The role of vitamin D in inflammatory bowel disease: a guide for clinical practice

Expert Rev Gastroenterol Hepatol. 2020 Jul;14(7):539-552. doi: 10.1080/17474124.2020.1775580. Epub 2020 Jun 16.

Abstract

Introduction: Inflammatory bowel disease (IBD) is a chronic inflammatory condition of the gastrointestinal tract that carries significant morbidity and mortality. Given the need to identify modifiable risk factors to prevent IBD development and to mitigate disease severity, vitamin D has become a major candidate of interest.

Areas covered: In this review, we discuss the regulatory role played by vitamin D in intestinal immune homeostasis, updates in the recent literature exploring its role in de novo IBD pathogenesis and established IBD activity. We also discuss societal recommendations on its therapeutic role in maintaining bone health and future directions for studying its role in regulating disease activity.

Expert opinion: In contrast to findings from earlier studies suggesting a causal role in IBD, recent findings indicate that vitamin D deficiency may be a sequela rather than a cause of IBD. Additionally, clinical trials exploring vitamin D therapy in reducing disease activity remain inconclusive thus far, with the current evidence best supporting a therapeutic role of vitamin D in bone health. Future studies are needed to clarify the role of vitamin D in IBD development and disease activity and to determine its therapeutic potential for IBD disease activity.

Keywords: Crohn’s disease; Inflammatory bowel disease; bone health; cholecalciferol; ergocalciferol; immunotherapy; ulcerative colitis; vitamin D.

MeSH terms

  • Bone and Bones / metabolism
  • Disease Progression
  • Gastrointestinal Tract* / drug effects
  • Gastrointestinal Tract* / immunology
  • Gastrointestinal Tract* / metabolism
  • Gastrointestinal Tract* / physiopathology
  • Homeostasis
  • Humans
  • Inflammatory Bowel Diseases* / drug therapy
  • Inflammatory Bowel Diseases* / etiology
  • Inflammatory Bowel Diseases* / immunology
  • Inflammatory Bowel Diseases* / physiopathology
  • Vitamin D Deficiency* / drug therapy
  • Vitamin D Deficiency* / immunology
  • Vitamin D Deficiency* / physiopathology
  • Vitamin D* / metabolism
  • Vitamin D* / pharmacology
  • Vitamin D* / physiology

Substances

  • Vitamin D