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Pérez-Jeldres T, Bustamante ML, Segovia-Melero R, Aguilar N, Magne F, Ascui G, Uribe D, Azócar L, Hernández-Rocha C, Estela R, Silva V, De La Vega A, Arriagada E, Gonzalez M, Onetto GF, Escobar S, Baez P, Zazueta A, Pavez-Ovalle C, Miquel JF, Álvarez-Lobos M. Genotype Prevalence of Lactose Deficiency, Vitamin D Deficiency, and the Vitamin D Receptor in a Chilean Inflammatory Bowel Disease Cohort: Insights from an Observational Study. Int J Mol Sci 2023; 24:14866. [PMID: 37834314 PMCID: PMC10573577 DOI: 10.3390/ijms241914866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 09/28/2023] [Accepted: 09/29/2023] [Indexed: 10/15/2023] Open
Abstract
Lactose intolerance (LI) and vitamin D deficiency (VDD) have been linked to inflammatory bowel disease (IBD). We conducted an observational study in 192 Chilean IBD patients to investigate the prevalence of a specific gene variant (LCT-13910 CC genotype) associated with LI and the prevalence of VDD/Vitamin D Receptor (VDR) gene variants. Blood samples were analyzed using Illumina's Infinium Global Screening Array. The LCT-13910 CC genotype was found in 61% of IBD patients, similar to Chilean Hispanic controls and lower than Chilean Amerindian controls. The frequency of the LCT-13910-C allele in Chilean IBD patients (0.79) was comparable to the general population and higher than Europeans (0.49). Regarding VDR and VDD variants, in our study, the rs12785878-GG variant was associated with an increased risk of IBD (OR = 2.64, CI = 1.61-4.32; p-value = 0.001). Sixty-one percent of the Chilean IBD cohort have a genetic predisposition to lactose malabsorption, and a significant proportion exhibit genetic variants associated with VDD/VDR. Screening for LI and VDD is crucial in this Latin American IBD population.
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Affiliation(s)
- Tamara Pérez-Jeldres
- Department of Gastroenterology, School of Medicine, Pontificia Universidad Católica de Chile, Santiago 8320000, Chile
- Department of Gastroenterology, Hospital San Borja Arriarán, Santiago 8360160, Chile (M.G.)
| | - M. Leonor Bustamante
- Biomedical Sciences Institute, Faculty of Medicine, Universidad de Chile, Santiago 8380453, Chile
- Fundación Diagnosis, Santiago 7500580, Chile
| | | | - Nataly Aguilar
- Department of Gastroenterology, School of Medicine, Pontificia Universidad Católica de Chile, Santiago 8320000, Chile
- Department of Gastroenterology, Hospital San Borja Arriarán, Santiago 8360160, Chile (M.G.)
| | - Fabien Magne
- Biomedical Sciences Institute, Faculty of Medicine, Universidad de Chile, Santiago 8380453, Chile
| | - Gabriel Ascui
- La Jolla Institute for Immunology, San Diego, CA 92037, USA
| | - Denisse Uribe
- Instituto de Nutrición y Tecnología de Alimentos, Facultad de Medicina Universidad de Chile, Santiago 8380453, Chile
| | - Lorena Azócar
- Department of Gastroenterology, School of Medicine, Pontificia Universidad Católica de Chile, Santiago 8320000, Chile
| | - Cristián Hernández-Rocha
- Department of Gastroenterology, School of Medicine, Pontificia Universidad Católica de Chile, Santiago 8320000, Chile
| | - Ricardo Estela
- Department of Gastroenterology, Hospital San Borja Arriarán, Santiago 8360160, Chile (M.G.)
| | - Verónica Silva
- Department of Gastroenterology, Hospital San Borja Arriarán, Santiago 8360160, Chile (M.G.)
| | - Andrés De La Vega
- Department of Gastroenterology, Hospital San Borja Arriarán, Santiago 8360160, Chile (M.G.)
| | - Elizabeth Arriagada
- Department of Gastroenterology, Hospital San Borja Arriarán, Santiago 8360160, Chile (M.G.)
