Specific Aim 1: Characterize the effects of vitamin D treatment on expression of α4β7 on B cells in patients with inflammatory bowel disease (IBD). Specific Aim 2: Determine the effects of vitamin D treatment on fecal immunoglobulins, percentage of Ig-coated gut bacteria, gut microbiome composition (global and bound by immunoglobulins) in patients with IBD and the association of these parameters with change in α4β7+ B cells . Specific Aim 3: Compare BCR repertoire (BCR clonotypes, immunoglobulin heavy chain gene (IGHV), and isotype usage) between α4β7+ and α4β7- B cells in patients with IBD and identify α4β7+ BCR clonotypes associated with Ig-bound gut bacteria .
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
48
Patient with inflammatory bowel disease who have low vitamin D (25(OH)D less than or equal to 25 ng/mL) will take Vitamin D 50,000 IU by mouth every week for 12 weeks. Patients will fill out questionnaires to document disease activity score (HBI or Mayo score and sIBDQ) and have blood and stool samples collected before (Week 0), during (Week 8) and after (Week 12) vitamin D intervention.
Stanford University School of Medicine
Stanford, California, United States
Reduction in α4β7+ B cells by 20%
Expression of gut tropic integrin α4β7+ on B cells assessed at gene expression level (single cell transcriptomics) and protein level (cytometry)
Time frame: Week 12
Reduction in immunoglobulin coating of commensal gut bacteria by 20%.
Immunoglobulin coating of gut bacteria will be measured from stool samples using Ig-Seq
Time frame: Week 12
Increase in serum vitamin D (25(OH)D levels by 10 ng/mL
25(OH)D will be measured from serum by standard laboratory assay (HPLC)
Time frame: Week 12
Decrease in disease activity index scores by 50%
Disease activity index scores will be measured by Harvey Bradshaw Index in Crohn's disease patients and Mayo Score disease activity index in ulcerative colitis patients
Time frame: Week 12
Decrease cohort mean fecal calprotectin or C-reactive protein (CRP) by 50%.
Fecal calprotectin will be measured from stool samples. CRP will be measured from plasma
Time frame: Week 12
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