Vitamin D3 synthesis in human skin is initiated by solar ultraviolet radiation (UVR) exposure of precursor 7-dehydrocholesterol (7DHC), but influence of age on the early stage of vitamin D3 metabolism is uncertain. We performed a prospective standardised study in healthy ambulant adults aged ≥65 and ≤40 years examining (1) if baseline skin 7DHC concentration differs between younger and older adults and (2) the impact of older age on serum vitamin D3 response to solar simulated UVR. Eleven younger (18–40 years) and 10 older (65–89 years) adults, phototype I–III, received low-dose UVR (95% UVA, 5% UVB, 1.3 SED) to ~35% of the body surface area. Biopsies were taken for 7DHC assay from unexposed skin, skin immediately and 24 h post-UVR, and blood sampled at baseline, 24 h and 7 d post-UVR for vitamin D3 assay. Samples were analysed by HPLC-MS/MS. Baseline skin 7DHC (mean ± SD) was 0.22 ± 0.07 and 0.25 ± 0.08 µg/mg in younger versus older adults (no significant difference). Baseline serum vitamin D3 concentration was 1.5 ± 1.5 and 1.5 ± 1.7 nmol/L in younger versus older adults, respectively, and showed a significant increase in both groups post-UVR (no significant differences between age groups). Thus, skin 7DHC concentration was not a limiting factor for vitamin D3 production in older relative to younger adults. This information assists public health guidance on sun exposure/vitamin D nutrition, with particular relevance to the growing populations of healthy ambulant adults ≥65 years.

Resistance exercise (RE) increases collagen synthesis in young and older men, whereas hydrolyzed collagen (HC) ingestion improves this response to RE in a dose-response manner in young men. However, the collagen synthesis response to RE with and without HC in middle-aged men is unknown. Eight resistance-trained men (age: 49 ± 8 yr; height: 1.78 ± 0.02 m; mass: 90 ± 4 kg) took part in this double-blind, crossover design study and undertook 4 × 10 repetitions of lower-limb RE at maximum load, after consuming 0 g, 15 g, or 30 g vitamin C-enriched HC. We analyzed venous blood samples for N-terminal propeptide of type 1 pro-collagen (PINP), β-isomerized C-terminal telopeptide of type 1 collagen (β-CTx), and 18 collagen amino acids throughout all three interventions. The serum PINP concentration × time area-under-the-curve (AUC) was higher following 30 g (169 ± 28 µg/mL × h) than 15 g (134 ± 23 µg/mL × h, P < 0.05) HC ingestion, and both 15 g and 30 g were higher than 0 g HC (96 ± 23 µg/mL × h, P < 0.05). RE with 0 g HC showed no change in serum PINP concentration. The AUCs for glycine, proline, hydroxyproline, alanine, arginine, lysine, serine, leucine, valine, and isoleucine were greater with 30 g than 15 g and 0 g HC ingestion (P < 0.05) and greater with 15 g than 0 g HC ingestion (P < 0.05). Plasma β-CTx concentration decreased after RE independently of HC dose. Our study suggests connective tissue anabolic resistance to RE in middle-aged men but ingesting 15 g HC rescues the collagen synthesis response and 30 g augments that response further. This dose response is associated with the increased bioavailability of collagen amino acids in the blood, which stimulate collagen synthesis.NEW & NOTEWORTHY This study is the first to document the dose-response effect of hydrolyzed collagen (HC) ingestion before resistance exercise (RE) on collagen turnover in middle-aged, resistance-trained men. Strikingly, RE alone did not increase collagen synthesis (suggesting connective tissue anabolic resistance), but ingesting 15 g HC rescued the collagen synthesis response and 30 g augmented that response further. These results were associated with the increased bioavailability of collagen amino acids in the blood, which stimulate collagen synthesis.