| | - Mauricio Gonzalez
- Department of Gastroenterology, Hospital San Borja Arriarán, Santiago 8360160, Chile (M.G.)
| | - Gian-Franco Onetto
- Department of Gastroenterology, Hospital San Borja Arriarán, Santiago 8360160, Chile (M.G.)
| | - Sergio Escobar
- Department of Gastroenterology, Hospital San Borja Arriarán, Santiago 8360160, Chile (M.G.)
| | - Pablo Baez
- Center of Medical Informatics and Telemedicine, University of Chile, Santiago 8380453, Chile
| | - Alejandra Zazueta
- Biomedical Sciences Institute, Faculty of Medicine, Universidad de Chile, Santiago 8380453, Chile
| | - Carolina Pavez-Ovalle
- Department of Gastroenterology, School of Medicine, Pontificia Universidad Católica de Chile, Santiago 8320000, Chile
| | - Juan Francisco Miquel
- Department of Gastroenterology, School of Medicine, Pontificia Universidad Católica de Chile, Santiago 8320000, Chile
| | - Manuel Álvarez-Lobos
- Department of Gastroenterology, School of Medicine, Pontificia Universidad Católica de Chile, Santiago 8320000, Chile
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Atazadeh F, Fazeli Z, Vahidnezhad H, Namazi N, Younespour S, Youssefian L, Abdollahimajd F, Uitto J. Increased level of cathelicidin (LL‐37) in vitiligo: Possible pathway independent from vitamin D receptor gene polymorphism. Exp Dermatol 2020; 29:1176-1185. [DOI: 10.1111/exd.14200] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Revised: 09/03/2020] [Accepted: 09/18/2020] [Indexed: 12/11/2022]
Affiliation(s)
- Fatemeh Atazadeh
- Skin Research Center Shahid Beheshti University of Medical Sciences Tehran Iran
| | - Zahra Fazeli
- Department of Medical Genetics Faculty of Medicine Shahid Beheshti University of Medical Sciences Tehran Iran
| | - Hassan Vahidnezhad
- Department of Dermatology and Cutaneous Biology Sidney Kimmel Medical CollegeThomas Jefferson University Philadelphia PA USA
- Jefferson Institute of Molecular Medicine Thomas Jefferson University Philadelphia PA USA
| | - Nastaran Namazi
- Skin Research Center Shahid Beheshti University of Medical Sciences Tehran Iran
| | - Shima Younespour
- Dentistry Research institute Tehran University of Medical Sciences Tehran Iran
| | - Leila Youssefian
- Department of Dermatology and Cutaneous Biology Sidney Kimmel Medical CollegeThomas Jefferson University Philadelphia PA USA
- Jefferson Institute of Molecular Medicine Thomas Jefferson University Philadelphia PA USA
| | - Fahimeh Abdollahimajd
- Skin Research Center Shahid Beheshti University of Medical Sciences Tehran Iran
- Clinical Research Development Unit Shohada‐e Tajrish HospitalShahid Beheshti University of Medical Sciences Tehran Iran
| | - Jouni Uitto
- Department of Dermatology and Cutaneous Biology Sidney Kimmel Medical CollegeThomas Jefferson University Philadelphia PA USA
- Jefferson Institute of Molecular Medicine Thomas Jefferson University Philadelphia PA USA
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3
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The relationship between selected VDR gene polymorphisms and susceptibility to inflammatory bowel disease in Slovak population. Biologia (Bratisl) 2019. [DOI: 10.2478/s11756-019-00212-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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Swelam MM, El-Barbary RAH, Saudi WM, Fathi MS, Soliman DA, Abd Elrehem HH. Associations among two vitamin D receptor (VDR) gene polymorphisms (ApaI and TaqI) in acne vulgaris: A pilot susceptibility study. J Cosmet Dermatol 2018; 18:1113-1120. [DOI: 10.1111/jocd.12781] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2018] [Revised: 06/19/2018] [Accepted: 08/01/2018] [Indexed: 12/27/2022]
Affiliation(s)
- Mervat M. Swelam
- Dermatology and Venereology, Faculty of Medicine for Girls; Al-Azhar University; Cairo Egypt
| | - Rasha A. H. El-Barbary
- Dermatology and Venereology, Faculty of Medicine for Girls; Al-Azhar University; Cairo Egypt
| | - Wael M. Saudi
- Dermatology and Venerology Department, Faculty of Medicine; Misr University for Science and Technology; Cairo Egypt
| | - Marwa S. Fathi
- Medical Microbiology and Immunology; Ain Shams University; Cairo Egypt
| | | | - Heba H. Abd Elrehem
- Dermatology and Venereology, Faculty of Medicine for Girls; Al-Azhar University; Cairo Egypt
