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Nieuwe meta-analyses, RCTs en systematic reviews die wij dagelijks monitoren in PubMed. Onafhankelijk geïndexeerd, niet redactioneel bewerkt.
Frontiers in immunology · 2026
This study aimed to investigate alterations in intestinal mucosal barrier function and gut microbiota in pediatric patients with congenital heart disease undergoing cardiopulmonary bypass, and to evaluate whether perioperative probiotic administration improves intestinal homeostasis and clinical outcomes. A randomized, double-blind, placebo-controlled trial was conducted in infants with non-cyanosis CHD in need of surgical correction with CPB. Infants aged 1 month to 1 year were enrolled between June 2021 and July 2022. Participants in the treatment group received perioperative probiotics containing Bifidobacterium infantis and Lactobacillus, while patients in control group were supplied with placebo. Clinical outcomes including diarrhea incidence, time to initiation of enteral nutrition and duration of gastrointestinal decompression were recorded. Blood samples were collected for measurement of intestinal fatty acid-binding protein (IFABP), diamine oxidase (DAO), D-lactate (D-LA), and C-reactive protein (CRP). Fecal samples were obtained to characterize alterations in gut microbiota. Intestinal mucosal barrier function was impaired after CPB surgery, as evidenced by significant increases in IFABP, DAO, D-LA and CRP levels. Additionally, CPB disrupted microbial diversity, increased the abundance of opportunistic pathogenic bacteria such as Enterococcus and decreased the abundance of beneficial microbiota such as Bifidobacterium. Post-surgery levels of IFABP and DAO were significantly lower in the treatment group than in the control group. However, no significant differences were observed for D-LA and CRP levels. Patients receiving probiotics initiated enteral feeding earlier. While the incidence of diarrhea and duration of gastrointestinal decompression did not differ between groups. Probiotic administration altered the baseline microbial community structure and partially attenuated CPB-induced alterations in bacterial diversity. Infants with CHD undergoing CPB are at risk for intestinal mucosal barrier impairment and gut microbiota perturbation. Probiotics administration may alleviate intestinal injury and, to some extent, prevent dysbiosis after CPB. Further studies with larger sample sizes are warranted to validate the protective effect of probiotics in this setting.
BMC gastroenterology · 2026
Crohn's disease (CD) exhibits substantial heterogeneity in disease behavior and therapeutic outcomes across distinct disease locations. Specific alterations in the gut microbiota and metabolites may drive this variation. This review aims to characterize the distinctive microbial and metabolic signatures across CD phenotypes based on disease location. Electronic databases were searched from inception to December 2025 for studies that observed alterations in gut microbiota and metabolites in CD patients with different disease locations. Forty-eight studies including 3,577 CD patients and 2,916 healthy controls (HCs) were analyzed. Ileal Crohn's disease (ICD) was characterized by significant dysbiosis compared with HCs, featuring enrichment of Enterobacteriaceae (especially adherent-invasive Escherichia coli [AIEC]), Fusobacterium and Shigella, alongside depletion of Faecalibacterium prausnitzii, Roseburia and Coprococcus. Patients with colonic Crohn's disease (CCD) exhibited increased levels of Proteobacteria, pro-inflammatory families (Actinomycetaceae, Micrococcaceae) and opportunistic pathogens (Streptococcus, Klebsiella). In contrast, a decrease in short-chain fatty acid (SCFA)-producing families (Lachnospiraceae, Ruminococcaceae) and F. prausnitzii was observed in CCD. Ileocolonic Crohn's disease (ICCD) displayed features combining ICD and CCD elements, with specific depletion in Alistipes communis and enrichment of Shigella flexneri. More pro-inflammatory bacteria were observed in ICD compared with CCD. In terms of metabolic alterations, ICD showed impaired enterohepatic bile acid circulation with excessive fecal loss of conjugated bile acids, while CCD exhibited defective conversion of primary to secondary bile acids. ICCD exhibited both impaired ileal reabsorption and defective colonic transformation. Our results identified disease location-specific alterations in the microbiome and metabolome of CD, which might be associated with the clinical manifestations and prognosis of different phenotypes.
