Vitamin D status in irritable bowel syndrome and the impact of supplementation on symptoms: what do we know and what do we need to know?

BACKGROUND: Low vitamin D status is associated with risk of colorectal cancer and has been implicated in inflammatory bowel disease. Irritable bowel syndrome (IBS) is a chronic, relapsing, functional bowel disorder. A nascent literature suggests a role for vitamin D in IBS, but this has not been collated or critiqued. To date, seven studies have been published: four observational studies and three randomised controlled trials (RCTs). All observational studies reported that a substantial proportion of the IBS population was vitamin D deficient. Two intervention studies reported improvement in IBS symptom severity scores and quality of life (QoL) with vitamin D supplementation. There are limited data around the role of vitamin D in IBS. CONCLUSIONS: The available evidence suggests that low vitamin D status is common among the IBS population and merits assessment and rectification for general health reasons alone. An inverse correlation between serum vitamin D and IBS symptom severity is suggested and vitamin D interventions may benefit symptoms. However, the available RCTs do not provide strong, generalisable evidence; larger and adequately powered interventions are needed to establish a case for therapeutic application of vitamin D in IBS

Next-generation sequencing analysis for detecting human papillomavirus in oral verrucous carcinoma

Purpose The aetiology of oral verrucous carcinoma is unknown whilst human papillomavirus ‘involvement’ remains contentious. Dubiety can be attributed to varied detection procedures and difficulties in defining ‘gold-standard’ histological criteria for diagnosing ‘verrucous’ lesions. Their paucity also hampers investigation. Design We aimed to analyse oral verrucous lesions for HPV subtype genomes using ‘next generation sequencing’ for the detection of papilloma virus sequences, identifying subtypes and computing viral loads. We identified a total of 78 oral verrucous cases [62 carcinomas and 16 hyperplasias]. DNA was extracted from all and sequenced at a coverage between 2.5 and 13%. Findings An HPV-16 sequence was detected in one carcinoma and one hyperplasia, and an HPV-2 sequence was detected in one carcinoma out of the 78 cases, with viral loads of 2.24, 8.16 and 0.33 viral genomes per cell respectively. Practical implications Our results indicate no conclusive human papilloma virus involvement in oral verrucous carcinoma or hyperplasia