AbstractWe investigated the effects of resistance exercise (RE), hydrolysed collagen (HC) ingestion and circulating oestrogen concentration on collagen synthesis in a naturally menstruating female CrossFit athlete. In a double‐blind, randomised cross‐over design, the participant (36 years; height 1.61 m; mass 82.6 kg) consumed 0 or 30 g HC prior to performing back‐squat RE when endogenous circulating oestrogen concentration was low (onset of menses, OM) and high (late follicular phase, LF) during two consecutive menstrual cycles. Ten 5‐mL blood samples were collected during each of the four interventions to analyse concentrations of serum 17β‐oestradiol, and biomarkers of type I collagen turnover, that is serum procollagen type I N‐terminal propeptide (PINP, a biomarker of collagen synthesis) and plasma β‐isomerised C‐terminal telopeptide of type I collagen (β‐CTX, a biomarker of collagen breakdown), as well as the serum concentration of 18 collagen amino acids. 17β‐Oestradiol concentration was 5‐fold higher at LF (891 ± 116 pmol L−1) than OM (180 ± 13 pmol L−1). The PINP concentration × time area under the curve (AUC) was higher in the 30 g HC OM intervention (201 μg L−1 h) than the 30 g HC LF (144 μg L−1 h), 0 g HC OM (151 μg L−1 h) and 0 g HC LF (122 μg L−1 h) interventions. β‐CTX concentration decreased 1.4‐fold from pre‐RE to 6 h post‐RE in all interventions. Thus, high circulating oestrogen concentration was associated with lower collagen synthesis following RE in this female athlete. Ingesting 30 g HC, however, augmented the collagen synthesis response at LF and particularly at OM.

OBJECTIVES:Automated immunoassays for 1,25-dihydroxyvitamin D (1,25(OH)2D) have increased the use of serum measurements in clinical and research settings, but disagreement with LC-MS/MS methods remains an issue. METHODS:In this study, we examined this problem using samples obtained from healthy young adults, n=80, mean age 21.7 (18-32) years, and a large cohort of paediatric samples, n=422, mean age 7.3 (0-17) years. We compared serum concentrations of 1,25(OH)2D3/D2 produced by the DiaSorin LIAISON® XL immunoassay against an LC-MS/MS method with immunoaffinity enrichment and DAPTAD derivation. RESULTS:Both assays showed intra/inter-assay imprecision of ≤9.4 % across their respective assay range. DEQAS between April 2020 to Jan 2024 (n=80) showed mean bias (SD, 95 %CI) for DiaSorin -0.6 % (6.2, -12.8 to 11.6) and LC-MS/MS of +1.3 % (7.4, -13.3 to 15.8) against their respective method group means. Comparison of measurements in the adult samples showed a strong correlation (r2=0.9331) and concordance (CCC=0.959) between the two methods. LC-MS/MS values were lower than DiaSorin by an overall mean (±SD, 95 %CI) of -1.6 (±14.3, -29.6 to 26.5) pmol/L with an increased negative bias at higher concentrations. In the paediatric samples, weaker correlation (r2=0.6536) and concordance (CCC=0.782) were observed, with greater bias mean (±SD, 95 %CI) of -9.8 (±23.4, -55.7 to 35.9) pmol/L. The variability in the paediatric samples was not associated with concentration or participant age. There was an increase in the correlation and concordance when 1,25(OH)2D2 was included in the analysis. CONCLUSIONS:It is likely that the metabolites of vitamin D present in the paediatric population contributed to the measurement of 1,25(OH)2D. The inconsistent agreement highlights the need for better assay harmonisation and paediatric reference intervals using LC-MS/MS method.

