ABSTRACT
The aim of the study was to assess the effectiveness of vitamin D[3] [1, 25[OH][2]D[3]] treatment in IBD with regard to tumor necrosis factor-alpha [TNF-alpha] serum level and clinical disease activity index [CDAI]. Vitamin D has immune-regulatory functions in experimental inflammatory bowel disease [IBD] and vitamin D deficiency is common in IBD patients. This was a randomized clinical trial on 108 IBD patients with serum 25-OHD levels less than 30ng/ml, which divided into vitamin D and control groups. Vitamin D group received 50000 IU vitamin D[3] for 12 weeks. Before and after the study, TNF-alpha and 25-OHD serum levels were measured by ELISA method. Data were analyzed using paired t-test, chi-square test and Spearman correlation coefficient. P-values less than 0.05 were considered statistically significant. Before the intervention no significant difference was found between baseline characteristics and TNF-alpha serum level of two groups. After intervention TNF-alpha serum level reduced but this reduction was not statistically significant [p=0.07, 95% CI: -0.45 to 8.14]. The mean serum 25-OHD level of vitamin D increased from 15.54 to 67.89, which was statistically significant [p= 0.00, 95% CI: -61.40 to -43.30]. TNF-alpha level was also associated significantly with CDAI before [Spearman's rho: 0.3, p<0.0001] and after [Spearman's rho: 0.27, P=0.01] intervention. Oral supplementation vitamin D[3] significantly increased serum vitamin D levels and insignificantly reduced serum TNF-alpha level. More studies with larger samples would be beneficial to assess vitamin D[3] supplementation efficient effect in IBD
ABSTRACT
Inflammatory bowel disease [IBD] is a chronic disease of unknown etiology, in which genetic factors, seem to play an important role in the disease predisposition and course. Assessment of tumor necrosis factor [TNF- alpha] gene polymorphisms in many populations showed a possible association with IBD. Considering the genetic variety in different ethnic groups, the aim of the present study was to investigate the association of five important single nucleotide polymorphisms [SNPs] in the promoter region of [TNF- alpha] gene with IBD in Iran. In this case-control study, 156 Ulcerative colitis [UC] patients, 50 Crohn's disease [CD] patients and 200 sex and age matched healthy controls of Iranian origin were enrolled. The study was performed during a two year period [2008-2010] at Taleghani Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran. DNA samples were evaluated for [TNF- alpha] gene polymorphisms [including -1031, -863, -857, -308 and -238] by PCR and RFLP methods. The frequency of the mutant allele of -1031 polymorphism was significantly higher in Iranian patients with Crohn's disease compared to healthy controls [P=0.01, OR=1.92; 95% CI: 1.14-3.23]. None of the other evaluated polymorphisms demonstrated a significant higher frequency of mutant alleles in Iranian IBD patients compared to controls. Among the five assessed [SNPs], only -1031 polymorphism of [TNF- alpha] gene may play a role in disease susceptibility for Crohn's disease in Iran. This pattern of distribution of [TNF- alpha] gene polymorphisms could be specific in this population