The effects of two vitamin D regimens on ulcerative colitis activity index, quality of life and oxidant/anti-oxidant status

Abstract

BackgroundThe optimum dosage for vitamin D supplementation has not yet been elucidated in patients with Ulcerative colitis (UC). The aim of this study was to investigate the effects of two vitamin D regimens in UC patients with vitamin D deficiency.MethodsIn this double blind randomized clinical trial, 50 patients with mild to moderate UC, who met inclusion criteria, received either 1000 or 2000 IU/day of vitamin D (as low dose or high dose group, respectively) for 12 weeks. Serum 25-hydroxy vitamin D (25-OHD) level, total antioxidant capacity (TAC), and Total Oxidant Status (TOS), the inflammatory bowel disease questionnaire − 9 (IBDQ-9) score and the Simple Clinical Colitis Activity Index Questionnaire (SCCAI) score were assessed before and after intervention.ResultsAt the end of study, serum 25-OHD levels significantly increased in the high dose group (P < 0.001) and the increase was significantly more than low dose group (6.7 ± 3.8 ng/mL in the high dose group versus 0.2 ± 0.5 ng/mL in the low dose group) (P < 0.001). Serum TOS concentration decreased significantly (− 0.37 ± 0.26) only in the high dose group (P value = 0.023). There was no statistically significant change in serum TAC between two groups during the study. IBDQ-9 mean score significantly increased in high dose group compared to the low dose group (P value = 0.001) and SCCAI score in both groups reduced (− 2.58 ± 2.16 and − 0.9 ± 0.3 in high dose and low dose respectively), while this reduction was significant only in the high dose group (P value ≥0.001).ConclusionOur results indicate that 2000 IU daily dose of vitamin D can increase serum 25-OHD concentration, and quality of life, while it reduces disease activity in UC patients with vitamin D deficiency. We recommend assessment of the vitamin D status in all patients with UC because they may benefit from vitamin D therapy.

Vitamin D intake is associated with decreased risk of immune checkpoint inhibitor‐induced colitis

“…In conclusion, here we report that patients taking vitamin D at the time their first ICI treatment was initiated had significantly reduced odds of developing ICI colitis over the course of their immunotherapy regimen. These results may suggest benefit in prophylactic use of vitamin D supplementation to prevent ICI colitis, as previously demonstrated in inflammatory bowel disease [56][57][58][59]65,66 and graft-versus-host disease. 49,67,68 Cancer August 15, 2020…”

“…In conclusion, here we report that patients taking vitamin D at the time their first ICI treatment was initiated had significantly reduced odds of developing ICI colitis over the course of their immunotherapy regimen. These results may suggest benefit in prophylactic use of vitamin D supplementation to prevent ICI colitis, as previously demonstrated in inflammatory bowel disease 56‐59,65,66 and graft‐versus‐host disease 49,67,68 . The specific mechanism by which vitamin D may prevent immune‐related colitis should be further explored through future correlative studies, including cytokine analyses and immune profiling at baseline and at the time of colitis.…”

The Role of Autophagy in Inflammatory Bowel Disease

“…The findings revealed by that study indicate the reduction of autophagy process on the occurrence of UC ( Hu et al, 2019 ). Recent evidence demonstrated that activating intestinal nuclear receptor vitamin D receptor (VDR) could downregulate intestinal inflammation via inducing autophagy-mediated inflammasome suppression ( Bakke and Sun, 2018 ; Karimi et al, 2019 ; Law et al, 2019 ). A low VDR expression and dysfunction of vitamin D/VDR signaling was also observed in UC patients ( Bakke and Sun, 2018 ).…”

Effects of coenzyme Q10 on health-related quality of life, clinical disease activity and blood pressure in patients with mild to moderate ulcerative colitis: a randomized clinical trial

“…At other extremes, several other studies similar to the present study have used the SCCAI to assess disease severity in UC subjects ( 8 , 30 ), which was recently considered to be more reflective of actual disease activity in comparison to other clinical scores ( 39 ). Although it should be noted that serum CoQ10 levels may be influenced by a variety of factors (e.g., age, race, plasma lipid levels, and use of concurrent medications) ( 9 , 28 ).…”

“…The clinical status of UC patients was determined using the Simple Clinical Colitis Activity Index Questionnaire (SCCAIQ) at pre- and post-intervention stages ( 8 , 30 ). The SCCAI comprises a frequency of defecation during the day and night, the urgency of defecation, rectal bleeding, a physician’s assessment of disease severity, and extraintestinal manifestations, which classifies patients into three grades of disease severity: inactive UC (i.e., in remission) and active UC (i.e., mild, moderate, and severe).…”