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NAFLD and vitamin D: Evidence for intersection of microRNA-regulated pathways
- Zixuan Zhang, Rachel Moon, James L. Thorne, J. Bernadette Moore
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- Journal:
- Nutrition Research Reviews / Volume 36 / Issue 1 / June 2023
- Published online by Cambridge University Press:
- 09 December 2021, pp. 120-139
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- Article
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Non-alcoholic fatty liver disease (NAFLD) is now the most common cause of chronic liver disease, worldwide. The molecular pathogenesis of NAFLD is complex, involving numerous signalling molecules, including microRNAs (miRNAs). Dysregulation of miRNA expression is associated with hepatic inflammation, fibrosis and hepatocellular carcinoma. Although miRNAs are also critical to the cellular response to vitamin D, mediating regulation of the vitamin D receptor and vitamin D’s anti-cancer effects, the role of vitamin-D-regulated miRNAs in NAFLD pathogenesis has been relatively unexplored. Therefore, this review aims to critically assess the evidence for a potential subset of miRNAs that are both dysregulated in NAFLD and modulated by vitamin D. Comprehensive review of eighty-nine human studies identified twenty-five miRNAs found dysregulated in more than one NAFLD study. In contrast, only seventeen studies, including a protocol for a trial in NAFLD, had examined miRNAs in relation to vitamin D status, response to supplementation, or vitamin D in the context of the liver. This paper summarises these data and reviews the biological roles of six miRNAs (miR-21, miR-30, miR-34, miR-122, miR-146, miR-200) found dysregulated in multiple independent NAFLD studies. While modulation of miRNAs by vitamin D has been understudied, integration of the data suggests seven vitamin-D-modulated miRNAs (miR-27, miR-125, miR-155, miR-192, miR-223, miR-375, miR-378) potentially relevant to NAFLD pathogenesis. Our summary tables provide a significant resource to underpin future hypothesis-driven research, and we conclude that the measurement of serum and hepatic miRNAs in response to vitamin D supplementation in larger trials is warranted.
Chapter 27 - Child-care Environment
- from Section 6 - Epidemiology and Risk Factors
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- By Rachel Moon
- Edited by Marta C. Cohen, Irene B. Scheimberg, J. Bruce Beckwith, Fern R. Hauck, University of Virginia
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- Book:
- Investigation of Sudden Infant Death Syndrome
- Published online:
- 04 June 2019
- Print publication:
- 13 June 2019, pp 156-158
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10 - Risk Factors and Theories
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- By Rachel Y Moon, Department of Pediatrics, University of Virginia School of Medicine, Charlottesville, Virginia, USA, Fern R Hauck, Department of Family Medicine, University of Virginia School of Medicine, Charlottesville, Virginia, USA
- Edited by Jodhie R. Duncan, University of Melbourne, Roger W. Byard, University of Adelaide
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- Book:
- SIDS Sudden Infant and Early Childhood Death
- Published by:
- The University of Adelaide Press
- Published online:
- 20 July 2018
- Print publication:
- 30 April 2018, pp 169-186
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Summary
Introduction
Identification of factors that increase risk of, or are protective against, sudden infant death syndrome (SIDS) has largely been accomplished through epidemiological case-control studies. Risk factors include side and prone positioning, prenatal and postnatal tobacco smoke exposure, sleeping on soft or cushioned surfaces (particularly sofas, couches, and armchairs), bed sharing, soft bedding, head covering and overheating, and prematurity. Protective factors include breastfeeding, pacifier use, and room sharing. In this chapter, we will discuss the evidence for these risk and protective factors. We will also review the leading theories for SIDS causation including the Triple Risk Hypothesis, rebreathing theory, and deficient arousal and autonomic regulation, and how these theories create a plausible explanation for the risk and protective factors for SIDS identified in casecontrol studies.
Risk Factors
Side and prone sleep position
The prone sleep position was noted in multiple case-control studies to be associated with SIDS (1-6), beginning in 1965 in the United Kingdom (UK) (7). Even before this, in 1944, Abramson reported that prone positioning was found in 68% of young infants who died of accidental mechanical suffocation in New York City (8). Public health campaigns, which first promoted non-prone positioning in the 1980s and then supine placement, only beginning in the 1990s in many Western countries, have all been associated with a decline in SIDS rates. Subsequent studies have confirmed the association of prone sleep positioning and an increased SIDS risk (adjusted odds ratio [aOR] 2.3-13.1) (9-11). Physiologic studies have demonstrated an association of prone positioning with an increased risk of hypercapnia and hypoxia (12-14), overheating (15), diminished cerebral oxygenation (16), altered autonomic control (17), and increased arousal thresholds (18).
