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Sirs,

We read the study of Matricon et al. with great interest.[1] The authors found that immune activation was observed more frequently in irritable bowel syndrome (IBS) patients. IBS is one of the most common gastrointestinal conditions, characterised by chronic abdominal pain, discomfort, bloating and alteration of bowel habits in the absence of any organic cause. There is no effective medical therapy established to alter the natural history of IBS.[2] However, developments in the management of IBS are intriguing.

The pathogenesis of IBS remains uncertain. More recent studies have considered the role of inflammation, alterations in faecal flora and bacterial overgrowth. Chronic, low-grade inflammation of the gastrointestinal mucosa and inappropriate mast cell activation have also been implicated as potential aetiological factors.[2] Elevated levels of plasma proinflammatory interleukins (IL), such as TNF-alpha, IL-1 beta and IL-6, have been observed in patients with IBS.[3] Several medical conditions including headache, fibromyalgia, chronic fatigue syndrome and depression appear with greater frequency in patients diagnosed with IBS. Furthermore, IBS patients are at an increased risk of osteoporosis and related fractures.[4]

A variety of dietary, pharmacological and psychological treatments have been studied in patients with IBS. But there is no proven effective management for IBS. Vitamin D supplementation may have a beneficial effect in IBS patients with anti-proliferative, pro-differentiating, immunomodulatory and anti-inflammatory action.

Besides the effect of vitamin D on bone and mineral metabolism, it also has biological effects by binding to the vitamin D receptor. Vitamin D has been shown to inhibit mononuclear and T lymphocyte cell proliferation by decreasing the production of IL-1beta, IL-2, IL-6, interferon γ, and TNF-alpha. Chronic vitamin D deficiency may have serious adverse consequences, including hypertension, diabetes, autoimmune disorders, multiple sclerosis, infections, neuropsychological functioning, falls and physical performance and cancer.[5] In addition, vitamin D deficiency is common in patients with anxiety, depression and fibromyalgia, which appear with greater frequency in patients with IBS.

All taken together, vitamin D supplementation may have beneficial effect in patients with IBS and vitamin D deficiency, with anti-proliferative, pro-differentiating, immunomodulatory and anti-inflammatory action.

Acknowledgement

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  2. Acknowledgement
  3. References

Declaration of personal and funding interests: None.

References

  1. Top of page
  2. Acknowledgement
  3. References