scholarly journals Vitamin D and Inflammatory Bowel Disease

2015 ◽  
Vol 2015 ◽  
pp. 1-16 ◽  
Author(s):  
Marco Ardesia ◽  
Guido Ferlazzo ◽  
Walter Fries
Keyword(s):  
Inflammatory Bowel Disease ◽  
Vitamin D ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Vitamin D Receptor ◽  
Bowel Disease ◽  
Vitamin D Levels ◽  
Inflammatory Bowel ◽  
Low Serum

Vitamin D deficiency has been recognized as an environmental risk factor for Crohn’s disease since the early 80s. Initially, this finding was correlated with metabolic bone disease. Low serum 25-hydroxyvitamin D levels have been repeatedly reported in inflammatory bowel diseases together with a relationship between vitamin D status and disease activity. Subsequently, low serum vitamin D levels have been reported in various immune-related diseases pointing to an immunoregulatory role. Indeed, vitamin D and its receptor (VDR) are known to interact with different players of the immune homeostasis by controlling cell proliferation, antigen receptor signalling, and intestinal barrier function. Moreover, 1,25-dihydroxyvitamin D is implicated in NOD2-mediated expression of defensin-β2, the latter known to play a crucial role in the pathogenesis of Crohn’s disease (IBD1 gene), and several genetic variants of the vitamin D receptor have been identified as Crohn’s disease candidate susceptibility genes. From animal models we have learned that deletion of the VDR gene was associated with a more severe disease. There is a growing body of evidence concerning the therapeutic role of vitamin D/synthetic vitamin D receptor agonists in clinical and experimental models of inflammatory bowel disease far beyond the role of calcium homeostasis and bone metabolism.

Vitamin D status in children with inflammatory bowel disease

2021 ◽  
Vol 19 (1) ◽  
pp. 5-10
Author(s):  
I.Yu. Pronina ◽  
◽  
V.S. Tsvetkova ◽  
A.S. Potapov ◽  
E.L. Semikina ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Inflammatory Bowel Disease ◽  
Vitamin D ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Bowel Disease ◽  
Vitamin D Status ◽  
Vitamin D Levels ◽  
Bowel Diseases ◽  
Inflammatory Bowel

Objective. To study vitamin D status in children with inflammatory bowel diseases (IBD) depending on the diagnosis, gender, age and a season of examination. Patients and methods. The study included 244 children (130 boys and 114 girls) aged 3 to 18 years. The patients were divided into 2 groups depending on the nosological form of disease: Crohn’s disease (CD) – 130 children, ulcerative colitis (UC) – 114 children. Blood vitamin D levels were determined by the method of competitive electrochemiluminescence. Results. Normal levels of vitamin D (>30 ng/ml) were found only in 11.1% of children with IBD (in 11.5% with CD and 10.5% with UC). Vitamin D status corresponded to deficiency levels in 65.9% of cases, of them 15.2% had deep deficiency (<10 ng/ml). Vitamin D status decreased with increasing age of the patients (ρ = -0.2686). No statistically significant differences were found in vitamin D levels that would be dependent on the season of examination, neither were they found in groups of patients with CD and UC. Conclusion. The study showed an extremely low vitamin D status in patients with IBD. The problem of assessing vitamin D levels in children with IBD and its monitoring as well as development of individual algorithms for supplementation remains topical. Key words: vitamin D, inflammatory bowel disease, Crohn’s disease, ulcerative colitis, children

Evaluation of Vitamin D Levels and Colonic Expression of the Vitamin D Receptor in Puerto Ricans With Inflammatory Bowel Disease

2015 ◽  
Vol 110 ◽  
pp. S836
Author(s):  
Priscilla M. Medero-Rodriguez ◽  
Yamilka Abreu-Delgado ◽  
Raymond A. Isidro ◽  
Alexandra Gonzalez ◽  
Gil Diaz ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Vitamin D ◽  
Vitamin D Receptor ◽  
Bowel Disease ◽  
Puerto Ricans ◽  
Vitamin D Levels ◽  
Inflammatory Bowel

scholarly journals Treatment of Inflammatory Bowel Disease in Children

1990 ◽  
Vol 4 (7) ◽  
pp. 404-406 ◽  
Author(s):  
D Grant Gall
Keyword(s):  
Ulcerative Colitis ◽  
Inflammatory Bowel Disease ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Enteral Nutrition ◽  
Bowel Disease ◽  
Growth Failure ◽  
Nutritional Therapy ◽  
Inflammatory Bowel

