Vitamin D is a potential treatment for the management of gastrointestinal mucositis

Abstract

Purpose of the review Gastrointestinal mucositis (GM) is a severe side effect of cancer treatments, negatively impacting the patient’s quality of life, and has limited treatment. GM consists of complex biological processes involving apoptosis and inflammation, leading to damage and ulceration of the gastrointestinal system. Recently, vitamin D has been shown to have multiple roles in the gut, including immunomodulation, epithelial barrier regulation and microbiome regulation. Hence, this review aims to put forth vitamin D as a potential therapeutic due to its protective role in the intestine. Recent findings Recent studies have shown that vitamin D can reduce intestinal inflammation by reducing NF-κB (nuclear factor kappa-light-chain-enhancer of activated B cells) activation. Vitamin D also targets and maintains the intestinal epithelial barrier via the tight junction protein expression and the inhibition of microbiome translocation. Significant evidence also suggests that vitamin D exerts multiple therapeutic effects through binding to vitamin D receptors (VDRs), and the downregulation of VDR has been associated with the severity of the disease. Additionally, vitamin D deficiency is reported in cancer patients. Summary There is a dire need for effective treatment for GM, and recent animal and human studies show that vitamin D may be a potential therapy to prevent or treat GM.

Gastrointestinal mucositis: a sign of a (systemic) inflammatory response

“…Bacillus coagulans MZY531 ameliorated CYP-induced intestinal mucosal injury and inflammation by upregulating the ZO-1 pathway and downregulating the expression of the TLR4/MyD88/NF-ĸB pathway [52]. Unfortunately third-party fecal microbiota transplantation in hematology patients was safe but did not decrease infections in this randomized double-blind phase II trial [53 ▪ ]. Diet components such as vitamin D are promising as prebiotics often in combination, and result in downregulation of inflammation and harnessing integrity [54].…”