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5
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Sex bias in paediatric autoimmune disease – Not just about sex hormones? J Autoimmun 2016; 69:12-23. [DOI: 10.1016/j.jaut.2016.02.011] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2016] [Revised: 02/25/2016] [Accepted: 02/29/2016] [Indexed: 02/06/2023]
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Meeker S, Seamons A, Maggio-Price L, Paik J. Protective links between vitamin D, inflammatory bowel disease and colon cancer. World J Gastroenterol 2016; 22:933-48. [PMID: 26811638 PMCID: PMC4716046 DOI: 10.3748/wjg.v22.i3.933] [Citation(s) in RCA: 87] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2015] [Revised: 09/28/2015] [Accepted: 11/24/2015] [Indexed: 02/06/2023] Open
Abstract
Vitamin D deficiency has been associated with a wide range of diseases and multiple forms of cancer including breast, colon, and prostate cancers. Relatively recent work has demonstrated vitamin D to be critical in immune function and therefore important in inflammatory diseases such as inflammatory bowel disease (IBD). Because vitamin D deficiency or insufficiency is increasingly prevalent around the world, with an estimated 30%-50% of children and adults at risk for vitamin D deficiency worldwide, it could have a significant impact on IBD. Epidemiologic studies suggest that low serum vitamin D levels are a risk factor for IBD and colon cancer, and vitamin D supplementation is associated with decreased colitis disease activity and/or alleviated symptoms. Patients diagnosed with IBD have a higher incidence of colorectal cancer than the general population, which supports the notion that inflammation plays a key role in cancer development and underscores the importance of understanding how vitamin D influences inflammation and its cancer-promoting effects. In addition to human epidemiological data, studies utilizing mouse models of colitis have shown that vitamin D is beneficial in preventing or ameliorating inflammation and clinical disease. The precise role of vitamin D on colitis is unknown; however, vitamin D regulates immune cell trafficking and differentiation, gut barrier function and antimicrobial peptide synthesis, all of which may be protective from IBD and colon cancer. Here we focus on effects of vitamin D on inflammation and inflammation-associated colon cancer and discuss the potential use of vitamin D for protection and treatment of IBD and colon cancer.
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Vitamin D and inflammatory bowel disease. BIOMED RESEARCH INTERNATIONAL 2015; 2015:470805. [PMID: 26000293 PMCID: PMC4427008 DOI: 10.1155/2015/470805] [Citation(s) in RCA: 64] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/27/2014] [Revised: 02/02/2015] [Accepted: 02/13/2015] [Indexed: 12/11/2022]
Abstract
Vitamin D deficiency has been recognized as an environmental risk factor for Crohn's disease since the early 80s. Initially, this finding was correlated with metabolic bone disease. Low serum 25-hydroxyvitamin D levels have been repeatedly reported in inflammatory bowel diseases together with a relationship between vitamin D status and disease activity. Subsequently, low serum vitamin D levels have been reported in various immune-related diseases pointing to an immunoregulatory role. Indeed, vitamin D and its receptor (VDR) are known to interact with different players of the immune homeostasis by controlling cell proliferation, antigen receptor signalling, and intestinal barrier function. Moreover, 1,25-dihydroxyvitamin D is implicated in NOD2-mediated expression of defensin-β2, the latter known to play a crucial role in the pathogenesis of Crohn's disease (IBD1 gene), and several genetic variants of the vitamin D receptor have been identified as Crohn's disease candidate susceptibility genes. From animal models we have learned that deletion of the VDR gene was associated with a more severe disease. There is a growing body of evidence concerning the therapeutic role of vitamin D/synthetic vitamin D receptor agonists in clinical and experimental models of inflammatory bowel disease far beyond the role of calcium homeostasis and bone metabolism.