Food research international (Ottawa, Ont.) · 2026
Early, intensive dietary intervention may open a therapeutic window for type 2 diabetes (T2D) remission. We conducted a randomized, 2:1 crossover trial in 34 newly diagnosed overweight or obese patients with T2D. Participants were assigned to receive either high-fiber nutritional therapy (HFNT)-a 7-day very-low-calorie, high-fiber diet followed by a 23-day standard diabetes diet-or conventional diabetes treatment (control condition). Each treatment was administered for 90 days before crossover. Compared with the control condition, early HFNT led to greater reductions in HbA1c [-9.45% (-18.04, -4.63) vs 1.44% (-7.73, 3.08); P = 0.010] and fasting plasma glucose [-12.70% (-24.51, -6.01) vs 3.46% (-8.14, 0.94); P = 0.005], while changes in BMI and HOMA-IR were not significant (P > 0.05). Gut microbiome profiling revealed enrichment of short-chain fatty acid-producing taxa (Eubacterium ruminantium group, Blautia, Roseburia, Akkermansia muciniphila, Oscillospira) and depletion of pathogenic genera (Escherichia-Shigella) after HFNT, with compositional shifts correlating with improved glycemic control. Notably, glycemic benefits in participants receiving HFNT first persisted after crossover, whereas participants receiving conventional care first did not achieve full metabolic recovery after switching. These findings suggest that in newly diagnosed T2D, early, fiber-enriched, intermittent energy restriction can induce durable glycemic improvements, potentially mediated by gut microbiota remodeling. This trial highlights a narrow but impactful nutritional intervention window that may alter the trajectory of T2D progression.
European journal of orthodontics · 2026
Halitosis is primarily caused by oral microbiota dysbiosis, exacerbated by orthodontic appliances that promote plaque retention. Probiotics offer a potential non-invasive strategy to rebalance oral flora and reduce volatile sulfur compounds (VSCs), but their clinical effectiveness remains largely underexplored in Orthodontics. The aim of these trials was to determine the effect of oral probiotics containing Lactobacillus salivarius Oral S1 on plaque and gingival indices as well as on halitosis (via VSC) in patients treated with orthodontic brackets or aligners vs placebo. This study was ran as two separate parallel 2-arm trials (fixed appliance trial and aligner trial) in two centers. Each trial included 59 patients randomly allocated to either probiotics or placebo. The intervention was 1 month course of probiotics, compared with placebo. The primary outcome was the modified plaque index (PI-M) and the secondary outcomes were the gingival index (GI) and the VSC levels i.e. H2S, CH3SH, (CH3)2S and their sum (total VSC), all measured at baseline (T0), after 1 month of intervention (T1), and 2 months after discontinuation of the probiotics (T2). In the aligner group, a significant treatment × time interaction was detected for H2S (P < .001) and total VSC (P < .001), indicating that the changes in these variables over time differed significantly between the treatment groups. In the fixed appliance group, a statistically significant treatment × time interaction was identified for PI-M (P = .01), GI (P < .001), H2S (P = .03), and total VSC (P = .03). Probiotic use was particularly effective in the latter group, with notable improvements in plaque control, gingival health, and halitosis reduction. Partial relapse occurred by T2, suggesting that benefits mostly diminish after intervention cessation. Administration of oral probiotics for 1 month significantly improved periodontal health and reduced halitosis in orthodontic patients, especially in those with fixed appliances.
Nutrients · 2026
Chronic kidney disease (CKD) is characterised by a disrupted gut-kidney axis, wherein intestinal dysbiosis is associated with the accumulation of uraemic toxins and the potential depletion of beneficial short-chain fatty acids (SCFAs). Whilst acetate, propionate, and butyrate are known to modulate systemic inflammation and blood pressure, their precise circulating concentrations across different CKD stages and age groups remain poorly defined. This systematic review and meta-analysis aimed to quantify blood SCFA concentrations in CKD patients compared to healthy controls. We conducted a systematic search of Medline, EMBASE, and the Cochrane Library for clinical studies reporting blood SCFA concentrations in humans with CKD. Methodological quality was assessed using the NIH tool. Standardised mean differences (SMDs) were calculated for the quantitative meta-analysis, with subgroup analyses performed for age, CKD stage, and treatment modality (dialysis vs. transplantation). Twenty-one studies encompassing 9661 participants were included. Quantitative synthesis revealed a significant and consistent systemic depletion of circulating acetate and propionate in adult CKD patients compared to healthy controls (p < 0.05). This depletion followed a stage-dependent trajectory, worsening alongside declining glomerular filtration rates. Notably, a "butyrate paradox" was identified in paediatric cohorts; whilst adults showed progressive butyrate depletion, children with CKD often maintained or exhibited elevated levels, particularly in the context of hypertension. Furthermore, whilst haemodialysis patients exhibited the most profound SCFA deficiencies, kidney transplantation appeared to partially restore these metabolites toward healthy baseline levels. CKD is associated with a profound systemic reduction in acetate and propionate, supporting the model of a compromised gut-kidney axis based on converging evidence. The divergent results for butyrate in paediatric versus adult populations suggest that SCFA metabolism is influenced by age-related factors or compensatory mechanisms. These findings highlight the potential for SCFA monitoring as a candidate or emerging markers for detecting early renal damage and stratifying risk.