Subsequent studies have identified that the risk of side sleep positioning is similar to that of prone positioning (aOR 2.0 and 2.6 respectively) (10). Side positioning also has a higher population-attributable risk than prone positioning (11), likely because many infants who are placed on their side are found prone (10). Placement in, or rolling to, the prone position, particularly when infants are unaccustomed to that position, places infants at extremely high risk of SIDS (aOR 8.7-45.4) (10, 19). Thus all caregivers, including childcare providers, family members, and friends, should place the infant in the supine position for every sleep.
5 - Routine pediatric care
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- By Elaine Abrams, Department of Pediatrics, Harlem Hospital Center and College of Physicians and Surgeons, Columbia University, New York, NY, Rachel Y. Moon, Division of General Pediatrics and Community Health, Children's National Medical Center, Washington, DC, Lisa-Gaye Robinson, Department of Pediatrics, Harlem Hospital Center and College of Physicians and Swgeons, Columbia University, New York, NY, Russell B. Van Dyke, Department of Pediatrics, Tulane University Health Sciences Center, New Orleans, LA
- Edited by Steven L. Zeichner, National Cancer Institute, Bethesda, Maryland, Jennifer S. Read
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- Book:
- Handbook of Pediatric HIV Care
- Published online:
- 23 December 2009
- Print publication:
- 04 May 2006, pp 134-176
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Summary
Introduction
HIV infection is a chronic illness with diverse clinical manifestations and psychosocial challenges. The routine care of HIV-infected children demands a dedicated multidisciplinary approach from a variety of health care professionals including medical sub-specialists, nurses, psychiatrists, psychologists, dentists, social workers and case managers. The HIV primary care provider, while ensuring health maintenance and preventing disease, must serve as the coordinator of an array of services crucial to the management of these children in the context of the family. Important management considerations attend the care of both HIV-exposed children and those children ultimately identified as HIV-infected.
Care of the HIV-exposed infant
Routine care for the infant born to an HIV-infected mother should begin well before the infant's birth. Clinicians should collaborate with the mother's primary care providers to minimize the risk of HIV transmission. Care of the infant after birth includes continued interventions to reduce the risk of HIV infection, as well as HIV diagnostic evaluations and routine infant care (Table 5.1). Care of the HIV-exposed newborn in the hospital begins with a thorough maternal history, including HIV disease status [HIV RNA concentration (viral load), CD4+ lymphocyte count, and HIV-related complications), receipt of interventions to prevent mother-to-child transmission (e.g., antiretroviral prophylaxis, cesarean delivery before labor and before ruptured membranes), and history of other infections (e.g., syphilis, herpes simplex virus, hepatitis B and C, cytomegalovirus, toxoplasmosis, gonorrhea, or tuberculosis (TB)).
10 - Immunizations
- from Part II - General issues in the care of pediatric HIV patients
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- By Rachel Y. Moon, Department of General Pediatrics and Adolescent Medicine, Children's National Medical Center, Washington, DC
- Edited by Steven L. Zeichner, National Cancer Institute, Bethesda, Maryland, Jennifer S. Read, National Cancer Institute, Bethesda, Maryland
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- Book:
- Textbook of Pediatric HIV Care
- Published online:
- 03 February 2010
- Print publication:
- 28 April 2005, pp 145-152
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Summary
General principles for immunizations in HIV-exposed and HIV-infected patients
Routine pediatric immunizations should be given to all HIV-exposed infants and HIV-infected children according to the schedule recommended by the Advisory Committee on Immunization Practices (ACIP) and the American Academy of Pediatrics (AAP) [1]. Additional vaccines, such as the polyvalent pneumococcal vaccine, may be indicated because of the patient's immunocompromised state. Please note that the recommendations in this chapter are US recommendations; guidelines in other countries and localities may vary.
In the USA, HIV-exposed and -infected children should not receive live-virus or live-bacteria vaccines, with the exception of measles, mumps, rubella (MMR), and varicella vaccine. The inactivated polio vaccine (IPV) should be given instead of the live oral polio vaccine (OPV). Varicella vaccine should be considered in HIV-infected children who are in CDC clinical class N1 or A1 with adequate CD4 counts (see below) [2]. MMR should be given to all HIV-exposed and -infected children unless they are severely immunocompromised (see below) [3]. Although Bacille Calmette—Guerin (BCG) is not recommended for HIV-exposed and -infected children in the USA [4, 5], the World Health Organization recommends BCG in HIV-infected children in countries with high HIV prevalence [6, 7]. However, testing for HIV infection in asymptomatic children without risk factors for HIV is not indicated before administering live virus vaccines.
In general, children with symptomatic HIV infection tend to have poor immunologic responses to vaccines, with decreasing responses as the infection progresses.