{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T18:30:20Z","timestamp":1792002620409,"version":"4.4.0"},"reference-count":90,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2025,9,8]],"date-time":"2025-09-08T00:00:00Z","timestamp":1757289600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Life"],"abstract":"<jats:p>Patients with bowel diseases (inflammatory bowel disease (IBD) in general) tend to seek medical, nursing, and\/or physiotherapeutic consultations. Physiotherapists specialized in gastrointestinal (visceral) therapy can help reduce inflammation in patients with ulcerative colitis (UC). In this study, we divided UC patients into three groups according to their age: the youngest (18\u201335 years old), middle-aged (36\u201349 years old), and oldest (50\u201370 years old). Our hypothesis was that gut inflammatory markers (zonulin and fecal calprotectin levels) and microbiota strains would exhibit age-dependent variations in UC patients. We compared differences in zonulin, calprotectin, and vitamin D levels, together with a plethora of microbiota strains, based on age. Calprotectin is a marker of intestinal inflammation and zonulin identifies gut permeability; as IBD is characterized by gastrointestinal inflammation, these are useful markers for diagnosing and monitoring treatment\/s in IBD patients, including ulcerative colitis (UC). Dysbiosis can alter the normal balance of intestinal function, and thus, several microbiota strains were compared between different age ranges in UC patients. The results indicated that the middle-aged UC (36\u201349) patients had the highest endogenous vitamin D levels, as well as lower zonulin and calprotectin levels than the youngest (18\u201335) and oldest (50\u201370) UC participants, respectively. The middle-aged group also had lower Enterococcus, E. Coli biovare, and Pseudomonas spp. levels than the youngest UC participants. Meanwhile, the most LPS microbiota producers were found in middle-aged patients. Finally, a higher number of Candida albicans and elevated LPS were found in the oldest UC participants than in the middle-aged (36\u201349) group. This study was, however, limited by uneven age-group sizes, which may have may limited the power in the youngest cohort. Although altered gut microbiota levels can increase gut inflammation in rodent models of UC, a definitive cause\u2013effect relationship between UC and intestinal microbiota alteration is difficult to demonstrate in humans.<\/jats:p>","DOI":"10.3390\/life15091412","type":"journal-article","created":{"date-parts":[[2025,9,8]],"date-time":"2025-09-08T10:29:07Z","timestamp":1757327347000},"page":"1412","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Microbiota and Gut Inflammatory Markers (Zonulin and Fecal Calprotectin) Exhibit Age-Dependent Variation in Patients with Ulcerative Colitis"],"prefix":"10.3390","volume":"15","author":[{"given":"Jos\u00e9 Joaqu\u00edn","family":"Merino","sequence":"first","affiliation":[{"name":"Instituto Pluridisciplinar (UCM) and Facultad de Farmacia, Departamento de Farmacolog\u00eda, Farmacognosia y Bot\u00e1nica, Universidad Complutense de Madrid (UCM), Paseo Ramon y Cajal s\/n, 28040 Madrid, Spain"},{"name":"Regenerative Medicine Group, Research Institute Hospital 12 de Octubre (imas12), 28041 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nur\u00eda","family":"Bastande Rey","sequence":"additional","affiliation":[{"name":"Laboratorio Eurofins Megalab, 02003 Albacete, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rub\u00e9n","family":"Fern\u00e1ndez-Garc\u00eda","sequence":"additional","affiliation":[{"name":"Department of Nursing, Physiotherapy and Medicine, University of Almeria, 04120 Almeria, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,9,8]]},"reference":[{"key":"ref_1","first-page":"763","article-title":"Personalised therapy in inflammatory bowel disease","volume":"47","author":"Nos","year":"2024","journal-title":"Gastroenterol. Hepatol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1470","DOI":"10.1111\/apt.17988","article-title":"Review article: A practical approach to persistent gastrointestinal symptoms in inflammatory bowel disease in remission","volume":"59","author":"Aliu","year":"2024","journal-title":"Aliment. Pharmacol. Ther."