Philosophical transactions of the Royal Society of London. Series B, Biological sciences · 2026
Malnutrition still affects millions of children in Africa. Changes in the gut microbiome have been implicated in malnutrition, but there has been inconsistent nomenclature of microbes. This meta-analysis reviews the microbiome literature using natural language processing (NLP) methods. We searched PubMed for gut microbiome studies of undernourished children living in low- and middle-income countries (LMICs). The primary analysis focused on continental coverage and study characteristics of microbiome research in sub-Saharan Africa (ss-Africa). We also used an NLP tool for normalizing primary data from full-text publications in ss-Africa compared with other LMICs, and between diseased and healthy children. We identified 16 studies. Most studies were conducted in Malawi and characterized the faecal microbiome using 16S rRNA sequencing. For comparison, 18 studies conducted in Bangladesh, India, Pakistan and Peru were included. With this, we identified frequently reported microbes that were distinctly identified in ss-Africa and highlighted possible signatures of an undernourished faecal microbiome across the globe. The consistent associations between elevated Pseudomonadota levels and severe acute malnutrition provide new insights into host-microbiome interactions in African contexts. However, the overlap between taxa associated with healthy and stunting underscores the need for further research to better inform potential targeted interventions in Africa. This article is part of the theme issue 'Biological, biomedical and environmental drivers of stunting'.
Molecular nutrition & food research · 2026
Xanthohumol (XN), a dietary flavonoid from hops (Humulus lupulus), possesses anti-inflammatory and microbiome-modulatory properties with potential therapeutic benefits for Crohn's disease (CD). To investigate the effects of XN on the gut environment in CD, we conducted a randomized, placebo-controlled clinical trial-the XN Microbiome and Signature (XMaS) trial (NCT4590508). 19 participants with clinically active CD completed the study. They were randomized to receive 24 mg/day of XN or placebo for 8 weeks, with clinical assessments at baseline and every 2 weeks. We assessed changes to Crohn's disease activity index (CDAI) scores, systemic inflammation, gut barrier function, profiling of microbial metabolism of XN, and gut microbiota composition and metabolism. Integration analysis of gut microbiota abundance, fecal metabolites, and inflammatory markers with CDAI scores revealed a pattern in which reductions in secondary bile acids and increases in IL-10 were associated with improved CDAI score in XN-treated individuals. These findings suggest that XN beneficially modulates the gut environment in CD by influencing microbial bile acid metabolism and host inflammatory response, thereby improving symptoms in individuals with severe innate immune activation.
African journal of reproductive health · 2026
This meta-analysis systematically evaluated the effects of probiotic supplementation on vaginal microbiota and inflammatory factors in women. PubMed, Embase, Web of Science, CNKI, and Wanfang were searched from inception to January 2026 for randomized and controlled studies. Outcomes included vaginal pH, Nugent score, and inflammatory cytokines (IL-4, IL-6, IL-10, TNF-α). Fifteen studies were included. Compared with controls, probiotics did not significantly reduce IL-4, IL-6, IL-10, or TNFα levels, nor did they significantly improve Nugent score. However, probiotic supplementation significantly reduced vaginal pH (OR = 0.36, 95% CI: 0.15-0.89; P = 0.03), indicating improved maintenance of a weakly acidic vaginal environment. Sensitivity analyses showed generally stable results, although heterogeneity remained substantial for several outcomes. Overall, probiotics appear effective in modulating vaginal acid-base balance but show limited evidence for improving inflammatory cytokine profiles or restoring vaginal microbiota structure. Current data are insufficient to support routine probiotic use for optimizing vaginal microbiota and inflammatory status. Further high-quality, well-designed randomized controlled trials are required to clarify their clinical benefits. Cette méta-analyse a évalué de manière systématique les effets de la supplémentation en probiotiques sur le microbiote vaginal et les facteurs inflammatoires chez les femmes. Les bases de données PubMed, Embase, Web of Science, CNKI et Wanfang ont été consultées depuis leur création jusqu’en janvier 2026 afin d’identifier des études randomisées et contrôlées. Les critères de jugement comprenaient le pH vaginal, le score de Nugent et les cytokines inflammatoires (IL-4, IL-6, IL-10, TNF-α). Quinze études ont été incluses. Comparativement aux groupes témoins, les probiotiques n’ont pas réduit significativement les concentrations d’IL4, IL-6, IL-10 ou TNF-α, ni amélioré significativement le score de Nugent. En revanche, la supplémentation en probiotiques a significativement réduit le pH vaginal (OR = 0,36 ; IC à 95 % : 0,15–0,89 ; P = 0,03), indiquant un meilleur maintien d’un environnement vaginal faiblement acide. Les analyses de sensibilité ont montré des résultats globalement stables, bien qu’une hétérogénéité substantielle persiste pour plusieurs critères. Dans l’ensemble, les probiotiques semblent efficaces pour moduler l’équilibre acido-basique vaginal, mais les preuves restent limitées quant à leur capacité à améliorer les profils cytokiniques inflammatoires ou à restaurer la structure du microbiote vaginal. Les données actuelles sont insuffisantes pour recommander l’utilisation systématique des probiotiques dans l’optimisation du microbiote vaginal et du statut inflammatoire. Des essais contrôlés randomisés de haute qualité sont nécessaires pour confirmer leurs bénéfices cliniques.
