Effects of Vitamin D Supplementation on Bone Health and Bone-related Parameters in HIV-infected Patients: A Systematic Review and Meta-analysis.

PURPOSE: There is growing evidence that bone health is decreased in individuals with HIV infection. Vitamin D deficiency is also highly prevalent among HIV-infected patients. The literature was systematically reviewed to determine whether bone health and bone-related parameters may improve with vitamin D supplementation in HIV-infected individuals. METHODS: Four databases were systematically searched for randomized clinical trials of vitamin D supplementation in HIV infection, published from January 1990 to September 2021. No language or publication restrictions were applied. Standardized mean differences (SMD) with 95% CIs are reported. A random-effects model was used to perform meta-analysis. FINDINGS: Ten studies met the inclusion criteria (N = 733 participants at study completion). The mean ages of the patients in the included trials ranged from 10 to 49 years. The meta-analysis indicated that with vitamin D supplementation, serum 25-hydroxy vitamin D (25[OH]D) level was significantly increased (SMD, 1.86; 95% CI, 1.02 to 2.70; I2 = 94.4%), but there were no significant effects on levels of serum 1,25-dihydroxy vitamin D (1,25-[OH]2D) (SMD, 0.29; 95% CI, -0.07 to 0.64; I2 = 67.4%), total bone mineral density (SMD, 0.07; 95% CI, -0.23 to 0.37; I2 = 00.0%), spine bone mineral density (SMD, 0.15; 95% CI, -0.19 to 0.49; I2 = 17.3%), and parathyroid hormone level (SMD, -0.18; 95% CI, -0.37 to 0.02; I2 = 1.2%) in HIV-infected patients. IMPLICATIONS: This study showed that vitamin D supplementation can improve serum 25(OH)D in HIV-infected patients. The effects of vitamin D supplementation on other bone health-related parameters such as bone mineral density and parathyroid hormone in HIV-infected patients need to be further investigated in larger-scale, well-designed randomized, controlled trials.

Near Infrared Laser Photobiomodulation of Periodontal Ligament Stem Cells.

OBJECTIVE: To determine the effect of different energy densities of near infrared diode lasers with wavelengths of 810 or 940 nm on the proliferation and survival of periodontal ligament derived stem cells (PDLSCs). METHODS: After isolation and characterisation, PDLSCs were cultured in clear 96-well plates. Each well was irradiated by either 810 nm (L1) or 940 nm (L2) lasers, with energy densities of 0.5, 1.5 and 2.5 J/cm2 and an output power of 100 mW. A non-irradiated well was used as a control. Cellular viability was measured 24 hours after irradiation using 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl-2H-tetrazolium bromide (MTT) assay and proliferation was measured 24, 48 and 72 hours after irradiation using trypan blue staining and counting. Propidium iodide (PI) staining was used to identify any pyknotic nuclei or nuclear fragmentation 72 hours after irradiation. RESULTS: An increase in viability was observed only in the group with the 940 nm laser irradiation at energy density of 2.5 J/cm2 (P < 0.001). The proliferation of cells was significantly increased in the group with 940 nm laser irradiation at energy density of 2.5 J/cm2 at all the time points examined in comparison to other groups (P < 0.001). PI staining showed no change in cell nuclei in any of the groups. CONCLUSION: Irradiation of PDLSCs with a 940 nm laser at an energy density of 2.5 J/cm2 could promote efficient cell proliferation.

Evaluation of local and circulating osteopontin in malignant and benign primary bone tumors.

