calcitriol and Sepsis

Sepsis and acute kidney injury (AKI) represent an important burden in intensive care unit clinical practices. The Journal published important contributions in sepsis for novel therapeutic approaches suggesting that combined molecular targets (e.g., dual inhibition of IL-1β and IL-18, and coadministration of endothelial progenitor cells and stromal cell-derived factor-1α analog) could perform better. The clinical effectiveness of 1,25-dihydroxyvitamin D was reported in a double-blind, randomized, placebo-controlled trial. Although its experimental properties appeared favorable in the pro- and antiinflammatory cytokine balance, 1,25-dihydroxyvitamin D failed to improve survival. Strategies for decreasing antimicrobial resistances are of particular importance. Effective (aerosolized antibiotics for ventilator-associated pneumonia) and ineffective (procalcitonin algorithm for antibiotic deescalation) approaches were published. In 2014, several publications raised an important point shared by survivors from sepsis and/or AKI. The increased number of survivors over time brought out long-term sequelae, leading to a poor outcome after hospital discharge. Among them, cardiovascular events and chronic kidney disease may explain the significant increase in the risk of death, which can persist up to 10 years and significantly increases the use of health care. Postdischarge survival represents a new target for future research in sepsis and AKI to find how we can prevent and manage long-term sequelae. A milestone of the year was the Ebola outbreak. The Journal contributed to our better understanding of Ebola virus disease with a paper underlying the crucial role of a large implementation of pragmatic supportive care, including fluid infusion and correction of metabolic abnormalities, to save more lives.

Topics: Acute Kidney Injury; Humans; Sepsis; Vitamin D

Vitamin D deficiency, determined by blood levels of 25-hydroxyvitamin D [25(OH) D, i.e. the major vitamin D form in blood], has been shown to associate with all-cause mortalities. We recently demonstrated that blood levels of 1,25-dihydroxyvitamin D [1,25(OH). We studied mechanisms known to regulate kidney 25-hydroxylvitamin D 1α-hydroxylase which physiologically catalyzes the conversion of 25(OH) D into 1,25(OH). We demonstrated in both human subjects and mice that sepsis-associated 1,25(OH). Because FGF-23 and IGF-1 have multiple biological functions besides their role in regulating kidney 1α-hydroxylase, our data suggest that FGF-23 and IGF-1 are warranted for further investigation as potential agents for the correction of 1,25(OH)

Topics: Animals; Case-Control Studies; Disease Models, Animal; Down-Regulation; Female; Fibroblast Growth Factor-23; Fibroblast Growth Factors; Humans; Insulin-Like Growth Factor I; Kidney; Kidney Function Tests; Male; Mice; Mice, Inbred C57BL; Parathyroid Hormone; Sepsis; Signal Transduction; Vitamin D; Vitamin D Deficiency

Socially anxious cannabis users are influenced by cannabis expectancies and normative perceptions. The present study examines the influence of psychosocial factors on cannabis use vulnerability factors as the result of interactions between norms perceptions, social anxiety, and expectancies.. Participants were 149 (36.2% female) current cannabis users aged 18-36 (. Among cannabis users with perceptions of greater injunctive norms, social anxiety was associated with greater cannabis craving when tension reduction expectancies were greater. However, social anxiety was unrelated to cannabis craving when expectances were low. This suggests that cannabis craving among socially anxious adults was greatest when cannabis use was viewed as acceptable and expected to reduce tension, and highlights the importance of considering norms, expectancies, and social anxiety in understanding cannabis-related behaviors.. The A876P-substitution bridges in vitro and in vivo studies using J6/JFH1-based recombinants. We provide the first in vivo evidence that HVR1 protects cross-genotype conserved HCV neutralisation epitopes, which advocates the possibility of using HVR1-deleted viruses as vaccine antigens to boost broadly reactive protective nAb responses.. We conclude that the photo-processing of eVSGs leads to the production of PAHs with attached aliphatic sidegroups that are revealed by the 3.4. De 4,331 publicaciones encontradas, 16 estudios cumplieron con los criterios de inclusión. El 50 % (8/16) de los estudios revisados fueron realizados en países de Sur América, Centro América y del Caribe. El diseño de casos y controles fue el más frecuente. El anterior sistema de clasificación de casos (OMS-1997) fue utilizado en todos los estudios incluidos en esta revisión.. El estrés oxidativo-nitrosativo se encuentra presente en el curso de la infección por virus dengue, demostrado por los cambios en las concentraciones plasmáticas de óxido nítrico, antioxidantes y marcadores de lipoperoxidación y de oxidación de proteínas. Por último, parece existir una asociación entre la elevación de los niveles plasmáticos de los carbonilos proteicos y malondialdehído con la severidad del dengue.