Environmental health perspectives · 2026
BACKGROUND: Emerging observational studies suggest that air pollution can influence the gut microbiome. However, this association is often highly confounded by factors, such as diet and poverty. The gut virome may influence respiratory health independent of the gut microbiome. We recently demonstrated in a randomized waitlist-controlled trial (ClinicalTrials.gov NCT03351504) that a clean lighting intervention reduced the level of personal exposure to air pollution among adult women in rural Uganda. OBJECTIVES: To determine the effect of a solar lighting intervention on changes to the gut microbiome and virome and secondarily to determine the association between these changes on lung health. METHODS: Between 2018 and 2019, we collected stool samples and assessed respiratory symptoms and spirometry from 80 adult women living in rural Uganda at baseline and 12 and 18 months postrandomization. The intervention group received a solar lighting system after randomization, while the waitlist-controlled group received one at 12 months. Deep metagenomics sequencing of stool was performed and profiled for nonviral and viral taxonomic composition. The primary analysis focused on pre- vs postintervention changes due to power considerations, adjusting for potential confounding by age, diet, antibiotic use, and season. A sensitivity analysis was conducted using intention-to-treat principles. When comparing pre- vs postintervention periods, we used sparse partial least-squares models to identify nonviral and viral signatures of reduced air pollution exposure. Mixed effects models were used to evaluate changes in health outcomes as well as associations between microbial signatures of reduced air pollution exposure and health. RESULTS: The average age was 39.2 years. The solar lighting intervention led to larger changes in viral compared to nonviral microbial community structure and differential abundance of bacteria, eukaryotes, and viruses. Provision of solar lighting systems was associated with a reduction in the presence of respiratory symptoms from 57.1% to 36.1% (p = 0.002), while there was no impact on lung function. Microbiome and virome signatures had AUCs of 0.74 and 0.76, respectively, in predicting pre- vs postintervention stool samples. Microbiome signatures were associated with a lower risk of respiratory symptoms (OR = 0.68 (0.49 - 0.94), p = 0.020). CONCLUSION: Among adult women living in rural Uganda, both nonviral and viral components of the gut microbial community changed after a clean lighting intervention. Microbiome signatures reflective of lower air pollution exposures were associated with improved respiratory symptoms. These observations suggest that air pollution may influence lung health through the gut-lung axis, warranting further exploration in future intervention studies.
Medicine · 2026
Chronic constipation significantly affects quality of life and is associated with symptoms such as abdominal pain, bloating, and incomplete bowel movements. Conventional treatments often fail to meet patient expectations, necessitating alternative approaches. GutBio Plus, a multispecies probiotic containing Lactobacillus and Bifidobacterium strains, was evaluated for safety and efficacy in managing chronic constipation in an open-label, placebo-controlled clinical trial. This single-center study included 60 participants aged ≥18 years who were diagnosed with chronic constipation based on the ROME IV criteria. Participants were randomized into 2 groups using computer-generated random sequences: a GutBio Plus capsules group (n = 45) and a placebo group (n = 15) in a 3:1 ratio. Sample size was calculated to detect a clinically meaningful difference in complete spontaneous bowel movements (CSBM) with 90% power at α = 0.02. The intervention lasted 29 days, followed by posttreatment follow-up on day 45. The primary outcome was the proportion of participants achieving ≥3 CSBM per week at day 29. Outcomes included CSBM, stool consistency (Bristol Stool Form Scale), abdominal pain, bloating, and Patient Assessment of Constipation Quality of Life. GutBio Plus significantly improved CSBM frequency, with 100% of participants in the treatment group achieving ≥3 CSBM per week by the end of treatment, compared to 7.69% in the placebo group (P < .05). Improvements in abdominal pain, bloating, and stool consistency were significantly greater in the treatment group than in the control group. The Patient Assessment of Constipation Quality of Life scores also showed marked improvements in physical discomfort, psychosocial well-being, and satisfaction in GutBio Plus users (P < .05). Sustained benefits were observed after the treatment. GutBio Plus is a safe and effective treatment for chronic constipation, offering significant symptom relief and an improved quality of life. The sustained benefits highlight its potential as a reliable alternative to conventional laxatives.
