High prevalence of vitamin A deficiency in Crohn's disease patients according to serum retinol levels and the relative dose-response test

Soares-Mota, Márcia; Silva, Tianny A; Gomes, Luanda M; Pinto, Marco Antonio S.; Mendonça, Laura Maria Carvalho de; Farias, Maria Lúcia Fleiuss; Nunes, Tiago; Ramalho, Andréa; Zaltman, Cyrla

doi:10.3748/wjg.v21.i5.1614

Cited by 44 publications

(30 citation statements)

References 40 publications

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“…To further investigate the possibility of fat malabsorption in dogs with CIE and low serum 25(OH)D concentration, a coefficient of fat absorption test of feces or malabsorption blood test could be performed and compared between dogs with CIE and low serum 25(OH)D and normal serum 25(OH)D concentrations. Although serum vitamin A concentrations were not different between groups, measurement of hepatic vitamin A stores using the relative dose response test was demonstrated to be more sensitive than serum retinol concentration for the detection of vitamin A deficiency in humans with CD . Therefore, it is possible that measurement of hepatic vitamin A stores may have been a more accurate way to assess vitamin A status in our patients.…”

Section: Discussionmentioning

confidence: 85%

Comparison of clinical, clinicopathologic, and histologic variables in dogs with chronic inflammatory enteropathy and low or normal serum 25‐hydroxycholecalciferol concentrations

Wennogle

Priestnall

Suárez‐Bonnet

et al. 2019

Veterinary Internal Medicne

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Background The cause of low serum vitamin D concentrations in dogs with chronic inflammatory enteropathy (CIE) is not well understood. Objective Improve understanding of pathogenesis of low serum vitamin D concentrations in dogs with CIE by comparing several clinical, clinicopathologic, and histologic variables between CIE dogs with low and normal serum 25‐hydroxyvitamin D concentrations (25[OH]D). Animals Fifteen dogs with CIE and low serum 25[OH]D concentrations; 15 dogs with CIE and normal serum 25(OH)D concentrations. Methods Prospective cohort study. Clinical and clinicopathologic variables were compared between groups. Correlations between serum 25(OH)D concentration and histopathologic variables were assessed. Results Dogs with CIE and low serum 25(OH)D concentrations had higher canine chronic enteropathy clinical activity index scores (P = .003), lower serum α‐tocopherol (P < .001), cholesterol (P < .001), and albumin (P < .001) concentrations and higher serum C‐reactive protein (P = .004) concentrations compared to CIE dogs with normal serum 25(OH)D concentrations. Serum concentrations of vitamin D‐binding protein (VDBP) were not different between groups (P = .91). Duodenal morphologic and inflammatory histopathological scores (P = .002 and P = .004, respectively) and total histopathological scores in duodenum and combined duodenum and ileum negatively correlated with serum 25(OH)D concentration. Conclusions and Clinical Importance The pathogenesis of low serum vitamin D concentrations in dogs with CIE is likely multifactorial. Fat malabsorption deserves further study in dogs with low serum vitamin D concentration and CIE. Loss of VDBP does not appear to be an important cause of low serum vitamin D concentration in dogs with CIE.

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Section: Discussionmentioning

confidence: 85%

Comparison of clinical, clinicopathologic, and histologic variables in dogs with chronic inflammatory enteropathy and low or normal serum 25‐hydroxycholecalciferol concentrations

Wennogle

Priestnall

Suárez‐Bonnet

et al. 2019

Veterinary Internal Medicne

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“…Serum retinol levels in adults and children with Crohn's disease are lower than those in healthy people probably due to a deficiency in nutrient absorption [ 123 , 124 ]; similar results were reported for ulcerative colitis [ 125 ]. Considering the tolerogenic role of RA in the intestinal mucosa and the fact that IBD patients have low levels of serum retinoids, RA administration should be an adjuvant treatment for inflammatory diseases.…”

