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Effect of high-dose vitamin D supplementation on antibody titers to heat shock protein 27 in adolescent girls

  • Zahra Khorasanchi , Afsane Bahrami , Shima Tavallaee , Zahra Mazloum Khorasani , Mozhgan Afkhamizadeh , Ezzat Khodashenas , Gordon A. Ferns and Majid Ghayour-Mobarhan ORCID logo EMAIL logo
Published/Copyright: April 29, 2020

Abstract

Background

Although vitamin D deficiency is associated with several inflammatory conditions, there have been few studies on the effects of vitamin D supplementation on markers of oxidative stress (OS) and inflammation. The aim of the current study was to evaluate the effects of high-dose vitamin D supplementation on heat shock protein 27 antibody (anti-Hsp27) titers in adolescent girls.

Methods

Five hundred and fifty adolescent girls received vitamin D3 at a dose of 50,000 IU/week for 9 weeks. Demographic, clinical and biochemical markers including serum fasting blood glucose (FBG), lipid profile and anti-Hsp27 titers as well as hematological parameters including white blood cell (WBC) count and red blood cell (RBC) distribution width (RDW) were determined in all the subjects at baseline and at the end of the study.

Results

Serum vitamin D significantly increased from 6.4 (4.2–9.6) ng/mL to 35.6 (25.8–47.5) ng/mL (p < 0.001) following the intervention. Furthermore, serum anti-Hsp27 titers were significantly lower after the 9-week vitamin D administration period (0.22 [0.12–0.33] optical density [OD] vs. 0.19 [0.11–0.31] OD; p = 0.002). A significant correlation was found between serum anti-Hsp27 and RDW (r = 0.13, p = 0.037). The reduction in RDW values after intervention was particularly evident in subjects with the greatest increase in serum vitamin D levels.

Conclusions

High-dose vitamin D supplementation was found to reduce antibody titers to Hsp27. Further randomized placebo-controlled trials are warranted to determine the long-term effect of vitamin D administration on the inflammatory process especially that associated with chronic disease.


Majid Ghayour-Mobarhan, MD, PhD, Metabolic Syndrome Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran, Phone: +98 5138002288, Fax: +98 5138002287
aZahra Khorasanchi and Afsane Bahrami equally contributed as first author.
  1. Author contribution: All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission. Study design: Majid Ghayour-Mobarhan, Zahra Khorasanchi and Afsane Bahrami. Data collection: Zahra Khorasanchi, Afsane Bahrami, Shima Tavallaee, Zahra Mazloum Khorasani, Mozhgan Afkhamizadeh and Ezzat Khodashenas. Statistical analysis: Afsane Bahrami. Data interpretation: Zahra Khorasanchi, Afsane Bahrami, Shima Tavallaee, Majid Ghayour-Mobarhan and Gordon A. Ferns. Manuscript preparation: Zahra Khorasanchi, Afsane Bahrami and Majid Ghayour-Mobarhan. Literature search: Zahra Khorasanchi, Afsane Bahrami and Majid Ghayour-Mobarhan. Collection of funds: Majid Ghayour-Mobarhan.

  2. Research funding: This study was supported by Mashhad University of Medical Sciences, http://dx.doi.org/10.13039/501100004748 (grant number 931188).

  3. Employment or leadership: None declared.

  4. Honorarium: None declared.

  5. Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.

  6. Conflict of interest: The authors have no conflict of interest to declare.

  7. Informed consent: Informed consent was obtained from all participants and their parents.

References

1. Ghayour-Mobarhan M, Saber H, Ferns GA. The potential role of heat shock protein 27 in cardiovascular disease. Clin Chim Acta 2012;413:15–24.10.1016/j.cca.2011.04.005Search in Google Scholar PubMed

2. Marnell L, Mold C, Du Clos TW. C-reactive protein: ligands, receptors and role in inflammation. Clin Immunol 2005;117:104–11.10.1016/j.clim.2005.08.004Search in Google Scholar PubMed

3. Medzhitov R. Origin and physiological roles of inflammation. Nature 2008;454:428–35.10.1038/nature07201Search in Google Scholar PubMed