International journal of medical sciences · 2026
Gut health is closely associated with metabolic homeostasis, and alterations in gut microbiota composition have been linked to inflammation and metabolic disorders. Prebiotics targeting specific taxa, such as Akkermansia muciniphila, have attracted interest for their potential to modulate gut microbiota composition. While preclinical studies have suggested a role for A. muciniphila in gut-related metabolic pathways, clinical evidence supporting its effects on microbiome regulation and metabolic outcomes remains limited. Therefore, this study aimed to explore the effects of a prebiotic blend designed to promote A. muciniphila on gut microbiota composition and selected physiological parameters. Seventy participants were randomized to receive either placebo or the AKK formula for 8 weeks. Anthropometric assessments, blood tests, and stool examinations were performed at baseline and at weeks 4 and 8. The main analyses were conducted in the per-protocol population (n = 25 per group). The results revealed no significant markers of liver or kidney dysfunction in either group. The AKK formula group showed an increased qPCR-derived relative abundance of A. muciniphila compared with total bacteria. Gut microbiome analysis further demonstrated selective changes in gut microbiota composition in the AKK formula group, including an increased relative abundance of Bifidobacterium and decreased relative abundances of Proteobacteria, Erysipelotrichia, and Escherichia-Shigella. A trend toward lower gastrointestinal discomfort scores was observed in the AKK formula group during the intervention period. The AKK formula increased the relative abundance of A. muciniphila, was associated with selective modulation of gut microbiota composition, and showed a trend toward reduced gastrointestinal discomfort, supporting its potential relevance in future gut health research.
Frontiers in endocrinology · 2026
Probiotics have demonstrated positive effects on obesity and type 2 diabetes (T2D) in various studies. Postbiotics, specifically nonliving bacterial lysates derived from cell walls and DNA, are increasingly recognized as safe, stable, and effective alternatives for improving host metabolic health. to conduct a randomized, double-blind, placebo-controlled clinical trial (RCT) to assess the short-term safety and effectiveness of the bacterial lysate of Lactobacillus (L.) rhamnosus DV - NRRL B-68023 as an adjunct to standard antidiabetic therapy. Fifty-five participants with T2D were enrolled and assigned via computer-generated randomization to receive either 100 mg of L. rhamnosus DV lysate twice daily or a matching placebo. Blinding was ensured through identical masked packaging. The primary efficacy analysis was performed on a per-protocol (PP) population of 42 participants (intervention, n=20; placebo, n=22) who completed the 3-month treatment and 3-month follow-up. Primary endpoints were HbA1c and fasting plasma glucose (FPG). Secondary endpoints included HOMA-2 modeled insulin sensitivity (%S), β-cell function (%B), and anthropometric parameters, evaluated at baseline, 3, and 6 months. The trial was registered at ClinicalTrials.gov (NCT05770076). The primary analysis revealed a significant overall treatment effect for HbA1c (p<0.001). After 3 months, the intervention group showed a mean HbA1c reduction of -0.63% (95% CI: -0.98 to -0.28), while the placebo group significantly worsened (0.50%; 95% CI: 0.17 to 0.84). For FPG, a favorable between-group trend was observed (p=0.086), with a reduction of 1.32 mmol/L in the active group compared to an increase of 0.12 mmol/L in the placebo group. Exploratory analysis showed significant treatment effects for waist circumference (p = 0.021) and insulin sensitivity (%S, p = 0.013). Although within-group improvements were noted for BMI and β-cell function (%B) in the intervention group (p<0.05), between-group differences for these parameters were not statistically significant (p>0.05). Three-month supplementation with L. rhamnosus DV lysate significantly improves glycemic control (HbA1c) and reduces waist circumference compared to placebo in T2D patients. While positive trends in insulin sensitivity and anthropometrics were observed, further large-scale studies are required to confirm these metabolic benefits and assess long-term sustainability. https://clinicaltrials.gov/keywords, identifier NCT05770076.
Nutrients · 2026
Background: Ulcerative colitis (UC) is a multifactorial disease characterized by aberrant mucosal immune activation in response to intestinal dysbiosis. Contemporary management strategies aim to target inflammation and microbiome alterations while reducing relapse risk. A multidimensional assessment integrating clinical, inflammatory, immune, and microbial endpoints may better capture therapeutic effects beyond symptom control. Aims: To evaluate whether supplementation with Lactobacillus rhamnosus GG co-formulated with vitamin D3 (Dicoflor IBD Immuno) as an adjunct to optimized mesalamine (5-ASA) is associated with coordinated changes across clinical and biological domains in mild-to-moderate UC, using a multidimensional assessment framework. Methods: This single-center, randomized, double-blind, placebo-controlled pilot trial was conducted at Fondazione Ca' Granda IRCCS Policlinico di Milano between May 2022 and May 2024. Thirty-six patients with mild-to-moderate UC receiving optimized 5-ASA were randomized to LGG+VitD3 (ALD3) or placebo (AP) for 4 weeks. Clinical activity, health-related quality of life (HRQoL), fecal calprotectin, peripheral immune cell subsets, and gut microbiota composition were assessed at baseline and week 4. Results: Both 5-ASA-LGG+VitD3 (ALD3)- and 5-ASA-placebo (AP)-treated patients showed significant improvement in clinical activity and HRQoL, without between-group differences. A higher proportion of clinical responders was observed in the ALD3 group, although this was not statistically significant. LGG+VitD3-supplemented patients showed reduced fecal calprotectin levels and increased frequencies of IL-22-producing CD4+ T cells. Microbiome analysis revealed enrichment of short-chain fatty acid-producing taxa, including Coprococcus and Fusicatenibacter, in ALD3-treated patients. Conclusions: In patients with mild UC receiving optimized 5-ASA, LGG+VitD3 supplementation does not improve short-term clinical outcomes beyond placebo but is associated with favorable modulation of inflammatory, immune, and microbial parameters, supporting the relevance of multidimensional biological endpoints in adjunctive UC management.