Skin exposure to ultraviolet radiation (UVR) triggers conversion of precursor 7-dehydrocholesterol (7DHC) to vitamin D3, which then enters the bloodstream. The aim of this study was to assess if skin 7DHC concentration differs between younger and older adults, and to explore the impact of solar-simulated UVR (SSR) on 7DHC (in skin) and vitamin D3 (cholecalciferol; in serum) in these age groups. Younger (n = 10, 18–40 years) and older (n = 11; 65–89 years) adults of skin phototype I–III were exposed to a suberythemal dose of SSR (95% UVA, 5% UVB, 1.3 standard erythemal dose) over 35% body surface area in the UK winter. Six 5-mm buttock skin punch biopsies were taken: two from unexposed skin, two immediately post-UVR and two at 24 h post-UVR. Blood was taken at baseline, 24 h and 7 days post-UVR. Skin and serum samples were assayed using high-performance liquid chromatography–tandem mass spectrometry. Baseline mean (SD) 7DHC concentrations were 0.22 (0.07) µg mg–1 and 0.25 (0.08) µg mg–1 in younger and older adults, respectively. Immediately post-UVR, 7DHC concentrations were 0.27 (0.10) µg mg–1 and 0.22 (0.08) µg mg–1 in younger and older adults, respectively, and 24 h post-UVR they were 0.27 (0.08) µg mg–1 and 0.28 (0.13) µg mg–1, respectively. Baseline serum vitamin D3 concentrations in younger adults were 1.5 (1.5) nmol L–1 vs. 1.5 (1.7) nmol L–1 in older adults; 24 h post-UVR they were 3.1 (2.0) nmol L–1 in younger adults vs. 2.5 (2.0) nmol L–1 in older adults and 7 days post-UVR they were 2.0 (2.1) vs. 1.7 (1.2) nmol L–1, respectively. No significant difference was seen in any parameter between age groups. Thus, in contrast to previous assumptions, skin 7DHC concentration is not a limiting factor for vitamin D3 synthesis in healthy older adults relative to younger adults. The early vitamin D3 biosynthetic pathway does not appear to differ between these age groups.

BACKGROUND:Resistance exercise (RE) stimulates collagen synthesis in skeletal muscle and tendon but there is limited and equivocal evidence regarding an effect of collagen supplementation and exercise on collagen synthesis. Furthermore, it is not known if a dose-response exists regarding the effect of hydrolyzed collagen (HC) ingestion and RE on collagen synthesis. OBJECTIVE:To determine the HC dose-response effect on collagen synthesis after high-intensity RE in resistance-trained young men. METHODS:Using a double-blind, randomized crossover design, 10 resistance-trained males (age: 26 ± 3 y; height: 1.77 ± 0.04 m; mass: 79.7 ± 7.0 kg) ingested 0 g, 15 g, or 30 g HC with 50 mg vitamin C 1 h before performing 4 sets' barbell back squat RE at 10-repetition maximum load, after which they rested for 6 h. Blood samples were collected throughout each of the 3 interventions to analyze procollagen type Ⅰ N-terminal propeptide (PINP) and β-isomerized C-terminal telopeptide of type I collagen (β-CTX) concentration, and the concentration of 18 collagen amino acids. RESULTS:The serum PINP concentration × time area under the curve (AUC) was greater for 30 g (267 ± 79 μg·L-1·h) than for 15 g (235 ± 70 μg·L-1·h, P = 0.013) and 0 g HC (219 ± 88 μg·L-1·h, P = 0.002) but there was no difference between 0 and 15 g HC (P = 0.225). The AUCs of glycine and proline were greater for 30 g than for 15 and 0 g HC (P < 0.05). Plasma β-CTX concentration decreased from -1 to +6 h (P < 0.05), with no differences between interventions. CONCLUSIONS:Ingesting 30 g HC before high-intensity RE augments whole-body collagen synthesis more than 15 g and 0 g HC in resistance-trained young males.

Radioimmunofixation of human ferritin following isoelectric focusing of serum was developed to study the microheterogeneity of this protein in native serum without previous purification or concentration. This method requires only 2-10 microliter of serum and can be used with levels of ferritin as low as 10 micrograms/l. In this way, the extensive microheterogeneity of this protein was revealed, since in some cases it produced as many as 35 bands with isoelectric points in a pH range of 4.95-5.9. Very different isoelectric focusing patterns (spectrotypes) of ferritin were observed during the investigation of pathological sera. The high sensitivity of this technique makes it useful for the investigation of serum ferritin in diseases involving modifications of the metabolism of this protein.

