Inadequate sunlight exposure in patients with inflammatory bowel disease

Vernia, Piero; Scotti, G; Giudici, A.; Chiappini, A; Cannizzaro, S.; Afferri, Maria Teresa; Carolis, Aurora De

doi:10.1111/1751-2980.12567

Cited by 18 publications

(14 citation statements)

References 27 publications

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“…Very few studies have specifically tested the association of sun exposure prior to disease onset and risk of IBD, and none of these has been in children. Vernia and colleagues showed that adults with IBD had significantly lower sun exposure than non‐IBD age‐ and sex‐matched controls, with lower exposure in those with Crohn's disease than ulcerative colitis . Of note, 25OHD levels were not correlated with self‐reported sun exposure.…”

Section: Associations Of Vitamin D and Sun Exposure With Ibd And Pibdmentioning

confidence: 99%

Low Sun Exposure and Vitamin D Deficiency as Risk Factors for Inflammatory Bowel Disease, With a Focus on Childhood Onset

Holmes

Harris

Lucas

2018

Photochem & Photobiology

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The incidence and prevalence of inflammatory bowel disease (IBD) are increasing worldwide. Some ecological studies show increasing incidence with increasing latitude. Ambient ultraviolet radiation varies inversely with latitude, and sun exposure of the skin is a major source of vitamin D. Vitamin D deficiency is common in patients with IBD. Sun exposure and vitamin D have immune effects that could plausibly reduce, or be protective for, IBD. One quarter of new IBD cases are diagnosed in childhood or adolescence, but most research is for adult-onset IBD. Here, we review the evidence for low sun exposure and/or vitamin D deficiency as risk factors for IBD, focusing where possible on pediatric IBD, where effects of environmental exposures may be clearer. The literature provides some evidence of a latitude gradient of IBD incidence, and evidence for seasonal patterns of timing of birth or disease onset is inconsistent. High prevalence of vitamin D deficiency occurs in people with IBD, but cannot be interpreted as being a causal risk factor. Evidence of vitamin D supplementation affecting disease activity is limited. Further research on predisease sun exposure and well-designed supplementation studies are required to elucidate whether these potentially modifiable exposures are indeed risk factors for IBD.

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Section: Associations Of Vitamin D and Sun Exposure With Ibd And Pibdmentioning

confidence: 99%

Low Sun Exposure and Vitamin D Deficiency as Risk Factors for Inflammatory Bowel Disease, With a Focus on Childhood Onset

Holmes

Harris

Lucas

2018

Photochem & Photobiology

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“…These factors contribute to the high rates of vitamin D insufficiency or deficiency seen worldwide, especially in locations with marked seasonality where the lack of UVB available from sunlight during the winter months prevents vitamin D production. Limited UVB exposure is one of the most important environmental factors linked to the onset of immune mediated chronic inflammatory diseases, like IBD and MS (Nerich et al, 2011; Breuer et al, 2014; Lu et al, 2015; Vernia et al, 2017). A reverse correlation between latitude and disease severity/prevalence is seen for these conditions, especially in northern countries that display high rates of chronic inflammatory diseases.…”

Section: Introductionmentioning

confidence: 99%

Skin Exposure to Narrow Band Ultraviolet (UVB) Light Modulates the Human Intestinal Microbiome