Nutrients · 2026
An Endocrine Society Clinical Practice Guideline on vitamin D was published in 2024. Its main objective was the use of vitamin D to lower the risk of disease in individuals without established indications for vitamin D treatment or 25-hydroxavitamin D (25(OH)D) testing. The methodology followed the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) and the Evidence-to-Decision (EtD) framework. Evidence from randomized controlled trials (RCTs) retrieved by a systematic review was prioritized to inform this guideline. It was concluded that vitamin D supplementation reduces rickets and respiratory tract infections in children, mortality in individuals aged 75 years or older, pregnancy complications (outcomes), and progression of prediabetes to diabetes mellitus. Consequently, empiric vitamin D supplementation was recommended for individuals aged 1 to 18 years and ≥75 years, pregnant women, and individuals with prediabetes. Empiric vitamin D supplementation is defined as a vitamin D intake that exceeds the Dietary Reference Intakes (DRIs) and is implemented without 25(OH)D testing. This article provides a comprehensive guideline summary and critical appraisal based on a narrative review on scientific publications regarding that guideline. Several publications discussed the 2024 Endocrine Society Clinical Practice Guideline on vitamin D. The main criticisms and discussion relate to unclear vitamin D dosages, guideline applicability to certain populations including controversy with previous vitamin D guidelines, and the implications of 25(OH)D testing. The 2024 Endocrine Society Clinical Practice Guideline on vitamin D followed a rigorous methodological approach with high quality standards but it leaves many open questions and uncertainties warranting clarification.
Nutrients · 2026
Background/Objectives: Vitamin D deficiency is highly prevalent among young Indian women. This study evaluated the dose-response effects of varying levels of daily oral vitamin D3 intake on serum 25-hydroxyvitamin D [25(OH)D] concentrations and related bone biomarkers in vitamin D-deficient and insufficient young women. Methods: In a 12-week, double-blind, randomized controlled trial conducted in urban Bangalore, 108 non-pregnant, non-lactating women aged 18-35 years with serum 25(OH)D <20 ng/mL were randomized (1:1:1:1) to receive daily vitamin D3 at doses of 0, 400, 600, or 800 IU delivered via a fortified chocolate wafer. Serum 25(OH)D, parathyroid hormone (PTH), bone-specific alkaline phosphatase (BSAP), and osteocalcin were measured at baseline, and at weeks 4, 8, and 12. Intention-to-treat analysis was performed using mixed linear and logistic models to assess the effect of intervention. Results: At baseline, 76.4% of participants were vitamin D-deficient (<12 ng/mL) and 23.6% were insufficient (12-20 ng/mL). Serum 25(OH)D increased significantly over time in the 400, 600, and 800 IU/day groups, with a significant time × dose interaction effect (p < 0.001), demonstrating an overall graded response across doses. By week 12, vitamin D sufficiency (≥20 ng/mL) was achieved in 7.4%, 26.9%, 37.0%, and 65.4% of participants in the 0, 400, 600, and 800 IU groups, respectively. From baseline to week 12, the mean increase in serum 25(OH)D was 7.69 ng/mL in the 400 IU group, 8.83 ng/mL in the 600 IU group, and 10.23 ng/mL in the 800 IU group; no significant difference was observed between the 400 IU and 600 IU groups, whereas the 800 IU group demonstrated the greatest overall increase. PTH decreased over time without a significant time × dose interaction. No significant interaction effect was noted for BSAP and osteocalcin. Mean compliance was high (>98%) across all groups, and no serious adverse events were reported. Conclusions: Daily dietary intake of vitamin D3 at doses of 400-800 IU for 12 weeks significantly improved serum 25(OH)D concentrations in vitamin D-deficient young Indian women. While PTH levels decreased over time, effects on bone turnover markers were modest and not dose specific. A daily dose of 800 IU/day was the most effective, achieving vitamin D sufficiency in 65% of participants.