ABSTRACT Introduction Montmorency cherry concentrate (MCC) supplementation enhances functional recovery from exercise, potentially due to antioxidant and anti-inflammatory effects. However, to date, supporting empirical evidence for these mechanistic hypotheses is reliant on indirect blood biomarkers. This study is the first to investigate functional recovery from exercise alongside molecular changes within the exercised muscle after MCC supplementation. Methods Ten participants completed two maximal unilateral eccentric knee extension trials after MCC or placebo (PLA) supplementation for 7 d before and 48 h after exercise. Knee extension maximum voluntary contractions, maximal isokinetic contractions, single leg jumps, and soreness measures were assessed before, immediately, 24 h, and 48 h after exercise. Venous blood and vastus lateralis muscle samples were collected at each time point. Plasma concentrations of interleukin-6, tumor necrosis factor alpha, C-reactive protein, creatine kinase, and phenolic acids were quantified. Intramuscular mRNA expressions of superoxide dismutase 1 (SOD1), SOD3, glutathione peroxidase 1 (GPX1), GPX3, GPX4, GPX7, catalase, and nuclear factor erythroid 2–related factor 2 and relative intramuscular protein expressions of SOD1, catalase, and GPX3 were quantified. Results MCC supplementation enhanced the recovery of normalized maximum voluntary contraction 1-s average compared with PLA (postexercise PLA, 59.5% ± 18.0%, vs MCC, 76.5% ± 13.9%; 24 h PLA, 69.8% ± 15.9%, vs MCC, 80.5% ± 15.3%; supplementation effect P = 0.024). MCC supplementation increased plasma hydroxybenzoic, hippuric, and vanillic acid concentrations (supplementation effect P = 0.028, P = 0.002, P = 0.003); SOD3, GPX3, GPX4, GPX7 (supplement effect P < 0.05), and GPX1 (interaction effect P = 0.017) gene expression; and GPX3 protein expression (supplementation effect P = 0.004) versus PLA. There were no significant differences between conditions for other outcome measures. Conclusions MCC supplementation conserved isometric muscle strength and upregulated antioxidant gene and protein expression in parallel with increased phenolic acid concentrations.

Shatavari has long been used as an Ayurvedic herb for women’s health, but empirical evidence for its effectiveness has been lacking. Shatavari contains phytoestrogenic compounds that bind to the estradiol receptor. Postmenopausal estradiol deficiency contributes to sarcopenia and osteoporosis. In a randomised double-blind trial, 20 postmenopausal women (68.5 ± 6 years) ingested either placebo (N = 10) or shatavari (N = 10; 1000 mg/d, equivalent to 26,500 mg/d fresh weight shatavari) for 6 weeks. Handgrip and knee extensor strength were measured at baseline and at 6 weeks. Vastus lateralis (VL) biopsy samples were obtained. Data are presented as difference scores (Week 6—baseline, median ± interquartile range). Handgrip (but not knee extensor) strength was improved by shatavari supplementation (shatavari +0.7 ± 1.1 kg, placebo −0.4 ± 1.3 kg; p = 0.04). Myosin regulatory light chain phosphorylation, a known marker of improved myosin contractile function, was increased in VL following shatavari supplementation (immunoblotting; placebo −0.08 ± 0.5 a.u., shatavari +0.3 ± 1 arbitrary units (a.u.); p = 0.03). Shatavari increased the phosphorylation of Aktser473 (Aktser473 (placebo −0.6 ± 0.6 a.u., shatavari +0.2 ± 1.3 a.u.; p = 0.03) in VL. Shatavari supplementation did not alter plasma markers of bone turnover (P1NP, β-CTX) and stimulation of human osteoblasts with pooled sera (N = 8 per condition) from placebo and shatavari supplementation conditions did not alter cytokine or metabolic markers of osteoblast activity. Shatavari may improve muscle function and contractility via myosin conformational change and further investigation of its utility in conserving and enhancing musculoskeletal function, in larger and more diverse cohorts, is warranted.