PURPOSE: The development of novel and efficient biomarkers for primary bone cancers is of grave importance. METHODS: The expression pattern of osteopontin (OPN) was investigated in the 153 patients with benign (n = 72) and malignant (n = 81) primary bone cancers. Both local and circulating OPN mRNA expression levels and their protein concentration in serum and tumor site were assessed using real-time qRT-PCR, ELISA, and immunohistochemistry techniques, respectively. As a control, 29 healthy individuals were considered. The number of 153 tumor tissue specimens and the 153 paired margins were taken on surgical resection from the patients. 153 blood samples were also drained from all participants, then peripheral blood mononuclear cells (PBMC) and sera were separated. RESULTS: The mean mRNA expression was significantly higher in all of the cancerous tissues than the paired margins and the PBMC of the patients than the controls. Consistently, the protein concentrations of OPN in serum and tumor tissues were significantly higher in the patients. Furthermore, the malignant cases had significantly elevated the mRNA levels and the protein compared to the benign cases. OPN could potentially differentiate the patients from the controls with 100% sensitivity and specificity in serum. Moreover, OPN could predict some of the malignant cases' clinicopathological features, including metastasis, recurrence, grade, and response to chemotherapy. CONCLUSIONS: In conclusion, OPN might be involved in the pathogenesis of primary bone tumors and can be considered as a potential biomarker to bone cancer diagnosis.

An updated review of mechanistic potentials of melatonin against cancer: pivotal roles in angiogenesis, apoptosis, autophagy, endoplasmic reticulum stress and oxidative stress.

Cancers are serious life-threatening diseases which annually are responsible for millions of deaths across the world. Despite many developments in therapeutic approaches for affected individuals, the rate of morbidity and mortality is high. The survival rate and life quality of cancer patients is still low. In addition, the poor prognosis of patients and side effects of the present treatments underscores that finding novel and effective complementary and alternative therapies is a critical issue. Melatonin is a powerful anticancer agent and its efficiency has been widely documented up to now. Melatonin applies its anticancer abilities through affecting various mechanisms including angiogenesis, apoptosis, autophagy, endoplasmic reticulum stress and oxidative stress. Regarding the implication of mentioned cellular processes in cancer pathogenesis, we aimed to further evaluate the anticancer effects of melatonin via these mechanisms.

Association of Serum Vitamin D with Serum Cytokine Profile in Patients with Knee Osteoarthritis.

OBJECTIVE: The role of vitamin D in the pathogenesis of osteoarthritis (OA) is not well understood. In this study, we aimed to investigate the association of serum vitamin D with the serum cytokine profile in patients with primary knee OA. DESIGN: In a cross-sectional study, 116 patients with radiologic diagnosis of grade I to III knee OA were included. The study population included 79 (75.9%) females and 25 (24.1%) males with a mean age of 55.1 ± 9.6 years. The serum concentration of IL-6, IL-8, TNF-α, IL-4, IL-10, IL-13, and vitamin D were assessed using an enzyme-linked immunosorbent assay. The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) was used for the assessment of patient's reported disability associated with knee OA. RESULTS: Serum vitamin D status was deficient, insufficient, and sufficient in 18 (15.5%), 63 (54.3%), 35 (30.2%) patients, respectively. Higher levels of serum IL-6 were observed in patients with vitamin D deficiency (P = 0.022). The mean serum vitamin D level was not associated with OA grade (P = 0.88) and WOMAC scores of the patients (P = 0.67). Serum IL-6 level was significantly associated with both OA grade and WOMAC scores of the patients (P < 0.001 and P = 0.001, respectively). The vitamin D status was not significantly associated with the serum levels of other evaluated cytokines. CONCLUSION: Vitamin D deficiency in knee OA seems to be associated with a higher release of IL-6. Therefore, vitamin D supplementation could reduce the disease burden by controlling the IL-6 release.

Effect of photobiomodulation with 810 and 940 nm diode lasers on human gingival fibroblasts.

