Role of vitamin D on gut microbiota in cystic fibrosis

Abstract

This review explores the potential for vitamin D to favorably alter the gut microbiota, given emerging evidence of the role of vitamin D in controlling mucosal inflammation in the gut. It will focus on cystic fibrosis (CF) patients, a population with both vitamin D deficiency due to gut malabsorption and an altered gut microbiota composition. Recent evidence shows that vitamin D acts to maintain the integrity of the gut mucosal barrier by enhancement of intercellular junctions that control mucosal permeability and reduction of pro-inflammatory cytokines such as IL-8. In addition, vitamin D receptor-mediated signaling has been shown to inhibit inflammation-induced apoptosis of intestinal epithelial cells. As a result of these effects on the intestinal mucosa, maintenance of sufficient vitamin D status may be essential for the development of a healthy gut microbiota, particularly in conditions defined by chronic mucosal inflammation such as CF. We hypothesize here that high dose vitamin D may be used to favorably manipulate the aberrant mucosa seen in patients with CF. This may result in improved clinical outcomes in association with a low inflammatory environment that allows beneficial bacteria to outcompete opportunistic pathogens. Current evidence is sparse but encouraging, and additional evidence is needed to establish vitamin D as a therapeutic approach for gut microbiota modification.

Circulating 25‐hydroxyvitamin D, nasopharyngeal microbiota, and bronchiolitis severity

“…Alternatively, low 25OHD levels are related to up-regulation of proinflammatory cytokines and an impaired epithelial barrier, leading to enhanced inflammation and dysbiosis. 3 Furthermore, we have previously shown that lower circulating 25OHD levels associate with specific nasopharyngeal metabolomic signature – e.g., enriched proinflammatory lipids that can serve as mediators in the microbiome-host interactions in the airways. 2 …”

“…2 Vitamin D compounds have pleiotropic regulatory roles on both innate and adaptive immune responses. 3 Low levels of 25-hydroxyvitamin D (25OHD), the major circulating form of vitamin D, have been found to be associated with higher risk and severity of acute respiratory infections (ARIs) in children. 4 Recent studies also have reported an association of maternal 5 and cord blood 6 vitamin D levels with infant gut microbiota.…”

The Cross-Talk Between Gut Microbiota and Lungs in Common Lung Diseases

“…Due to gut malabsorption, in cystic fibrosis patients, vitamin D deficiency frequently occurs (Sexauer et al, 2015). Given the vital role of vitamin D in mediating gut mucosal inflammation, vitamin D as a therapeutic approach for gut microbiota modification in cystic fibrosis has been attempted (Vanstone et al, 2015;Kanhere et al, 2018). Vitamin D can develop a healthy gut microbiota, maintain the integrity of the gut mucosal barrier, and allow beneficial bacteria to outcompete opportunistic pathogens (Kanhere et al, 2018).…”

“…Given the vital role of vitamin D in mediating gut mucosal inflammation, vitamin D as a therapeutic approach for gut microbiota modification in cystic fibrosis has been attempted (Vanstone et al, 2015;Kanhere et al, 2018). Vitamin D can develop a healthy gut microbiota, maintain the integrity of the gut mucosal barrier, and allow beneficial bacteria to outcompete opportunistic pathogens (Kanhere et al, 2018). Enhancing intercellular junctions, reducing proinflammatory cytokines such as IL-8, and inhibiting apoptosis of intestinal epithelial cells might be involved in the action mechanism of vitamin D (Kanhere et al, 2018).…”

“…Vitamin D can develop a healthy gut microbiota, maintain the integrity of the gut mucosal barrier, and allow beneficial bacteria to outcompete opportunistic pathogens (Kanhere et al, 2018). Enhancing intercellular junctions, reducing proinflammatory cytokines such as IL-8, and inhibiting apoptosis of intestinal epithelial cells might be involved in the action mechanism of vitamin D (Kanhere et al, 2018). Current evidence for the application of vitamin D in patients with cystic fibrosis is encouraging but sparse, and more sufficient evidence is expected.…”