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Article ; Online: Rhodococcus equi infection.

Yamshchikov, Alexandra V / Schuetz, Audrey / Lyon, G Marshall

2010 Volume 10, Issue 5, Page(s) 350–359

Abstract: Rhodococcus equi is a veterinary pathogen that can cause substantial morbidity in patients that are immunocompromised and are occupationally and recreationally exposed to farming, livestock, and dry soil environments. Although the clinical spectrum of ... ...

Abstract	Rhodococcus equi is a veterinary pathogen that can cause substantial morbidity in patients that are immunocompromised and are occupationally and recreationally exposed to farming, livestock, and dry soil environments. Although the clinical spectrum of disease associated with R equi is broad, pulmonary involvement is a predominant feature in most cases. We present a case of occupationally acquired R equi pneumonia and mediastinal lymphadenitis in a patient that has had a renal transplant and is in receipt of a stable immunosuppression regimen. We review the pathogenesis and clinical characteristics of infections with Rhodococcus spp, and discuss approaches to treatment of this disease entity in populations of patients who are immunocompromised.
MeSH term(s)	Actinomycetales Infections/complications ; Actinomycetales Infections/drug therapy ; Actinomycetales Infections/microbiology ; Aged ; Anti-Bacterial Agents/therapeutic use ; Humans ; Immunocompromised Host ; Immunosuppressive Agents/therapeutic use ; Kidney Transplantation ; Lymphadenitis/microbiology ; Male ; Mediastinal Diseases/microbiology ; Occupational Exposure ; Pneumonia, Bacterial/complications ; Pneumonia, Bacterial/drug therapy ; Pneumonia, Bacterial/microbiology ; Rhodococcus equi/isolation & purification
Chemical Substances	Anti-Bacterial Agents ; Immunosuppressive Agents
Language	English
Publishing date	2010-05
Publishing country	United States
Document type	Case Reports ; Journal Article ; Research Support, N.I.H., Extramural ; Review
ZDB-ID	2061641-7
ISSN	1474-4457 ; 1473-3099
ISSN (online)	1474-4457
ISSN	1473-3099
DOI	10.1016/S1473-3099(10)70068-2
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Article ; Online: Journey of a survivor of near drowning, polymicrobial pneumonia, and acute respiratory distress syndrome.

Ecklund, Margaret M / Wahl, Gary / Yamshchikov, Alexandra V / Smith, Michael S

Critical care nursing clinics of North America

2012 Volume 24, Issue 4, Page(s) 601–623

Abstract: This article discusses a woman who collapsed and landed in a puddle of water in a park near a horse trail. Her rescue and resuscitation started an extraordinary effort by her body to heal from multiple insults. This case study highlights the diagnosis ... ...

Abstract	This article discusses a woman who collapsed and landed in a puddle of water in a park near a horse trail. Her rescue and resuscitation started an extraordinary effort by her body to heal from multiple insults. This case study highlights the diagnosis and support of polymicrobial pneumonia secondary to near drowning and the multisystem complications throughout the 3-month hospitalization. It highlights the evidence for treatment of the polymicrobial nature of submersion injury, acute lung injury, and benefits of progressive mobility. Social media as a tool for the family's communication and coping are also discussed.
MeSH term(s)	Adult ; Coinfection/etiology ; Coinfection/therapy ; Female ; Humans ; Near Drowning/complications ; Pneumonia, Bacterial/etiology ; Pneumonia, Bacterial/therapy ; Respiratory Distress Syndrome, Adult/etiology ; Respiratory Distress Syndrome, Adult/therapy ; Social Media ; Survivors
Language	English
Publishing date	2012-12
Publishing country	United States
Document type	Case Reports ; Journal Article
ZDB-ID	1313997-6
ISSN	1558-3481 ; 0899-5885
ISSN (online)	1558-3481
ISSN	0899-5885
DOI	10.1016/j.ccell.2012.07.002
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Article ; Online: The role of vitamin D deficiency in sepsis and potential therapeutic implications.

Watkins, Richard R / Yamshchikov, Alexandra V / Lemonovich, Tracy L / Salata, Robert A

The Journal of infection

2011 Volume 63, Issue 5, Page(s) 321–326

Abstract: Recent studies have shown that vitamin D has important functions besides bone and calcium homeostasis. Cells of the innate and adaptive immune system express vitamin D receptors and respond to stimulation by 1, 25-dihydroxyvitamin D. Patients with sepsis ...