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Abstract
The emerging role of vitamin D as a regulator of both innate and adaptive immune responses has encouraged the investigation of its role in the pathogenesis of a variety of autoimmune conditions including the inflammatory bowel diseases (IBD), Crohn's disease and ulcerative colitis. Animal models consistently demonstrate that vitamin D significantly impacts on the modulation of astrointestinal inflammation, while epidemiological and observational data show an inverse relationship between vitamin D status and the onset/progression of Crohn's disease as well as the development of colorectal cancer. As vitamin D supplementation is readily available, at low cost, it is a very attractive potential therapeutic option. The biological plausibility for a role for vitamin D in inflammation modulation, the potential genetic links associated with vitamin D metabolism and the clinical aspects for it in IBD will be discussed.
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Affiliation(s)
- Simon Ghaly
- Centre for Inflammatory Bowel Diseases, Fremantle Hospital and School of Medicine and Pharmacology, University of Western Australia, Level 5, T Block, Alma St, Fremanlte, Western Australia 6159, Australia
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Rapid and simultaneous detection of vitamin D receptor gene polymorphisms by a single ARMS-PCR assay. Mol Diagn Ther 2014; 18:97-103. [PMID: 24127289 DOI: 10.1007/s40291-013-0060-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
BACKGROUND Vitamin D has various roles in many biological actions such as calcium homeostasis, cell proliferation, and cell differentiation to many target tissues. These effects are mediated by the active form of vitamin D, 1,25(OH)2D3, which binds to a cytoplasmic protein called vitamin D receptor (VDR). VDR gene has four common single nucleotide polymorphisms (SNPs) that are defined by the presence of restriction sites for FokI (F/f), TaqI (T/t), BsmI (B/b), and ApaI (A/a). The association of VDR gene polymorphisms with several diseases has been investigated. In most studies, VDR genotyping was performed by polymerase chain reaction (PCR)-restriction fragment length polymorphism (RFLP) assays, which are cumbersome and time consuming, and their results are sometimes difficult to interpret. OBJECTIVE We modified previously reported primers for VDR genotyping and set up a single amplification-refractory mutation system (ARMS)-PCR method for simultaneous genotyping of four common VDR polymorphisms. METHODS In this study, 218 DNA samples were analyzed for VDR genetic variants by this ARMS-PCR technique; 136 of them were re-genotyped by PCR-RFLP assays to compare genotyping results. RESULT We obtained allelic frequencies of 69 vs. 31 % for F/f, 34 vs. 66 % for B/b, 70 vs. 30 % for T/t, and 52 vs. 48 % for A/a in this sample of the Iranian population. In addition, comparisons of the results of these two methods showed good uniformity in VDR genotypes; although, in some samples, ambiguity in restriction patterns was present. CONCLUSION As ARMS-PCR is more rapid, economic, and user friendly than PCR-RFLP, its substitution would be welcomed in disease association and pharmacogenetic studies of VDR variants.
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The role of Vitamin D level and related single nucleotide polymorphisms in Crohn's disease. Nutrients 2013; 5:3898-909. [PMID: 24084050 PMCID: PMC3820050 DOI: 10.3390/nu5103898] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2013] [Revised: 08/19/2013] [Accepted: 09/12/2013] [Indexed: 12/11/2022] Open
Abstract
New Zealand has one of the highest rates of Crohn's Disease (CD) in the world, and there is much speculation as to why this might be. A high risk of CD has been associated with deficient or insufficient levels of Vitamin D (Vit D), lifestyle as well as various genetic polymorphisms. In this study we sought to analyse the relevance of serum Vit D levels, lifestyle and genotype to CD status. Serum samples were analysed for 25-OH-Vitamin D levels. DNA was isolated from blood and cheek-swabs, and Sequenom and ImmunoChip techniques were used for genotyping. Serum Vit D levels were significantly lower in CD patients (mean = 49.5 mg/L) than those found in controls (mean = 58.9 mg/L, p = 4.74 × 10⁻⁶). A total of seven single nucleotide polymorphisms were examined for effects on serum Vit D levels, with adjustment for confounding variables. Two variants: rs731236[A] (VDR) and rs732594[A] (SCUBE3) showed a significant association with serum Vit D levels in CD patients. Four variants: rs7975232[A] (VDR), rs732594[A] (SCUBE3), and rs2980[T] and rs2981[A] (PHF-11) showed a significant association with serum Vit D levels in the control group. This study demonstrates a significant interaction between Vit D levels and CD susceptibility, as well as a significant association between Vit D levels and genotype.