4. Rodríguez-Hernández H, Simental-Mendía LE, Rodríguez-Ramírez G, Reyes-Romero MA. Obesity and inflammation: epidemiology, risk factors, and markers of inflammation. Int J Endocrinol 2013;2013:678159.10.1155/2013/678159Search in Google Scholar PubMed PubMed Central

5. Wang F, Pan W, Pan S, Ge J, Wang S, et al. Red cell distribution width as a novel predictor of mortality in ICU patients. Ann Med 2011;43:40–6.10.3109/07853890.2010.521766Search in Google Scholar PubMed

6. Martin JL, Mestril R, Hilal-Dandan R, Brunton LL, Dillmann WH. Small heat shock proteins and protection against ischemic injury in cardiac myocytes. Circulation 1997;96:4343–8.10.1161/01.CIR.96.12.4343Search in Google Scholar

7. Vander Heide RS. Increased expression of HSP27 protects canine myocytes from simulated ischemia-reperfusion injury. Am J Physiol Heart Circ Physiol 2002;282:H935–41.10.1152/ajpheart.00660.2001Search in Google Scholar PubMed

8. Yamboliev IA, Hedges JC, Mutnick JL, Adam LP, Gerthoffer WT. Evidence for modulation of smooth muscle force by the p38 MAP kinase/HSP27 pathway. Am J Physiol Heart Circ Physiol 2000;278:H1899–907.10.1152/ajpheart.2000.278.6.H1899Search in Google Scholar PubMed

9. Dudeja V, Vickers S, Saluja A. The role of heat shock proteins in gastrointestinal diseases. Gut 2009;58:1000–9.10.1136/gut.2007.140194Search in Google Scholar PubMed PubMed Central

10. Ghayour-Mobarhan M, Sahebkar A, Parizadeh SM, Moohebati M, Tavallaie S, et al. Antibody titres to heat shock protein 27 are elevated in patients with acute coronary syndrome. Int J Exp Pathol 2008;89:209–15.10.1111/j.1365-2613.2008.00586.xSearch in Google Scholar PubMed PubMed Central

11. Pourghadamyari H, Moohebati M, Parizadeh SM, Falsoleiman H, Dehghani M, et al. Serum antibody titers against heat shock protein 27 are associated with the severity of coronary artery disease. Cell Stress Chaperones 2011;16:309–16.10.1007/s12192-010-0241-7Search in Google Scholar

12. Sahebkar A, Pourghadamyari H, Moohebati M, Parizadeh SM, Falsoleiman H, et al. A cross-sectional study of the association between heat shock protein 27 antibody titers, pro-oxidant–antioxidant balance and metabolic syndrome in patients with angiographically-defined coronary artery disease. Clin Biochem 2011;44:1390–5.10.1016/j.clinbiochem.2011.09.011Search in Google Scholar

13. Taché Y, Martinez V, Million M, Rivier J. Corticotropin-releasing factor and the brain-gut motor response to stress. Can J Gastroenterol Hepatol 1999;13(Suppl A):18A–25.10.1155/1999/375916Search in Google Scholar

14. Törnblom H, Lindberg G, Nyberg B, Veress B. Full-thickness biopsy of the jejunum reveals inflammation and enteric neuropathy in irritable bowel syndrome. Gastroenterology 2002;123:1972–9.10.1053/gast.2002.37059Search in Google Scholar

15. Kojima K, Musch MW, Ren H, Boone DL, Hendrickson BA, et al. Enteric flora and lymphocyte-derived cytokines determine expression of heat shock proteins in mouse colonic epithelial cells. Gastroenterology 2003;124:1395–407.10.1016/S0016-5085(03)00215-4Search in Google Scholar

16. Nakayoshi T, Adachi H, Ohbu-Murayama K, Enomono M, Fukami A, et al. Plasma heat shock protein 27 is increased in renal dysfunction and habitual smoking in a Japanese general population. J Cardiol 2016;67:110–4.10.1016/j.jjcc.2015.04.005Search in Google Scholar PubMed

17. Ospelt C, Camici GG, Engler A, Kolling C, Vogetseder A, et al. Smoking induces transcription of the heat shock protein system in the joints. Ann Rheum Dis 2014;73:1423–6.10.1136/annrheumdis-2013-204486Search in Google Scholar PubMed

