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

Mayur Garg, Philip Hendy, John Nik Ding, Sophie Shaw, Georgina Hold, Ailsa Hart

Research output: Contribution to journalArticle

17 Citations (Scopus)
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Abstract

Background and Aims

There is evidence 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-IBD controls with baseline 25(OH) vitamin D <50 nmol/L, and markers of inflammation and faecal microbiota analysed.

Results

Eight patients with active UC, 9 with inactive UC and 8 non-IBD controls received 40,000 units cholecalciferol weekly for 8 weeks. Mean baseline 25(OH) vitamin D increased from 34 (range 12–49) nmol/L 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 reduced from median 275 to 111µg/g (p = 0.02), platelet count reduced (mean 375 to 313x10 9/L, p = 0.03), and albumin increased (mean 43 to 45g/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.

Original languageEnglish
Pages (from-to)963-972
Number of pages10
JournalJournal of Crohn's and Colitis
Volume12
Issue number8
Early online date3 May 2018
DOIs
Publication statusPublished - Aug 2018

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Microbiota
Ulcerative Colitis
Vitamin D
Inflammation
Leukocyte L1 Antigen Complex
Enterobacteriaceae
Cholecalciferol
Platelet Count
Albumins

Keywords

  • Basic science
  • experimental models and pathophysiology
  • clinical trials

Cite this

The Effect of Vitamin D on Intestinal Inflammation and Faecal Microbiota in Patients with Ulcerative Colitis. / Garg, Mayur; Hendy, Philip; Ding, John Nik; Shaw, Sophie; Hold, Georgina; Hart, Ailsa.

In: Journal of Crohn's and Colitis, Vol. 12, No. 8, 08.2018, p. 963-972.

Research output: Contribution to journalArticle

Garg, Mayur ; Hendy, Philip ; Ding, John Nik ; Shaw, Sophie ; Hold, Georgina ; Hart, Ailsa. / The Effect of Vitamin D on Intestinal Inflammation and Faecal Microbiota in Patients with Ulcerative Colitis. In: Journal of Crohn's and Colitis. 2018 ; Vol. 12, No. 8. pp. 963-972.
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title = "The Effect of Vitamin D on Intestinal Inflammation and Faecal Microbiota in Patients with Ulcerative Colitis",
abstract = "Background and AimsThere is evidence 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.MethodsVitamin 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-IBD controls with baseline 25(OH) vitamin D <50 nmol/L, and markers of inflammation and faecal microbiota analysed.ResultsEight patients with active UC, 9 with inactive UC and 8 non-IBD controls received 40,000 units cholecalciferol weekly for 8 weeks. Mean baseline 25(OH) vitamin D increased from 34 (range 12–49) nmol/L 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 reduced from median 275 to 111µg/g (p = 0.02), platelet count reduced (mean 375 to 313x10 9/L, p = 0.03), and albumin increased (mean 43 to 45g/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).ConclusionsVitamin 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.",
keywords = "Basic science, experimental models and pathophysiology, clinical trials",
author = "Mayur Garg and Philip Hendy and Ding, {John Nik} and Sophie Shaw and Georgina Hold and Ailsa Hart",
note = "This work was supported by the European Crohn’s and Colitis Organisation Fellowship awarded to Dr Mayur Garg, and St Mark’s Foundation Research Grant 2015 awarded to Prof Ailsa Hart and Dr Mayur Garg.",
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T1 - The Effect of Vitamin D on Intestinal Inflammation and Faecal Microbiota in Patients with Ulcerative Colitis

AU - Garg, Mayur

AU - Hendy, Philip

AU - Ding, John Nik

AU - Shaw, Sophie

AU - Hold, Georgina

AU - Hart, Ailsa

N1 - This work was supported by the European Crohn’s and Colitis Organisation Fellowship awarded to Dr Mayur Garg, and St Mark’s Foundation Research Grant 2015 awarded to Prof Ailsa Hart and Dr Mayur Garg.

PY - 2018/8

Y1 - 2018/8

N2 - Background and AimsThere is evidence 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.MethodsVitamin 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-IBD controls with baseline 25(OH) vitamin D <50 nmol/L, and markers of inflammation and faecal microbiota analysed.ResultsEight patients with active UC, 9 with inactive UC and 8 non-IBD controls received 40,000 units cholecalciferol weekly for 8 weeks. Mean baseline 25(OH) vitamin D increased from 34 (range 12–49) nmol/L 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 reduced from median 275 to 111µg/g (p = 0.02), platelet count reduced (mean 375 to 313x10 9/L, p = 0.03), and albumin increased (mean 43 to 45g/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).ConclusionsVitamin 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.

AB - Background and AimsThere is evidence 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.MethodsVitamin 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-IBD controls with baseline 25(OH) vitamin D <50 nmol/L, and markers of inflammation and faecal microbiota analysed.ResultsEight patients with active UC, 9 with inactive UC and 8 non-IBD controls received 40,000 units cholecalciferol weekly for 8 weeks. Mean baseline 25(OH) vitamin D increased from 34 (range 12–49) nmol/L 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 reduced from median 275 to 111µg/g (p = 0.02), platelet count reduced (mean 375 to 313x10 9/L, p = 0.03), and albumin increased (mean 43 to 45g/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).ConclusionsVitamin 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.

KW - Basic science

KW - experimental models and pathophysiology

KW - clinical trials

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DO - 10.1093/ecco-jcc/jjy052

M3 - Article

VL - 12

SP - 963

EP - 972

JO - Journal of Crohn's and Colitis

JF - Journal of Crohn's and Colitis

SN - 1873-9946

IS - 8

ER -