},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Szymanska, E., Wierzbicka, A., Dadalski, M., and Kierkus, J. (2021). Fecal Zonulin as a Noninvasive Biomarker of Intestinal Permeability in Pediatric Patients with Inflammatory Bowel Diseases-Correlation with Disease Activity and Fecal Calprotectin. J. Clin. Med., 10.","DOI":"10.3390\/jcm10173905"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1351","DOI":"10.1016\/j.crohns.2014.05.006","article-title":"Age-related differences in presentation and course of inflammatory bowel disease: An update on the population-based literature","volume":"8","author":"Duricova","year":"2014","journal-title":"J. Crohn\u2019s Colitis"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"31","DOI":"10.3748\/wjg.v20.i1.31","article-title":"Natural history and long-term clinical course of Crohn\u2019s disease","volume":"20","author":"Freeman","year":"2014","journal-title":"World J. Gastroenterol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"395","DOI":"10.1038\/s41575-024-00997-y","article-title":"Host-pathobiont interactions in Crohn\u2019s disease","volume":"22","author":"Caruso","year":"2024","journal-title":"Nat. Rev. Gastroenterol. Hepatol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"44","DOI":"10.1053\/j.gastro.2023.09.019","article-title":"Pathobionts in Inflammatory Bowel Disease: Origins, Underlying Mechanisms, and Implications for Clinical Care","volume":"66","author":"Gilliland","year":"2024","journal-title":"Gastroenterology"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"521","DOI":"10.1053\/j.gastro.2023.11.303","article-title":"AGA Clinical Practice Update on Diet and Nutritional Therapies in Patients with Inflammatory Bowel Disease: Expert Review","volume":"166","author":"Hashash","year":"2024","journal-title":"Gastroenterology"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"e174726","DOI":"10.1172\/JCI174726","article-title":"Dietary carbohydrates regulate intestinal colonization and dissemination of Klebsiella pneumoniae","volume":"134","author":"Hecht","year":"2024","journal-title":"J. Clin. Investig."},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Li, H., Wang, Z., Guan, Z., Miao, J., Li, W., Yu, P., and Molina Jimenez, C. (2024). UCFNNet: Ulcerative colitis evaluation based on fine-grained lesion learner and noise suppression gating. Comput. Methods Programs Biomed., 247.","DOI":"10.1016\/j.cmpb.2024.108080"},{"key":"ref_11","first-page":"562","article-title":"Associations between eicosapentaenoic acid and docosahexaenoic acid consumption and inflammatory bowel disease in adults: The National Health and Nutrition Examination Survey (NHANES) 2009\u20132010","volume":"33","author":"Wang","year":"2024","journal-title":"Asia Pac. J. Clin. Nutr."},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Wimalawansa, S.J. (2024). Physiology of Vitamin D-Focusing on Disease Prevention. Nutrients, 16.","DOI":"10.3390\/nu16111666"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"428","DOI":"10.1126\/science.adh7954","article-title":"Vitamin D regulates microbiome-dependent cancer immunity","volume":"384","author":"Giampazolias","year":"2024","journal-title":"Science"},{"key":"ref_14","first-page":"332","article-title":"Probiotics plus vitamin D in irritable bowel syndrome: A prospective multicentric non-interventional study","volume":"70","author":"Altman","year":"2024","journal-title":"Minerva Gastroenterol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"652","DOI":"10.3923\/ijp.2024.652.659","article-title":"Compound