Topics: Acid-Base Imbalance; Acidosis, Renal Tubular; Aged; Air Pollution, Indoor; Amino Acid Substitution; Animals; Animals, Newborn; Anti-Bacterial Agents; Antibodies, Neutralizing; Apoptosis; Blood Vessel Prosthesis; Blood Vessel Prosthesis Implantation; Bone Marrow Transplantation; Carbonic Anhydrase Inhibitors; Castleman Disease; Cat Diseases; Cats; Cell Proliferation; Cell- and Tissue-Based Therapy; Chemical and Drug Induced Liver Injury; Chemotaxis, Leukocyte; Clinical Trials as Topic; Coated Materials, Biocompatible; Diagnosis, Differential; Disease Models, Animal; Environmental Monitoring; Female; Gas Chromatography-Mass Spectrometry; Genotype; Granuloma, Foreign-Body; Heart Failure; Hepacivirus; Hepatitis C; Horse Diseases; Horses; Housing; Humans; Hypercalcemia; Hypokalemia; Immunophenotyping; In Vitro Techniques; Liver; Liver Function Tests; Lymphocytes; Macrophages; Male; Medicine, Chinese Traditional; Metabolomics; Mice; Mice, Inbred C57BL; Middle Aged; Models, Animal; Mutation; Myocardial Ischemia; Neovascularization, Physiologic; Neutrophil Infiltration; Ocular Hypertension; Ophthalmic Solutions; Parathyroid Hormone; Particulate Matter; Polyethylene Terephthalates; Prednisolone; Prospective Studies; Prosthesis Design; Prosthesis-Related Infections; Rats; Rats, Wistar; Reactive Oxygen Species; Rifampin; Saponins; Sepsis; Skin; Stem Cells; Stroke Volume; Sulfonamides; Texas; Thiophenes; Time Factors; Ventricular Dysfunction, Left; Ventricular Function, Left; Viral Hepatitis Vaccines; Viral Nonstructural Proteins; Viral Proteins; Vitamin D; Wound Healing

In sepsis, the vitamin D active metabolite 1,25-dihydroxyvitamin D (1,25(OH)2D) may play a crucial role by its action to produce cathelicidin and improve endothelial barrier function, such that a deficiency in 1,25(OH)2D is associated with poor outcome. To test our hypothesis, we performed analysis of stored plasma samples from a prospective observational study in 91 patients with sepsis, age of 59.1+/-2.0 years, 52.7% females, and 11.0% deaths at 30 days. Vitamin D status, including 25-hydroxyvitamin D (25(OH)D), 1,25(OH)2D, 24,25-dihydroxyvitamin D (24,25(OH)2D), and parathyroid hormone (PTH), were measured daily over 3 days after hospital admission. At baseline, 1,25(OH)2D was significantly different between survivors vs. non-survivors. But there was no significant difference in 25(OH)D, 24,25(OH)2D, and PTH. In a multivariable binomial logistic regression model, age, total calcium and 1,25(OH)2D were significant predictors of 30-day mortality. Kaplan Meier analysis showed that patients with mean 1,25(OH)2D measured over 3 days of < = 13.6 pg/mL had 57.1% 30-day survival compared to 91.7% in patients with 1,25 (OH)2D level >13.6 pg/mL (p<0.01). From repeated measures regression analysis, there was significant increase in 1,25(OH)2D for increases in 25(OH)D in both survivors and non-survivors. However, compared to survivors, the low 25(OH)D in non-survivors was insufficient to account for the larger decrease in 1,25(OH)2D, indicating a dysfunctional 1α-hydroxylase. Additionally, there was a significant negative correlation between PTH and 1,25(OH)2D in both survivors and non-survivors, suggesting a severe impairment in the effect of PTH to increase renal 1α-hydroxylase activity. In conclusion, low 1,25(OH)2D levels are associated with increased 30-day mortality in sepsis patients, likely due to impaired 25(OH)D hydroxylation and PTH insensitivity. Our data also suggest that the active metabolite 1,25(OH)2D may be an important therapeutic target in the design of sepsis clinical trials.

Topics: 24,25-Dihydroxyvitamin D 3; 25-Hydroxyvitamin D3 1-alpha-Hydroxylase; Aged; Calcium; Female; Humans; Kidney; Male; Middle Aged; Parathyroid Hormone; Prognosis; Prospective Studies; Sepsis; Survival Analysis; Vitamin D