Section: Immunomodulatory Effect Of Ra During Inflammatory Processmentioning

confidence: 77%

Impact of Retinoic Acid on Immune Cells and Inflammatory Diseases

Oliveira

Teixeira

Sato

2018

Mediators of Inflammation

169

128

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Vitamin A metabolite retinoic acid (RA) plays important roles in cell growth, differentiation, organogenesis, and reproduction and a key role in mucosal immune responses. RA promotes dendritic cells to express CD103 and to produce RA, enhances the differentiation of Foxp3+ inducible regulatory T cells, and induces gut-homing specificity in T cells. Although vitamin A is crucial for maintaining homeostasis at the intestinal barrier and equilibrating immunity and tolerance, including gut dysbiosis, retinoids perform a wide variety of functions in many settings, such as the central nervous system, skin aging, allergic airway diseases, cancer prevention and therapy, and metabolic diseases. The mechanism of RA is interesting to explore as both a mucosal adjuvant and a combination therapy with other effective agents. Here, we review the effect of RA on innate and adaptive immunity with a special emphasis on inflammatory status.

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“…This DC subpopulation may be the reason vitamin A was incorporated into the tDC generation process for this trial. Vitamin A deficiency is prevalent in patients with Crohn’s disease and correlates with disease severity ( 90 ). Conventional CD103+ CD11b+ intestinal DC convert vitamin A to retinoic acid through expression of RALDH which is atypical of DC found in draining lymph nodes ( 91 ).…”

Section: Crohn’s Diseasementioning

confidence: 99%

Clinical Tolerogenic Dendritic Cells: Exploring Therapeutic Impact on Human Autoimmune Disease

et al. 2017

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Tolerogenic dendritic cell (tDC)-based clinical trials for the treatment of autoimmune diseases are now a reality. Clinical trials are currently exploring the effectiveness of tDC to treat autoimmune diseases of type 1 diabetes mellitus, rheumatoid arthritis, multiple sclerosis (MS), and Crohn’s disease. This review will address tDC employed in current clinical trials, focusing on cell characteristics, mechanisms of action, and clinical findings. To date, the publicly reported human trials using tDC indicate that regulatory lymphocytes (largely Foxp3+ T-regulatory cell and, in one trial, B-regulatory cells) are, for the most part, increased in frequency in the circulation. Other than this observation, there are significant differences in the major phenotypes of the tDC. These differences may affect the outcome in efficacy of recently launched and impending phase II trials. Recent efforts to establish a catalog listing where tDC converge and diverge in phenotype and functional outcome are an important first step toward understanding core mechanisms of action and critical “musts” for tDC to be therapeutically successful. In our view, the most critical parameter to efficacy is in vivo stability of the tolerogenic activity over phenotype. As such, methods that generate tDC that can induce and stably maintain immune hyporesponsiveness to allo- or disease-specific autoantigens in the presence of powerful pro-inflammatory signals are those that will fare better in primary endpoints in phase II clinical trials (e.g., disease improvement, preservation of autoimmunity-targeted tissue, allograft survival). We propose that pre-treatment phenotypes of tDC in the absence of functional stability are of secondary value especially as such phenotypes can dramatically change following administration, especially under dynamic changes in the inflammatory state of the patient. Furthermore, understanding the outcomes of different methods of cell delivery and sites of delivery on functional outcomes, as well as quality control variability in the functional outcomes resulting from the various approaches of generating tDC for clinical use, will inform more standardized ex vivo generation methods. An understanding of these similarities and differences, with a reference point the large number of naturally occurring tDC populations with different immune profiles described in the literature, could explain some of the expected and unanticipated outcomes of emerging tDC clinical trials.

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High prevalence of vitamin A deficiency in Crohn's disease patients according to serum retinol levels and the relative dose-response test

Abstract: Patients with CD have higher prevalence of vitamin A deficiency, as assessed by two independent methods.

Cited by 44 publications

References 40 publications

Comparison of clinical, clinicopathologic, and histologic variables in dogs with chronic inflammatory enteropathy and low or normal serum 25‐hydroxycholecalciferol concentrations

Comparison of clinical, clinicopathologic, and histologic variables in dogs with chronic inflammatory enteropathy and low or normal serum 25‐hydroxycholecalciferol concentrations

Impact of Retinoic Acid on Immune Cells and Inflammatory Diseases

Clinical Tolerogenic Dendritic Cells: Exploring Therapeutic Impact on Human Autoimmune Disease

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