Higher plasma vitamin D is associated with reduced risk of Clostridium difficile infection in patients with inflammatory bowel diseases.


BACKGROUND:Patients with inflammatory bowel diseases (IBD) have an increased risk of clostridium difficile infection (CDI). Cathelicidins are anti-microbial peptides that attenuate colitis and inhibit the effect of clostridial toxins. Plasma calcifediol [25(OH)D] stimulates production of cathelicidins. AIM:To examine the association between plasma 25(OH)D and CDI in patients with IBD. METHODS:From a multi-institutional IBD cohort, we identified patients with at least one measured plasma 25(OH)D. Our primary outcome was development of CDI. Multivariate logistic regression models adjusting for potential confounders were used to identify independent effect of plasma 25(OH)D on risk of CDI. RESULTS:We studied 3188 IBD patients of whom 35 patients developed CDI. Patients with CDI-IBD were older and had greater co-morbidity. The mean plasma 25(OH)D level was significantly lower in patients who developed CDI (20.4 ng/mL) compared to non-CDI-IBD patients (27.1 ng/mL) (P = 0.002). On multivariate analysis, each 1 ng/mL increase in plasma 25(OH)D was associated with a 4% reduction in risk of CDI (OR 0.96, 95% CI 0.93-0.99, P = 0.046). Compared to individuals with vitamin D >20 ng/mL, patients with levels <20 ng/mL were more likely to develop CDI (OR 2.27, 95% CI 1.16-4.44). The mean plasma 25(OH)D in patients with CDI who subsequently died was significantly lower (12.8 ± 8.1 ng/mL) compared to those who were alive at the end of follow-up (24.3 ± 13.2 ng/mL) (P = 0.01). CONCLUSIONS:Higher plasma calcifediol [25(OH)D] is associated with reduced risk of C. difficile infection in patients with IBD. Further studies of therapeutic supplementation of vitamin D in patients with inflammatory bowel disease and C. difficile infection may be warranted.


Aliment Pharmacol Ther


Ananthakrishnan AN,Cagan A,Gainer VS,Cheng SC,Cai T,Szolovits P,Shaw SY,Churchill S,Karlson EW,Murphy SN,Kohane I,Liao KP




Has Abstract


2014-05-01 00:00:00












  • Increased intestinal permeability and NOD2 variants in familial and sporadic Crohn's disease.

    abstract:BACKGROUND:Abnormal barrier function may be genetically determined in Crohn's disease. AIM:To examine the role of abnormal intestinal permeability in genetic predisposition in multiplex vs. sporadic Crohn's disease families. METHODS:Intestinal permeability was measured in patients, relatives and partners by means of ...

    journal_title:Alimentary pharmacology & therapeutics

    pub_type: 杂志文章,多中心研究


    authors: D'Incà R,Annese V,di Leo V,Latiano A,Quaino V,Abazia C,Vettorato MG,Sturniolo GC

    更新日期:2006-05-15 00:00:00

  • Diffusion-weighted magnetic resonance imaging is effective to detect ileocolonic ulcerations in Crohn's disease.

    abstract:BACKGROUND:Magnetic resonance entero-colonography enables accurate assessment of ileocolonic Crohn's disease, but the need for bowel cleansing and rectal enema limits considerably its use in daily practice. AIM:We evaluated the accuracy of diffusion-weighted magnetic resonance entero-colonography with neither bowel cl...

    journal_title:Alimentary pharmacology & therapeutics

    pub_type: 杂志文章


    authors: Buisson A,Hordonneau C,Goutte M,Boyer L,Pereira B,Bommelaer G

    更新日期:2015-08-01 00:00:00

  • Effects of lactulose and polyethylene glycol on colonic transit.

    abstract:BACKGROUND:The effects of lactulose and polyethylene glycol on colonic transit are poorly established. AIM:To assess the effects of these laxatives on colonic transit in normal subjects. METHODS:Colonic transit (mean residence time, cumulative counts in stool, counts remaining in the proximal or distal colon) was mea...

    journal_title:Alimentary pharmacology & therapeutics

    pub_type: 临床试验,杂志文章


    authors: Fritz E,Hammer HF,Lipp RW,Högenauer C,Stauber R,Hammer J

    更新日期:2005-02-01 00:00:00

  • Mycophenolate mofetil in refractory inflammatory bowel disease.

    abstract:BACKGROUND:Mycophenolate mofetil has been claimed to be effective and well tolerated in refractory inflammatory bowel disease although there is little information regarding its use in clinical practice. AIM:To review our experience in achieving and maintaining remission in refractory inflammatory bowel disease and to ...

