIPK1. Among regenerative techniques, PRP, dermal papilla and sheath cup cells, adipose-derived stem cells, stromal vascular fraction, and exosomes have reported promising

BACKGROUND: Cytarabine (Ara-C) remains the cornerstone of remission-induction and consolidation chemotherapy for acute myeloid leukemia (AML) and related hematological malignancies. Despite more than six decades of clinical use, its multi-organ toxicity continues to be managed almost exclusively through dose attenuation and supportive care, with no approved upstream pharmacological prevention strategy available. OBJECTIVES: This scoping review aimed to systematically map the breadth and nature of pharmacological agents tested in vivo for their capacity to mitigate cytarabine-induced multi-organ toxicity, to characterize their mechanisms of action and organ targets, and to identify evidence gaps and agents with translational potential. METHODS: The review was designed and reported in accordance with the PRISMA-ScR checklist. A structured electronic search was conducted across PubMed/MEDLINE, Scopus, Cochrane Library and Embase, and Web of Science from database inception to 15 July 2025. Eligible studies were restricted to full-text, peer-reviewed, English-language research involving in vivo mammalian models administered cytarabine as the

Skin and hair quality directly impact facial plastic surgery outcomes, influencing wound healing, scar quality, pigmentation, inflammation, and perioperative telogen effluvium. This review summarizes the nutritional biologics-dietary nutrients and bioactive compounds with mechanistic and clinical relevance to aesthetic practice. Vitamins A and C support keratinocyte differentiation and collagen hydroxylation; vitamin D and zinc contribute to barrier immunity, antimicrobial peptides, and tissue repair. A structured nutritional assessment and targeted correction of deficiencies, paired with a low-glycemic, antioxidant-rich dietary pattern, offers a practical, low-risk strategy to optimize perioperative recovery and long-term maintenance after facial aesthetic and reconstructive procedures.

INTRODUCTION: Telogen effluvium (TE) affects the scalp and is marked by widespread, non-scarring hair loss. This systematic review and meta-analysis aimed to evaluate the association between these micronutrients and TE across different age-groups. METHODOLOGY: Eligible studies included RCTs, clinical trials, cohort, case-control, and cross-sectional studies that reported serum levels of zinc, copper, or vitamin D in TE patients versus healthy controls. Meta-analyses were conducted using RevMan 5.3 with a random-effects model; heterogeneity was assessed via I 2 and chi2 statistics. RESULTS: Out of 372 papers, 29 articles were considered suitable for the systematic review extracted through the database search. Diagnostic methods included trichoscopy and standardized assays (e.g., AAS, ICP-MS). This review analyzed TE patients as predominantly female. Meta-analyses revealed significantly lower serum ferritin (SMD = -0.57, 95% CI: -1.01 to -0.12, p = 0.01) and vitamin D (SMD = -0.87, 95% CI: -1.49 to -0.25, p = 0.006) levels in TE cases versus controls. CONCLUSION: TE is strongly associated with deficiencies in ferritin and vitamin D. Despite high heterogeneity, findings underscore the role of trace element imbalances in hair loss. Personalized nutritional interventions and standardized diagnostic protocols are recommended to address variability and improve cli

INTRODUCTION: Alopecia Areata (AA) is a T-cell-mediated autoimmune disorder. Vitamin D acts as an immunomodulator potentially relevant to pathogenesis. Since data from North India remains limited, this study aimed to assess serum 25-hydroxyvitamin D [25(OH)D] levels in AA patients compared to matched controls and evaluate correlations with disease severity. METHODS: This hospital-based case-control study included 44 AA patients and 44 matched healthy controls. Disease severity was assessed using the Severity of Alopecia Tool (SALT) score. Serum 25(OH)D was measured using Chemiluminescence Immunoassay (CLIA). RESULTS: Median serum 25- hydroxyvitamin D was significantly lower in cases (17.10 ng/mL) versus controls (22.60 ng/mL; p = 0.015). Deficiency (<20 ng/mL) was observed in 54.55% of cases versus 38.64% of controls. Vitamin D deficiency increased the odds of AA by 3.22 times (OR: 3.22; 95% CI: 1.18-8.79; p = 0.022). Stratified analysis revealed a significant difference only among urban residents (p = 0.041). No significant correlation was found between Vitamin D levels and SALT scores (p = 0.442). CONCLUSIONS: Serum 25- hydroxyvitamin D deficiency is significantly associated with Alopecia Areata in this North Indian cohort, particularly among urban residents. Screening for deficiency may be a valuable addition to management.

Platelet-rich plasma (PRP) is widely used in nonscarring alopecia, yet the biological context accompanying measurable trichoscopic change in routine practice remains incompletely described. This study aimed to provide a complementary longitudinal analysis of the same real-world treatment cohort, focusing on within-subject trichoscopic change and paired biomarker trajectories rather than on baseline response stratification. In this ambispective observational cohort, participants underwent paired baseline (T1) and follow-up (T2) assessments after PRP, PRP + exosomes, PRP + nutricomplex, or nutricomplex alone. Total hair density (hairs/cm2) was summarized as absolute change (Δ) and percent change (%Δ). Longitudinal systemic profiling included complete blood count (CBC)-derived inflammatory indices-neutrophil-to-lymphocyte ratio (NLR), derived neutrophil-to-lymphocyte ratio (dNLR), systemic immune-inflammation index (SII), platelet-to-lymphocyte ratio (PLR), and systemic inflammation response index (SIRI)-as well as selected soluble markers, including vitamin D, tumor necrosis factor-alpha (TNF-α), vascular endothelial growth factor (VEGF), and transforming growth factor-beta 1 (TGF-β1). Paired changes were evaluated using Wilcoxon signed-rank tests, between-regimen differences in %Δ density with Kruskal-Wallis testing, a