Ulcerative colitis treated by injection of 300,000 IU of vitamin D – RCT
A randomized controlled trial on the effect of vitamin D3 on inflammation and cathelicidin gene expression in ulcerative colitis patients
The Saudi Journal of Gastroenterology Year : 2016 | Volume : 22 | Issue : 4 | Page : 316-323
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Amrollah Sharifi1, Mohammad Javad Hosseinzadeh-Attar1, Homayoon Vahedi2, Saharnaz Nedjat3
1 Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
2 Digestive Disease Research Center, Digestive Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
3 Department of Epidemiology and Biostatistics, School of Public Health, Knowledge Utilization Research Center, Tehran University of Medical Sciences, Tehran, Iran
Background: Inflammatory bowel disease (IBD) is an intestinal chronic inflammatory condition and includes Crohn's disease (CD) and ulcerative colitis (UC). It has been proposed that Vitamin D supplementation may have a beneficial role in IBD.
Aim: To characterize the effects of Vitamin D on cathelicidin (hCAP/LL37) gene expression, ESR, and serum hs-CRP levels. Materials and Methods: Ninety UC patients on remission were randomized to receive 300,000 IU intramuscular Vitamin D or 1 mL normal saline as placebo, respectively. Before and 90 days after intervention, serum levels of 25 (OH)-Vitamin D3, PTH, Calcium, ESR, and hs-CRP were measured. Cathelicidin gene expression was also quantified using qRT-PCR.
Results: Baseline serum 25-OH-Vitamin D3 levels were not different between the two groups and after intervention, increased only in Vitamin D group (P < 0.001). Hs-CRP levels were lower in Vitamin D group after intervention (Before: 3.43 ± 3.47 vs 3.86 ± 3.55 mg/L, P = 0.56; after: 2.31 ± 2.25 vs 3.90 ± 3.97 mg/L, P= 0.023). ESR decreased significantly in Vitamin D group (Before: 12.4 ± 6.1 vs 12.1 ± 5.3 mm/h, P= 0.77; after: 6.7 ± 4.5 vs 11.4 ± 5.5 mm/h, P< 0.001). The mean fold change in hCAP18 gene expression in Vitamin D group was significantly higher than placebo group. (Mean ± SD: 3.13 ± 2.56 vs 1.09 ± 0.56; median ± interquartile range: 2.17 ± 3.81 vs 0.87 ± 0.53, P<,; 0.001).
Conclusion: Decreases in ESR and hs-CRP levels and increase in LL37 gene expression support the hypothesis that Vitamin D supplementation may have a beneficial role in UC patients.
Ulcerative Colitis reduced by half with probiotic VSL #3
From C o nsumer LABS Sept 2017
Clinical guidelines for the treatment of ulcerative colitis in countries such as South Korea and Canada currently recommend against the use of probiotics for treatment and/or to induce or maintain "complete remission" (Choi, Intest Res 2017 [free PDF]; Bressler, Gastroenterology 2015 [free PDF]). These positions were taken despite an analysis showing that three randomized, controlled trials among people with active ulcerative colitis receiving standard medications found that those who took the probiotic VSL #3 (3.6 trillion cells daily) for an average of 3 months had a higher remission rate compared to those who took placebo (43.8% vs. 24.8%, respectively) (Mardini Inflamm Bowel Dis 2014). The American Gastroenterological Association has not issued an official guideline on the use of probiotics for the treatment of ulcerative colitis, but plans on releasing one in the spring of 2019