As no curative therapy exists, supportive measures play an important role in the management of patients with inflammatory bowel disease (IBO). Aminosalicylic acid (ASA) compounds and corticosteroids remain the mainstay of medical therapy. Aminosalicylates are recommended for therapy of mild to moderate active ulcerative colitis and for the maintenance of remission in ulcerative colitis. The role of 5-ASA preparations in Crohn's disease is less clear. In granulomatous colitis, 5-ASA therapy is recommended. With the development of new delivery systems, the role for 5-ASA in the treatment of small bowel Crohn's disease is under investigation. Prednisone remains the drug of choice in severe ulcerative colitis and active Crohn's disease. The role of immunosuppressive drugs in pediatric patients is unclear. Nutritional therapy has been an important advance in the treatment of children with Crohn's disease, especially those with growth failure. Nutritional therapy can consist of combined total parenteral and enteral nutrition or enteral nutrition alone. An initial period of total parenteral nutrition followed by a six to eight week course of enteral therapy with a semisynthetic diet has been shown to be effective in the management of patients with severe active disease and growth failure.

scholarly journals Monozygotic twins with Crohn’s disease and ulcerative colitis: a unique case report

Gut ◽  
1997 ◽  
Vol 41 (4) ◽  
pp. 557-560 ◽  
Author(s):  
N P Breslin ◽  
A Todd ◽  
C Kilgallen ◽  
C O’Morain
Keyword(s):  
Inflammatory Bowel Disease ◽  
Crohn’S Disease ◽  
Case Report ◽  
Crohn's Disease ◽  
Bowel Disease ◽  
Monozygotic Twins ◽  
Antineutrophil Cytoplasmic Antibody ◽  
Environmental Agents ◽  
Inflammatory Bowel

Background—A large number of monozygotic and dizygotic twin pairs with inflammatory bowel disease have been reported. To date no twin pair has developed phenotypically discordant inflammatory bowel disease. This case report is the first documented occurrence of discordant inflammatory bowel disease occurring in monozygotic twins.Case report—Twenty two year old identical male twins presented within three months of each other with inflammatory bowel disease that proved to be discordant in overall disease type, disease distribution, clinical course, and histopathological findings. Twin 1 developed a severe pancolitis necessitating total colectomy while twin 2 developed a predominantly distal patchy colitis with frequent granulomas, controlled by aminosalicylates. Twin 1 was antineutrophil cytoplasmic antibody (ANCA) negative at the time of testing while twin 2 (Crohn’s disease) was ANCA positive. Significantly, the twins possessed the HLA type DR3-DR52-DQ2 previously associated with extensive colitis.Conclusion—This case report confirms the important role played by genetic factors in the development of inflammatory bowel disease. It also highlights the crucial role of undetermined environmental agents in dictating disease expression and phenotype.

scholarly journals Intestinal Ultrasound in Inflammatory Bowel Disease: A Valuable and Increasingly Important Tool

2021 ◽  
pp. 1-17
Author(s):  
Catarina Frias-Gomes ◽  
Joana Torres ◽  
Carolina Palmela
Keyword(s):  
Ulcerative Colitis ◽  
Inflammatory Bowel Disease ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Disease Activity ◽  
Bowel Disease ◽  
Response To Therapy ◽  
Inflammatory Bowel

