Abstract
Introduction: AIM: To study the association between vitamin D (Vit D) and Vitamin D receptor (VDR) in Inflammatory bowel disease (IBD) patients in Nebraska. To study the association of novel inflammatory markers TREM1(Triggering receptor expressed on myeloid cells 1) and TREM 2(Triggering receptor expressed on myeloid cells) expression in tissue biopsy specimens from terminal ileum(TI) and rectum(R) in Inflammatory Bowel Disease patients vs controls. Methods: The study included 8 cases of IBD and 11 controls who are matched to age and sex. They are healthy controls from the same geographical area visiting for colon cancer screening. Cases are already documented IBD patients visiting an endoscopy clinic for a colon cancer screening surveillance. Patients with IBD are already on a treatment plan. Vitamin D levels in the blood were measured and studied. VDR expression was studied in the biopsy specimens obtained from the terminal ileum and rectum of the cases and controls using immunohistochemistry. Histology and degree of inflammation was also studied from the tissue sections of the biopsy specimens from terminal ileum and rectum. The expression of TREM 1 and TREM 2 in the tissue specimens from the TI and R is studied using immunofluorescence. Results: The Vit D levels were not significantly different between the cases and control population. cases:29.5 ± 9.32ng/ml controls:30.82 ± 18.24ng/ml. Cases showed significantly higher expression of TREM 1 in TI and R sections (TI: P<.04, R: P<.02). TREM 2 expression is higher in cases but the expression is not significant (TI: P<0.93 R: P<0.45). The expression of VDR is insignificant between cases and controls (TI: P<0.13, R: P<0.83). When the cases were grouped into Vit D insufficient and Vit D sufficient levels, Vit D insufficient showed higher expression of TREM 1 and Vit D sufficient showed higher expression of TREM 2. Conclusion: Though cases and controls showed insignificant Vit D levels, they showed increased expression of TREM 1 and TREM in TI and rectum sections of biopsy. With insufficient Vit D levels, there is increased inflammatory state compared to the sufficient Vit D levels, which correlates with increased TREM1 which is a pro-inflammatory marker and decreased TREM2 which is an anti-inflammatory marker.