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Abstract
Inflammatory bowel disease is associated with industrialization, and its incidence has increased markedly over time. The prospect of reversing these trends motivates the search for the agent(s) involved. Modernity entails several physical and behavioral modifications that compromise both the photosynthesis of cholecalciferol in the skin and of its bioavailability. Although deficiency in this "vitamin" has therefore emerged as a leading candidate, and despite the publication of a randomized control trial that showed a trend toward statistically significant benefit in Crohn's disease, its causal agency has yet to be demonstrated by an adequately powered study. We discuss the strengths and weaknesses of the case being made by epidemiologists, geneticists, clinicians, and basic researchers, and consolidate their findings into a model that provides mechanistic plausibility to the claim. Specifically, converging data sets suggest that local activation of vitamin D coordinates the activity of the innate and adaptive arms of immunity, and of the intestinal epithelium, in a manner that promotes barrier integrity, facilitates the clearance of translocated flora, and diverts CD4 T cell development away from inflammatory phenotypes. Because smoking is an important risk-altering exposure, we also discuss its newly established melanizing effect and other emerging evidence linking tobacco use to immune function through vitamin D pathways.
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Li K, Shi Q, Yang L, Li X, Liu L, Wang L, Li Q, Wang G, Li CY, Gao TW. The association of vitamin D receptor gene polymorphisms and serum 25-hydroxyvitamin D levels with generalized vitiligo. Br J Dermatol 2013; 167:815-21. [PMID: 22762534 DOI: 10.1111/j.1365-2133.2012.11132.x] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND Vitiligo is an acquired depigmentation autoimmune disorder that has been described as being associated with lower levels of 25-hydroxyvitamin D [25(OH)D]. Genetic variations within the vitamin D receptor (VDR) gene could lead to significant receptor dysfunction, and could further affect the formation of the biologically active 25(OH)D. Therefore, we hypothesized that VDR polymorphisms might be involved in vitiligo by affecting the formation of 25(OH)D. OBJECTIVES To evaluate the potential association between VDR polymorphisms and vitiligo susceptibility and the serum levels of 25(OH)D. METHODS We performed a hospital-based study of 749 patients with vitiligo and 763 matched controls. We investigated four VDR polymorphisms (FokI, BsmI, ApaI and TaqI) to determine whether they are associated with vitiligo susceptibility in the Chinese population. In addition, the levels of 25(OH)D were measured to evaluate possible associations between the VDR polymorphic variants and clinical and laboratory findings of vitiligo. RESULTS A significantly decreased risk of developing vitiligo was found to be associated with the BsmI-B, ApaI-A and TaqI-t alleles. According to the genotype distribution, 25(OH)D concentrations were significantly higher in patients carrying the FokI ff or ApaI AA genotypes compared with those carrying the FF or aa genotypes. Logistic regression analysis also showed a dose-response relationship between decreased risk of vitiligo and increased 25(OH)D levels in ApaI-A variant genotype carriers. CONCLUSIONS Our findings suggest that these VDR polymorphisms are associated with 25(OH)D levels and that there exists a genetic predisposition for vitiligo in the Chinese population.