<b><i>Background:</i></b> Intestinal ultrasound is emerging as a non-invasive tool for monitoring disease activity in inflammatory bowel disease patients due to its low cost, excellent safety profile, and availability. Herein, we comprehensively review the role of intestinal ultrasound in the management of these patients. <b><i>Summary:</i></b> Intestinal ultrasound has a good accuracy in the diagnosis of Crohn’s disease, as well as in the assessment of disease activity, extent, and evaluating disease-related complications, namely strictures, fistulae, and abscesses. Even though not fully validated, several scores have been developed to assess disease activity using ultrasound. Importantly, intestinal ultrasound can also be used to assess response to treatment. Changes in ultrasonographic parameters are observed as early as 4 weeks after treatment initiation and persist during short- and long-term follow-up. Additionally, Crohn’s disease patients with no ultrasound improvement seem to be at a higher risk of therapy intensification, need for steroids, hospitalisation, or even surgery. Similarly to Crohn’s disease, intestinal ultrasound has a good performance in the diagnosis, activity, and disease extent assessment in ulcerative colitis patients. In fact, in patients with severe acute colitis, higher bowel wall thickness at admission is associated with the need for salvage therapy and the absence of a significant decrease in this parameter may predict the need for colectomy. Short-term data also evidence the role of intestinal ultrasound in evaluating therapy response, with ultrasound changes observed after 2 weeks of treatment and significant improvement after 12 weeks of follow-up in ulcerative colitis. <b><i>Key Messages:</i></b> Intestinal ultrasound is a valuable tool to assess disease activity and complications, and to monitor response to therapy. Even though longer prospective data are warranted, intestinal ultrasound may lead to a change in the paradigm of inflammatory bowel disease management as it can be used in a point-of-care setting, enabling earlier intervention if needed.

scholarly journals On the Pathogenesis Trail: What Marker B Cell Clones Tell Us about Inflammatory Bowel Disease

1996 ◽  
Vol 10 (2) ◽  
pp. 115-119
Author(s):  
Jonathan Braun ◽  
Yadrira Valles-Ayoub ◽  
Linda Berberian ◽  
Mark Eggena ◽  
Lynn K Gordon ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Inflammatory Bowel Disease ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
B Cell ◽  
Bowel Disease ◽  
Practical Importance ◽  
Cell Clones ◽  
Inflammatory Bowel

Clonal patterns of B cell activity have been recognized in inflammatory bowel disease, most notably in the immunogenetic relationship of perinuclear-antineutrophil cytoplasmic antibodies to ulcerative colitis. Conceptually, this most likely reflects the B cell response to antigens predominating at these sites of mucosal inflammation. Identification of these B cell clones and their antigenic targets may be of pathogenetic and practical importance to diagnosis and treatment. The authors describe strategies to identify such clones, based on recent advances in the characterization and detection of antibody gene products. As an example of this strategy, a clonal detection system was used to identify new marker antibodies potentially useful in the laboratory diagnosis of Crohn’s disease and ulcerative colitis. One surprising outcome of such studies is the unexpected and specific association of the B cell clonal response inCampylobacter jejunienterocolitis and inflammatory bowel disease. By analogy to the pathogenetic role ofHelicobacter pylori-induced mucositis in peptic ulcer disease, this evidence renews attention to the role of Cjejuniin the initiation of ulcerative colitis and Crohn’s disease.

scholarly journals Role of Intestinal Microflora in Initiation and Perpetuation of Inflammatory Bowel Disease

1990 ◽  
Vol 4 (7) ◽  
pp. 271-277 ◽  
Author(s):  
RB Sartor
Keyword(s):  
Inflammatory Bowel Disease ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Bowel Disease ◽  
Autoimmune Response ◽  
Parasitic Infections ◽  
Viral Agent ◽  
Septic Complications ◽  
Inflammatory Bowel

Ulcerative colitis and Crohn's disease occur in regions of the intestine colonized by the highest concentrations of normal flora bacteria and resemble certain chronic bacterial, viral or parasitic infections. However, the role of endogenous and pathogenic bacteria in the induction and perpetuation of chronic idiopathic intestinal inflammation remains controversial. No convincing evidence incriminates a single bacterial, mycobacterial or viral agent as the cause of a high percentage of cases of idiopathic inflammatory bowel disease (IBD). Subtle alterations of luminal microbial flora are nearly impossible to detect, but concentrations of certain anaerobic bacteria, including Bacteroides vulgatus, are increased in active Crohn's disease and correlate with disease activity. Recent investigations suggest mechanisms which bacteria may induce an autoimmune response through molecular mimicry or alterations in host antigens or immunoregulation. Intestinal bacteria contain formylated peptides and cell wall polymers ( endotoxin and peptidoglycan-polysaccharide complexes) which have potent and well characterized inflammatory and immunoregulatory properties and can produce acute and chronic intestinal and systemic inflammation in experimental animals. These proinflammatory molecules are probably absorbed more readily in IBO due ro increased mucosa! permeability during active and perhaps quiescent phases of disease. While the primary mechanisms of intestinal injury remain unknown, it is likely that commensal bacteria and their products amplify and perpetuate the inflammatory response of IBO and may be responsible for extraintestinal manifestations in addition to the frequent septic complications of these diseases.