Xuejie Preparation Improved Dextran Sulfate Sodium-Induced Ulcerative Colitis in Mice by Mitigating Inflammation-Induced Damage and Downregulating TNF-\u03b1 Expression","volume":"20","author":"Zhao","year":"2024","journal-title":"Int. J. Pharmacol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"240","DOI":"10.1016\/j.cgh.2016.05.035","article-title":"Low Serum Vitamin D During Remission Increases Risk of Clinical Relapse in Patients With Ulcerative Colitis","volume":"15","author":"Gubatan","year":"2017","journal-title":"Clin Gastroenterol Hepatol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"625","DOI":"10.1210\/endrev\/bnae009","article-title":"Consensus Statement on Vitamin D Status Assessment and Supplementation: Whys, Whens, and Hows","volume":"45","author":"Giustina","year":"2024","journal-title":"Endocr. Rev."},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Levinson, T., and Wasserman, A. (2022). C-Reactive Protein Velocity (CRPv) as a New Biomarker for the Early Detection of Acute Infection\/Inflammation. Int. J. Mol. Sci., 23.","DOI":"10.3390\/ijms23158100"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"370","DOI":"10.1136\/archdischild-2023-325668","article-title":"Inflammatory bowel disease: Recent developments","volume":"109","author":"Ashton","year":"2024","journal-title":"Arch. Dis. Child."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"556","DOI":"10.1016\/j.cca.2020.08.025","article-title":"Calprotectin in inflammatory bowel disease","volume":"510","author":"Qujeq","year":"2020","journal-title":"Clin. Chim. Acta"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1093\/ibd\/izae032","article-title":"Comparison of Fecal Calprotectin and Myeloperoxidase in Predicting Outcomes in Inflammatory Bowel Disease","volume":"31","author":"Swaminathan","year":"2024","journal-title":"Inflamm. Bowel Dis."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1111\/j.1749-6632.2012.06538.x","article-title":"Zonulin, regulation of tight junctions, and autoimmune diseases","volume":"1258","author":"Fasano","year":"2012","journal-title":"Ann. N. Y Acad. Sci."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"G11","DOI":"10.1152\/ajpgi.00113.2021","article-title":"Biomarkers for assessment of intestinal permeability in clinical practice","volume":"321","author":"Seethaler","year":"2021","journal-title":"Am. J. Physiol. Gastrointest. Liver Physiol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"104","DOI":"10.1016\/j.parkreldis.2018.02.022","article-title":"Fecal markers of intestinal inflammation and intestinal permeability are elevated in Parkinson\u2019s disease","volume":"50","author":"Schwiertz","year":"2018","journal-title":"Park. Relat. Disord."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1038\/nrmicro3552","article-title":"Gut biogeography of the bacterial microbiota","volume":"14","author":"Donaldson","year":"2016","journal-title":"Nat. Rev. Microbiol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1016\/j.plabm.2017.09.001","article-title":"Fecal zonulin is elevated in Crohn\u2019s disease and in cigarette smokers","volume":"9","year":"2017","journal-title":"Pract. Lab. Med."},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Xu, M., Li, F., Zhang, X., Chen, B., Geng, Y., Ouyang, P., Chen, D., Li, L., and Huang, X. (2024). Microbiome analysis reveals the intestinal microbiota characteristics and potential impact of Procambarus clarkii. Appl. Microbiol. Biotechnol., 108.","DOI":"10.1007\/s00253-023-12914-5"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"142","DOI":"10.5009\/gnl17013","article-title":"Fecal Immunochemical Test and Fecal Calprotectin Results Show Different Profiles in Disease Monitoring for Ulcerative Colitis","volume":"12","author":"Sugihara","year":"2018","journal-title":"Gut Liver."