    journal_title:Alimentary pharmacology & therapeutics

    pub_type: 杂志文章


    authors: Ford AC,Towler RJ,Moayyedi P,Chalmers DM,Axon AT

    更新日期:2003-06-01 00:00:00

  • The prevalence of irritable bowel syndrome-type symptoms in paediatric inflammatory bowel disease, and the relationship with biochemical markers of disease activity.

    abstract:BACKGROUND:A large proportion (25-46%) of adults with inflammatory bowel disease in remission has symptoms of irritable bowel syndrome (IBS), which are thought to reflect ongoing inflammation. Data on paediatric inflammatory bowel disease patients are lacking. AIM:To investigate (i) the prevalence of IBS-type symptoms...

    journal_title:Alimentary pharmacology & therapeutics

    pub_type: 杂志文章


    authors: Diederen K,Hoekman DR,Hummel TZ,de Meij TG,Koot BG,Tabbers MM,Vlieger AM,Kindermann A,Benninga MA

    更新日期:2016-07-01 00:00:00

  • Review article: Long-term Helicobacter pylori infection--from gastritis to gastric cancer.

    abstract::An analysis carried out in 1994 by the WHO International Agency for Research on Cancer (IARC) resulted in Helicobacter pylori being designated as a Group 1 carcinogen and thus clearly having an association with the development of gastric cancer. In the case of H. pylori, the evaluation was made solely on the basis of ...

    journal_title:Alimentary pharmacology & therapeutics

    pub_type: 杂志文章,评审


    authors: Asaka M,Kudo M,Kato M,Sugiyama T,Takeda H

    更新日期:1998-02-01 00:00:00

  • Intragastric acid control in non-steroidal anti-inflammatory drug users: comparison of esomeprazole, lansoprazole and pantoprazole.

    abstract:BACKGROUND:Studies to date have not directly compared the pharmacodynamic efficacies of different proton pump inhibitors in controlling intragastric acidity in patients treated with non-steroidal anti-inflammatory drugs. AIM:To compare acid suppression with once-daily esomeprazole 40 mg, lansoprazole 30 mg and pantopr...

    journal_title:Alimentary pharmacology & therapeutics

    pub_type: 杂志文章,多中心研究,随机对照试验


    authors: Goldstein JL,Miner PB Jr,Schlesinger PK,Liu S,Silberg DG

    更新日期:2006-04-15 00:00:00

  • H2-antagonist maintenance therapy versus Helicobacter pylori eradication in patients with chronic duodenal ulcer disease: a prospective study.

    abstract:BACKGROUND:Few outcome studies directly compare Helicobacter pylori eradication therapy with maintenance H2-antagonist therapy in duodenal ulcer disease. AIM:To examine prospectively the efficacy of H. pylori eradication therapy with ranitidine maintenance therapy over 1 year in patients with confirmed chronic duodena...

    journal_title:Alimentary pharmacology & therapeutics

    pub_type: 临床试验,杂志文章,随机对照试验


    authors: Prach AT,Malek M,Tavakoli M,Hopwood D,Senior BW,Murray FE

    更新日期:1998-09-01 00:00:00

  • Viral nucleotide changes in asymptomatic hepatitis B carriers undergoing interferon treatment.

    abstract:BACKGROUND:Interferon might induce mutation in regions of hepatitis B virus DNA that encode for immunologic target of cytotoxic T lymphocytes. AIM:To investigate the short-term effect of steroid priming and interferon therapy on hepatitis B virus, we followed the nucleotide changes in the precore and core region of he...

    journal_title:Alimentary pharmacology & therapeutics

    pub_type: 杂志文章


    authors: How W,Ng WC,Tan MF,Seet BL,Guan R

    更新日期:1996-04-01 00:00:00

  • Risk of colorectal adenomas in patients with coeliac disease.

    abstract:BACKGROUND:Coeliac disease is associated with an increased risk of lymphoma and small bowel malignancy, but most studies have found no increased risk of colorectal cancer. AIM:To compare the prevalence of colorectal adenomas in coeliac disease patients with that in non-coeliac disease controls. METHODS:We identified ...

    journal_title:Alimentary pharmacology & therapeutics

    pub_type: 杂志文章


    authors: Lebwohl B,Stavsky E,Neugut AI,Green PH

    更新日期:2010-10-01 00:00:00

  • Randomized, multicentre comparison of sodium alginate and cisapride in the symptomatic treatment of uncomplicated gastro-oesophageal reflux.

