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Randomized Controlled Trial
. 2022 Jun 6:12:904987.
doi: 10.3389/fcimb.2022.904987. eCollection 2022.

High Dose Intramuscular Vitamin D3 Supplementation Impacts the Gut Microbiota of Patients With Clostridioides Difficile Infection

Sang Hoon Lee  1 , Han-Ki Park  2 , Chang Don Kang  1 , Dae Hee Choi  1 , Sung Chul Park  1 , Jin Myung Park  1 , Seung-Joo Nam  1 , Gi Bong Chae  3 , Kyoung Yul Lee  4 , Hyunseok Cho  5 , Sung Joon Lee  1
Affiliations
Randomized Controlled Trial

High Dose Intramuscular Vitamin D3 Supplementation Impacts the Gut Microbiota of Patients With Clostridioides Difficile Infection

Sang Hoon Lee et al. Front Cell Infect Microbiol. .

"VSports手机版" Abstract

Background and aim: Current therapeutic strategies for Clostridioides difficile infections (CDI), including oral vancomycin, metronidazole and fecal microbial transplantation, have limited efficacy and treatment failure may occur in as many as one- third of cases VSports手机版. Recent studies have reported that lower concentrations of 25-hydroxyvitamin D are associated with CDI severity and recurrence. However, there have been no studies on microbiota composition after the administration of vitamin D in patients with CDI. Therefore, our study aimed to compare the microbiota composition between the two groups, including eight CDI-positive patients with vitamin D supplementation and ten CDI-positive patients without vitamin D supplementation by using 16S rRNA microbial profiling. .

Methods: Twenty subjects were enrolled in this prospective randomized controlled study. One subject dropped out due to lack of contact with the guardian after discharge and one subject dropped out due to withdrawal of consent. Thus, 18 patients with CDI and vitamin D insufficiency (vitamin D level < 17 ng/mL) were divided into two groups: CDI with vitamin D supplementation (n = 8) and CDI without vitamin D supplementation (control: n = 10). Subjects with vitamin D insufficiency were randomized to receive 200,000 IU intramuscular cholecalciferol whereas patients in the control group received only oral vancomycin. Stool samples were obtained twice before vancomycin was administered and eight weeks after treatment; the V3-V4 16S rRNA metagenomic sequencing was performed using EzBioCloud. V体育安卓版.

Results: The alpha diversity of the gut microbiota in the recovery state was significantly higher than that in the CDI state. Analysis of bacterial relative abundance showed significantly lower Proteobacteria and higher Lachnospiraceae, Ruminococcaceae, Akkermansiaceae, and Bifidobacteriaceae in the recovery state. When comparing the control and vitamin D treatment groups after eight weeks, increase in alpha diversity and, abundance of Lachnospiraceae, and Ruminococcaceae exhibited the same trend in both groups. A significant increase in Bifidobacteriaceae and Christensenellaceae was observed in the vitamin D group; Proteobacteria abundance was significantly lower in the vitamin D treatment group after eight weeks than that in the control group V体育ios版. .

Conclusion: Our study confirmed that the increase in the abundance of beneficial bacteria such as Bifidobacteriaceae, and Christensenellaceae were prominently evident during recovery after administration of a high dose of cholecalciferol. These findings indicate that vitamin D administration may be useful in patients with CDI, and further studies with larger sample sizes are required VSports最新版本. .

Keywords: bifidobacteriaceae; cholecalciferol; christensenellaceae; clostridioides difficile infection; microbiota; vitamin D V体育平台登录. .

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Schematic diagram showing the recruitment process.
Figure 2
Figure 2
Changes in the gut microbiota between Clostridioides difficile infection and recovery after eight weeks. (A) Alpha diversity. (B) Weighted UniFrac distance. (C) Relative abundances of individual bacteria that were significantly different between Clostridioides difficile infection and recovery. Blue dots indicate C. difficile infection state (0 week), red dots indicate recovery after eight weeks, and black lines represent changes in the same patient. n.s, not significant; *P < 0.05, **P < 0.01 and ***P < 0.001 (Wilcoxon signed rank test and Mann-Whitney U test).
Figure 3
Figure 3
Effect of vitamin D supplementation on the gut microbiome. (A) Alpha diversity. (B) Weighted UniFrac distance. (C) Principal coordinates analysis (Bray–Curtis dissimilarity). (D) Relative abundances of Proteobacteria. (E) Relative abundances of Enterobacteriaceae. (F) Relative abundances of Escherichia. (G) Relative abundances of Christensenellaceae. n.s, not significant; *P < 0.05 (Wilcoxon signed rank test and Mann-Whitney U test).
Figure 4
Figure 4
Effect of vitamin D supplementation on the individual gut taxa. A, B. Cladogram (A) and linear discriminant analysis scores (B) using LEfSe analysis of the fecal microbiota in Clostridioides difficile infection versus recovery after eight weeks in the vitamin D treatment group. (C–G). Differences in the abundance of individual bacteria between the control group and vitamin (D) supplement group. (C) Proteobacteria. (D) Lachnospiraceae. (E) Ruminococcaceae. (F) Bifidobacteriaceae. (G) Christensenellaceae. *P < 0.05, **P < 0.01 (Wilcoxon signed rank test).
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