},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Li, F., Ma, J., Geng, S., Wang, J., Liu, J., Zhang, J., and Sheng, X. (2015). Fecal calprotectin concentrations in healthy children aged 1\u201318 months. PLoS ONE., 10.","DOI":"10.1371\/journal.pone.0119574"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"4090807","DOI":"10.1155\/2022\/4090807","article-title":"Vitamin D Supplementation for the Treatment of Depressive Symptoms in Women with Type 2 Diabetes: A Randomized Clinical Trial","volume":"2022","author":"Penckofer","year":"2022","journal-title":"J. Diabetes Res."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"656","DOI":"10.1016\/j.ajpath.2023.02.004","article-title":"Vitamin D and Microbiome: Molecular Interaction in Inflammatory Bowel Disease Pathogenesis","volume":"193","author":"Aggeletopoulou","year":"2023","journal-title":"Am. J. Pathol."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"e00617","DOI":"10.14309\/ctg.0000000000000617","article-title":"Fecal Calprotectin for the Diagnosis and Management of Inflammatory Bowel Diseases","volume":"14","author":"Kapel","year":"2023","journal-title":"Clin. Transl. Gastroenterol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"573","DOI":"10.1038\/nrgastro.2017.88","article-title":"Gut microbiota and UC: Causation or correlation?","volume":"14","author":"Ni","year":"2017","journal-title":"Nat. Rev. Gastroenterol. Hepatol."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"450","DOI":"10.1053\/gast.2002.34755","article-title":"Use of surrogate markers of inflammation and Rome criteria to distinguish organic from nonorganic intestinal disease","volume":"123","author":"Tibble","year":"2002","journal-title":"Gastroenterology"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"3681","DOI":"10.3748\/wjg.v24.i33.3681","article-title":"From bench to bedside: Fecal calprotectin in inflammatory bowel diseases clinical setting","volume":"24","author":"Mumolo","year":"2018","journal-title":"World J. Gastroenterol."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"279","DOI":"10.1158\/1055-9965.EPI-03-0160","article-title":"Bowel inflammation as measured by fecal calprotectin: A link between lifestyle factors and colorectal cancer risk","volume":"13","author":"Poullis","year":"2004","journal-title":"Cancer Epidemiol. Biomarkers Prev."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"332","DOI":"10.1097\/MIB.0b013e3182810066","article-title":"Fecal calprotectin more accurately reflects endoscopic activity of ulcerative colitis than the Lichtiger Index, C-reactive protein, platelets, hemoglobin, and blood leukocytes","volume":"19","author":"Schoepfer","year":"2013","journal-title":"Inflamm. Bowel Dis."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"1137","DOI":"10.1097\/MEG.0000000000000692","article-title":"Fecal calprotectin for the prediction of small-bowel Crohn\u2019s disease by capsule endoscopy: A systematic review and meta-analysis","volume":"28","author":"Kopylov","year":"2016","journal-title":"Eur. J. Gastroenterol. Hepatol."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"547","DOI":"10.1016\/j.dld.2008.01.017","article-title":"Faecal calprotectin as reliable non-invasive marker to assess the severity of mucosal inflammation in children with inflammatory bowel disease","volume":"40","author":"Canani","year":"2008","journal-title":"Dig. Liver Dis."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"522","DOI":"10.3892\/mmr.2014.2180","article-title":"Faecal calprotectin as a novel biomarker for differentiating between inflammatory bowel disease and irritable bowel syndrome","volume":"10","author":"Chang","year":"2014","journal-title":"Mol. Med. Rep."