Vitamin D Deficiency Increases the Risk for Moderate to Severe Disease Activity in Crohn's Disease Patients in South Africa, Measured by the Harvey Bradshaw Index

Basson, Abigail R.; Swart, Rina; Jordaan, Esmè; Mazinu, Mikatako; Watermeyer, Gillian

doi:10.1080/07315724.2015.1039665

Cited by 20 publications

(25 citation statements)

References 43 publications

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“…Our findings support data from the clinical study [6] where vitamin D inhibited inflammation and reduced the risk of relapse. We, and others have previously demonstrated an association between low 25-vitD levels and increased disease activity scores [32, 33] and faecal calprotectin levels [34]. These data support that vitamin D has immunoregulatory effects.…”

Section: Discussionsupporting

confidence: 81%

Vitamin D increases programmed death receptor-1 expression in Crohn’s disease

et al. 2017

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Background: Vitamin D modulates inflammation in Crohns disease (CD). Programmed death (PD)-1 receptor contributes to the maintenance of immune tolerance. Vitamin D might modulate PD-1 signalling in CD.Aim: To investigate PD-1 expression on T cell subsets in CD patients treated with vitamin D or placebo.Methods: We included 40 CD patients who received 1200 IU vitamin D3 for 26 weeks or placebo and eight healthy controls. Peripheral blood mononuclear cells (PBMCs) and plasma were isolated at baseline and week 26. The expressions of PD-1, PD-L1, and surface activation markers were analysed by flow cytometry. Soluble PD-1 plasma levels were measured by ELISA.Results: PD-1 expression upon T cell stimulation was increased in CD4+CD25+int T cells in vitamin D treated CD patients from 19% (range 10 39%) to 29% (11 79%)(p = 0.03) compared with placebo-treated patients. Vitamin D treatment, but not placebo, decreased the expression of the T cell activation marker CD69 from 42% (31 62%) to 33% (19 - 54%)(p = 0.01). Soluble PD-1 levels were not influenced by vitamin D treatment.Conclusions: Vitamin D treatment increases CD4+CD25+int T cells ability to up-regulate PD-1 in response to activation and reduces the CD69 expression in CD patients.

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Section: Discussionsupporting

confidence: 81%

Vitamin D increases programmed death receptor-1 expression in Crohn’s disease

et al. 2017

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“…Out of 1351 citations, 27 articles comprising of 8316 IBD patients met our predefined inclusion and exclusion criteria. The PRISMA flow diagram is presented in Figure .…”

Section: Resultsmentioning

confidence: 99%

“…Figure shows the forest plot of low 25(OH)D status and risk of clinically active disease. For the outcome of clinically active disease, 17 studies met inclusion criteria and included a total of 3143 patients. There was no evidence of publication bias based on funnel plot asymmetry (Figure S1A, Egger's Test P = .768).…”

Section: Resultsmentioning

confidence: 99%

“…Low vitamin D status was defined by vitamin D deficiency thresholds set by individuals studies. Most of our included studies defined low 25(OH)D with a serum level < 20 ng/mL (19 studies). Five studies defined low 25(OH)D as <30 ng/mL.…”

Section: Methodsmentioning

confidence: 99%

“…The same study demonstrated that IBD patients also had increased odds of lower vitamin D levels compared to matched controls. Due to the potential mechanistic link between vitamin D and colitis and the high prevalence of vitamin D deficiency in IBD patients, many groups have sought to examine the impact of vitamin D levels on IBD clinical outcomes, often with conflicting results. Many of these previous studies were limited by their small sample size and inability to detect differences in clinical outcomes between low and high vitamin D groups.…”

Section: Introductionmentioning

confidence: 99%

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Systematic review with meta‐analysis: association of vitamin D status with clinical outcomes in adult patients with inflammatory bowel disease

Gubatan

Chou

Nielsen

et al. 2019

Aliment Pharmacol Ther

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Summary Background Vitamin D deficiency is highly prevalent among patients with IBD, however, data on its association with clinical outcomes are conflicting. Aim To perform a systematic review and meta‐analysis to explore the association of low vitamin D status with clinical outcomes in patients with IBD. Methods We searched PubMed, Embase, Scopus and Web of Science from inception to February 2018 for observational studies evaluating the association of low 25(OH)D status on IBD disease activity, mucosal inflammation, clinical relapse and quality of life. Odds ratios (ORs) were pooled and analysed using a random effects model. Results Twenty‐seven studies were eligible for inclusion comprising 8316 IBD patients (3115 ulcerative colitis, 5201 Crohn's disease). Among IBD patients, low 25(OH)D status was associated with increased odds of disease activity (OR 1.53, 95% CI 1.32‐1.77, I2 = 0%), mucosal inflammation (OR 1.25, 95% CI 1.06‐1.47, I2 = 0%), low quality of life (QOL) scores (OR 1.30, 95% CI 1.06‐1.60, I2 = 0%) and future clinical relapse (OR 1.23, 95% CI 1.03‐1.47, I2 = 0%). In subgroup analysis, low vitamin D status was associated with Crohn's disease activity (OR 1.66, 95% CI 1.36‐2.03, I2 = 0%), mucosal inflammation (OR 1.39, 95% CI 1.03‐1.85, I2 = 0%), clinical relapse (OR 1.35, 95% CI 1.14‐1.59, I2 = 0%), and low QOL scores (OR 1.25, 95% CI 1.04‐1.50, I2 = 0%) and ulcerative colitis disease activity (OR 1.47, 95% CI 1.03‐2.09, I2 = 0%) and clinical relapse (OR 1.20, 95% 1.01‐1.43, I2 = 0%). Conclusions Low 25(OH)D status is a biomarker for disease activity and predictor of poor clinical outcomes in IBD patients.

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Inflammatory biomarkers response to two dosages of vitamin D supplementation in patients with ulcerative colitis: A randomized, double-blind, placebo-controlled pilot study

Karimi

Tabataba-vakili

Ebrahimi‐Daryani

et al. 2020

Clinical Nutrition ESPEN

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Vitamin D Deficiency Increases the Risk for Moderate to Severe Disease Activity in Crohn's Disease Patients in South Africa, Measured by the Harvey Bradshaw Index

Abstract: Low serum 25(OH)D was associated with increased CD activity in a South African cohort.

Cited by 20 publications

References 43 publications

Vitamin D increases programmed death receptor-1 expression in Crohn’s disease

Vitamin D increases programmed death receptor-1 expression in Crohn’s disease

Systematic review with meta‐analysis: association of vitamin D status with clinical outcomes in adult patients with inflammatory bowel disease

Inflammatory biomarkers response to two dosages of vitamin D supplementation in patients with ulcerative colitis: A randomized, double-blind, placebo-controlled pilot study

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