Zhurnal nevrologii i psikhiatrii imeni S.S. Korsakova · 2026
To evaluate the relationship between vitamin D levels and the frequency and intensity of tension headaches, as well as the therapeutic effectiveness of vitamin D. A systematic review of the literature was conducted, including observational and interventional studies on the relationship between vitamin D levels and tension headache characteristics. The review included 8 studies selected from PubMed, ScienceDirect, Google Scholar, eLibrary, and Europe PMC databases that met the inclusion criteria. The study design, clinical parameters of pain, vitamin D levels, and the effect of therapy were assessed. Vitamin D deficiency is associated with a higher incidence and longer duration of headache episodes, but not with increased intensity. Several studies found a significant negative correlation between vitamin D levels and headache frequency or duration. Interventional studies confirmed the clinical benefit of vitamin D therapy in patients with hypovitaminosis. There is strong evidence linking vitamin D deficiency to a more severe course of tension headaches. Assessing and correcting vitamin D levels may be important in comprehensive treatment. However, further randomized controlled trials are needed to confirm causality and establish standardized therapeutic strategies. Цель обзора — оценить связь уровня витамина D с частотой и интенсивностью головной боли напряжения и эффективность его применения. Проведен систематизированный обзор литературы, включающий обсервационные и интервенционные исследования, посвященные связи между уровнем витамина D и характеристиками головной боли напряжения. В анализ включены 8 исследований, отобранных по базам PubMed, ScienceDirect, Google Scholar, eLibrary, Europe PMC, соответствующих критериям включения. Оценивались дизайн исследований, клинические параметры боли, уровень витамина D и эффект терапии. Показано, что дефицит витамина D ассоциирован с более высокой частотой и длительностью эпизодов головной боли, но не с ее интенсивностью. В нескольких работах установлена статистически значимая отрицательная корреляция между уровнем витамина D и частотой/длительностью болевого синдрома. Интервенционные исследования подтвердили клинический эффект терапии витамином D у пациентов с подтвержденным гиповитаминозом. Существуют убедительные данные о связи между дефицитом витамина D и более тяжелым течением головной боли напряжения. Включение оценки и коррекции витаминного статуса может стать важной частью комплексного подхода к лечению головной боли напряжения. Однако необходимы дальнейшие рандомизированные контролируемые исследования для подтверждения причинно-следственных связей и разработки стандартизированных терапевтических стратегий.
Frontiers in immunology · 2026
Atopic Dermatitis (AD) in children is a common chronic skin condition characterized by dry, itchy and inflamed skin. Various treatments have been applied in the management of AD in children, but the differences in efficacy of different treatment options have not been systematically summarized. The aim of this study was to compare the efficacy of different treatments for atopic dermatitis in children by network meta-analysis. We conducted a systematic literature search to select randomized controlled trials (RCTs) that met the inclusion criteria. Databases included PubMed, EMBASE, Cochrane Library, and Web of Science, with a March 10, 2025, search deadline. Certainty of evidence was graded using the CINeMA tool, and risk of bias was assessed using risk of bias 2.0. The efficacy of different treatment regimens was compared using Bayesian network meta-analysis with R software. The primary outcome indicators were the SCORAD (Clinical Score for Atopic Dermatitis) and EASI (Atopic Dermatitis Area and Severity Index) scores. Thirty-two randomized controlled trials (n=3961) were included. Meta-analysis showed Dupilumab was more effective than Melatonin, Probiotics, SCG, Synbiotic, and Vitamin D for SCORAD. Cumulative probability rankings indicated Dupilumab (96.0%), Tralokinumab (86.8%), and PEC (69.2%) as the top treatments. For EASI, Pimecrolimus, Dupilumab, and Nemolizumab were superior to Probiotics, with Pimecrolimus showing the highest efficacy (99.9%). Dupilumab may offer greater benefits in reducing SCORAD scores, while Pimecrolimus appears to be more effective for improving EASI. These treatments show potential as favorable options for managing pediatric atopic dermatitis. https://www.crd.york.ac.uk/PROSPERO/view/CRD420250650919, identifier CRD420250650919.