et al. 2019

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The recent worldwide rise in idiopathic immune and inflammatory diseases such as multiple sclerosis (MS) and inflammatory bowel diseases (IBD) has been linked to Western society-based changes in lifestyle and environment. These include decreased exposure to sunlight/UVB light and subsequent impairment in the production of vitamin D, as well as dysbiotic changes in the makeup of the gut microbiome. Despite their association, it is unclear if there are any direct links between UVB light and the gut microbiome. In this study we investigated whether exposing the skin to Narrow Band Ultraviolet B (NB-UVB) light to increase serum vitamin D levels would also modulate the makeup of the human intestinal microbiota. The effects of NB-UVB light were studied in a clinical pilot study using a healthy human female cohort (n = 21). Participants were divided into those that took vitamin D supplements throughout the winter prior to the start of the study (VDS+) and those who did not (VDS−). After three NB-UVB light exposures within the same week, the serum 25(OH)D levels of participants increased on average 7.3 nmol/L. The serum response was negatively correlated to the starting 25-hydroxy vitamin D [25(OH)D] serum concentration. Fecal microbiota composition analysis using 16S rRNA sequencing showed that exposure to NB-UVB significantly increased alpha and beta diversity in the VDS− group whereas there were no changes in the VDS+ group. Bacteria from several families were enriched in the VDS− group after the UVB exposures according to a Linear Discriminant Analysis (LDA) prediction, including Lachnospiracheae, Rikenellaceae, Desulfobacteraceae, Clostridiales vadinBB60 group, Clostridia Family XIII, Coriobacteriaceae, Marinifilaceae, and Ruminococcus. The serum 25(OH)D concentrations showed a correlation with the relative abundance of the Lachnospiraceae, specifically members of the Lachnopsira and Fusicatenibacter genera. This is the first study to show that humans with low 25(OH)D serum levels display overt changes in their intestinal microbiome in response to NB-UVB skin exposure and increases in 25(OH)D levels, suggesting the existence of a novel skin-gut axis that could be used to promote intestinal homeostasis and health.Clinical Trial Registration: clinicaltrials.gov, NCT03962673. Registered 23 May 2019 – Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT03962673?term=NCT03962673&rank=1.

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“…An inverse association between vitamin D levels and the development of IC, CD, and UC has also been demonstrated, indicating a protective role of higher vitamin D levels on IC, CD, and UC [ 29 , 30 ]. Most Vitamin D is synthesized in the skin after exposure to sunlight with only a small amount obtained from food intake, whereas insufficient sunlight exposure is a risk factor for all uveitis (including IC), UC, and CD [ 21 , 31 , 32 ]. The above phenomena suggest that there may be one or more immune-mediated mechanisms that provide a bridge between IBD and IC.…”

Section: Discussionmentioning

confidence: 99%

Association between Inflammatory Bowel Disease and Iridocyclitis: A Mendelian Randomization Study

Meng

Tan

Liu

et al. 2023

JCM

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Background: Iridocyclitis (IC) is a common extraintestinal manifestation of inflammatory bowel disease (IBD). Observational studies showed patients with ulcerative colitis (UC) and Crohn’s disease (CD) both have a higher risk of IC. However, due to the inherent limitations of observational studies, the association and its directionality between the two forms of IBD and IC remain undiscerned. Methods: Genetic variants for IBD and IC were selected as instruments from genome-wide association studies (GWAS) and FinnGen database as instrumental variables, respectively. A bidirectional Mendelian randomization (MR) and multivariable MR were performed successively. Three different MR methods were performed to determine the causal association, including inverse-variance weighted (IVW), MR Egger, and weighted median, whereas IVW was used as the main analysis. Different methods for sensitivity analysis were used, including MR-Egger intercept test, MR Pleiotropy RESidual Sum and Outlier test, Cochran’s Q test, and leave-one-out analysis. Results: Bidirectional MR suggested both UC and CD were positively associated with IC as a whole, acute and subacute IC, and chronic IC. However, in the MVMR analysis, only the association from CD to IC remained stable. In the reverse analysis, no association was observed from IC to UC or CD. Conclusions: Both UC and CD are associated with an increased risk of IC compared with healthy individuals. However, the association between CD and IC is stronger. In the reverse direction, patients with IC do not suffer a higher risk of UC or CD. We emphasize the importance of ophthalmic examinations for IBD patients, especially for CD patients.

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Inadequate sunlight exposure in patients with inflammatory bowel disease

Cited by 18 publications

References 27 publications

Low Sun Exposure and Vitamin D Deficiency as Risk Factors for Inflammatory Bowel Disease, With a Focus on Childhood Onset

Low Sun Exposure and Vitamin D Deficiency as Risk Factors for Inflammatory Bowel Disease, With a Focus on Childhood Onset

Skin Exposure to Narrow Band Ultraviolet (UVB) Light Modulates the Human Intestinal Microbiome

Association between Inflammatory Bowel Disease and Iridocyclitis: A Mendelian Randomization Study

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