Effects of vitamin D supplementation on intestinal permeability, cathelicidin and disease markers in Crohn’s disease: Results from a randomised double-blind placebo-controlled study
Tara Raftery1
Adrian R Martineau2
Claire L Greiller2
Subrata Ghosh3
Deirdre McNamara4
Kathleen Bennett5
Jon Meddings3
Maria O’Sullivan1⇑
1Department of Clinical Medicine, Trinity Centre for Health Sciences, St. James’s Hospital, Dublin, Ireland
2Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
3Department of Medicine, University of Calgary, Calgary, AB, Canada
4Department of Clinical Medicine, Trinity Centre for Health Sciences, Tallaght Hospital, Dublin, Ireland
5Department of Pharmacology and Therapeutics, Trinity Centre for Health Sciences, St. James’s Hospital, Dublin, Ireland
Maria O’Sullivan, Department of Clinical Medicine, Trinity Centre for Health Sciences, St. James’s Hospital, Dublin 8, Ireland. Email: maria.osullivan at tcd.ie
Background Vitamin D (vitD) supplementation may prolong remission in Crohn’s disease (CD); however, the clinical efficacy and mechanisms are unclear.
Aim To determine changes in intestinal permeability (IP), antimicrobial peptide (AMP) concentrations and disease markers in CD, in response to vitD supplementation.
Methods In a double-blind randomised placebo-controlled study, we assigned 27 CD patients in remission to 2000 IU/day vitD or placebo for 3 mos. We determined IP, plasma cathelicidin (LL-37 in ng/mL), human-beta-defensin-2 (hBD2 in pg/mL), disease activity (Crohn’s Disease Activity Index (CDAI)), C-reactive protein (CRP in mg/L), fecal calprotectin (µg/g), Quality of Life (QoL) and serum 25-hydroxyvitamin D (25(OH)D in nmol/L) at 0 and 3 mos.
Results At 3 mos., 25(OH)D concentrations were significantly higher in those whom were treated (p < 0.001). Intra-group analysis showed increased LL-37 concentrations (p = 0.050) and maintenance of IP measures in the treated group. In contrast, in the placebo group, the small bowel (p = 0.018) and gastro-duodenal permeability (p = 0.030) increased from baseline. At 3 mos., patients with 25(OH)D ≥ 75 nmol/L had significantly lower CRP (p = 0.019), higher QoL (p = 0.037), higher LL-37 concentrations (p < 0.001) and non-significantly lower CDAI scores (p = 0.082), compared to those with levels <75 nmol/L.
Conclusion Short-term treatment with 2000 IU/day vitD significantly increased 25(OH)D levels in CD patients in remission and it was associated with increased LL-37 concentrations and maintenance of IP. Achieving 25(OH)D ≥ 75 nmol/l was accompanied by higher circulating LL-37, higher QoL scores and reduced CRP. Registered at ClinicalTrials.gov (NCT01792388).
Download the PDF from Vitamin D Life
See also Vitamin D Life
- Crohn’s disease helped when vitamin D level raised above 30 ng – RCT Feb 2015
- Overview Gut and vitamin D
- Proof that Vitamin D Works 76 diseases as of Jan 2017
- Search Vitamin D Life for Crohn's 316 items as of June 2015
- Intervention - Vitamin D
which has the following listing for Gut Intervention
- Diverticular disease:12X reduction if low Vitamin D and given 100,000 IU monthly – RCT Aug 2020
- Irritable Bowel Syndrome treated by weekly 50,000 IU Vitamin D – RCT Feb 2019
- Ulcerative Colitis inflammation treated by weekly vitamin D (40,000 IU) – July 2018
- Gut bacteria of Crohn's disease patients improved by Vitamin D – March 2018
- Vitamin D changed microbiota in gut and airway, might reduce cystic fibrosis – RCT Nov 2017
- Crohn's Disease relapse rate of 3 in 8 with 1,000 IU vs 0 in 12 with 10,000 IU of Vitamin D – RCT Feb 2017
- Ulcerative colitis treated by injection of 300,000 IU of vitamin D – RCT July 2016
- IBS quality of life improved by vitamin D (50,000 IU every two weeks) – RCT May 2016
- IBS – 82 percent had low vitamin D, 3,000 IU spray helped a lot – RCT Dec 2015
- Crohn's disease treated by 2000 IU Vitamin D - RCT June 2015
- Crohn’s disease helped when vitamin D level raised above 30 ng – RCT Feb 2015
- Irritable Bowel Syndrome - can it be treated by 3000 IU of vitamin D - RCT Feb 2014
- Crohn's Disease patients normalizing their Vitamin D levels decreased risk of surgery by 44 percent – Aug 2013
- Crohn’s helped by 5000 IU vitamin D – April 2013
See also PubMed
- Vitamin D deficiency and risk factors in children with Crohn's disease July 2015
small intestine involved diseases 5.2X more likely if low vitamin D