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"953","DOI":"10.1002\/jgh3.13010","article-title":"Assessing vitamin D as a biomarker in inflammatory bowel disease","volume":"7","author":"Yeaman","year":"2023","journal-title":"JGH Open"},{"key":"ref_42","doi-asserted-by":"crossref","unstructured":"L\u00f3pez-Mu\u00f1oz, P., Beltr\u00e1n, B., S\u00e1ez-Gonz\u00e1lez, E., Alba, A., Nos, P., and Iborra, M. (2019). Influence of Vitamin D Deficiency on Inflammatory Markers and Clinical Disease Activity in UC Patients. Nutrients, 11.","DOI":"10.3390\/nu11051059"},{"key":"ref_43","doi-asserted-by":"crossref","unstructured":"Wang, J., Mei, L., Hao, Y., Xu, Y., Yang, Q., Dai, Z., Yang, Y., Wu, Z., and Ji, Y. (2024). Contemporary Perspectives on the Role of Vitamin D in Enhancing Gut Health and Its Implications for Preventing and Managing Intestinal Diseases. Nutrients, 16.","DOI":"10.3390\/nu16142352"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"38","DOI":"10.1016\/j.cyto.2017.12.023","article-title":"Higher serum vitamin D levels are associated with protective serum cytokine profiles in patients with ulcerative colitis","volume":"103","author":"Gubatan","year":"2018","journal-title":"Cytokine"},{"key":"ref_45","doi-asserted-by":"crossref","unstructured":"Yeung, C.Y., Chiang Chiau, J.S., Cheng, M.L., Chan, W.T., Jiang, C.B., Chang, S.W., Liu, C.Y., Chang, C.W., and Lee, H.C. (2021). Effects of Vitamin D-Deficient Diet on Intestinal Epithelial Integrity and Zonulin Expression in a C57BL\/6 Mouse Model. Front. Med., 8.","DOI":"10.3389\/fmed.2021.649818"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"76","DOI":"10.1016\/j.metabol.2017.01.007","article-title":"Gut microbiota interactions with the immunomodulatory role of vitamin D in normal individuals","volume":"69","author":"Luthold","year":"2017","journal-title":"Metabolism"},{"key":"ref_47","doi-asserted-by":"crossref","unstructured":"Wobke, T.K., Sorg, B.L., and Steinhilber, D. (2014). Vitamin D in inflammatory diseases. Front. Physiol., 5.","DOI":"10.3389\/fphys.2014.00244"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"S-998","DOI":"10.1016\/S0016-5085(18)33341-9","article-title":"Tu1715\u2014The Effect of Vitamin D Administration on Inflammatory Marker in Patients with Inflammatory Bowel Disease","volume":"154","author":"Jun","year":"2018","journal-title":"Gastroenterology"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1111\/j.1365-2036.2010.04355.x","article-title":"Clinical trial: Vitamin D3 treatment in Crohn\u2019s disease\u2014A randomized double-blind placebo-controlled study","volume":"32","author":"Agnholt","year":"2010","journal-title":"Aliment. Pharmacol. Ther."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"1129","DOI":"10.1136\/gut.2003.036657","article-title":"Measurement of vitamin D levels in inflammatory bowel disease patients reveals a subset of Crohn\u2019s disease patients with elevated 1,25-dihydroxyvitamin D and low bone mineral density","volume":"53","author":"Abreu","year":"2004","journal-title":"Gut"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"3373","DOI":"10.1210\/jc.2014-1714","article-title":"25(OH)D-2 Half-Life Is Shorter Than 25(OH)D-3 Half-Life and Is Influenced by DBP Concentration and Genotype","volume":"99","author":"Jones","year":"2014","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_52","doi-asserted-by":"crossref","unstructured":"Cusato, J., Bertani, L., Antonucci, M., Tomasello, C., Caviglia, G.P., Dibitetto, S., Massano, A., Mangia, M., Mula, J., and Ceccarelli, L. (2021). Vitamin D-Related Genetics as Predictive Biomarker of Clinical Remission in Adalimumab-Treated Patients Affected by Crohn\u2019s Disease: A Pilot Study. Pharmaceuticals, 14.","DOI":"10.3390\/ph14121230"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"1679","DOI":"10.3945\/jn.113.180794","article-title":"Vitamin D regulates the gut microbiome and protects mice from dextran sodium sulfate-induced colitis","volume":"143","author":"Ooi","year":"2013","journal-title":"J. Nutr."