    abstract:AIM:To assess the efficacy and tolerance of sodium alginate compared to cisapride in patients suffering from reflux symptoms, without severe oesophagitis. METHODS:A total of 353 patients with symptoms of reflux oesophagitis (average age 40 years, 51% men, 33% smokers, 43% consumers of alcoholic drinks) were selected a...

    journal_title:Alimentary pharmacology & therapeutics

    pub_type: 临床试验,杂志文章,多中心研究,随机对照试验


    authors: Poynard T,Vernisse B,Agostini H

    更新日期:1998-02-01 00:00:00

  • Review article: the epidemiology and prevention of gastric cancer.

    abstract:BACKGROUND:Gastric cancer can be divided into cardia and noncardia gastric adenocarcinoma (NCGA). Non cardia gastric cancer is a disease that has declined in global incidence but has remained as an extremely lethal cancer. AIM:To review recent advances in epidemiology and strategies in prevention of non cardia gastric...

    journal_title:Alimentary pharmacology & therapeutics

    pub_type: 杂志文章,评审


    authors: Fock KM

    更新日期:2014-08-01 00:00:00

  • Helicobacter pylori first-line treatment and rescue options in patients allergic to penicillin.

    abstract:BACKGROUND:Helicobacter pylori eradication is a challenge in patients allergic to penicillin, especially those who have failed a first-eradication trial. AIM:To assess the efficacy and tolerability of H. pylori first-line treatment and rescue options in patients allergic to penicillin. METHODS:Prospective single cent...

    journal_title:Alimentary pharmacology & therapeutics

    pub_type: 杂志文章


    authors: Gisbert JP,Gisbert JL,Marcos S,Olivares D,Pajares JM

    更新日期:2005-11-15 00:00:00

  • Successful induction of tolerance to infliximab in patients with Crohn's disease and prior severe infusion reactions.

    abstract:AIM:To appraise the tolerance and efficacy of an induction of tolerance protocol to infliximab permitting the re-administration of the drug to patients with Crohn's disease having had infusion reactions requiring suspension of treatment. METHODS:Fourteen patients were included in the induction of tolerance protocol. E...

    journal_title:Alimentary pharmacology & therapeutics

    pub_type: 杂志文章


    authors: Duburque C,Lelong J,Iacob R,Seddik M,Desreumaux P,Fournier C,Wallaert B,Cortot A,Colombel JF

    更新日期:2006-09-01 00:00:00

  • Double-blind placebo-controlled multicentre studies of rebamipide, a gastroprotective drug, in the treatment of functional dyspepsia with or without Helicobacter pylori infection.

    abstract:BACKGROUND:Functional dyspepsia is a problem that is difficult to treat in clinical practice. AIM:To evaluate the efficacy and safety of rebamipide (a cytoprotective drug) in functional dyspepsia. METHODS:Patients with functional dyspepsia (n=557) were divided a priori into two studies by Helicobacter pylori status, ...

    journal_title:Alimentary pharmacology & therapeutics

    pub_type: 临床试验,杂志文章,多中心研究,随机对照试验


    authors: Talley NJ,Riff DS,Schwartz H,Marcuard SP

    更新日期:2001-10-01 00:00:00

  • Rabeprazole containing triple therapy to eradicate Helicobacter pylori infection on the Texas-Mexican border.

    abstract:BACKGROUND:Antibiotic resistance and duration of therapy influence the success of proton-pump inhibitor-containing Helicobacter pylori eradication therapy. Clarithromycin resistance is associated with treatment failure. AIM:To examine the success of a 7-day rabeprazole-clarithromycin-amoxicillin therapy in the study p...

    journal_title:Alimentary pharmacology & therapeutics

    pub_type: 杂志文章


    authors: Cardenas VM,Graham DY,El-Zimaity HM,Opekun AR,Campos A,Chavez A,Guerrero L

    更新日期:2006-01-15 00:00:00

  • The prevalence of Helicobacter pylori in peptic ulcer disease.

    abstract::Both duodenal and gastric ulcer disease are closely associated with Helicobacter pylori infection. An infected individual has an estimated lifetime risk of 10-20% for the development of peptic ulcer disease, which is at least 3-4 fold higher than in non-infected subjects. H. pylori infection can be diagnosed in 90-100...

    journal_title:Alimentary pharmacology & therapeutics

    pub_type: 杂志文章,评审


    authors: Kuipers EJ,Thijs JC,Festen HP

    更新日期:1995-01-01 00:00:00

  • Gastrimmune-induced antigastrin-17 antibodies inhibit acid secretion in a rat fistula model.