Abstract	Recent studies have shown that vitamin D has important functions besides bone and calcium homeostasis. Cells of the innate and adaptive immune system express vitamin D receptors and respond to stimulation by 1, 25-dihydroxyvitamin D. Patients with sepsis have a high mortality rate as well as a high prevalence of vitamin D deficiency. In addition, septic patients have decreased vitamin D binding protein levels which further exacerbates vitamin D deficiency. Therapy with vitamin D in animal models of sepsis improves blood coagulation parameters in disseminated intravascular coagulation and modulates levels of systemic inflammatory cytokines including TNF-α and IL-6. Vitamin D can enhance the induction of the antimicrobial peptides cathelicidin and β-defensin which are found on mucosal and epithelial surfaces and act as the body's first line of defense against viral and bacterial pathogens. Vitamin D is potentially an attractive therapeutic agent for sepsis given its low cost and low risk of toxicity and side effects. Further prospective, randomized, controlled clinical trials of adjunctive vitamin D therapy in patients who are deficient are needed in the management of human sepsis syndrome.
MeSH term(s)	Adaptive Immunity/physiology ; Animals ; Disease Models, Animal ; Humans ; Immune System/drug effects ; Immune System/immunology ; Immune System/metabolism ; Immunity, Innate/physiology ; Receptors, Calcitriol/genetics ; Receptors, Calcitriol/metabolism ; Sepsis/drug therapy ; Sepsis/etiology ; Sepsis/immunology ; Vitamin D/physiology ; Vitamin D/therapeutic use ; Vitamin D Deficiency/complications ; Vitamin D Deficiency/drug therapy ; Vitamin D Deficiency/immunology
Chemical Substances	Receptors, Calcitriol ; Vitamin D (1406-16-2)
Language	English
Publishing date	2011-11
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	424417-5
ISSN	1532-2742 ; 0163-4453
ISSN (online)	1532-2742
ISSN	0163-4453
DOI	10.1016/j.jinf.2011.07.002
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Article ; Online: Vitamin D as adjunctive therapy in refractory pulmonary tuberculosis: a case report.

Yamshchikov, Alexandra V / Oladele, Alawode / Leonard, Michael K / Blumberg, Henry M / Ziegler, Thomas R / Tangpricha, Vin

Southern medical journal

2009 Volume 102, Issue 6, Page(s) 649–652

Abstract: Vitamin D regulates calcium homeostasis in the body and may play a major role in regulating immune responses to tuberculosis (TB). Pilot studies suggest that vitamin D supplementation may improve outcomes in pulmonary TB (PTB), but clinical evidence ... ...

Abstract	Vitamin D regulates calcium homeostasis in the body and may play a major role in regulating immune responses to tuberculosis (TB). Pilot studies suggest that vitamin D supplementation may improve outcomes in pulmonary TB (PTB), but clinical evidence using vitamin D in TB treatment is limited. We present a case of vitamin D deficiency in a woman with refractory drug-susceptible PTB. Antituberculous therapy and the correction of vitamin D deficiency resulted in clinical and microbiologic improvement at month 13 of her treatment. The basis for vitamin D/TB interactions and a brief literature review are discussed. Data from controlled trials are needed to evaluate the efficacy of vitamin D as adjunctive TB therapy.
MeSH term(s)	Female ; Humans ; Middle Aged ; Tuberculosis, Pulmonary/complications ; Tuberculosis, Pulmonary/drug therapy ; Vitamin D/therapeutic use ; Vitamin D Deficiency/complications ; Vitamin D Deficiency/drug therapy ; Vitamins/therapeutic use
Chemical Substances	Vitamins ; Vitamin D (1406-16-2)
Language	English
Publishing date	2009-05-12
Publishing country	United States
Document type	Case Reports ; Journal Article ; Research Support, N.I.H., Extramural
ZDB-ID	185329-6
ISSN	1541-8243 ; 0038-4348
ISSN (online)	1541-8243
ISSN	0038-4348
DOI	10.1097/SMJ.0b013e3181a5d37e
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Article ; Online: Vitamin D for treatment and prevention of infectious diseases: a systematic review of randomized controlled trials.

Yamshchikov, Alexandra V / Desai, Nirali S / Blumberg, Henry M / Ziegler, Thomas R / Tangpricha, Vin

Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists

2009 Volume 15, Issue 5, Page(s) 438–449

Abstract: Objective: To review the existing human controlled intervention studies of vitamin D as adjunctive therapy in settings of infection and provide recommendations for design and implementation of future studies in this field on the basis of the evidence ... ...