18. Volm M, Mattern J, Stammler G. Up-regulation of heat shock protein 70 in adenocarcinomas of the lung in smokers. Anticancer Res 1995;15:2607–9.Search in Google Scholar

19. Prummel M, Van Pareren Y, Barker O, Wiersinga W. Anti-heat shock protein (hsp) 72 antibodies are present in patients with Graves’ disease (GD) and in smoking control subjects. Clin Exp Immunol 1997;110:292–5.10.1111/j.1365-2249.1997.tb08330.xSearch in Google Scholar PubMed PubMed Central

20. Nakanishi N, Suzuki K, Tatara K. White blood cell count and clustered features of metabolic syndrome in Japanese male office workers. Occup Med 2002;52:213–8.10.1093/occmed/52.4.213Search in Google Scholar PubMed

21. Nakanishi N, Yoshida H, Matsuo Y, Suzuki K, Tatara K. White blood-cell count and the risk of impaired fasting glucose or type II diabetes in middle-aged Japanese men. Diabetologia 2002;45:42–8.10.1007/s125-002-8243-1Search in Google Scholar PubMed

22. Patel KV, Semba RD, Ferrucci L, Newman AB, Fried LP, et al. Red cell distribution width and mortality in older adults: a meta-analysis. J Gerontol A Biol Sci Med Sci 2009;65:258–65.10.1093/gerona/glp163Search in Google Scholar

23. Cavusoglu E, Chopra V, Gupta A, Battala VR, Poludasu S, et al. Relation between red blood cell distribution width (RDW) and all-cause mortality at two years in an unselected population referred for coronary angiography. Int J Cardiol 2010;141:141–6.10.1016/j.ijcard.2008.11.187Search in Google Scholar

24. Tonelli M, Sacks F, Arnold M, Moye L, Davis B, et al. Relation between red blood cell distribution width and cardiovascular event rate in people with coronary disease. Circulation 2008;117:163–8.10.1161/CIRCULATIONAHA.107.727545Search in Google Scholar

25. Guillot X, Semerano L, Saidenberg-Kermanac’h N, Falgarone G, Boissier M-C. Vitamin D and inflammation. Joint Bone Spine 2010;77:552–7.10.1016/j.jbspin.2010.09.018Search in Google Scholar

26. Reis JP, von Mühlen D, Miller ER, Michos ED, Appel LJ. Vitamin D status and cardiometabolic risk factors in the United States adolescent population. Pediatrics 2009;124:e371–9.10.1542/peds.2009-0213Search in Google Scholar

27. Hyppönen E, Läärä E, Reunanen A, Järvelin M-R, Virtanen SM. Intake of vitamin D and risk of type 1 diabetes: a birth-cohort study. Lancet 2001;358:1500–3.10.1016/S0140-6736(01)06580-1Search in Google Scholar

28. Munger KL, Levin LI, Hollis BW, Howard NS, Ascherio A. Serum 25-hydroxyvitamin D levels and risk of multiple sclerosis. J Am Med Assoc 2006;296:2832–8.10.1001/jama.296.23.2832Search in Google Scholar PubMed

29. Merlino LA, Curtis J, Mikuls TR, Cerhan JR, Criswell LA, et al. Vitamin D intake is inversely associated with rheumatoid arthritis: results from the Iowa Women’s Health Study. Arthritis Rheumatol 2004;50:72–7.10.1002/art.11434Search in Google Scholar PubMed

30. Lappe JM, Travers-Gustafson D, Davies KM, Recker RR, Heaney RP. Vitamin D and calcium supplementation reduces cancer risk: results of a randomized trial. Am J Clin Nutr 2007;85:1586–91.10.1093/ajcn/85.6.1586Search in Google Scholar PubMed

31. D’ambrosio D, Cippitelli M, Cocciolo MG, Mazzeo D, Di Lucia P, et al. Inhibition of IL-12 production by 1, 25-dihydroxyvitamin D3. Involvement of NF-kappaB downregulation in transcriptional repression of the p40 gene. J Clin Invest 1998;101:252–62.10.1172/JCI1050Search in Google Scholar PubMed PubMed Central