BACKGROUND: The growth and proliferation of gingival fibroblasts are important in the process of oral wound healing, and photobiomodulation (PBM) might be able to modify this process. OBJECTIVES: The aim of the current study was to evaluate the biomodulatory effect of a single session of laser PBM by means of 810 nm and 940 nm diode lasers alone and their combined application with different fluencies on human gingival fibroblasts (HGFs). MATERIAL AND METHODS: Cells were provided by the Pasteur Institute, the National Cell Bank of Iran (NCBI) (C-165). Laser irradiation was carried out using 810 nm, 940 nm and 810 nm + 940 nm in the continuous wave (CW) mode, 100 mW, and energy densities of 0.5, 1.5 and 2.5 J/cm2. Cell viability was evaluated at 24 h with the MTT assay. Trypan blue staining was used to evaluate proliferation 24, 48 and 72 h after laser therapy. Propidium iodine was used to stain DNA and the cell nucleus. RESULTS: Laser irradiation (810 nm, 0.5 J/cm2) increased the viability of gingival fibroblasts, while this dose had an inhibitory effect with 940 nm. No positive effect on cell viability was found with other settings at 24 h. The viability results were not statistically different from those of the control in the dual wavelength group. At all single-laser irradiation doses, the cell proliferation results were lower as compared to the control at 48 and 72 h. The dual wavelength group results were significantly better than those of the control for the 1.5 J/cm2 and 2.5 J/cm2 energy densities (p < 0.001). Propidium iodine staining showed no negative effect of laser irradiation on the cell nucleus in any of the groups. CONCLUSIONS: Although a single irradiation dose of 810 nm, 0.5 J/cm2, resulted in a positive effect on cell viability at 24 h, no statistically significant stimulatory effect on viability and proliferation was observed for the other single wavelength group. When a combination of the 2 wavelengths was used, better results were observed as compared to the control, which needs to be further investigated in future studies.

Melatonin in the treatment of fibromyalgia symptoms: A systematic review.

The available pharmacological modalities for the treatment of fibromyalgia (FM) are associated with a variety of adverse effects and limited benefits. In this study, we systematically reviewed the impact of melatonin in the treatment of FM. Interventional studies, either controlled or uncontrolled and randomized or non-randomized, were included. PubMed, EMBASE, Scopus, Web of Science, and the Cochrane Library were searched without time limitation. Primary outcome measures were the effect of melatonin on the disease impact, pain, sleep quality, tender point count, fatigue, anxiety, stiffness, and depression in FM patients. Four studies, reporting the effect of melatonin on 98 patients, were eligible to include. All the studies reported the positive effect of melatonin on the FM symptoms. No major adverse event was reported. A significant level of heterogeneity was observed between the studies. Therefore, further high-quality controlled clinical trials are needed to understand the role of melatonin in FM treatment fully.

The effect of low-level laser radiation on improving inferior alveolar nerve damage after sagittal split osteotomy: a systematic review.

Inferior alveolar nerve (IAN) damage is a common complication occurring after sagittal split osteotomy (SSO) and results in sensory disorders of the jaw region. In recent years, published experimental and clinical evidence suggests that low-level laser (LLL) radiation is effective in nerve recovery. Therefore, the aim of the present study was to review clinical trial studies investigating the effect of LLL radiation on improving the sensory defects of IAN after SSO. The keywords associated with SSO and LLL were searched in PubMed, Medline (via Ovid), Web of Science (WOS), Scopus, and Cochrane Library databases. Then, controlled clinical trial studies published before November 2017 regarding LLL radiation conducted on patients with IAN neuropathy due to SSO were investigated. The articles fulfilling the study criteria were further scrutinized and the necessary information was extracted from them. A total of seven papers were included in the study. The diode laser used had a wavelength range of 760-930 nm, radiation power of 20-200 mw, and radiation energy of 10.2-95 J (per point of radiation). In the mentioned studies, the patients underwent 3-20 sessions of laser irradiation and were monitored for an additional 0-23 months after completion of the laser intervention. The tests performed in the mentioned studies dealt with examining the perceptions of superficial touch and pressure, two-point discrimination, stimulus movement on skin, temperature, and pain. Furthermore, the patients' general awareness regarding sensory perception in the mandibular region was gauged. In six studies, laser irradiation caused relative improvement in the IAN sensory disorder for a subjective test as well as for one or more objective tests. In the reviewed clinical trial studies, LLL was generally found to be effective in improving the IAN sensory disturbance resulting from SSO, though there was no placebo effect.