Abstract	Objective: To review the existing human controlled intervention studies of vitamin D as adjunctive therapy in settings of infection and provide recommendations for design and implementation of future studies in this field on the basis of the evidence reviewed. Methods: We conducted a systematic review of randomized controlled clinical trials that studied vitamin D for treatment or prevention of infectious diseases in humans. Studies from 1948 through 2009 were identified through search terms in PubMed and Ovid MEDLINE. Results: Thirteen published controlled trials were identified by our search criteria. Ten trials were placebo controlled, and 9 of the 10 were conducted in a rigorous double-blind design. The selected clinical trials demonstrated substantial heterogeneity in baseline patient demographics, sample size, and vitamin D intervention strategies. Serious adverse events attributable to vitamin D supplementation were rare across all studies. On the basis of studies reviewed to date, the strongest evidence supports further research into adjunctive vitamin D therapy for tuberculosis, influenza, and viral upper respiratory tract illnesses. In the selected studies, certain aspects of study design are highlighted to help guide future clinical research in the field. Conclusion: More rigorously designed clinical trials are needed for further evaluation of the relationship between vitamin D status and the immune response to infection as well as for delineation of necessary changes in clinical practice and medical care of patients with vitamin D deficiency in infectious disease settings.
MeSH term(s)	Communicable Diseases/drug therapy ; Communicable Diseases/microbiology ; Communicable Diseases/transmission ; Communicable Diseases/virology ; Humans ; Randomized Controlled Trials as Topic ; Vitamin D/therapeutic use ; Vitamin D Deficiency/complications ; Vitamin D Deficiency/prevention & control
Chemical Substances	Vitamin D (1406-16-2)
Language	English
Publishing date	2009-06-02
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Review ; Systematic Review
ZDB-ID	1473503-9
ISSN	1934-2403 ; 1530-891X
ISSN (online)	1934-2403
ISSN	1530-891X
DOI	10.4158/EP09101.ORR
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Zs.A 5034: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (2.OG) ab Jg. 2022: Lesesaal (EG)
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Article ; Online: Vitamin D status and antimicrobial peptide cathelicidin (LL-37) concentrations in patients with active pulmonary tuberculosis.

Yamshchikov, Alexandra V / Kurbatova, Ekaterina V / Kumari, Meena / Blumberg, Henry M / Ziegler, Thomas R / Ray, Susan M / Tangpricha, Vin

The American journal of clinical nutrition

2010 Volume 92, Issue 3, Page(s) 603–611

Abstract: Background: Vitamin D insufficiency is common in industrialized and developing nations. Recent studies have shown that vitamin D insufficiency is associated with a higher risk of active tuberculosis. Laboratory studies provided a mechanism for this link ...

Abstract	Background: Vitamin D insufficiency is common in industrialized and developing nations. Recent studies have shown that vitamin D insufficiency is associated with a higher risk of active tuberculosis. Laboratory studies provided a mechanism for this link on the basis of findings that vitamin D metabolites regulate the expression of cathelicidin (LL-37), which is an endogenous antimicrobial peptide with activity against Mycobacterium tuberculosis. Little information is available on the clinical relation between vitamin D, LL-37 concentrations, and disease severity in patients with tuberculosis. Objective: The primary objective of the study was to evaluate the relation between vitamin D nutriture, serum LL-37 concentrations, and tuberculosis by using samples stored in the Tuberculosis Trials Consortium serum repository. Design: We measured 25-hydroxyvitamin D [25(OH)D] and LL-37 concentrations in 95 serum specimens from patients with culture-confirmed pulmonary tuberculosis and correlated these concentrations to clinical and demographic variables. Results: The prevalence of vitamin D insufficiency [serum 25(OH)D concentration lt 30 ng/mL] in patients with active tuberculosis was 86% (n = 95) with a mean baseline serum 25(OH)D concentration of 20.4 ng/mL. Factors associated with vitamin D insufficiency were black race and indoor lifestyle. The mean ( plusmn SD) baseline LL-37 concentration was 49.5 plusmn 23.8 ng/mL. Higher LL-37 concentrations correlated with acid fast bacilli sputum smear positivity and weight gt 10% below ideal body weight. Serum vitamin D status of the study subjects did not correlate with serum LL-37 concentrations. Conclusion: More prospectively designed studies are needed to evaluate the clinical implications of vitamin D insufficiency in patients with tuberculosis and the utility of circulating LL-37 as a potential biomarker in patients with active tuberculosis disease. The parent trial was registered at clinicaltrials.gov as NCT00023335.
MeSH term(s)	Adult ; Analysis of Variance ; Antimicrobial Cationic Peptides ; Black People ; Cathelicidins/blood ; Female ; Humans ; Life Style ; Male ; Middle Aged ; Mycobacterium tuberculosis/isolation & purification ; Prevalence ; Risk Factors ; Severity of Illness Index ; Sputum/microbiology ; Sunlight ; Thinness ; Tuberculosis, Pulmonary/blood ; Tuberculosis, Pulmonary/complications ; Tuberculosis, Pulmonary/drug therapy ; Vitamin D/analogs & derivatives ; Vitamin D/blood ; Vitamin D Deficiency/complications ; Vitamin D Deficiency/ethnology
Chemical Substances	Antimicrobial Cationic Peptides ; Cathelicidins ; Vitamin D (1406-16-2) ; 25-hydroxyvitamin D (A288AR3C9H)
Language	English
Publishing date	2010-07-07
Publishing country	United States
Document type	Clinical Trial, Phase III ; Journal Article ; Multicenter Study ; Randomized Controlled Trial ; Research Support, N.I.H., Extramural
ZDB-ID	280048-2
ISSN	1938-3207 ; 0002-9165
ISSN (online)	1938-3207
ISSN	0002-9165
DOI	10.3945/ajcn.2010.29411
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Article ; Online: Alterations in vitamin D status and anti-microbial peptide levels in patients in the intensive care unit with sepsis.

