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  • Therefore if appropriate vitamin supplement times

    2019-05-23

    Therefore, if appropriate vitamin supplement (>3 times/wk) for pregnant women would reduce the serum levels of copper, which has been demonstrated in the current issue of the , is it possible that the fetus might escape a potentially toxic bioaccumulation of mercury and copper? Of course, the fetus might also be at risk for complications arising from low serum levels of copper in a similar situation. It remains unclear why frequent use of a vitamin supplement is associated with decreased serum levels of mercury or copper. Before attempting to answer this question, two basic inquiries should be considered. First, it is unclear that pregnant women in southern Taiwan are at risk for multiple-micronutrient deficiencies. It is not clear which components and contents of the “vitamin (multiple-micronutrient)” are associated with blocking the azilsartan medoxomil of mercury and copper as shown in the current study by Huang et al. In fact, multiple-micronutrient deficiencies often coexist among women of reproductive age in low- to middle-income countries and are frequently exacerbated during pregnancy. In general, it is difficult to accept Taiwan as a low- to middle-income country. As previously shown, vitamin D is associated with enhancing trace element absorption, and evidence confirms the potential harms associated with vitamin D deficiency, displaying the enormous benefits of supplementation to replenish and maintain adequate vitamin D indices. However, uncertainty has arisen regarding levels that are considered adequate because, as shown above, elevated levels of vitamin D3 are linked to enhanced absorption of toxic elements. Taken together, these trace elements and nutrition might have a U-shaped phenomenon of benefits and risks, since the asserted benefits exist only within a specific range, and the risks present outside of this range. In conclusion, adequate and balanced nutritional support, including adequate amount of trace elements, are important for the human body, regardless of the nature of the observed population (men or women; or pregnancy or not). If pregnant women undergo proper dietary assessment and nutritional education to increase their own nutritional awareness, this could help such women decide whether extra vitamin supplements could be beneficial. Conflicts of interest
    Acknowledgments This article was supported by grants from the Ministry of Science and Technology, Executive Yuan (MOST 103-2314-B-010-043-MY3), and Taipei Veterans General Hospital (V103C-112; V104C-095; and V105C-096). We also acknowledge the contribution of the Clinical Research Core Laboratory and the Medical Science & Technology Building of Taipei Veterans General Hospital in providing experimental space and facilities.
    Introduction Macrophages activated by tumor necrosis factor-α (TNFα) and interferon-γ are referred to as M1 macrophages and capable of inducing inflammation. Correspondingly, macrophages activated by interleukin (IL)-4 are referred to as M2 macrophages and able to suppress inflammation. Toll-like receptors (TLRs) are primarily expressed on macrophages and are crucial pathogenic mediators of murine steatotic liver IR injury. As a member of the TNF receptors superfamily, decoy receptor 3 (DcR3) is a secreted molecule and soluble receptor. DcR3 is able to block the effects of its known ligands, namely TNF-like cytokine 1A (TL1A), Fas ligand (Fas-L), and LIGHT (homologous to lymphotoxins, inducible expression, competes with herpesvirus glycoprotein D for herpesvirus entry mediator, a receptor expressed on T lymphocytes). Consequently, DcR3 can inhibit macrophage activation, migration, differentiation, as well as chemokine and cytokine release. There are positive regulatory loops between M1 macrophages and Th1 cytokines, and also between M2 macrophages and Th2 cytokines. The macrophages isolated from DcR3-transgenic (Tg) mice display higher levels of anti-inflammatory Th2 cytokines and lower levels of inflammatory Th1 cytokines. An increased serum DcR3 level is observed in patients with Th2 cytokines-associated allergic diseases, whereas a decreased level of Th1 cytokines has been reported in DcR3 transgenic mice. In general, TLR/nuclear factor (NF)-κB-activated Th1 cytokines are pathogenic. However, in contrast, the IL-4-activated Th2 cytokines are protective during IR injury. In mice, an increase in Th2 cytokines results in attenuation of neutrophil infiltration and liver IR injury.