Christian Encarnacion

 Introduction. Human Campylobacter jejuni infections comprises most bacterial gastrointestinal illnesses worldwide^1,2. C. jejuni transmissions are primarily foodborne and sequelae of C. jejuni campylobacteriosis also result in autoimmune diseases such as Guillain-Barre Syndrome^1,2. Studies have shown that C. jejuni promotes proinflammatory cytokines that result in debilitating changes to the integrity of the colonic epithelia^3,4. Other studies have indicated the anti-inflammatory benefits of vitamin D against C. jejuni infection as well as suppressing epithelial cell apoptosis^4,5. Additionally, recent clinical trials have shown that benefits of vitamin D supplementation against gastrointestinal diseases^6,7. Methods. An experimental colitis mouse model was utilized to observe inflammatory effects as a result of a gut epithelial vitamin D receptor (VDR) deletion. The efficacy of prophylactic vitamin D treatment four days prior to C. jejuni infection was assessed with an acute campylobacteriosis model. Double-blind placebo-controlled clinical trials were conducted to observe the benefits of vitamin D supplementation in subjects with ulcerative colitis (UC) and intestinal bowel disease (IBD). Results. VDR-deficient mice had more severe diarrhea, higher occurrences of rectal bleeding, and more pronounced ulcerations in the colon⁴. Epithelial VDR signaling attenuates the PUMA-mediated proapoptotic pathway by blocking NF-κB activation, reducing apoptotic cell bodies and inflammation^4,5. Vitamin D also dampens the stimulation of immune cell populations like macrophages and dendritic cells, reducing their pro-inflammatory mediator secretion⁵. Thus, proinflammatory TNF and IFN–γ concentrations were lower in mice receiving prophylactic vitamin D⁵. Likewise, UC patients that received treatment of the one-time shot of vitamin D showed markedly reduced levels of IFN–γ and TNF–α⁶. IBD patients that received vitamin D supplementation showed markedly improved quality of life, as well as reduced frequency and severity of symptoms⁷. Conclusions. C. jejuni campylobacteriosis promotes proinflammatory cytokines and epithelial cell apoptosis, disrupting the colonic epithelia and resulting in symptoms such as abdominal pain and diarrhea. Vitamin D has been shown to block the PUMA-mediated proapoptotic pathway and reduce inflammation. Clinical trials have proven to be an effective supplement for patients suffering from other gastrointestinal diseases to reduce inflammation and frequency of symptoms.

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4. He L, Liu T, Shi Y, et al. Gut epithelial vitamin D receptor regulates microbiota-dependent mucosal inflammation by suppressing intestinal epithelial cell apoptosis. Endocrinology. 2018;159(2):967-979.https://www.ncbi.nlm.nih.gov/pubmed/29228157. doi: 10.1210/en.2017-00748.
5. Mousavi S, Lobo de Sá, Fábia Daniela, Schulzke J, Bücker R, Bereswill S, Heimesaat MM. Vitamin D in acute Campylobacteriosis–Results from an intervention study applying a clinical campylobacter jejuni induced enterocolitis model. Frontiers in Immunology. 2019;10.http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=6735268&tool=pmcentrez&rendertype=abstract. doi: 10.3389/fimmu.2019.02094.
6. Sharifi A, Vahedi H, Nedjat S, Rafiei H, Hosseinzadeh‐Attar MJ. Effect of single‐dose injection of vitamin D on immune cytokines in ulcerative colitis patients: A randomized placebo‐controlled trial. APMIS. 2019;127(10):681-687. https://onlinelibrary.wiley.com/doi/abs/10.1111/apm.12982. doi: 10.1111/apm.12982.
7. Abbasnezhad A, Amani R, Hajiani E, Alavinejad P, Cheraghian B, Ghadiri A. Effect of vitamin D on gastrointestinal symptoms and health‐related quality of life in irritable bowel syndrome patients: A randomized double‐blind clinical trial. Neurogastroenterology & Motility. 2016;28(10):1533-1544. https://onlinelibrary.wiley.com/doi/abs/10.1111/nmo.12851. doi: 10.1111/nmo.12851.