The demand for measurement of vitamin D metabolites for clinical diagnosis and to advance our understanding of the role of vitamin D in human health has significantly increased in the last decade. New developments in technologies employed have enabled the separation and quantification of additional metabolites and interferences. Also, developments of immunoassays have changed the landscape. Programmes and materials for assay standardisation, harmonisation and the expansion of the vitamin D external quality assurance scheme (DEQAS) with the provision of target values as measured by a reference measurement procedure have improved standardisation, quality assurance and comparability of measurements. In this article, we describe developments in the measurement of the commonly analysed vitamin D metabolites in clinical and research practice. We describe current analytical approaches, discuss differences between assays, their origin, and how these may be influenced by physiological and experimental conditions. The value of measuring metabolites beyond 25 hydroxyvitamin D (25(OH)D), the marker of vitamin D status, in routine clinical practice is not yet confirmed. Here we provide an overview of the value and application of the measurement of 1,25 dihydroxyvitamin D, 24,25 dihydroxyvitamin D and free 25OHD in the diagnosis of patients with abnormalities in vitamin D metabolism and for research purposes.

Currently there is no reliable tool available to monitor gastrointestinal function in the critically ill. Biomarkers are therefore of great interest in this field as the lack of monitoring tools impedes any interventional studies. The potential biomarkers citrulline and intestinal fatty acid-binding protein (I-FABP) are the present focus. Targeted literature searches were undertaken for physiology and pathophysiology, sampling, measurement methods and clinical use of citrulline and I-FABP as biomarkers of intestinal function and injury. Physiology and pathophysiology, specific aspects of sampling and different laboratory assays are summarized and respective pitfalls outlined. Studies in animals and patients outside the ICU support the rationale for these biomarkers. At the same time, evidence in critically ill patients is not yet convincing, several specific aspects need to be clarified, and methodology and interpretation to be refined. We conclude that there are good physiological rationales for citrulline as a marker of enterocyte function and for I-FABP as a marker of intestinal injury, but further studies are needed to clarify whether and how they could be used in daily practice in caring for critically ill patients.

We assessed the effects of post‐exercise cold‐water immersion (CWI) in modulating PGC‐1α mRNA expression in response to exercise commenced with low muscle glycogen availability. In a randomized repeated‐measures design, nine recreationally active males completed an acute two‐legged high‐intensity cycling protocol (8 × 5 min at 82.5% peak power output) followed by 10 min of two‐legged post‐exercise CWI (8°C) or control conditions (CON). During each trial, one limb commenced exercise with low (LOW: <300 mmol·kg−1 dw) or very low (VLOW: <150 mmol·kg−1 dw) pre‐exercise glycogen concentration, achieved via completion of a one‐legged glycogen depletion protocol undertaken the evening prior. Exercise increased (P < 0.05) PGC‐1α mRNA at 3 h post‐exercise. Very low muscle glycogen attenuated the increase in PGC‐1α mRNA expression compared with the LOW limbs in both the control (CON VLOW ~3.6‐fold vs. CON LOW ~5.6‐fold: P = 0.023, ES 1.22 Large) and CWI conditions (CWI VLOW ~2.4‐fold vs. CWI LOW ~8.0 fold: P = 0.019, ES 1.43 Large). Furthermore, PGC‐1α mRNA expression in the CWI‐LOW trial was not significantly different to the CON LOW limb (P = 0.281, ES 0.67 Moderate). Data demonstrate that the previously reported effects of post‐exercise CWI on PGC‐1α mRNA expression (as regulated systemically via β‐adrenergic mediated cell signaling) are offset in those conditions in which local stressors (i.e., high‐intensity exercise and low muscle glycogen availability) have already sufficiently activated the AMPK‐PGC‐1α signaling axis. Additionally, data suggest that commencing exercise with very low muscle glycogen availability attenuates PGC‐1α signaling.

