Vitamin D-Binding Protein (Gc-Globulin) in Acute Liver Failure in Children

Grama, Alina; Burac, Lucia; Aldea, Cornel; Bulata, Bogdan; Delean, Dan; Samaşcă, Gabriel; Carmen, Abrudan; Sîrbe, Claudia; Pop, Tudor Lucian

doi:10.3390/diagnostics10050278

Cited by 16 publications

(12 citation statements)

References 36 publications

(71 reference statements)

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“…Beyond its classical role in calcium homeostasis, evidence arose from studies demonstrating antioxidant [ 82 , 83 , 84 ] and anti-fibrotic [ 85 , 86 , 87 ] functions, preventing inflammatory response [ 88 ] and intervening in immune-mediated injuries [ 3 , 8 , 89 , 90 , 91 , 92 , 93 , 94 ]. Treatment opportunities influence the prognosis and quality of life in patients with autoimmune diseases, and the immunomodulatory effects of vitamin D represent a potential supplementation therapy as vitamin D is deficient in patients suffering from autoimmune diseases [ 29 ].…”

Section: Introductionmentioning

confidence: 99%

An Update on the Effects of Vitamin D on the Immune System and Autoimmune Diseases

Simu

Rednic

Grama

et al. 2022

IJMS

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122

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Vitamin D intervenes in calcium and phosphate metabolism and bone homeostasis. Experimental studies have shown that 1,25-dihydroxyvitamin D (calcitriol) generates immunologic activities on the innate and adaptive immune system and endothelial membrane stability. Low levels of serum 25-hydroxyvitamin D (25(OH)D) are associated with an increased risk of developing immune-related diseases such as psoriasis, type 1 diabetes, multiple sclerosis, and autoimmune diseases. Various clinical trials describe the efficacy of supplementation of vitamin D and its metabolites for treating these diseases that result in variable outcomes. Different disease outcomes are observed in treatment with vitamin D as high inter-individual difference is present with complex gene expression in human peripheral blood mononuclear cells. However, it is still not fully known what level of serum 25(OH)D is needed. The current recommendation is to increase vitamin D intake and have enough sunlight exposure to have serum 25(OH)D at a level of 30 ng/mL (75 nmol/L) and better at 40–60 ng/mL (100–150 nmol/L) to obtain the optimal health benefits of vitamin D.

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Section: Introductionmentioning

confidence: 99%

An Update on the Effects of Vitamin D on the Immune System and Autoimmune Diseases

Simu

Rednic

Grama

et al. 2022

IJMS

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122

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“…Studies on different clinical and laboratory parameters in ALF in children found that high TB level [3,44,57], increased INR [1,3,44,57], lower transaminases [58], young age [12,57,59], and encephalopathy [3,44,57] are prognostic factors for those who will need LT. Our team recently published a study on the role of Gc-globulin as a prognostic marker in children with ALF [25].…”

Section: Discussionmentioning

confidence: 99%

“…Until now, many factors proved to be possible prognostic markers for an unfavorable outcome in pediatric ALF: age under ten years, etiology (viral infections, Wilson's disease-WD), the presence of grade III/IV HE, a quick decrease in the liver volume or serum level of aminotransferases, increased level of bilirubin, severe coagulopathy (high International Normalized Ratio, INR, and decreased level of coagulation factors V and VII). Moreover, alpha-fetoprotein (AFP), serum phosphate, serum lactate, ammonia, vitamin D-binding protein were identified as possible prognostic factors in ALF [3,15,[22][23][24][25][26][27].…”

Section: Introductionmentioning

confidence: 99%

The Role of Predictive Models in the Assessment of the Poor Outcomes in Pediatric Acute Liver Failure