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Affiliation(s)
- K Li
- Department of Dermatology, Xijing Hospital, Fourth Military Medical University, Xi'an, China
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Xue LN, Xu KQ, Zhang W, Wang Q, Wu J, Wang XY. Associations between vitamin D receptor polymorphisms and susceptibility to ulcerative colitis and Crohn's disease: a meta-analysis. Inflamm Bowel Dis 2013; 19:54-60. [PMID: 22467262 DOI: 10.1002/ibd.22966] [Citation(s) in RCA: 77] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Several polymorphisms have been identified in the vitamin D receptor (VDR) gene, while their roles in the incidence of ulcerative colitis (UC) and Crohn's disease (CD) are conflicting. This meta-analysis was designed to clarify the impact of these polymorphisms on UC and CD risk. METHODS The PubMed, Embase, and Cochrane electronic databases were searched from February 1995 to August 2011 for studies on the four VDR polymorphisms: TaqI, BsmI, FokI, and ApaI. Data were extracted and pooled odd ratios (ORs) and 95% confidence intervals (95% CIs) were calculated. RESULTS Nine studies were included. In Asians, the ff genotype of FokI was associated with increased UC risk (OR = 1.65; 95% CI, 1.11- 2.45). The "a" allele carrier status of ApaI appeared to be a protective factor for CD (OR = 0.81; 95% CI, 0.67-0.97). The tt genotype increased the risk of CD in Europeans (OR = 1.23; 95% CI, 1.02-1.49). Moreover, the tt genotype of TaqI in males had a moderate elevated risk of UC (OR = 1.56; 95% CI, 1.02-2.39) and CD (OR = 1.84; 95% CI, 1.19-2.83). CONCLUSIONS The meta-analysis reveals a significant increase in CD risk for Europeans carrying TaqI tt genotype and a significant decrease in CD risk for all carriers of the Apal "a" allele. For Asians, the VDR FokI polymorphism appears to confer susceptibility to UC. For males, the TaqI tt genotype is associated with susceptibilities to both UC and CD. Our study explored the genetic risk prediction in UC and CD, and may provide valuable insights into IBD therapy.
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Affiliation(s)
- Le-Ning Xue
- Department of Gastroenterology, Changzhou No 2 Hospital, Affiliated with Nanjing Medical University, Changzhou City, Jiangsu Province, China
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Iijima H, Shinzaki S, Takehara T. The importance of vitamins D and K for the bone health and immune function in inflammatory bowel disease. Curr Opin Clin Nutr Metab Care 2012; 15:635-40. [PMID: 22914505 DOI: 10.1097/mco.0b013e328357f623] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
PURPOSE OF REVIEW This review summarizes the recent literature about the roles of vitamins D and K in bone metabolism and immunity-mediated inflammatory processes in inflammatory bowel diseases (IBDs). RECENT FINDINGS The levels of vitamins D and K are lower than normal in patients with IBD, especially in Crohn's disease. Although vitamins D and K are important for the maintenance of bone mineral density in non-IBD patients, an association between vitamins D or K and bone metabolism is not apparent in IBD patients. Recent studies showed that vitamins D and K are suggested to have immune-suppressive effects, both in animal models of colitis and human trials. In particular, vitamin D suppresses dendritic and T-cell functions by inhibiting the production of proinflammatory cytokines. Insufficiency of vitamin D is associated with the activated phenotype of IBD. SUMMARY Vitamins D and K potentially contribute to the maintenance of bone health in IBD, but this effect may be diminished by other factors such as steroid use, reduced exposure to sunlight, and inflammatory cytokines. Vitamin D and possibly vitamin K are suggested to be involved in the suppression of immune-mediated inflammation and modulation of disease activity.
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Affiliation(s)
- Hideki Iijima
- Department of Gastroenterology and Hepatology, Osaka University Graduate School of Medicine, Suita, Osaka, Japan.
