This uncommissioned review article was subject to full peer-review.
Review article: vitamin D and inflammatory bowel disease – established concepts and future directions
Article first published online: 12 JUN 2012
© 2012 Blackwell Publishing Ltd
Alimentary Pharmacology & Therapeutics
Volume 36, Issue 4, pages 324–344, August 2012
How to Cite
Garg, M., Lubel, J. S., Sparrow, M. P., Holt, S. G. and Gibson, P. R. (2012), Review article: vitamin D and inflammatory bowel disease – established concepts and future directions. Alimentary Pharmacology & Therapeutics, 36: 324–344. doi: 10.1111/j.1365-2036.2012.05181.x
- Issue published online: 16 JUL 2012
- Article first published online: 12 JUN 2012
- Manuscript Accepted: 25 MAY 2012
- Manuscript Revised: 24 MAY 2012
- Manuscript Revised: 11 MAY 2012
- Manuscript Received: 18 APR 2012
Understanding of the role of vitamin D in health and disease has increased markedly in the past decade, with its involvement extending well beyond traditional roles in calcium and phosphate homeostasis and musculoskeletal health. This conceptual expansion has been underpinned by identification and exploration of components of this axis including vitamin D-binding protein, key enzymes and receptors in multiple cell types, and a greater recognition of nonclassical autocrine and paracrine effects. Its influence in IBD remains uncertain.
To review the role of vitamin D in bone health, immune regulation and cancer prevention in IBD, and to outline practical issues and limitations of its use.
An extensive online literature review including PubMed and Medline.
In patients with IBD, the vitamin D axis provides an important and often underutilised pathway to preserving bone health. Furthermore, an exciting body of clinical and basic science research demonstrates that these pathways may have an integral part to play in regulation of the immune response in IBD, through effects on the intestinal barrier, antigen presenting cells and adaptive T cells. The possibility of chemoprevention requires further study. The optimal target level of 25-hydroxy vitamin D in patients with IBD is currently uncertain, as is the best therapeutic modality.
Study of vitamin D pathways may result in the development of relatively inexpensive therapeutic options to optimise patient outcomes. Further prospective clinical research is required to address efficacy and long-term safety.