Lecture 9 Cancer Prevention or Exacerbation

31 views4 pages
11 Apr 2012
Lecture 9 Cancer Prevention or Exacerbation – Folate and Vitamin D
Evidence based medicine aims to:
Apply best available evidence from clinical trials to clinical decision making
Assess strength of evidence with respect to risk/benefits of treatment/diagnostic
Levels of evidence
I: RCTs, meta-analyses, systematic reviews
II: Cohort, case control studies
III: opinions, case studies, expert communities
Phases of clinical trials
Phase 1: Safety Screening
Phase 2: Dose-finding, initial efficacy
Phase 3: Final testing: efficacy and compare to current Rx
Phase 4: “post-approval” studies
Clinical evidence against smoking based on prospective cohort epidemiology
Low 25(OH)D predicts multiple sclerosis (MS)
1,25(OH)2D affects antigen presentation & Th1 development
1,25(OH)2D influences Th1/Th2 development
Linking vitamin D with MS
Geographical variation
Immunomodulation of 1,25(OH)2D
Season of birth
VDDR1 and concurrent MS case study
Relapse/remission and increase/decrease 25(OH)D
Oral vitamin D intake, UVB radiation
Decreased 25(OH)D
Seasonal MRI activity
A phase 1/2 dose escalation study of high dose of vitamin D supplementation in MS
patients (randomized, open-label, matched intervention trial)
Mean serum 25(OH)D concentration ~420nmol/L without significant changes in
serum/urinary Ca measures
Dosing regimen physiologically attainable 25(OH)D concentrations at 1yr
No significant adverse effects
Treatment group improve
Lymphocyte proliferation assay
T cell proliferative response to MS-associated antigentic stimulation were
significantly reduced in treated
Unlock document

This preview shows page 1 of the document.
Unlock all 4 pages and 3 million more documents.

Already have an account? Log in

Get OneClass Notes+

Unlimited access to class notes and textbook notes.

YearlyBest Value
75% OFF
$8 USD/m
$30 USD/m
You will be charged $96 USD upfront and auto renewed at the end of each cycle. You may cancel anytime under Payment Settings. For more information, see our Terms and Privacy.
Payments are encrypted using 256-bit SSL. Powered by Stripe.