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Vitamin D changed microbiota in gut and airway, might reduce cystic fibrosis – RCT Nov 2017

Bolus weekly vitamin D3 supplementation impacts gut and airway microbiota in adults with cystic fibrosis: a double–blind, randomized, placebo-controlled clinical trial

The Journal of Clinical Endocrinology & Metabolism, jc.2017-01983, https://doi.org/10.1210/jc.2017-01983
Mansi Kanhere Jiabei He Benoit Chassaing Thomas R Ziegler Jessica A Alvarez Elizabeth A Ivie Li Hao John Hanfelt Andrew T Gewirtz Vin Tangpricha

Background
Disruption of gut microbiota may exacerbate severity of cystic fibrosis (CF). Vitamin D deficiency is a common co-morbidity in patients with CF that may influence composition of the gut microbiota.

Objectives
Compare microbiota of vitamin D sufficient and insufficient CF patients, and assess impact of a weekly high-dose vitamin D3 bolus regimen on gut and airway microbiome in adults with CF and vitamin D insufficiency (25(OH)D <30 ng/mL).

Design
Forty-one subjects with CF were classified into two groups – vitamin D insufficient (n=23) and vitamin D sufficient (n=18). Subjects with vitamin D insufficiency were randomized to receive 50,000 IU of oral vitamin D3 or placebo weekly for 12 weeks. Sputum and stool samples were obtained pre and post intervention and 16S rRNA genes sequenced using Illumina MiSeq technology.

Results
Gut microbiota differed significantly based on vitamin D status with Gammaproteobacteria, which contain numerous potentially pathogenic species, being enriched in the vitamin D insufficient group. PCoA analysis showed differential gut microbiota composition within the vitamin D insufficient patients following 12 weeks treatment with placebo or vitamin D3 (Permanova = 0.024) with Lactococcus significantly enriched in subjects treated with vitamin D3, whereas Vellionella and Erysipelotrichacea were significantly enriched in patients treated with placebo.

Conclusion
This exploratory study suggests vitamin D insufficiency is associated with alterations in microbiota composition that may promote inflammation and that supplementation with vitamin D has the potential to impact microbiota composition. Additional studies to determine vitamin D’s impact on the microbiota benefits clinical outcomes in CF are warranted.

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