},{"key":"ref_54","doi-asserted-by":"crossref","unstructured":"Gao, H., Zhou, H., Zhang, Z., Gao, J., Li, J., and Li, X. (2023). Vitamin D3 alleviates inflammation in ulcerative colitis by activating the VDR-NLRP6 signaling pathway. Front. Immunol., 14.","DOI":"10.3389\/fimmu.2023.1135930"},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1177\/1756283X10377820","article-title":"Vitamin D and gastrointestinal diseases: Inflammatory bowel disease and colorectal cancer","volume":"4","author":"Raman","year":"2011","journal-title":"Therap. Adv. Gastroenterol."},{"key":"ref_56","doi-asserted-by":"crossref","unstructured":"Sun, J., and Zhang, Y.G. (2022). Vitamin D Receptor Influences Intestinal Barriers in Health and Disease. Cells, 11.","DOI":"10.3390\/cells11071129"},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"294","DOI":"10.1177\/2050640615572176","article-title":"Effects of vitamin D supplementation on intestinal permeability, cathelicidin and disease markers in Crohn\u2019s disease: Results from a randomised double-blind placebo-controlled study","volume":"3","author":"Raftery","year":"2015","journal-title":"United Eur. Gastroenterol. J."},{"key":"ref_58","first-page":"S1542-356500624-X","article-title":"The Real-World Impact of Vitamin D Supplementation on Inflammatory Bowel Disease Clinical Outcomes","volume":"22","author":"Sninsky","year":"2025","journal-title":"Clin. Gastroenterol. Hepatol."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1186\/s12979-025-00514-y","article-title":"Gut-vitamin D interplay: Key to mitigating immunosenescence and promoting healthy ageing","volume":"22","author":"Ullah","year":"2025","journal-title":"Immun. Ageing"},{"key":"ref_60","doi-asserted-by":"crossref","unstructured":"Hamza, F.N., Daher, S., Fakhoury, H.M.A., Grant, W.B., Kvietys, P.R., and Al-Kattan, K. (2023). Immunomodulatory Properties of Vitamin D in the Intestinal and Respiratory Systems. Nutrients, 15.","DOI":"10.3390\/nu15071696"},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"225","DOI":"10.1111\/1751-2980.12591","article-title":"Vitamin D administration leads to a shift of the intestinal bacterial composition in Crohn\u2019s disease patients, but not in healthy controls","volume":"19","author":"Schaffler","year":"2018","journal-title":"J. Dig. Dis."},{"key":"ref_62","doi-asserted-by":"crossref","unstructured":"Battistini, C., Ballan, R., Herkenhoff, M.E., Saad, S.M.I., and Sun, J. (2021). Vitamin d Modulates Intestinal Microbiota in Inflammatory Bowel Diseases. Int. J. Mol. Sci., 22.","DOI":"10.20944\/preprints202011.0276.v1"},{"key":"ref_63","doi-asserted-by":"crossref","unstructured":"Dell\u2019Anna, G., Fanizzi, F., Zilli, A., Furfaro, F., Solitano, V., Parigi, T.L., Ciliberto, A., Fanizza, J., Mandarino, F.V., and Fuccio, L. (2025). The Role of Vitamin D in Inflammatory Bowel Diseases: From Deficiency to Targeted Therapeutics and Precise Nutrition Strategies. Nutrients, 17.","DOI":"10.3390\/nu17132167"},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"200","DOI":"10.1159\/000489010","article-title":"High Prevalence of Vitamin D Deficiency among Patients with Inflammatory Bowel Disease","volume":"2","author":"Caviezel","year":"2018","journal-title":"Inflamm. Intest. Dis."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"100","DOI":"10.1080\/00365521.2016.1233577","article-title":"Vitamin D deficiency in inflammatory bowel disease: Prevalence and predictors in a Norwegian outpatient population","volume":"52","author":"Frigstad","year":"2017","journal-title":"Scand. J. Gastroenterol."},{"key":"ref_66","doi-asserted-by":"crossref","unstructured":"Mo, C., Bajgai, J., Rahman, M.H., Choe, S., Abdul-Nasir, S., Ma, H., He, W., Pham, T.T., Zhang, H., and Hoon, G.S. (2025). A pilot clinical trial to explore the effects of UV exposure on vitamin D synthesis and inflammatory responses in vitamin D-Deficient adults. Sci. Rep., 15.","DOI":"10.1038\/s41598-025-09203-8"},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"80","DOI":"10.1038\/ncpendmet0716","article-title":"Unexpected actions of vitamin D: New perspectives on the regulation of innate and adaptive immunity","volume":"4","author":"Adams","year":"2008","journal-title":"Nat. Clin. Pract. Endocrinol. Metab."