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Vitamin D levels in Crohn’s disease responded to disease activity, anti-TNF therapy
Low serum vitamin D levels were associated with disease activity in patients with Crohn’s disease, and the levels increased after anti-tumor necrosis factor therapy, according to new data.
Researchers enrolled 37 patients, 20 with active Crohn’s disease (CD) and 17 in remission. One subset of the cohort was enrolled before taking infliximab, with Harvey-Bradshaw Index (HBI) scores and vitamin D measured at enrollment and after 2 weeks. At enrollment, mean serum vitamin D levels in patients with active disease were 27 ng/mL (±2) compared with 38 ng/mL (±3) in remission patients (P=.02), independent of season or reported use of vitamin D supplements. Vitamin D levels were associated with HBI scores (P=.005), but not C-reactive protein. An HBI score greater than 5 was characterized as “active” disease.
Peripheral blood T cells from patients with active disease exhibited higher expression of the vitamin D receptor compared with those of patients in remission. With vitamin D, the proportion of CD25hi CD4+ cells increased in patients with CD.
The average increase in post-infliximab serum vitamin D levels was similar in both responders (15 ng/mL) and nonresponders (18 ng/mL), suggesting that initial vitamin D level improvements were independent of symptom scores.
“From a clinical viewpoint, low levels of vitamin D should not be interpreted in isolation, but in the context of the patient’s disease activity at that time, and warrant repeated testing once in remission,” the investigators wrote.
Disclosure: The researchers report no relevant financial disclosures.