Citation for published version (Harvard): Allan, R, Sharples, AP, Cocks, M, Drust, B, Dutton, J, Dugdale, HF, Mawhinney, C, Clucas, A, Hawkins, W, Morton, JP & Gregson, W 2019, 'Low pre-exercise muscle glycogen availability offsets the effect of postexercise cold water immersion in augmenting PGC-1 gene expression', Physiological reports, vol. 7, no. 11, e14082, pp. 1-13. https://doi.org/10.14814/phy2.14082

Background: Mediterranean diets limit red meat consumption and increase intakes of high-phytate foods, a combination that could reduce iron status. Conversely, higher intakes of fish, a good source of selenium, could increase selenium status. Objectives: A 1-y randomized controlled trial [New Dietary Strategies Addressing the Specific Needs of the Elderly Population for Healthy Aging in Europe (NU-AGE)] was carried out in older Europeans to investigate the effects of consuming a Mediterranean-style diet on indices of inflammation and changes in nutritional status. Methods: Selenium and iron intakes and status biomarkers were measured at baseline and after 1 y in 1294 people aged 65-79 y from 5 European countries (France. Italy. the Netherlands, Poland, and the United Kingdom) who had been randomly allocated either to a Mediterranean-style diet or to remain on their habitual, Western diet. Results: Estimated selenium intakes increased significantly with the intervention group (P < 0.01). but were not accompanied by changes in scrum selenium concentrations. Iron intakes also increased (P < 0.001), but there was no change in iron status. However, when stratified by study center. there were positive effects of the intervention on iron status for serum ferritin for participants in Italy (P = 0.04) and France (P = 0.04) and on soluble transferrin receptor (sTfR) for participants in Poland (P < 0.01). Meat intake decreased and fish intake increased to a greater degree in the intervention group, relative to the controls (P < 0.01 for both), but the overall effects of the intervention on meat and fish intakes were mainly driven by data from Poland and France. Changes in serum selenium in the intervention group were associated with greater changes in serum ferritin (P = 0.01) and body iron (P = 0.01), but not sTfR (P = 0.73); there were no study center x selenium status interactions for the iron biomarkers. Conclusions: Consuming a Mediterranean-style diet for 1 y had no overall effect on iron or selenium status, although there were positive effects on biomarkers of iron status in some countries.

Introduction: The use of dried blood spot (DBS) sampling for general wellness assessment and in clinical diagnostics has gained popularity as a convenient and less invasive alternative to venous sampling. Collection of blood samples from a finger/heel prick using conventional filter paper suffers from variability in sample volume and spot sizes which undermine the quality of results. We describe the use of a volumetric absorptive microsampler (VAMS), called MitraTM (Torrance, CA, USA) for measurement of 25OHD3 and interpretation of vitamin D status according to current international guidelines. Method: A liquid-chromatography mass spectrometry (LC-MS/MS) method was used for measurement of 25OHD3 (Tang et al. ASBMR 2015, LB-MO0026). We compared results from patient samples (n=97) collected by VAMS and Whatman® 903 cards extracted as whole spot (wDBS) and sub-punches (spDBS) against plasma 25OHD3 concentration. We investigated the volume displacement effects of haematocrit (Hct) on DBS 25OHD3 measurements and described the use of DBS-to-plasma equivalence value (PEV) to allow accurate interpretation of vitamin D status. Results: VAMS showed the best assay precision CV (<8.2%) compared to wDBS (<16.6%) and spDBS (<15.1%) across the assay range of 0.1-125 nmol/L, the least variability in recovery and lowest LLoQ (Figure 1). We observed a decrease in DBS 25OHD3 concentration in proportion to the reduction in plasma volume and increase in packed cell volume. The displacement effect of Hct resulted in a strong but negatively biased correlation (r2=0.893, -39.3%) between raw DBS values and plasma concentrations, that was dependent upon the level of Hct present in sample. We demonstrated the use of simple linear regression model to transform raw DBS values into PEVs. In a subsequent cohort of patient samples (n=70), PEVVAMS produced the most accurate interpretation of vitamin D status compared to PEVwDBS and PEVspDBS. Discussion: We present data supporting the use of VAMS for measurement of 25(OH)D3, particularly in circumstances where venesection may be impossible or difficult and where sample volume may be limited. Although the recovery of analyte remains Hct-dependent, the use of DBS-to-plasma equivalence values improves the clinical applicability and broadens the utility of DBS as a sampling technique.