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Schultz M, Butt AG. Is the north to south gradient in inflammatory bowel disease a global phenomenon? Expert Rev Gastroenterol Hepatol 2012; 6:445-7. [PMID: 22928897 DOI: 10.1586/egh.12.31] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Inflammatory bowel diseases (IBDs), such as Crohn's disease and ulcerative colitis, are multifactorial diseases that result from an overly aggressive immune response towards an environmental trigger in a genetically susceptible host. Much has been learned about susceptibility genes; however, environmental triggers are still largely unknown. In the 1990s, a large study from Europe suggested a north-south gradient regarding the incidence of IBD; however, this was never shown convincingly for the USA. In the present study, the authors used and extended data from the Nurses' Health Study I and II and were able to demonstrate that indeed the risk of developing IBD is significantly lower for the southern latitudes of the USA and did not depend on ancestry or lifestyle factors such as smoking. The authors speculate that an increased exposure to sunlight provides protection from IBD via the vitamin D pathway.
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Affiliation(s)
- Michael Schultz
- Department of Medicine, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand.
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Garg M, Lubel JS, Sparrow MP, Holt SG, Gibson PR. Review article: vitamin D and inflammatory bowel disease--established concepts and future directions. Aliment Pharmacol Ther 2012; 36:324-44. [PMID: 22686333 DOI: 10.1111/j.1365-2036.2012.05181.x] [Citation(s) in RCA: 70] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2012] [Revised: 05/11/2012] [Accepted: 05/25/2012] [Indexed: 02/06/2023]
Abstract
BACKGROUND Understanding of the role of vitamin D in health and disease has increased markedly in the past decade, with its involvement extending well beyond traditional roles in calcium and phosphate homeostasis and musculoskeletal health. This conceptual expansion has been underpinned by identification and exploration of components of this axis including vitamin D-binding protein, key enzymes and receptors in multiple cell types, and a greater recognition of nonclassical autocrine and paracrine effects. Its influence in IBD remains uncertain. AIM To review the role of vitamin D in bone health, immune regulation and cancer prevention in IBD, and to outline practical issues and limitations of its use. METHODS An extensive online literature review including PubMed and Medline. RESULTS In patients with IBD, the vitamin D axis provides an important and often underutilised pathway to preserving bone health. Furthermore, an exciting body of clinical and basic science research demonstrates that these pathways may have an integral part to play in regulation of the immune response in IBD, through effects on the intestinal barrier, antigen presenting cells and adaptive T cells. The possibility of chemoprevention requires further study. The optimal target level of 25-hydroxy vitamin D in patients with IBD is currently uncertain, as is the best therapeutic modality. CONCLUSIONS Study of vitamin D pathways may result in the development of relatively inexpensive therapeutic options to optimise patient outcomes. Further prospective clinical research is required to address efficacy and long-term safety.
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Affiliation(s)
- M Garg
- Department of Gastroenterology & Hepatology, Eastern Health, Box Hill, Vic., Australia.
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17
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Abstract
This review aims to provide a snapshot of the actual state of knowledge on genetic variants of nuclear receptors (NR) involved in regulating important aspects of liver metabolism. It recapitulates recent evidence for the application of NR in genetic diagnosis of monogenic ("Mendelian") liver disease and their use in clinical diagnosis. Genetic analysis of multifactorial liver diseases such as viral hepatitis or fatty liver disease identifies key players in disease predisposition and progression. Evidence from these analyses points towards a role of NR polymorphisms in common diseases, linking regulatory networks to complex and variable phenotypes. The new insights into NR variants also offer perspectives and cautionary advice for their use as handles towards diagnosis and treatment.
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Affiliation(s)
- Roman Müllenbach
- Department of Medicine II, Saarland University Medical Center, 66421 Homburg, Germany
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18
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Abstract
This review aims to provide a snapshot of the actual state of knowledge on genetic variants of nuclear receptors (NR) involved in regulating important aspects of liver metabolism. It recapitulates recent evidence for the application of NR in genetic diagnosis of monogenic (“Mendelian”) liver disease and their use in clinical diagnosis. Genetic analysis of multifactorial liver diseases such as viral hepatitis or fatty liver disease identifies key players in disease predisposition and progression. Evidence from these analyses points towards a role of NR polymorphisms in common diseases, linking regulatory networks to complex and variable phenotypes. The new insights into NR variants also offer perspectives and cautionary advice for their use as handles towards diagnosis and treatment.
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