Effect of photodynamic therapy by 810 and 940 nm diode laser on Herpes Simplex Virus 1: An in vitro study.

INTRODUCTION: Herpes simplex virus (HSV) is among the most common viruses in humans. HSV1 is often responsible for oral and perioral herpetic lesions. Photodynamic therapy (PDT) is a novel antimicrobial modality that involves the use of laser and a photosensitizer with a specific wavelength. This study aimed to assess and compare the effect of PDT with 810 and 940 nm diode laser and indocyanine green (ICG) photosensitizer on HSV1. METHODS: In this in vitro study, HSV1 isolated from herpes labialis and there were 6 experimental groups.The irradiation parameters were the same for all groups. Number of remaining viruses per milliliter in each group was determined using real-time polymerase chain reaction (PCR) and statistically analyzed by ANOVA. RESULTS: The virus count in all groups significantly decreased compared to the control group (P < 0.05) except in group ICG- without irradiation (P > 0.05). Comparison of groups 810- and 940- (use of each laser alone) with groups 810+ and 940+ (use of each laser plus ICG) revealed that reduction in virus count in groups 810+ and 940+ was significantly greater than that in groups 810- and 940-. CONCLUSION: 810 nm diode laser irradiation and ICG causes the greatest reduction in number of HSV1 compared to all the other groups. ICG without laser irradiation has not significant efficacy on reduction of virus count.

Effects of vitamin D optimization on quality of life of patients with fibromyalgia: A randomized controlled trial.

Background: Numerous studies have been conducted to evaluate the frequency of hypovitaminosis D in patients with fibromyalgia syndrome (FMS) and its association with FMS symptoms. This study aimed at assessing the effect of hypovitaminosis D on the symptoms and quality of life of patients with fibromyalgia. Methods: A total of 74 FMS patients with hypovitaminosis D were randomly assigned into group A (Trazodone 25 mg at bedtime + vitamin D 50 000 IU weekly) and group B (Trazodone 25 mg at bedtime + placebo). Serum vitamin D level, Widespread Pain Index (WPI), Fibromyalgia Impact Questionnaire (FIQ), Pittsburgh Sleep Quality Index (PSQI), and Short Form Health Survey (SF-36) were used at the beginning of the treatment and 4 and 8 weeks post treatment. Results: Significant improvements were observed in WPI, FIQ, and PSQI scores in both groups. Moreover, combination of vitamin D and Trazodone resulted in significant improvement of SF-36 scores compared to Trazodone therapy. Improvement in pain-related indices including the WPI and the physical component score (PCS) fraction of SF-36 was more noticeable in vitamin D/Trazodone combination therapy. Conclusion: This study suggests that vitamin D supplementation has significant therapeutic benefits in the management of FMS, especially in pain reduction of patients with fibromyalgia. According to our results, a combination of vitamin D supplements and a conventional antidepressant, when given to vitamin D-deficient fibromyalgia patients, could significantly improve both physical and psychological symptoms.

Metal oxides as a biostimulator for upregulation of genes involved in the biosynthesis of Rebaudioside- A.

Stevia rebaudiana Bertoni is a kind of perennial medicinal plant with sweetening properties which belongs to Asteraceae family. Its leaves with fundamental glycoside compounds consist of both a sugar part and a non-sugar sector. One of the glycoside compounds is Rebaudioside- A which has a greater importance in business. This experiment was conducted to evaluate the effects of Ag2O, CrO3, PbO, Fe2O3, BaO and TiO2 on the expression pattern of these genes in the Stevia rebaudiana. Rebaudioside- A biosynthesis was repeated 3 times with concentrations of 50, 100 and 200µM. Also, the results of the study pertaining to the expression pattern of these genes showed that metal oxides have led to an increase in the expression of the regulatory genes involved in biosynthesis of Rebaudioside- A. According to the expression profile, it was found that its effect on DXR, HDS, HDR, IDI and CPPS genes is more than other genes. The peak HPLC indicated for stevioside and Rebaudioside- A represents an increase in the production of this active ingredient under the influence of all treatments. In general, the expression profile of these genes and the results of HPLC show that whatever going to the end of the pathway of production of Rebaudioside- A, the activity of the enzymes increases under the influence of these treatments, and eventually a greater amount of Rebaudioside- A will be produced. This process shows that metal oxides will have a significant effect on the biosynthesis of Rebaudioside- A.