Jeng, Leo / Yamshchikov, Alexandra V / Judd, Suzanne E / Blumberg, Henry M / Martin, Gregory S / Ziegler, Thomas R / Tangpricha, Vin

Journal of translational medicine

2009 Volume 7, Page(s) 28

Abstract: Background: Vitamin D insufficiency is common in hospitalized patients. Recent evidence suggests that vitamin D may enhance the innate immune response by induction of cathelicidin (LL-37), an endogenous antimicrobial peptide produced by macrophages and ... ...

Abstract	Background: Vitamin D insufficiency is common in hospitalized patients. Recent evidence suggests that vitamin D may enhance the innate immune response by induction of cathelicidin (LL-37), an endogenous antimicrobial peptide produced by macrophages and neutrophils. Thus, the relationship between vitamin D status and LL-37 production may be of importance for host immunity, but little data is available on this subject, especially in the setting of human sepsis syndrome and other critical illness. Methods: Plasma concentrations of 25-hydroxyvitamin D (25(OH)D), vitamin D binding protein (DBP) and LL-37 in critically ill adult subjects admitted to intensive care units (ICUs) with sepsis and without sepsis were compared to healthy controls. Results: Critically ill subjects had significantly lower plasma 25(OH)D concentrations compared to healthy controls. Mean plasma LL-37 levels were significantly lower in critically ill subjects compared to healthy controls. Vitamin D binding protein levels in plasma were significantly lower in critically ill subjects with sepsis compared to critically ill subjects without sepsis. There was a significant positive association between circulating 25(OH)D and LL-37 levels. Conclusion: This study demonstrates an association between critical illness and lower 25(OH)D and DBP levels in critically ill patients as compared to healthy controls. It also establishes a positive association between vitamin D status and plasma LL-37, which suggests that systemic LL-37 levels may be regulated by vitamin D status. Optimal vitamin D status may be important for innate immunity especially in the setting of sepsis. Further invention studies to examine this association are warranted.
MeSH term(s)	Antimicrobial Cationic Peptides/blood ; Case-Control Studies ; Cathelicidins/blood ; Critical Illness ; Demography ; Female ; Health ; Humans ; Intensive Care Units ; Male ; Middle Aged ; Sepsis/blood ; Vitamin D/analogs & derivatives ; Vitamin D/blood ; Vitamin D-Binding Protein/blood
Chemical Substances	Antimicrobial Cationic Peptides ; Cathelicidins ; Vitamin D-Binding Protein ; Vitamin D (1406-16-2) ; ropocamptide (3DD771JO2H) ; 25-hydroxyvitamin D (A288AR3C9H)
Language	English
Publishing date	2009-04-23
Publishing country	England
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
ISSN	1479-5876
ISSN (online)	1479-5876
DOI	10.1186/1479-5876-7-28
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Article: Vitamin D status and antimicrobial peptide cathelicidin (LL-37) concentrations in patients with active pulmonary tuberculosis

Yamshchikov, Alexandra V / Kurbatova, Ekaterina V / Kumari, Meena / Blumberg, Henry M / Ziegler, Thomas R / Ray, Susan M / Tangpricha, Vin

American journal of clinical nutrition. 2010 Sept., v. 92, no. 3

2010

Abstract: BACKGROUND: Vitamin D insufficiency is common in industrialized and developing nations. Recent studies have shown that vitamin D insufficiency is associated with a higher risk of active tuberculosis. Laboratory studies provided a mechanism for this link ... ...

