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Colonic Epithelial Cell Proliferation Decreases with Increasing Levels of Serum 25-Hydroxy Vitamin D¹

Gastrointestinal Division, St. Luke’s-Roosevelt Hospital Center, New York, New York 10025 [P. R. H., N. A., B. H., H. K., S. F. M.]; Department of Medicine [P. R. H., N. A., B. H., H. K., S. F. M.] and Surgery [K. Fo.], College of Physicians and Surgeons, Columbia University, New York, New York 10032, Fox Chase Cancer Center, Philadelphia, Pennsylvania 19111 [K. A. M.]; and Strang Cancer Prevention Center, New York, New York 10021 [K. Fa., K. Y., M. L.]

Epidemiological evidence suggests a potential role for vitamin D in colon cancer prevention. Vitamin D, absorbed from the intestine or derived from solar ultraviolet light, is metabolized in the liver to 25-hydroxyvitamin D (25-OH D₃). Previous studies examining effects of vitamin D upon carcinogenesis have focused upon the active metabolite 1,25-dihydroxyvitamin D [1,25-(OH)₂ D₃], which interacts with nuclear vitamin D receptors in several organs. Until recently, the metabolism of 25-OH D₃ to 1,25-(OH)₂ D₃ was believed to occur only in the kidney, but more recent studies have shown that 25-OH D₃ conversion to 1,25-(OH)₂ D₃ can occur in other tissues. We examined the association between fasting levels of 25-OH D₃, 1,25-(OH)₂ D₃, and BsmI polymorphism of the vitamin D receptor (VDR) gene with indices of colonic epithelial cell proliferation and differentiation in a chemoprevention study, after giving vitamin D or calcium and taking rectal biopsies that were incubated with bromodeoxyuridine. Vitamin D receptor polymorphism was determined by genotyping of the 3' BsmI polymorphism in intron eight of the VDR gene.

No significant changes in cell proliferation or in differentiation were found in subjects between study start and end. However, fasting serum levels of 25-OH D₃ showed a highly significant decrease with whole crypt labeling index and the size of the proliferative compartment (phi h). There was no correlation between serum levels of 1,25-(OH)₂ D₃ and the proliferative parameters. Calcium supplementation induced a significant effect upon the relationship between serum 25-OH D₃ and rectal epithelial cell labeling index and phi h when studied by covariance analysis without a relationship with 1,25-(OH)₂ D₃ levels. VDR genotype did not influence the effects of serum 25-OH D₃ or serum 1,25-(OH)₂ D₃ levels upon proliferation.

These data suggest that there might be a local effect of 25-OH D₃ on colonic epithelial cells through conversion of 25-OH D₃ to 1,25-(OH)₂ D₃. Subsequent studies have demonstrated the presence of 1-hydroxylase mRNA in normal colorectal epithelium and in colorectal cancer. Thus, vitamin D may have an important role in determining the effects of calcium on colorectal epithelial proliferation and may explain some of the discrepancies found previously in studies that examine the direct role of calcium on the colorectal epithelium.

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