    abstract:BACKGROUND:Gastrimmune is an immunogenic form of gastrin. It raises in situ antibodies against two proliferative forms of gastrin: amidated and glycine-extended gastrin-17. It has been shown to have a therapeutic action in several in vivo tumour models. Following immunization, due to the complex equilibrium that exists...

    journal_title:Alimentary pharmacology & therapeutics

    pub_type: 杂志文章


    authors: Smith AM,Morris T,Justin T,Michaeli D,Watson SA

    更新日期:2001-12-01 00:00:00

  • The prevalence of clinically significant endoscopic findings in primary care patients with uninvestigated dyspepsia: the Canadian Adult Dyspepsia Empiric Treatment - Prompt Endoscopy (CADET-PE) study.

    abstract:BACKGROUND:Uninvestigated dyspepsia is common in family practice. The prevalence of clinically significant upper gastrointestinal findings (CSFs) in adult uninvestigated dyspepsia patients, and their predictability based on history, is unknown. METHODS:Prompt endoscopy was performed within 10 days of referral, in 1040...

    journal_title:Alimentary pharmacology & therapeutics

    pub_type: 杂志文章


    authors: Thomson AB,Barkun AN,Armstrong D,Chiba N,White RJ,Daniels S,Escobedo S,Chakraborty B,Sinclair P,Van Zanten SJ

    更新日期:2003-06-15 00:00:00

  • Prospective, randomized, parallel-group trial to evaluate the effects of lactulose and polyethylene glycol-4000 on colonic flora in chronic idiopathic constipation.

    abstract:BACKGROUND:Although lactulose and polyethylene glycol are osmotic laxatives widely used in the treatment of chronic constipation, no study has been conducted to compare their actions on the colonic bacterial ecosystem, which has an important influence on host health. AIM:To assess the effects of lactulose and polyethy...

    journal_title:Alimentary pharmacology & therapeutics

    pub_type: 临床试验,杂志文章,多中心研究,随机对照试验


    authors: Bouhnik Y,Neut C,Raskine L,Michel C,Riottot M,Andrieux C,Guillemot F,Dyard F,Flourié B

    更新日期:2004-04-15 00:00:00

  • Depression is associated with non-alcoholic fatty liver disease among adults in the United States.

    abstract:BACKGROUND:Currently, the relationship between depression and non-alcoholic fatty liver disease (NAFLD) is not clearly defined. AIM:To determine whether depression is associated with NAFLD and NAFLD-related advanced fibrosis in a large population sample. METHODS:We performed a cross-sectional analysis using the 2007-...

    journal_title:Alimentary pharmacology & therapeutics

    pub_type: 杂志文章


    authors: Kim D,Yoo ER,Li AA,Tighe SP,Cholankeril G,Harrison SA,Ahmed A

    更新日期:2019-09-01 00:00:00

  • Review article: Effector role of epithelia in inflammation--interaction with bacteria.

    abstract::The common response to infection is infiltration of the affected tissue by inflammatory cells. It is now recognized that the epithelium plays a crucial role in this immunological process by producing an array of proinflammatory cytokines including interleukin-8, tumour necrosis factor-alpha, monocyte chemotactic prote...

    journal_title:Alimentary pharmacology & therapeutics

    pub_type: 杂志文章,评审


    authors: Hecht G,Savkovic SD

    更新日期:1997-12-01 00:00:00

  • High efficacy of 1-week doxycycline- and amoxicillin-based quadruple regimen in a culture-guided, third-line treatment approach for Helicobacter pylori infection.

    abstract:BACKGROUND:Helicobacter pylori infection may persist after both first- and second-line current treatments. AIM:To assess the efficacy of a third-line, culture-guided treatment approach for the eradication of H. pylori. METHODS:Patterns of resistance were analysed in H. pylori isolates from 94 consecutive patients in ...

    journal_title:Alimentary pharmacology & therapeutics

    pub_type: 杂志文章


    authors: Cammarota G,Martino A,Pirozzi G,Cianci R,Branca G,Nista EC,Cazzato A,Cannizzaro O,Miele L,Grieco A,Gasbarrini A,Gasbarrini G

    更新日期:2004-04-01 00:00:00

  • Prospective evaluation of ranitidine bismuth citrate-based triple therapy for the treatment of Helicobacter pylori infection.

    abstract:BACKGROUND:There is a need for effective and inexpensive therapy for Helicobacter pylori with good patient compliance. AIM:To evaluate a simplified twice daily schedule for treating H. pylori. METHODS:Patients infected with H. pylori (positive by CLO- and 13C-urea breath tests [UBT]) and not previously treated with a...