},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"1462","DOI":"10.1093\/ibd\/izy094","article-title":"A Single Nucleotide Polymorphism in the Vitamin D Receptor Gene Is Associated with Decreased Levels of the Protein and a Penetrating Pattern in Crohn\u2019s Disease","volume":"24","author":"Salvador","year":"2018","journal-title":"Inflamm. Bowel Dis."},{"key":"ref_69","first-page":"97","article-title":"Lack of Vitamin D Receptor Leads to Hyperfunction of Claudin-2 in Intestinal Inflammatory Responses","volume":"25","author":"Zhang","year":"2019","journal-title":"Inflamm. Bowel Dis."},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"3983","DOI":"10.1172\/JCI65842","article-title":"Intestinal epithelial vitamin D receptor signaling inhibits experimental colitis","volume":"123","author":"Liu","year":"2013","journal-title":"J. Clin. Investig."},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"2386","DOI":"10.1210\/me.2003-0281","article-title":"A Crucial Role for the Vitamin D Receptor in Experimental Inflammatory Bowel Diseases","volume":"17","author":"Froicu","year":"2003","journal-title":"Mol. Endocrinol."},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"206","DOI":"10.1111\/imr.12180","article-title":"Microbiota activation and regulation of innate and adaptive immunity","volume":"260","author":"Alexander","year":"2014","journal-title":"Immunol. Rev."},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"963","DOI":"10.1093\/ecco-jcc\/jjy052","article-title":"The Effect of Vitamin D on Intestinal Inflammation and Faecal Microbiota in Patients with Ulcerative Colitis","volume":"12","author":"Garg","year":"2018","journal-title":"J. Crohn\u2019s Colitis"},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"647","DOI":"10.1053\/j.gastro.2019.04.016","article-title":"Environmental Risk Factors for Inflammatory Bowel Diseases: An Umbrella Review of Meta-Analyses","volume":"157","author":"Piovani","year":"2019","journal-title":"Gastroenterology"},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"1","DOI":"10.21926\/rpn.2502007","article-title":"The Crucial Role of Vitamin D in Regulating Gut Microbiota in Inflammatory Bowel Disease","volume":"5","author":"Bartolacci","year":"2025","journal-title":"Recent. Progress. Nutr."},{"key":"ref_76","doi-asserted-by":"crossref","unstructured":"Ahmadi, A., Yousefimashouf, R., Mohammadi, A., Nikkhoo, B., Shokoohizadeh, L., Khan Mirzaei, M., Alikhani, M.Y., Sheikhesmaili, F., and Khodaei, H. (2025). Investigating the expression of anti\/pro-inflammatory cytokines in the pathogenesis and treatment of ulcerative colitis and its association with serum level of vitamin D. Sci. Rep., 15.","DOI":"10.1038\/s41598-025-87551-1"},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"7577","DOI":"10.3748\/wjg.v19.i43.7577","article-title":"Clostridium difficile and inflammatory bowel disease: Role in pathogenesis and implications in treatment","volume":"19","author":"Nitzan","year":"2013","journal-title":"World J. Gastroenterol."},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"2423","DOI":"10.1210\/en.2010-0089","article-title":"Vitamin D deficiency in mice impairs colonic antibacterial activity and predisposes to colitis","volume":"151","author":"Lagishetty","year":"2010","journal-title":"Endocrinology"},{"key":"ref_79","doi-asserted-by":"crossref","unstructured":"Hamza, K.H., Dun\u00e9r, E., Ulmert, I., Arias, A., Sorobetea, D., and Lahl, K. (2021). Minor alterations in the intestinal microbiota composition upon Rotavirus infection do not affect susceptibility to DSS colitis. Sci. Rep., 11.","DOI":"10.1038\/s41598-021-92796-7"},{"key":"ref_80","doi-asserted-by":"crossref","unstructured":"Khan, I., Ullah, N., Zha, L., Bai, Y., Khan, A., Zhao, T., Che, T., and Zhang, C. (2019). Alteration of Gut Microbiota in Inflammatory Bowel Disease (IBD): Cause or Consequence? IBD Treatment Targeting the Gut Microbiome. Pathogens., 8.","DOI":"10.3390\/pathogens8030126"},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"1690","DOI":"10.1086\/420823","article-title":"Chemotaxonomic analysis of bacterial populations colonizing the rectal mucosa in patients with ulcerative colitis","volume":"38","author":"Macfarlane","year":"2004","journal-title":"Clin. Infect. Dis."