BackgroundPopulation‐based research on vitamin D has increased dramatically in recent years. Such studies are typically reliant on assay procedures to measure reliable and comparable levels of 25‐hydroxyvitamin D [25(OH)D] concentrations.MethodsConcentrations of 25(OH)D3 and 25(OH)D2 were measured using LC‐MS/MS in 5,915 participants (aged 31 years) of Northern Finland Birth Cohort 1966. Blood samples were assayed in batches over a course of 18 months. As anomalies were present in the measurements, 200 samples were reassayed using Diasorin RIA. Agreement between measurements was assessed by Passing–Bablok regression and limits of agreement (LoA). To harmonize LC‐MS/MS with Diasorin RIA measurements, formulae were derived from the LoA.ResultsConcentrations measured by LC‐MS/MS were much higher than those measured by Diasorin RIA, with a mean difference of 12.9 ng/ml. Constant variation was evident between batch measurements after log transformation. Statistical formula was applied separately for each batch of LC‐MS/MS measurements, enabling us to remove both the constant and proportional bias that was evident prior to the transformation.ConclusionDespite the introduction of schemes/programs to improve accuracy of assays to measure 25(OH)D, significant differences can still happen. In these instances, methods to harmonize measurements based on a relatively small number of replicates can be successfully applied to establish confidence and to enable between‐study comparisons.

24,25(OH)2D is the product of 25(OH)D catabolism by CYP24A1. The measurement of serum 24,25(OH)2D concentration may serve as an indicator of vitamin D catabolic status and the relative ratio with 25(OH)D can be used to identify patients with inactivating mutations in CYP24A1. We describe a LC-MS/MS method to determine: (1) the relationships between serum 24,25(OH)2D and 25(OH)D; (2) serum reference intervals in healthy individuals; (3) the diagnostic accuracy of 24,25(OH)2D measurement as an indicator for vitamin D status; 4) 24,25(OH)2D cut-off value for clinically significant change between inadequate and sufficient 25(OH)D status. Serum samples of healthy participants (n=1996) from Army recruits and patients (n=294) were analysed. The LC-MS/MS assay satisfied industry standards for method validation. We found a positive, concentration-dependent relationship between serum 24,25(OH)2D and 25(OH)2D concentrations. The 25(OH)D:24,25(OH)2D ratio was significantly higher (P<.001) at 25(OH)D<50 nmol/L. The reference interval for 25(OH)D:24,25(OH)2D ratio in healthy subjects was 7-23. Measurement of serum 24,25(OH)2D can be used as predictor of vitamin D status, a concentration of>4.2 nmol/L was identified as a diagnostic cut-off for 25(OH)D replete status. One patient sample with an elevated 25(OH)D:24,25(OH)2D ratio of 32 and hypercalcaemia who on genetic testing confirmed to have a biallelic mutation of CYP24A1. Our study demonstrated the feasibility of a combined 24,25(OH)2D and 25(OH)D assessment profile. Our established cut-off value for 24,25(OH)2D and ratio reference ranges can be useful to clinicians in the investigation of patients with an impaired calcium/phosphate metabolism and may point towards the existence of CYP24A1 gene abnormalities.