    journal_title:Alimentary pharmacology & therapeutics

    pub_type: 杂志文章


    authors: Mönkemüller KE,Hirschowitz BI

    更新日期:1999-05-01 00:00:00

  • NSAID-induced antral ulcers are associated with distinct changes in mucosal gene expression.

    abstract:BACKGROUND:The basis for individual variation in gastroduodenal vulnerability to NSAIDs is not well understood. AIM:To assess whether a gene expression signature is associated with susceptibility to gastroduodenal ulcerations. METHODS:Twenty-five Helicobacter pylori negative adults were treated for 7 days with naprox...

    journal_title:Alimentary pharmacology & therapeutics

    pub_type: 杂志文章


    authors: Desai JC,Goo T,Fukata M,Sanyal S,Dikman A,Miller K,Cohen L,Brooks A,Wang Q,Abreu MT,Aisenberg J

    更新日期:2009-07-01 00:00:00

  • Incidence of a clinical diagnosis of the irritable bowel syndrome in a United States population.

    abstract:BACKGROUND:The incidence of irritable bowel syndrome is uncertain. We aimed to determine the incidence of clinically diagnosed irritable bowel syndrome in the community. METHODS:Using the Rochester Epidemiology Project, all diagnoses of irritable bowel syndrome made among adult residents of Olmsted County, Minnesota, ...

    journal_title:Alimentary pharmacology & therapeutics

    pub_type: 杂志文章


    authors: Locke GR 3rd,Yawn BP,Wollan PC,Melton LJ 3rd,Lydick E,Talley NJ

    更新日期:2004-05-01 00:00:00

  • The effects of propranolol on hepatic encephalopathy in patients with cirrhosis and portal hypertension.

    abstract::Beta adrenoreceptor blocking drugs have been used for the prevention of haemorrhage from oesophageal varices. However, it is possible that these agents, by virtue of their effects on hepatic blood flow, may impair liver function and precipitate hepatic encephalopathy. We have therefore studied the effect of the beta b...

    journal_title:Alimentary pharmacology & therapeutics

    pub_type: 临床试验,杂志文章,随机对照试验


    authors: Dunk AA,Moore J,Symon A,Dickie A,Sinclair TS,Mowat NA,Brunt PW

    更新日期:1988-04-01 00:00:00

  • Treatment and prevention of relapse of mild oesophagitis with omeprazole and cisapride: comparison of two strategies.

    abstract:BACKGROUND:Oesophagitis is usually a chronic condition. Healing with omeprazole is often followed by early relapse. Combination treatment and subsequent maintenance treatment with the prokinetic cisapride may be of benefit in relapse prevention. METHODS:Patients with endoscopically proven oesophagitis, grade I (n = 12...

    journal_title:Alimentary pharmacology & therapeutics

    pub_type: 临床试验,杂志文章,随机对照试验


    authors: Kimmig JM

    更新日期:1995-06-01 00:00:00

  • Bone turnover during short-term therapy with methylprednisolone or budesonide in Crohn's disease.

    abstract:BACKGROUND:Glucocorticosteroids are used frequently for the treatment of relapses of Crohn's disease. AIM:To investigate the influence of the new topically active glucocorticosteroid budesonide in comparison with methylprednisolone on bone turnover in a randomized open trial. METHODS:Twenty-nine patients received eit...

    journal_title:Alimentary pharmacology & therapeutics

    pub_type: 临床试验,杂志文章,随机对照试验


    authors: D'Haens G,Verstraete A,Cheyns K,Aerden I,Bouillon R,Rutgeerts P

    更新日期:1998-05-01 00:00:00

  • The DU-MACH study: eradication of Helicobacter pylori and ulcer healing in patients with acute duodenal ulcer using omeprazole based triple therapy.

    abstract:AIM:To investigate the efficacy of two omeprazole triple therapies for the eradication of Helicobacter pylori, ulcer healing and ulcer relapse during a 6-month treatment-free period in patients with active duodenal ulcer. METHODS:This was a double-blind, randomized study in 15 centres across Canada. Patients (n = 149)...

    journal_title:Alimentary pharmacology & therapeutics

    pub_type: 临床试验,杂志文章,多中心研究,随机对照试验


    authors: Zanten SJ,Bradette M,Farley A,Leddin D,Lind T,Unge P,Bayerdörffer E,Spiller RC,O'Morain C,Sipponen P,Wrangstadh M,Zeijlon L,Sinclair P

    更新日期:1999-03-01 00:00:00