Pop

Aldea

Delean

et al. 2022

JCM

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Objectives: In children, acute liver failure (ALF) is a severe condition with high mortality. As some patients need liver transplantation (LT), it is essential to predict the fatal evolution and to refer them early for LT if needed. Our study aimed to evaluate the prognostic criteria and scores for assessing the outcome in children with ALF. Methods: Data of 161 children with ALF (54.66% female, mean age 7.66 ± 6.18 years) were analyzed based on final evolution (32.91% with fatal evolution or LT) and etiology. We calculated on the first day of hospitalization the PELD score (109 children), MELD, and MELD-Na score (52 children), and King’s College Criteria (KCC) for all patients. The Nazer prognostic index and Wilson index for predicting mortality were calculated for nine patients with ALF in Wilson’s disease (WD). Results: PELD, MELD, and MELD-Na scores were significantly higher in patients with fatal evolution (21.04 ± 13.28 vs. 13.99 ± 10.07, p = 0.0023; 36.20 ± 19.51 vs. 20.08 ± 8.57, p < 0.0001; and 33.07 ± 8.29 vs. 20.08 ± 8.47, p < 0.0001, respectively). Moreover, age, bilirubin, albumin, INR, and hemoglobin significantly differed in children with fatal evolution. Function to etiology, PELD, MELD, MELD-Na, and KCC accurately predicted fatal evolution in toxic ALF (25.33 vs. 9.90, p = 0.0032; 37.29 vs. 18.79, p < 0.0001; 34.29 vs. 19.24, p = 0.0002, respectively; with positive predicting value 100%, negative predicting value 88.52%, and accuracy 89.23% for King’s College criteria). The Wilson index for predicting mortality had an excellent predictive strength (100% sensibility and specificity), better than the Nazer prognostic index. Conclusions: Prognostic scores may be used to predict the fatal evolution of ALF in children in correlation with other parameters or criteria. Early estimation of the outcome of ALF is essential, mainly in countries where emergency LT is problematic, as the transfer to a specialized center could be delayed, affecting survival chances.

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“…As mentioned, open‐heart surgery induces acute stress (Hoda et al, 2006) and a systemic inflammatory response (Borgermann et al, 2012; Canbaz et al, 2008; Czerny et al, 2000; Holmes et al, 2002), and systemic inflammation associates with a decrease in circulating 25(OH)D (Alemzadeh et al, 2012; Bang et al, 2011; Barker et al, 2012; Binkley et al, 2017; Dahl et al, 1998; De et al, 2014; Duncan et al, 2012; Ghashut et al, 2014; Grama et al, 2020 ; Henriksen et al, 2014; Krishnan et al, 2010; Louw et al, 1992; Reid et al, 2011; Vayrynen et al, 2016; Waldron et al, 2013). Although the mechanism regulating the decrease and confounding the interpretation of endogenous vitamin D levels during inflammation is obscure, various cytokines have been found to control the enzymatic machinery that accelerates the metabolism of 25(OH)D in vitro (Edfeldt et al, 2010; Hummel et al, 2013; Koeffler et al, 1985; Pryke et al, 1990; Reichel et al, 1987; Stoffels et al, 2006, 2007) and, therefore, could account for the decrease in circulating 25(OH)D concentrations when systemic levels are elevated.…”

Section: Discussionmentioning

confidence: 99%

Vitamin D supplementation protects against reductions in plasma 25‐hydroxyvitamin D induced by open‐heart surgery: Assess‐d trial

et al. 2021

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Low vitamin D (serum or plasma 25‐hydroxyvitamin D (25(OH)D)) is a global pandemic and associates with a greater prevalence in all‐cause and cardiovascular mortality and morbidity. Open‐heart surgery is a form of acute stress that decreases circulating 25(OH)D concentrations and exacerbates the preponderance of low vitamin D in a patient population already characterized by low levels. Although supplemental vitamin D increases 25(OH)D, it is unknown if supplemental vitamin D can overcome the decreases in circulating 25(OH)D induced by open‐heart surgery. We sought to identify if supplemental vitamin D protects against the acute decrease in plasma 25(OH)D propagated by open‐heart surgery during perioperative care. Participants undergoing open‐heart surgery were randomly assigned (double‐blind) to one of two groups: (a) vitamin D (n = 75; cholecalciferol, 50,000 IU/dose) or (b) placebo (n = 75). Participants received supplements on three separate occasions: orally the evening before surgery and either orally or per nasogastric tube on postoperative days 1 and 2. Plasma 25(OH)D concentrations were measured at baseline (the day before surgery and before the first supplement bolus), after surgery on postoperative days 1, 2, 3, and 4, at hospital discharge (5–8 days after surgery), and at an elective outpatient follow‐up visit at 6 months. Supplemental vitamin D abolished the acute decrease in 25(OH)D induced by open‐heart surgery during postoperative care. Moreover, plasma 25(OH)D gradually increased from baseline to day 3 and remained significantly increased thereafter but plateaued to discharge with supplemental vitamin D. We conclude that perioperative vitamin D supplementation protects against the immediate decrease in plasma 25(OH)D induced by open‐heart surgery. ClinicalTrials.gov Identifier: NCT02460211.

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Vitamin D-Binding Protein (Gc-Globulin) in Acute Liver Failure in Children

Cited by 16 publications

References 36 publications

An Update on the Effects of Vitamin D on the Immune System and Autoimmune Diseases

An Update on the Effects of Vitamin D on the Immune System and Autoimmune Diseases

The Role of Predictive Models in the Assessment of the Poor Outcomes in Pediatric Acute Liver Failure

Vitamin D supplementation protects against reductions in plasma 25‐hydroxyvitamin D induced by open‐heart surgery: Assess‐d trial

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