Clinical effectiveness of low-level laser treatment on peripheral somatosensory neuropathy.

Peripheral sensory neuropathy treatment is one of the common treatment problems and causes morbidity and mortality in people suffering from that. Although treatment depends on the underlying cause of the condition, nevertheless, in some cases, there is no cure for it, and it requires palliative and symptomatic treatment. In laboratory studies, low-level laser has been effective in the nerves protection and restoration. The aim of this article is to investigate the clinical efficacy of low-level laser on improvement of the peripheral somatosensory neuropathy. Search in the articles published up to 30 October 2015 (full text and abstracts) in databases PubMed (Medline), Cochrane library, Physiotherapy Evidence Database was performed. The studies of low-level laser trials on patients with peripheral neuropathy were carried out and evaluated in terms of the exclusion criteria. There are 35 articles among which 10 articles had the intended and required criteria. 1, 3, and 6 articles study the patients with diabetes, neuropathy caused by trauma, and carpal tunnel syndrome, respectively. In six studies, laser led to a reduction in sensory impairment and improvement of the physiological function of the sensory nerves. In these articles, lasers (Diode, GaAlAs, He-Ne) had wavelength range 660-860 nm, radiation power 20-250 mW, energy density 0.45-70 J/cm2. The intervention sessions range was 6-21 times and patient follow-up was 0-6 months. According to the results of these studies, low-level laser therapy can improve sensory function in patients with peripheral somatosensory neuropathy, although little research have not been done, laser treatment regimens are varied and do not recommend a specific treatment protocol. It seems it requires more research to sum up better, particularly in relation to diabetes.

Analyzing Cytotoxic and Apoptogenic Properties of Scutellaria litwinowii Root Extract on Cancer Cell Lines.

The Scutellaria species (Lamiaceae) is used as a source of flavonoids to treat a variety of diseases in traditional medicine. In spite of many reports about the cytotoxic and antitumor effects of some species of this genus, anticancer researches on one of the Iranian species S. litwinowii have not yet been conducted. The cytotoxic properties of total methanol extract of S. litwinowii and its fractions were investigated on different cancer cell lines including AGS, HeLa, MCF-7, PC12 and NIH 3T3. Meanwhile, the role of apoptosis in this toxicity was explored. The cells were cultured in DMEM medium and incubated with different concentrations of herb plant extracts. Cell viability was quantitated by MTT assay. Apoptotic cells were determined using propidium iodide staining of DNA fragmentation by flow cytometry (sub-G1 peak). Scutellaria litwinowii inhibited the growth of malignant cells in a dose-dependent manner. Among solvent fractions of S. litwinowii, the methylene chloride fraction was found to be more toxic compared to other fractions. The IC(50) values of this fraction against AGS, HeLa, MCF-7 and PC12 cell lines after 24 h were determined, 121.2 ± 3.1, 40.9 ± 2.5, 115.9 ± 3.5 and 64.5 ± 3.4 µg/ml, respectively. Scutellaria litwinowii induced a sub-G1 peak in the flow cytometry histogram of treated cells compared to control cells indicating that apoptotic cell death is involved in S. litwinowii toxicity. Scutellaria litwinowii exerts cytotoxic and proapototic effects in a variety of malignant cell lines and could be considered as a potential chemotherapeutic agent in cancer treatment.