Mechanisms mediating postexercise cold-induced increases in PGC-1α gene expression in human skeletal muscle are yet to be fully elucidated but may involve local cooling effects on AMPK and p38 MAPK-related signaling and/or increased systemic β-adrenergic stimulation. Therefore, we aimed to examine whether postexercise cold water immersion enhancement of PGC-1α mRNA is mediated through local or systemic mechanisms. Ten subjects completed acute cycling (8 × 5 min at ~80% peak power output) followed by seated-rest (CON) or single-leg cold water immersion (CWI; 10 min, 8°C). Muscle biopsies were obtained preexercise, postexercise, and 3 h postexercise from a single limb in the CON condition but from both limbs in CWI [thereby providing tissue from a CWI and nonimmersed limb (NOT)]. Muscle temperature decreased up to 2 h postexercise following CWI (-5°C) in the immersed limb, with lesser changes observed in CON and NOT (-3°C, P < 0.05). No differences between limbs were observed in p38 MAPK phosphorylation at any time point (P < 0.05), whereas a significant interaction effect was present for AMPK phosphorylation (P = 0.031). Exercise (CON) increased gene expression of PGC-1α 3 h postexercise (~5-fold, P < 0.001). CWI augmented PGC-1α expression above CON in both the immersed (CWI; ~9-fold, P = 0.003) and NOT limbs (~12-fold, P = 0.001). Plasma normetanephrine concentration was higher in CWI vs. CON immediately postimmersion (860 vs. 665 pmol/l, P = 0.034). We report for the first time that local cooling of the immersed limb evokes transcriptional control of PGC-1α in the nonimmersed limb, suggesting increased systemic β-adrenergic activation of AMPK may mediate, in part, postexercise cold induction of PGC-1α mRNA.NEW & NOTEWORTHY We report for the first time that postexercise cold water immersion of one limb also enhances PGC-1α expression in a contralateral, nonimmersed limb. We suggest that increased systemic β-adrenergic stimulation, and not localized cooling per se, exerts regulatory effects on local signaling cascades, thereby modulating PGC-1α expression. Therefore, these data have important implications for research designs that adopt contralateral, nonimmersed limbs as a control condition while also increasing our understanding of the potential mechanisms underpinning cold-mediated PGC-1α responses.

Background: Parathyroid hormone (PTH) plays a key role in calcium and phosphate homeostasis. Upon binding to its receptor, it signals via a second messenger, cyclic adenosine 3, 5’ monophosphate (cAMP). Lack of increase in plasma and urinary cAMP concentrations in response to PTH are used as diagnostic markers for pseudohypoparathyroidism (PHP), a condition primarily associated with resistance to PTH (Ellsworth-Howard Test). Aims: 1) Develop and validate a LC-MS/MS method for the quantification of cAMP in plasma and urine. 2) Investigate assay performance in a rat pharmacokinetic study investigating the response to an oral dose of PTH (1-34) and the response to subcutaneous (sc) PTH administration in a patient with suspected PHP. Method: cAMP and 13C5-cAMP internal standard were extracted from EDTA plasma using a weak anion exchange solid phase extraction. Chromatography was performed in positive electrospray ionisation mode, using a pentafluorophenyl column with a 10 mins 2% formic acid water:acetonitrile gradient. Transitions were m/z 330/136 for cAMP and 335/136 for 13C5-cAMP. Over concentrations ranging from 4.6 (lower limit of quantification) to 293.5 nmol/L, the calibration curve was linear (mean curve fits of >0.95, 5 repeats) and intra- and inter-assay precisions were <12% and <8%, respectively. Spiked recovery was 98±5%. Application: A single oral dose of 5 mg/kg PTH (1–34) or placebo was administered to Sprague-Dawley rats after an overnight fast. cAMP was analysed in EDTA samples obtained at baseline, prior to dosing and every 15 min for 1h and then hourly for another 3h after dosing. In the suspected PHP patient, urinary cAMP was measured after a standard 20µg sc injection of teriparatide (Forsteo). Results: In rats, plasma PTH (1-34) and cAMP increased significantly within 15min of dosing, reaching peak values between 15 and 30 mins. PTH (1–34) concentration increased significantly by up to 6770-fold, although response to PTH (1-34) varied between animals. Plasma cAMP typically tripled, from 36.5±3.7 nmol/L at baseline to 108.9±26.3 nmol/L. Placebo had no effect.Urine cAMP from the suspected PHP patient did not change significantly reflecting a lack of biological response to sc PTH (1-34) despite a significant increase in plasma PTH (1-34) (27.8 to 101.1 pmol/L). Conclusion: The present method was robust and selective. It also showed utility in determining cAMP in biological systems and the ability to study the effect of drugs such as Forsteo.