Table of contents
- Nutraceuticals for the Treatment of IBD: Current Progress and Future Directions
- Clipped from the PDF
- Vitamin D Life pages containing Nutraceuticals in title (3 as of June 2022)
- Many gut trials have failed because they did not use Gut-Friendly Vitamin D
- IBS or IBD or IRRITABLE BOWEL in 39 Vitamin D Life titles as of June 2022
- IBD and Vitamin C
- Nutraceutical in Wikipedia
Nutraceuticals for the Treatment of IBD: Current Progress and Future Directions
Front Nutr. 2022 Jun 6;9:794169. doi: 10.3389/fnut.2022.794169
Quan-Yao Ban 1, Mei Liu 1, Ning Ding 1, Ying Chen 2, Qiong Lin 2, Juan-Min Zha 1, Wei-Qi He 1 3
PDF Table of Contents
Inflammatory bowel disease (IBD) is a chronic relapsing-remitting inflammatory disease of the gastrointestinal tract. Patients are usually diagnosed in adolescence and early adulthood and need lifelong treatment. In recent years, it has been found that diet plays an important role in the pathogenesis of IBD. Diet can change intestinal barrier function, affect the structure and function of intestinal flora, and promote immune disorder, thus promoting inflammation. Many patients believe that diet plays a role in the onset and treatment of the disease and changes their diet spontaneously. This review provides some insights into how nutraceuticals regulate intestinal immune homeostasis and improve intestinal barrier function. We reviewed the research results of dietary fiber, polyphenols, bioactive peptides, and other nutraceuticals in the prevention and treatment of IBD and sought better alternative or supplementary treatment methods for IBD patients.
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Vitamin D
Vitamin D is a fat-soluble steroid hormone that is divided into vitamin D2 and vitamin D3. The main source of the human body is vitamin D3 synthesized by keratinocytes in the sun. When lack of sunlight leads to insufficient endogenous vitamin D production, vitamin D can be directly taken in through a daily diet or nutritional supplement. Only activated vitamin D plays a physiological role. Vitamin D is absorbed in the small intestine, transported to the liver and converted into 25(OH)D, finally forming its active form in the kidney in 1,25 dihydroxyl vitamin D(1,25 (OH)2D). Vitamin D, as a pleiotropic hormone, not only contributes to the absorption of calcium and phosphate but also plays a vital role in maintaining intestinal immune homeostasis and intestinal barrier function (105).
Vitamin D/VDR Axis
Vitamin D and vitamin D receptor (VDR) combine and transcribe related genes, which play a role in immune regulation. When microorganisms invade epithelial cells, vitamin D/VDR signal transduction activates various immune cells, which ensures the elimination of bacteria. Then, vitamin D regulates the expression of proinflammatory factors by promoting Treg cell production of IL-10 and inhibiting Th1/Th17, thus regulating the excessive immune response (106-108). In this way, vitamin D can limit the inflammatory reaction and avoid mucosal injury. Therefore, the vitamin D/VDR axis is considered to be helpful to maintain intestinal immune homeostasis. In addition, the vitamin D signaling pathway regulates the tight junctions of intestinal epithelial cells, promotes the expression of antibacterial peptides, and improves intestinal barrier function (109).
Vitamin D and IBD Prognosis
Vitamin D deficiency is a predictor of poor prognosis for IBD. Data show that low vitamin D levels in IBD patients are related to an increase in disease activity, hospitalization, and medication (110, 111). In a recent meta-analysis and systematic review, the author thinks that increasing vitamin D levels could reduce the recurrence of IBD disease and improve the quality of life of patients, such as improving bone pain and self-health. This conclusion is consistent with previous studies (105). A previous randomized controlled trial showed that low vitamin D levels before diagnosis were not associated with IBD, while postdiagnosis low vitamin D levels were associated with IBD. The researchers believed that vitamin D deficiency has nothing to do with the pathogenesis of IBD, and it is not recommended to supplement unnecessary vitamin D to prevent disease (112). In an umbrella review of meta-analyses, the authors reviewed the observational studies on environmental factors and IBD risk and concluded that vitamin D deficiency increased the risk of IBD (113). At present, there is no consensus on whether vitamin D deficiency is the cause or a consequence of IBD. However, maintaining a normal serum 25(OH)D level can improve the prognosis of IBD patients, which has been widely recognized. In addition, for patients treated with anti-TNF-a drugs, supplementation with vitamin D improves the response to medicine (114). Evidence suggests that vitamin D can reduce serum hepcidin levels in children with IBD and reduce the risk of anemia (115).
Because steroid drugs have adverse effects on the bones of patients, it is very important to improve bone health by supplementing vitamin D. Decreased sunlight exposure caused by immunosuppressive therapy can also lead to decreased vitamin D levels. The detection of serum 25(OH)D levels should be a basic component of IBD management. At present, there is no consensus on the level of serum 25(OH)D that should be maintained for IBD patients (116). The main circulating form of vitamin D, 25(OH)D, mainly exists in the form of combining with protein, and a few exist in the form of free (117). Some scholars believe that measuring the free serum 25(OH)D level instead of the total serum 25(OH)D level may be a more effective !!!!!method to reflect vitamin D status (114).
VDR, a New Target
In the DSS-induced colitis model, a lack of VDR leads to overexpression of Claudin-2 protein, and intestinal permeability increases. Researchers have shown that upregulation of VDR gene expression can alleviate inflammation in IBD patients, while vitamin D status does not affect the expression of VDR in the intestinal tract (118). Paradoxically, a recent animal experiment found that specific knockout of the VDR gene could prevent oxazolone-induced colitis. The related mechanisms include inhibition of the immune response mediated by Th2 cells and the influence of natural killer T-cells (119). These studies provide evidence for developing new therapeutic targets, that is, regulating VDR expression in intestinal epithelial cells (120). Assuming that vascular dementia has a protective effect on IBD, whether vitamin D supplements can increase vascular dementia and improve the severity of IBD needs further study.
Vitamin D Life pages containing Nutraceuticals in title (3 as of June 2022)
Many gut trials have failed because they did not use Gut-Friendly Vitamin D
IBS or IBD or IRRITABLE BOWEL in 39 Vitamin D Life titles as of June 2022
IBD and Vitamin C
- Vitamin C Deficiency in Inflammatory Bowel Disease: The Forgotten Micronutrient - Oct 2021 PDF
Nutraceutical in Wikipedia
https://en.wikipedia.org/wiki/Nutraceutical June 2022
- "The word "nutraceutical" is a portmanteau of the words "nutrition" and "pharmaceutical", coined in 1989"
- "Nutraceuticals are products derived from food sources that are purported to provide extra health benefits, in addition to the basic nutritional value found in foods. Depending on the jurisdiction, products may claim to prevent chronic diseases, improve health, delay the aging process, increase life expectancy, or support the structure or function of the body"