Deconvoluting the Biological Roles of Vitamin D-Binding Protein During Pregnancy: A Both Clinical and Theoretical Challenge

Abstract

The teleological purpose of an ongoing pregnancy is to fulfill its fundamental role of a successful, uncomplicated delivery, in conjunction with an optimal intrauterine environment for the developing fetus. Vitamin D metabolism is adapted to meet both these demands during pregnancy; first by stimulation of calcium absorption for adequate intrauterine bone mineral accrual of the fetus, and second, by enhancing systemic and local maternal tolerance to paternal and fetal alloantigens. Vitamin D-binding protein (VDBP) is one of the key biomolecules that optimize vitamin D homeostasis and also contributes as an immune regulator for a healthy, ongoing pregnancy. In this regard, recent results indicate that dysregulation of VDBP equilibrium could be a risk factor for adverse fetal, maternal, and neonatal outcomes, including preeclampsia, preterm birth, and gestational diabetes. Moreover, it has been hypothesized to be also implicated in the interpretation of vitamin D status in the pregnant state. The aim of this review is to assess available literature regarding the association of VDBP with clinical outcomes during pregnancy, as a potential biomarker for future clinical practice, with a discourse on current knowledge gaps and future research agenda.

The Role of Vitamin D in Fertility and during Pregnancy and Lactation: A Review of Clinical Data

“…Some aspects of vitamin D metabolism are of physiologic relevance in pregnancy [ 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 ]. Compared to non-pregnant women, there is a significant increase in 1,25(OH)2D concentrations, with a 2-fold increase in in the first trimester of pregnancy and a further rise to a 2- to 3-fold increase during the course of pregnancy and a rapid decline after delivery [ 35 ].…”

“…Several observational studies reported an increase of DBP during pregnancy with a peak of approximately 40–50% higher serum DBP concentrations compared to non-pregnant women at the beginning of the third trimester and a decline at term [ 38 ]. The liver is usually the major production site of DBP, but given that human placental trophoblasts express DBP on their cell surface, it has been speculated that the rise in DBP concentrations might be partially the result of the high turnover rate of trophoblasts.…”

“…We did not restrict our search to cover specific outcomes but rather aimed to include all available outcomes regarding fertility as well as pregnancy and lactation because the purpose of this review is to provide an up to date overview of all clinical data on these issues. We refer the reader to other publications regarding physiologic mechanisms underlying the proposed effects of vitamin D on fertility, pregnancy and lactation [ 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 ].…”

Преконцепційний Відбір Жінок Групи Високого Ризику Розвитку Пізнього Гестозу (Огляд Літератури)

“…Вітамін D-зв'язуючий білок -це одна з ключових біомолекул, які оптимізують гомеостаз вітаміну D, а також сприяють імунному регулятору для здорової вагітності. У зв'язку з цим останні результати показують, що дисрегуляція рівноваги вітамін D-зв'язуючого білка може стати фактором ризику для плода, матері та новонародженого, включаючи прееклампсію, передчасні пологи та гестаційний діабет [18]. Згідно з результатами проведених досліджень, добавки кальцію, магнію та цинку мають значний вплив на профілактику ПЕ.…”

Vitamin D Binding Protein, Total and Free Vitamin D Levels in Different Physiological and Pathophysiological Conditions

“…At the Gc1 locus (rs7041) the G allele is associated with increased susceptibility to hepatitis C viral infection (71). Karras et al (72) has summarized a number of studies showing the impact of DBP and DBP polymorphisms on various outcomes of pregnancy. These studies demonstrate the recent interest in the impact of polymorphisms on DBP function, but it remains to be seen whether these initial results will be generalized across different populations.…”