32. Gysemans CA, Cardozo AK, Callewaert H, Giulietti A, Hulshagen L, et al. 1, 25-Dihydroxyvitamin D3 modulates expression of chemokines and cytokines in pancreatic islets: implications for prevention of diabetes in nonobese diabetic mice. Endocrinology 2005;146:1956–64.10.1210/en.2004-1322Search in Google Scholar

33. Veldman CM, Cantorna MT, DeLuca HF. Expression of 1, 25-dihydroxyvitamin D3 receptor in the immune system. Arch Biochem Biophys 2000;374:334–8.10.1006/abbi.1999.1605Search in Google Scholar

34. Bhardwaj S, Bhattacharjee J, Bhatnagar M, Tyagi S. Atherogenic index of plasma, castelli risk index and atherogenic coefficient-new parameters in assessing cardiovascular risk. Int J Pharm Biol Sci 2013;3:359–64.Search in Google Scholar

35. Garcion E, Sindji L, Leblondel G, Brachet P, Darcy F. 1, 25-Dihydroxyvitamin D3 regulates the synthesis of γ-glutamyl transpeptidase and glutathione levels in rat primary astrocytes. J Neurochem 1999;73:859–66.10.1046/j.1471-4159.1999.0730859.xSearch in Google Scholar

36. Wiseman H. Vitamin D is a membrane antioxidant ability to inhibit iron-dependent lipid peroxidation in liposomes compared to cholesterol, ergosterol and tamoxifen and relevance to anticancer action. FEBS Lett 1993;326:285–8.10.1016/0014-5793(93)81809-ESearch in Google Scholar

37. Ngo DT, Sverdlov AL, McNeil JJ, Horowitz JD. Does vitamin D modulate asymmetric dimethylarginine and C-reactive protein concentrations? Am J Med 2010;123:335–41.10.1016/j.amjmed.2009.09.024Search in Google Scholar PubMed

38. Timar A, Saberi-Karimian M, Ghazizadeh H, Parizadeh SM, Sabbaghzadeh R, et al. Evaluation of the serum prooxidant-antioxidant balance before and after vitamin D supplementation in adolescent Iranian girls. Adv Med Sci 2019;64:174–80.10.1016/j.advms.2018.10.004Search in Google Scholar PubMed

39. Yildirim I, Hur E, Kokturk F. Inflammatory markers: C-reactive protein, erythrocyte sedimentation rate, and leukocyte count in vitamin D deficient patients with and without chronic kidney disease. Int J Endocrinol 2013;2013:1–6.10.1155/2013/802165Search in Google Scholar PubMed PubMed Central

40. Bahrami A, Bahrami-Taghanaki H, Afkhamizadeh M, Avan A, Mazloum Khorasani Z, et al. Menstrual disorders and premenstrual symptoms in adolescents: prevalence and relationship to serum calcium and vitamin D concentrations. J Obstet Gynaecol 2018;38:989–95.10.1080/01443615.2018.1434764Search in Google Scholar PubMed

41. Bahrami A, Sadeghnia H, Avan A, Mirmousavi SJ, Moslem A, et al. Neuropsychological function in relation to dysmenorrhea in adolescents. Eur J Obstet Gynecol Reprod Biol 2017;215:224–9.10.1016/j.ejogrb.2017.06.030Search in Google Scholar PubMed

42. Holick MF, Binkley NC, Bischoff-Ferrari HA, Gordon CM, Hanley DA, et al. Evaluation, treatment, and prevention of vitamin D deficiency: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab 2011;96:1911–30.10.1210/jc.2011-0385Search in Google Scholar PubMed

43. Kazemi-Bajestani SM, Tayefi M, Ebrahimi M, Heidari-Bakavoli AR, Moohebati M, et al. The prevalence of metabolic syndrome increases with serum high sensitivity C-reactive protein concentration in individuals without a history of cardiovascular disease: a report from a large Persian cohort. Ann Clin Biochem 2017;54:644–8.10.1177/0004563216676842Search in Google Scholar PubMed

44. Sorouri M, Pourhoseingholi MA, Vahedi M, Safaee A, Moghimi-Dehkordi B, et al. Functional bowel disorders in Iranian population using Rome III criteria. Saudi J Gastroenterol 2010;16:154–60.10.4103/1319-3767.65183Search in Google Scholar PubMed PubMed Central