JAMA network open · 2026
Observational studies have reported associations between pregnancy vitamin D levels and offspring cognition, but no randomized clinical trial (RCT) has investigated the effect of high-dose vitamin D3 supplementation in pregnancy on offspring cognition into middle childhood. To assess whether high-dose vitamin D3 supplementation during pregnancy is associated with improved offspring cognition at age 10 years. This is a post hoc secondary analysis of the blinded, placebo-controlled Copenhagen Prospective Studies on Asthma in Childhood 2010 RCT conducted from March 4, 2009, to November 17, 2010. The cohort included 700 mother-child pairs from Denmark, of whom 623 were randomized. Exclusion criteria were vitamin D intake above 600 IU/d; endocrine, kidney, or heart disease; and insufficient Danish language proficiency. Cognitive assessments were conducted for the offspring at age 10 years, excluding those born at less than 28 weeks' gestation and with birth weight less than 1500 g. Participants were unblinded at 3 years of age, while investigators remained unaware of group assignments. The 10-year visits were conducted from February 11, 2019, to December 13, 2021. Statistical analyses were conducted from February to June 2025. High-dose (2800 IU/d) or standard-dose (400 IU/d) vitamin D3 from pregnancy week 24 to 1 week post partum. The primary outcome was cognitive functioning across 11 functions assessed at age 10 years using a comprehensive neuropsychological test battery as part of the Copenhagen Prospective Study on Neuro-Psychiatric Development (COPSYCH). The vitamin D3 RCT and the COPSYCH visit were completed by 498 children (mean [SD] age, 10.3 [0.4] years; 258 boys [51.8%]): 247 prenatally exposed to high-dose vitamin D3 and 251 prenatally exposed to standard-dose vitamin D3. Covariate-adjusted analyses of standardized scores (mean [SD], 0 [1]; higher values indicating better performance) showed positive associations of high-dose vitamin D3 with verbal memory (β = 0.17 SD; 95% CI, 0.03-0.32 SD; P = .02), visual memory (β = 0.24 SD; 95% CI, 0.06-0.42 SD; P = .01), and flexibility or set shift (β = 0.19 SD; 95% CI, 0.01-0.37 SD; P = .04); however, high-dose vitamin D3 was no longer associated with flexibility or set shift after multiple test correction. This post hoc analysis of an RCT suggests that high-dose vitamin D3 supplementation in pregnancy is positively associated with visual memory, verbal memory, and flexibility or set shift among offspring measured at age 10 years. These findings strengthen evidence on the association of prenatal vitamin D exposure with childhood cognition. ClinicalTrials.gov Identifier: NCT00856947.
Journal of the International Society of Sports Nutrition · 2026
Firefighting tasks performed in full protective equipment (PPE) impose extreme thermal and physical strain, providing a model of high-intensity exercise with substantial fluid and electrolyte loss. This study compared the effects of plain water (W), a carbohydrate-electrolyte solution (CES), and a menthol-supplemented carbohydrate-electrolyte solution (MCES) on hydration and performance recovery during the first hour of post-exercise recovery. Twenty-four male firefighters completed a standardized simulated firefighting protocol in protective clothing. Participants were randomly assigned to W, CES, or MCES (n = 8 each) and consumed 1.0 L of fluid during 60 minutes of recovery. Hydration status was evaluated using body-mass restoration, salivary osmolality, urine specific gravity, urine color, and urinary electrolytes. Renal markers, lactate clearance, cardiovascular and thermal responses, thirst ratings, and lower-limb explosive power were also assessed. Body mass restoration showed significant group effects, with MCES greater than W and CES at 60 min (p < 0.05). Rehydration rate was higher for both CES and MCES than W (p < 0.05). Salivary osmolality and urinary sodium favored electrolyte solutions over water (p < 0.05), while urine specific gravity was lower in MCES compared with W and CES (p < 0.05). Blood urea nitrogen and BUN/creatinine ratios were higher in W than both electrolyte conditions at 30 and 60 min (p < 0.05). Lactate clearance was reduced in W compared with CES and MCES (p < 0.05). Jump height declined from pre- to post-recovery in the W and CES groups but was maintained within the MCES group. Carbohydrate-electrolyte solutions improved hydration compared with water. L-menthol did not enhance rehydration but maintained explosive performance, supporting its role as a perceptual adjunct to electrolyte strategies for recovery after exercise in protective clothing.
The Journal of asthma : official journal of the Association for the Care of Asthma · 2026
To evaluate the effectiveness of a new device (SOBIstat-F®) for bronchodilator administration via pMDI compared with the conventional method. Protocols for managing severe asthma exacerbations include bronchodilators (short-acting beta-2 agonists and ipratropium bromide) administered by nebulizer or pressurized metered-dose inhaler(pMDI) with a valved holding chamber, corticosteroids IV, and magnesium sulfate IV. A randomized superiority clinical trial was conducted in children with severe acute asthma at the emergency department. Patients were assigned to one of the following groups: pMDI-SOBx, in which they received bronchodilators in pMDI through the SOBIstat-F® device, or in pMDI with oxygen via cannula or mask (pMDI-OxStand). The primary outcome was the need for hospitalization at the end of 8 h. 84 patients participated in the study, of which 43 were treated with the pMDI-SOBx device and 41 with pMDI-OxStand. There were no baseline differences between the groups. Children treated with pMDI-SOBx had a lower hospitalization rate compared to those with pMDI-OxStand (9.3% vs. 26.8%, respectively, p = 0.036; absolute risk difference: -17.5% [95% CI: -33.6 to -1.4] and OR: 0.26 [95% CI: 0.08-0.91]). Additionally, a significant clinical improvement (pulmonary score) was observed from 90 min (p < 0.001), and an increase in SpO2 was observed from 60 min (p < 0.001) in the pMDI-SOBx group. Side effects were similar. For the first time, bronchodilator administration using the SOBIstat-F® device was more effective than the conventional method in reducing hospitalizations and improving the clinical condition of children with severe asthma exacerbations.