scholarly journals The Role of Inflammation on Vitamin D Levels in a Cohort of Pediatric Patients With Inflammatory Bowel Disease

2018 ◽  
Vol 67 (4) ◽  
pp. 501-506 ◽  
Author(s):  
Caterina Strisciuglio ◽  
Sabrina Cenni ◽  
Francesca Paola Giugliano ◽  
Erasmo Miele ◽  
Grazia Cirillo ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Vitamin D ◽  
Bowel Disease ◽  
Pediatric Patients ◽  
Vitamin D Levels ◽  
Inflammatory Bowel

scholarly journals P554 Does vitamin D level correlates with disease activity in inflammatory bowel disease patients?

2021 ◽  
Vol 15 (Supplement_1) ◽  
pp. S520-S520
Author(s):  
M Sina ◽  
X Pemaj ◽  
I Akshija ◽  
A Hysa ◽  
A Koçollari ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Vitamin D ◽  
Crohn’S Disease ◽  
Disease Activity ◽  
Clinical Data ◽  
Bowel Disease ◽  
Vitamin D Insufficiency ◽  
Disease Type ◽  
Vitamin D Levels ◽  
Inflammatory Bowel

Abstract Background Vitamin D exerts an important role in the immune regulation. Several studies from the Western countries showed low level of vitamin D among inflammatory bowel disease (IBD) patients. They also showed that vitamin D may have an influence on disease activity. Data from the Eastern Europe are scarce. The aim of this study was to evaluate vitamin D level and the association between vitamin D and disease activity in biologic naïve patients with IBD. Methods This is a prospective study carried out at a tertiary hospital center in Albania from 2016–2020 including consecutive biologics–naïve IBD patients. Demographic and clinical data [age, gender, body mass index (BMI), disease location, extent, activity and duration) were collected. All patients underwent ileocolonoscopy. Vitamin D level and C-reactive protein (CRP) were measured within 2 weeks of their ileocolonoscopy. Montreal classification was used to evaluate the disease extent, while total Mayo score and Crohn’s disease activity index (CDAI) were used to assess disease activity in patients with ulcerative colitis (UC) and Crohn’s disease (CD) respectively. Vitamin D levels were considered as: normal &gt;30ng/ml; insufficient 10–30 ng/ml; deficient &lt;10ng/ml. Results A total of 96 patients were included in this study; mean age was 43.5±15.8 years, 52% females; 85.4% UC, mean disease duration 6.5±5 years. Vitamin D levels ranged from 3–58 ng/mL, with a mean level of 18 ±9.9 ng/ml (CD:17.5±12.4 ng/mL, UC:18.1±9.5, p=0.826). 63/96 patients (66%) had vitamin D deficiency (73.2% UC and 21.4% CD, p&lt;0.001), while 21/96 (22%) had vitamin D insufficiency. There was no significant difference in vitamin D insufficiency and IBD type (p&gt;0.05), although the insufficiency was found higher among CD that UC patients [7/14 (50%) vs 14/82 (17%) respectively]. No statistically significant association was found between vitamin D level and age, gender, BMI, disease type, activity, location, extent and duration. There was a negative correlation between CRP and vitamin D level (r=−0.178, p=0.054). Conclusion Low vitamin D levels are common in biologic-naïve patients with IBD. These levels are not associated with clinical data such as disease type, extent, duration or severity in IBD patients, but it seems that vitamin D influences the presence of inflammation in these patients.

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