45. Hovsepian S, Amini M, Aminorroaya A, Amini P, Iraj B. Prevalence of vitamin D deficiency among adult population of Isfahan City, Iran. J Health Popul Nutr 2011;29:149–55.10.3329/jhpn.v29i2.7857Search in Google Scholar PubMed PubMed Central

46. Quraishi SA, Litonjua AA, Moromizato T, Gibbons FK, Camargo CA, et al. Association between prehospital vitamin D status and hospital-acquired bloodstream infections. Am J Clin Nutr 2013;98:952–9.10.3945/ajcn.113.058909Search in Google Scholar PubMed PubMed Central

47. Beilfuss J, Berg V, Sneve M, Jorde R, Kamycheva E. Effects of a 1-year supplementation with cholecalciferol on interleukin-6, tumor necrosis factor-alpha and insulin resistance in overweight and obese subjects. Cytokine 2012;60:870–4.10.1016/j.cyto.2012.07.032Search in Google Scholar PubMed

48. Tabatabaeizadeh SA, Avan A, Bahrami A, Khodashenas E, Esmaeili H, et al. High-dose supplementation of vitamin D affects measures of systemic inflammation: reductions in high-sensitivity C-reactive protein level and neutrophil to lymphocyte ratio (NLR) distribution. J Cell Biochem 2017;118:4317–22.10.1002/jcb.26084Search in Google Scholar PubMed

49. Hoeck AD, Pal ML. Will vitamin D supplementation ameliorate diseases characterized by chronic inflammation and fatigue? Med Hypotheses 2011;76:208–13.10.1016/j.mehy.2010.09.032Search in Google Scholar PubMed

50. Song Y, Hong J, Liu D, Lin Q, Lai G. 1, 25-Dihydroxyvitamin D3 inhibits nuclear factor kappa B activation by stabilizing inhibitor IκBα via mRNA stability and reduced phosphorylation in passively sensitized human airway smooth muscle cells. Scand J Immunol 2013;77:109–16.10.1111/sji.12006Search in Google Scholar PubMed

51. Ebrahimi M, Ghayour-Mobarhan M, Rezaiean S, Hoseini M, Parizade SM, et al. Omega-3 fatty acid supplements improve the cardiovascular risk profile of subjects with metabolic syndrome, including markers of inflammation and auto-immunity. Acta Cardiol 2009;64:321–7.10.2143/AC.64.3.2038016Search in Google Scholar PubMed

52. Ghahramanlu E, Banihashem A, Mirhossini N-Z, Hosseini G, Mostafavi-Toroghi H, et al. Effect of zinc supplementation on serum antibody titers to heat shock protein 27 in patients with thalassemia major. Hematology 2014;19:113–9.10.1179/1607845413Y.0000000099Search in Google Scholar PubMed

53. Sahebkar A, Mohammadi A, Atabati A, Rahiman S, Tavallaie S, et al. Curcuminoids modulate pro-oxidant–antioxidant balance but not the immune response to heat shock protein 27 and oxidized LDL in obese individuals. Phytother Res 2013;27:1883–8.10.1002/ptr.4952Search in Google Scholar PubMed

54. Hayase T, Yamamoto Y, Yamamoto K, Muso E, Shiota K, et al. Similar effects of cocaine and immobilization stress on the levels of heat-shock proteins and stress-activated protein kinases in the rat hippocampus, and on swimming behaviors: the contribution of dopamine and benzodiazepine receptors. Behav Pharmacol 2003;14:551–62.10.1097/00008877-200311000-00008Search in Google Scholar PubMed

55. Wu T, Tanguay RM. Antibodies against heat shock proteins in environmental stresses and diseases: friend or foe? Cell Stress Chaperones 2006;11:1–12.10.1379/CSC-155R.1Search in Google Scholar

56. Tsan MF, Gao B. Heat shock proteins and immune system. J Leukoc Biol 2009;85:905–10.10.1189/jlb.0109005Search in Google Scholar PubMed

