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J Crohns Colitis. 2018 Jul 30;12(8):963-972. doi: 10.1093/ecco-jcc/jjy052.

The Effect of Vitamin D on Intestinal Inflammation and Faecal Microbiota in Patients with Ulcerative Colitis.

Garg M1,2,3, Hendy P3, Ding JN3,4, Shaw S5, Hold G5,6, Hart A3,7.

Author information

1
Department of Gastroenterology, Eastern Health, Victoria, Australia.
2
Eastern Health Clinical School, Monash University, Victoria, Australia.
3
St Mark's Hospital, Harrow, UK.
4
St Vincent's Hospital, Melbourne, Australia.
5
University of Aberdeen, Aberdeen, UK.
6
Faculty of Medicine, University of New South Wales, Sydney, Australia.
7
Imperial College, London, UK.

Abstract

Background and Aims:

Vitamin D may be immunomodulatory and alter faecal microbiota, but results from clinical studies in humans to date have been inconclusive. This study aimed to assess the effect of vitamin D replacement in vitamin D-deficient patients with and without ulcerative colitis [UC] on inflammation and faecal microbiota.

Methods:

Vitamin D was replaced over 8 weeks in patients with active UC [defined by faecal calprotectin ≥ 100 µg/g], inactive UC [faecal calprotectin < 100 µg/g] and non-inflammatory bowel disease [IBD] controls with baseline serum 25[OH] vitamin D <50 nmol/l, and markers of inflammation and faecal microbiota were analysed.

Results:

Eight patients with active UC, nine with inactive UC and eight non-IBD controls received 40000 units cholecalciferol weekly for 8 weeks. Mean baseline 25[OH] vitamin D increased from 34 [range 12-49] to 111 [71-158] nmol/l [p < 0.001], with no difference across the groups [p = 0.32]. In patients with active UC, faecal calprotectin levels decreased from a median 275 to 111 µg/g [p = 0.02], platelet count decreased [mean 375 to 313 × 109/l, p = 0.03] and albumin increased [mean 43 to 45 g/l, p = 0.04]. These parameters did not change in patients with inactive UC or non-IBD controls. No changes in overall faecal bacterial diversity were noted although a significant increase in Enterobacteriaceae abundance was observed in patients with UC [p = 0.03].

Conclusions:

Vitamin D supplementation was associated with reduced intestinal inflammation in patients with active UC, with a concomitant increase in Enterobacteriaceae but no change in overall faecal microbial diversity.

PMID:
29726893
DOI:
10.1093/ecco-jcc/jjy052
[Indexed for MEDLINE]

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