The importance and implications of serum levels of vitamin D in patients affected with Crohn’s Disease (CD) was recently discussed in a report published in the online journal Inflammatory Bowel Diseases (Official Journal of the Crohn’s and Colitis Foundation of America, Inc., March 27, 2014). This study was led by Maggie Ham, MD, and Maria S. Longhi, MD, PhD.
CD is a form of Inflammatory Bowel Disease (IBD), which can affect any part of the gastrointestinal tract (GIT), from the mouth to the rectum. Common symptoms of the disease include abdominal pain, diarrhea, weight loss, and anemia among others.
Diagnosis for Crohn’s Disease involves evaluation of active phase markers (including C-reactive protein levels, Erythrocyte sedimentation rate, and assessment of other inflammatory markers), nutritional status and physiological examinations, and scans of the GIT (endoscopy, computed tomography scanning, colonoscopy, etc.).
Since CD is an inflammatory disease, the affected areas are infiltrated with lymphocytes (including Natural Killer, cytotoxic and humoral immunity cells), especially during the acute phase. This study assessed the implications of vitamin D levels in people with CD, with respect to the amount of immune cells.
The study involved collection of blood samples from 37 patients, 20 of them being diagnosed with active CD and the remaining 17 presenting with remissions. Their Harvey Bradshaw Index (HBI – an assessment of gut health with respect to bowel movements and motion) and vitamin D levels were measured before and after two weeks of treatment with infiximab (an immunomodulator with anti-tumor necrosis factor properties). Before treatment with infiximab, the serum levels of patients with active disease was less compared to those with remissions.
Enzyme Linked Immunoassay (ELISA) was used to detect serum levels of vitamin D both before and after treatment. Gene expression for vitamin D receptors was also evaluated in CD4+ T cells in peripheral bloodstream and they were found to be more in patients with the acute disease after treatment with infiximab. There was a considerable rise in vitamin D levels of both groups after administration of infiximab, which correlated with the HBI but not that of C-Reactive Protein.
This study showed that low vitamin D levels are associated with CD, but the severity of the condition and its clinical significance cannot be assessed solely on the basis of this. It can be an indicator for the nutritional stability and a strong contender for supportive therapy in patients affected with CD. Also, immunomodulatory treatment increased serum levels of vitamin D in CD.