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Calcium and vitamin D may be involved in maintaining the integrity of the intestinal mucosal barrier, the dysfunction of which may lead to endotoxemia and inflammation, and contribute to colorectal carcinogenesis. We investigated supplemental calcium (1200\u2009mg, daily) and\/or vitamin D<jats:sub>3<\/jats:sub> (1000\u2009IU daily) effects on intestinal barrier function\u2010related biomarkers in a subset of 105 participants from a large colorectal adenoma recurrence chemoprevention clinical trial. We assessed expression of the tight junction proteins claudin\u20101 (CLDN1), occludin (OCLD), and mucin\u201012 (MUC12) in the normal\u2010appearing colorectal mucosa using standardized, automated immunohistochemistry and quantitative image analysis. Following 1 year of treatment, in the calcium relative to the no calcium group, the CLDN1, OCLD, and MUC12 expression increased by 14% (<jats:italic>P<\/jats:italic>\u2009=\u20090.17), 23% (<jats:italic>P<\/jats:italic>\u2009=\u20090.11), and 22% (<jats:italic>P<\/jats:italic>\u2009=\u20090.07), respectively. In secondary analyses, the estimated calcium treatment effects were greater among participants with baseline serum 25\u2010OH\u2010vitamin D concentrations below the median value of 22.69\u2009ng\/mL (CLDN1: 29%, <jats:italic>P<\/jats:italic>\u2009=\u20090.04; OCLD: 36%, <jats:italic>P<\/jats:italic>\u2009=\u20090.06; MUC12: 35%, <jats:italic>P<\/jats:italic>\u2009=\u20090.05). There were no biomarker expression changes in the vitamin D<jats:sub>3<\/jats:sub> alone group; however, modest increases were found in the combined calcium\/vitamin D<jats:sub>3<\/jats:sub> group. At baseline, obesity, history of a sessile\u2010serrated adenoma, colorectal MIB\u20101\/Ki\u201067 expression, and a family history of colorectal cancer were associated with CLDN1, OCLD, and MUC12 expression. Our study supports continued investigation of factors that could affect intestinal mucosal barrier integrity relevant to colorectal carcinogenesis.<\/jats:p>","DOI":"10.1002\/mc.23010","type":"journal-article","created":{"date-parts":[[2019,4,2]],"date-time":"2019-04-02T17:12:29Z","timestamp":1554225149000},"page":"1279-1290","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":24,"title":["Effects of supplemental calcium and vitamin D on tight\u2010junction proteins and mucin\u201012 expression in the normal rectal mucosa of colorectal adenoma patients"],"prefix":"10.1002","volume":"58","author":[{"given":"Hannah B.","family":"Mandle","sequence":"first","affiliation":[{"name":"Department of Epidemiology Rollins School of Public Health, Emory University Atlanta Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ferdous A.","family":"Jahan","sequence":"additional","affiliation":[{"name":"Department of Epidemiology Rollins School of Public Health, Emory University Atlanta Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8626-4186","authenticated-orcid":false,"given":"Roberd M.","family":"Bostick","sequence":"additional","affiliation":[{"name":"Department of Epidemiology Rollins School of Public Health, Emory University Atlanta Georgia"},{"name":"Winship Cancer Institute, Emory University Atlanta Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John A.","family":"Baron","sequence":"additional","affiliation":[{"name":"Department of Epidemiology Geisel School of Medicine at Dartmouth Lebanon New Hampshire"},{"name":"Department of Medicine Geisel School of Medicine at Dartmouth Lebanon New Hampshire"},{"name":"Department of Epidemiology University of North Carolina School of Medicine Chapel Hill North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth L.","family":"Barry","sequence":"additional","affiliation":[{"name":"Department of Epidemiology Geisel School of Medicine at Dartmouth Lebanon New Hampshire"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rami","family":"Yacoub","sequence":"additional","affiliation":[{"name":"Department of Epidemiology Rollins School of Public Health, Emory University Atlanta Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia","family":"Merrill","sequence":"additional","affiliation":[{"name":"Department of Epidemiology Rollins School of Public Health, Emory University Atlanta Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robin E.","family":"Rutherford","sequence":"additional","affiliation":[{"name":"Department of Medicine Division of Digestive Diseases, School of Medicine, Emory University Atlanta Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"March E.","family":"Seabrook","sequence":"additional","affiliation":[{"name":"Consultants in Gastroenterology West Columbia South Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7805-9913","authenticated-orcid":false,"given":"Veronika","family":"Fedirko","sequence":"additional","affiliation":[{"name":"Department of Epidemiology Rollins School of Public Health, Emory University Atlanta Georgia"},{"name":"Winship Cancer Institute, Emory University Atlanta 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