57. Otero T, Monlezun D, Christopher K, Camargo C, Quraishi SA. Vitamin D status and elevated red cell distribution width in community-dwelling adults: results from the National Health and Nutrition Examination Survey 2001–2006. J Nutr Health Aging 2017;21:1176–82.10.1007/s12603-017-0980-6Search in Google Scholar PubMed

58. Quraishi SA, Bittner EA, Blum L, Hutter MM, Camargo CA. Association between preoperative 25-hydroxyvitamin D level and hospital-acquired infections following Roux-en-Y gastric bypass surgery. JAMA Surg 2014;149:112–8.10.1001/jamasurg.2013.3176Search in Google Scholar PubMed PubMed Central

59. Fujita B, Franz M, Figulla H-R, Pfeifer R, Kabisch B, et al. Red cell distribution width and survival in patients hospitalized on a medical ICU. Clin Biochem 2015;48:1048–52.10.1016/j.clinbiochem.2015.07.011Search in Google Scholar PubMed

60. Öztürk ZA, Ünal A, Yiğiter R, Yesil Y, Kuyumcu ME, et al. Is increased red cell distribution width (RDW) indicating the inflammation in Alzheimer’s disease (AD)? Arch Gerontol Geriatr 2013;56:50–4.10.1016/j.archger.2012.10.002Search in Google Scholar PubMed

61. Zhou X, Dong L, Yang B, He Z, Chen Y, et al. Preinduction of heat shock protein 70 protects mice against post-infection irritable bowel syndrome via NF-κB and NOS/NO signaling pathways. Amino Acids 2015;47:2635–45.10.1007/s00726-015-2056-4Search in Google Scholar PubMed

62. Newkirk MM, Mitchell S, Procino M, Li Z, Cosio M, et al. Chronic smoke exposure induces rheumatoid factor and anti-heat shock protein 70 autoantibodies in susceptible mice and humans with lung disease. Eur J Immunol 2012;42:1051–61.10.1002/eji.201141856Search in Google Scholar PubMed

63. Öhman L, Simrén M. Pathogenesis of IBS: role of inflammation, immunity and neuroimmune interactions. Nat Rev Gastroenterol Hepatol 2010;7:163–73.10.1038/nrgastro.2010.4Search in Google Scholar PubMed

64. Spiller R, Jenkins D, Thornley J, Hebden J, Wright T, et al. Increased rectal mucosal enteroendocrine cells, T lymphocytes, and increased gut permeability following acute Campylobacter enteritis and in post-dysenteric irritable bowel syndrome. Gut 2000;47:804–11.10.1136/gut.47.6.804Search in Google Scholar PubMed PubMed Central

65. He Z, Sun X, Ma Z, Fu J, Huang B, et al. Heat shock protein 70 protects mouse against post-infection irritable bowel syndrome via up-regulating intestinal γδ T cell’s Th17 response. Cell Biosci 2018;8:38.10.1186/s13578-018-0237-zSearch in Google Scholar PubMed PubMed Central

66. Hu S, Ciancio MJ, Lahav M, Fujiya M, Lichtenstein L, et al. Translational inhibition of colonic epithelial heat shock proteins by IFN-γ and TNF-α in intestinal inflammation. Gastroenterology 2007;133:1893–904.10.1053/j.gastro.2007.09.026Search in Google Scholar PubMed PubMed Central

67. Barbatis C, Tsopanomichalou M. Heat shock proteins in inflammatory bowel disease. Ann Gastroenterol 2009;22:244–7.Search in Google Scholar

68. Aksoy S, Cam N, Gurkan U, Oz D, Özden K, et al. Oxidative stress and severity of coronary artery disease in young smokers with acute myocardial infarction. Cardiol J 2012;19:381–6.10.5603/CJ.2012.0069Search in Google Scholar PubMed

69. Forchhammer L, Møller P, Riddervold IS, Bønløkke J, Massling A, et al. Controlled human wood smoke exposure: oxidative stress, inflammation and microvascular function. Part Fibre Toxicol 2012;9:7.10.1186/1743-8977-9-7Search in Google Scholar PubMed PubMed Central

Received: 2019-06-26
Accepted: 2020-01-06
Published Online: 2020-04-29
Published in Print: 2020-05-26

©2020 Walter de Gruyter GmbH, Berlin/Boston

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