Bolus Weekly Vitamin D-3 Supplementation Impacts Gut and Airway Microbiota in Adults With Cystic Fibrosis: A Double-Blind, Randomized, Placebo-Controlled Clinical Trial

作者：Kanhere Mansi; He Jiabei; Chassaing Benoit; Ziegler Thomas R; Alvarez Jessica A; Ivie Elizabeth A; Hao Li; Hanfelt John; Gewirtz Andrew T; Tangpricha Vin^*

来源：Journal of Clinical Endocrinology & Metabolism, 2018, 103(2): 564-574.

DOI：10.1210/jc.2017-01983

Context: Disruption of gut microbiota may exacerbate severity of cystic fibrosis (CF). Vitamin D deficiency is a common comorbidity 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 D-3 bolus regimen on gut and airway microbiome in adults with CF and vitamin D insufficiency (25-hydroxy vitamin 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 D-3 or placebo weekly for 12 weeks. Sputum and stool samples were obtained pre- and postintervention and 16S ribosomal RNA genes sequenced using Illumina MiSeq technology.
Results: Gut microbiota differed significantly based on vitamin D status with Gammaproteobacteria, which contain numerous, potentially pathogenic species enriched in the vitamin D-insufficient group. Principal coordinates analysis showed differential gut microbiota composition within the vitamin D-insufficient patients following 12 weeks treatment with placebo or vitamin D-3 (permutation multivariate analysis of variance = 0.024), with Lactococcus significantly enriched in subjects treated with vitamin D-3, whereas Veillonella and Erysipelotrichaceae were significantly enriched in patients treated with placebo.
Conclusion: This exploratory study suggests that 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 the impact of vitamin D on microbiota benefit clinical outcomes in CF are warranted.

• 出版日期2018-2