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Crohn’s disease helped when vitamin D level raised above 30 ng – RCT Feb 2015

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

United European Gastroenterology Journal February 11, 2015 2050640615572176
Tara Raftery 1, Adrian R Martineau 2, Claire L Greiller 2, Subrata Ghosh 3, Deirdre McNamara 4, Kathleen Bennett 5, Jon Meddings 3, Maria O’Sullivan 1
1 Department of Clinical Medicine, Trinity Centre for Health Sciences, St. James’s Hospital, Dublin, Ireland
2 Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
3 Department of Medicine, University of Calgary, Calgary, AB, Canada
4 Department of Clinical Medicine, Trinity Centre for Health Sciences, Tallaght Hospital, Dublin, Ireland
5 Department 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.maria.osullivan at tcd.ie

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VitaminDWiki Summary and comment
  • 8 of the 12 participants got to a level > 30 ng in 3 months in winter
  • Many disease trials using vitamin D supplementation find 40 ng benefits are much better than those at 30 ng
  • PDF noted that results were better at 40 ng, but they did not have enough participants getting to that level to make statistically significant conclusions
  • Probably have gotten much better results if get > 40 ng by one or more of the following
  1. Used a form of vitamin D designed for use with poor gut function
  2. Used more IU/day - say >3,000 IU
  3. Used a loading dose
  4. Used cofactors – such as Vitamin K2
  5. Trial lasting more than 3 months

See also VitaminDWiki

 Download the PDF from VitaminDWiki.

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).

Attached files

ID Name Comment Uploaded Size Downloads
5060 Chron's QoL.jpg admin 17 Feb, 2015 12.28 Kb 1394
5059 Chron's.jpg admin 17 Feb, 2015 69.30 Kb 1440
5058 Crohn’s disease RCT.pdf admin 17 Feb, 2015 408.36 Kb 1478