Role of Vitamin D in the Natural History of Inflammatory Bowel Disease.
J Crohns Colitis. 2018 Feb 24;:
Authors: Nielsen OH, Rejnmark L, Moss AC
Inflammatory bowel disease (IBD), including ulcerative colitis and Crohn’s disease, is a chronic and unpredictable characterized by alternating periods of remission interspersed with relapses. In recent years accumulating support for an immunomodulating effect of vitamin D on both the innate and adaptive immune system has been presented. Through the vitamin D receptor, the active form of vitamin D, 1,25(OH)2D, induces antimicrobial peptide secretion, decrease dendritic cell activity, and promotes Th2 and regulatory T cell development and activity. In addition, vitamin D promotes an increased ratio of anti-inflammatory cytokines to pro-inflammatory cytokines. Studies in IBD point to a role for vitamin D in ameliorating disease outcome. Suboptimal circulating levels of 25-hydroxyvitamin D are common in IBD and appear to be associated with an increased risk of flares, IBD-related hospitalizations and surgeries, an inadequate response to TNF inhibitors, a deterioration in quality of life, as well as low bone mineral density. With only few available randomized double-blind, placebo-controlled studies investigating therapeutic effects of vitamin D related to IBD, further research is necessary to determine the true therapeutic potential of vitamin D, as well as defining its optimal range in serum to achieve and maintain quiescent disease. This review aims to summarize the latest knowledge on the extraskeletal effects of vitamin D in IBD, and outlines the potential deleterious consequences of vitamin D deficiency in this patient cohort.
PMID: 29529167 [PubMed – as supplied by publisher]