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Editorials

Is vitamin D supplementation a viable treatment for Crohn’s disease?

References

  • Papers of special note have been highlighted as:
  • • of interest
  • •• of considerable interest
  • Suibhne TN, Cox G, Healy M, et al. Vitamin D deficiency in Crohn’s disease: prevalence, risk factors and supplement use in an outpatient setting. J Crohns Colitis. 2012;6:182–188.
  • Khalili H, Huang ES, Ananthakrishnan AN, et al. Geographical variation and incidence of inflammatory bowel disease among US women. Gut. 2012;61:1686–1692.
  • Mouli VP, Ananthakrishnan AN. Review article: vitamin D and inflammatory bowel diseases. Aliment Pharmacol Ther. 2014;39:125–136.
  • O’Sullivan M. Vitamin D as a novel therapy in inflammatory bowel disease: new hope or false dawn? Proc Nutr Soc. 2015;74:114:5–12.
  • Giovannucci E. Epidemiology of vitamin D and colorectal cancer. Anticancer Agents Med Chem. 2013;13:11–19.
  • Skaaby T, Husemoen LL, Thuesen BH, et al. Prospective population-based study of the association between vitamin D status and incidence of autoimmune disease. Endocrine. 2015;50:231–238.
  • Garg M, Rosella O, Lubel JS, et al. Association of circulating vitamin D concentrations with intestinal but not systemic inflammation in inflammatory bowel disease. Inflamm Bowel Dis. 2013;19:2634–2643.
  • Raftery T, Merrick M, Healy M, et al. Vitamin D status is associated with intestinal inflammation as measured by Fecal Calprotectin in Crohn’s disease in clinical remission. Dig Dis Sci. 2015;60:2427–2435.
  • Jorgensen SP, Agnholt J, Glerup H, et al. Clinical trial: vitamin D3 treatment in Crohn’s disease - a randomized double-blind placebo-controlled study. Aliment Pharmacol Ther. 2010;32:377–383.
  • Raftery T, Martineau AR, Greiller CL, et al. Effects of vitamin D supplementation on intestinal permeability, cathelicidin and disease markers in Crohn’s disease: results froma randomised double-blind placebo-controlled study. United Eur Gastroenterol. 2015;3:294–302.

•• The largest to date and first 12 month RCT of vitamin D treatment in maintaining remission in CD.

  • Yang L, Weaver V, Smith JP, et al. Therapeutic effect of vitamin d supplementation in a pilot study of Crohn’s patients. Clin Transl Gastroenterol. 2013;4:e33.
  • Miheller P, Muzes G, Hritz I, et al. Comparison of the effects of 1,25 dihydroxyvitamin D and 25 hydroxyvitamin D on bone pathology and disease activity in Crohn’s disease patients. Inflamm Bowel Dis. 2009;15:1656–1662.
  • Heaney RP. Guidelines for optimizing design and analysis of clinical studies of nutrient effects. Nutr Rev. 2014;72:48–54.

•• Interesting and relevant discussions and insight into clinical studies involving nutrient rather than medical therapy.

  • Institute-of-Medicine. Dietary reference intakes for calcium and vitamin D. Washington (DC): The National Academies Press; 2011.
  • Martineau AR, James WY, Hooper RL, et al. Vitamin D3 supplementation in patients with chronic obstructive pulmonary disease (ViDiCO): a multicentre, double-blind, randomised controlled trial. Lancet Respir Med. 2015;3:120–130.

• Although not in CD, this is a good example of a high quality vitamin D RCT with pre-specified analysis of outcomes by basal 25OHD levels.

  • Bischoff-Ferrari HA. Optimal serum 25-hydroxyvitamin D levels for multiple health outcomes. Adv Exp Med Biol. 2008;624:55–71.
  • Holick MF, Binkley NC, Bischoff-Ferrari HA, et al. Evaluation, treatment, and prevention of vitamin D deficiency: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2011;96:1911–1930.
  • Zator ZA, Cantu SM, Konijeti GG, et al. Pretreatment 25-hydroxyvitamin D levels and durability of anti-tumor necrosis factor-alpha therapy in inflammatory bowel diseases. Jpen. 2014;38:385–391.
  • Martineau AR, Timms PM, Bothamley GH, et al. High-dose vitamin D(3) during intensive-phase antimicrobial treatment of pulmonary tuberculosis: a double-blind randomised controlled trial. Lancet. 2011;377:242–250.
  • Cantorna MT, McDaniel K, Bora S, et al. Vitamin D, immune regulation, the microbiota, and inflammatory bowel disease. Exp Biol Med. 2014;239:1524–1530.
  • Cantorna MT, Waddell A. The vitamin D receptor turns off chronically activated T cells. Ann N Y Acad Sci. 2014;1317:70–75.

• Current and thought provoking review of mechanisms that may underlie vitamin D effects, primarily based on animal data.

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