Abstract	BACKGROUND: Vitamin D insufficiency is common in industrialized and developing nations. Recent studies have shown that vitamin D insufficiency is associated with a higher risk of active tuberculosis. Laboratory studies provided a mechanism for this link on the basis of findings that vitamin D metabolites regulate the expression of cathelicidin (LL-37), which is an endogenous antimicrobial peptide with activity against Mycobacterium tuberculosis. Little information is available on the clinical relation between vitamin D, LL-37 concentrations, and disease severity in patients with tuberculosis. OBJECTIVE: The primary objective of the study was to evaluate the relation between vitamin D nutriture, serum LL-37 concentrations, and tuberculosis by using samples stored in the Tuberculosis Trials Consortium serum repository. DESIGN: We measured 25-hydroxyvitamin D [25(OH)D] and LL-37 concentrations in 95 serum specimens from patients with culture-confirmed pulmonary tuberculosis and correlated these concentrations to clinical and demographic variables. RESULTS: The prevalence of vitamin D insufficiency [serum 25(OH)D concentration lt 30 ng/mL] in patients with active tuberculosis was 86% (n = 95) with a mean baseline serum 25(OH)D concentration of 20.4 ng/mL. Factors associated with vitamin D insufficiency were black race and indoor lifestyle. The mean ( plusmn SD) baseline LL-37 concentration was 49.5 plusmn 23.8 ng/mL. Higher LL-37 concentrations correlated with acid fast bacilli sputum smear positivity and weight gt 10% below ideal body weight. Serum vitamin D status of the study subjects did not correlate with serum LL-37 concentrations. CONCLUSION: More prospectively designed studies are needed to evaluate the clinical implications of vitamin D insufficiency in patients with tuberculosis and the utility of circulating LL-37 as a potential biomarker in patients with active tuberculosis disease. The parent trial was registered at clinicaltrials.gov as NCT00023335.
Keywords	patients ; tuberculosis ; Mycobacterium tuberculosis ; vitamin D ; nutritional status ; antimicrobial peptides ; risk assessment ; metabolites ; gene expression regulation ; protein synthesis ; disease severity ; lifestyle ; Blacks ; risk factors ; body weight ; biomarkers
Language	English
Dates of publication	2010-09
Size	p. 603-611.
Publishing place	American Society for Clinical Nutrition
Document type	Article
ZDB-ID	280048-2
ISSN	1938-3207 ; 0002-9165
ISSN (online)	1938-3207
ISSN	0002-9165
Database	NAL-Catalogue (AGRICOLA)

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Article ; Online: Alterations in vitamin D status and anti-microbial peptide levels in patients in the intensive care unit with sepsis

Ziegler Thomas R / Martin Gregory S / Blumberg Henry M / Judd Suzanne E / Yamshchikov Alexandra V / Jeng Leo / Tangpricha Vin

Journal of Translational Medicine, Vol 7, Iss 1, p

2009 Volume 28

Abstract: Abstract Background Vitamin D insufficiency is common in hospitalized patients. Recent evidence suggests that vitamin D may enhance the innate immune response by induction of cathelicidin (LL-37), an endogenous antimicrobial peptide produced by ... ...

Abstract	Abstract Background Vitamin D insufficiency is common in hospitalized patients. Recent evidence suggests that vitamin D may enhance the innate immune response by induction of cathelicidin (LL-37), an endogenous antimicrobial peptide produced by macrophages and neutrophils. Thus, the relationship between vitamin D status and LL-37 production may be of importance for host immunity, but little data is available on this subject, especially in the setting of human sepsis syndrome and other critical illness. Methods Plasma concentrations of 25-hydroxyvitamin D (25(OH)D), vitamin D binding protein (DBP) and LL-37 in critically ill adult subjects admitted to intensive care units (ICUs) with sepsis and without sepsis were compared to healthy controls. Results Critically ill subjects had significantly lower plasma 25(OH)D concentrations compared to healthy controls. Mean plasma LL-37 levels were significantly lower in critically ill subjects compared to healthy controls. Vitamin D binding protein levels in plasma were significantly lower in critically ill subjects with sepsis compared to critically ill subjects without sepsis. There was a significant positive association between circulating 25(OH)D and LL-37 levels. Conclusion This study demonstrates an association between critical illness and lower 25(OH)D and DBP levels in critically ill patients as compared to healthy controls. It also establishes a positive association between vitamin D status and plasma LL-37, which suggests that systemic LL-37 levels may be regulated by vitamin D status. Optimal vitamin D status may be important for innate immunity especially in the setting of sepsis. Further invention studies to examine this association are warranted.
Keywords	Medicine ; R
Subject code	610
Language	English
Publishing date	2009-04-01T00:00:00Z
Publisher	BMC
Document type	Article ; Online
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