},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"4254","DOI":"10.3748\/wjg.v24.i37.4254","article-title":"VSL#3 Can Prevent Ulcerative Colitis-Associated Carcinogenesis in Mice","volume":"24","author":"Wang","year":"2018","journal-title":"World J. Gastroenterol."},{"key":"ref_83","doi-asserted-by":"crossref","first-page":"697","DOI":"10.1007\/s12664-024-01647-6","article-title":"Role of fungus in inflammatory bowel disease: The butterfly effect?","volume":"43","author":"Jena","year":"2024","journal-title":"Indian. J. Gastroenterol."},{"key":"ref_84","doi-asserted-by":"crossref","first-page":"280","DOI":"10.1038\/s41575-022-00613-x","article-title":"Fungal strain-dependent inflammation in IBD","volume":"19","author":"Kotsiliti","year":"2022","journal-title":"Nat. Rev. Gastroenterol. Hepatol."},{"key":"ref_85","doi-asserted-by":"crossref","first-page":"10295","DOI":"10.2147\/JIR.S528820","article-title":"Association of Recreational Physical Activity with Gut Microbiota Diversity and Composition, and Symptom Burden in Crohn\u2019s Disease: A Cross-Sectional Study","volume":"18","author":"Sun","year":"2025","journal-title":"J. Inflamm. Res."},{"key":"ref_86","first-page":"107","article-title":"Effect of Candida colonization on human ulcerative colitis and the healing of inflammatory changes of the colon in the experimental model of colitis ulcerosa","volume":"60","author":"Brzozowski","year":"2009","journal-title":"J. Physiol. Pharmacol."},{"key":"ref_87","doi-asserted-by":"crossref","unstructured":"Xie, H., Yu, S., Tang, M., Xun, Y., Shen, Q., and Wu, G. (2025). Gut microbiota dysbiosis in inflammatory bowel disease: Interaction with intestinal barriers and microbiota-targeted treatment options. Front. Cell Infect. Microbiol., 15.","DOI":"10.3389\/fcimb.2025.1608025"},{"key":"ref_88","doi-asserted-by":"crossref","unstructured":"Saez-Lara, M.J., Gomez-Llorente, C., Plaza-Diaz, J., and Gil, A. (2015). The Role of Probiotic Lactic Acid Bacteria and Bifidobacteria in the Prevention and Treatment of Inflammatory Bowel Disease and Other Related Diseases: A Systematic Review of Randomized Human Clinical Trials. BioMed Res. Int., 2015.","DOI":"10.1155\/2015\/505878"},{"key":"ref_89","doi-asserted-by":"crossref","unstructured":"Dziarski, R., Park, S.Y., Kashyap, D.R., Dowd, S.E., and Gupta, D. (2016). Pglyrp-Regulated Gut Microflora Prevotella falsenii, Parabacteroides distasonis and Bacteroides eggerthii Enhance and Alistipes finegoldii Attenuates Colitis in Mice. PLoS ONE., 11.","DOI":"10.1371\/journal.pone.0146162"},{"key":"ref_90","doi-asserted-by":"crossref","first-page":"152","DOI":"10.1093\/ecco-jcc\/jjaa093","article-title":"A Practical Guide for Faecal Calprotectin Measurement: Myths and Realities","volume":"15","author":"Nancey","year":"2021","journal-title":"J. Crohns Colitis."}],"container-title":["Life"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-1729\/15\/9\/1412\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T18:41:48Z","timestamp":1760035308000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-1729\/15\/9\/1412"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,8]]},"references-count":90,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2025,9]]}},"alternative-id":["life15091412"],"URL":"https:\/\/doi.org\/10.3390\/life15091412","relation":{},"ISSN":["2075-1729"],"issn-type":[{"value":"2075-1729","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9,8]]}}}