Assessment of serum levels of vitamin D and tumor necrosis factor alpha in ulcerative colitis patients at Egyptian Military Hospitals: Cross-sectional observational study … Original Research Article … |
The Egyptian Journal of Immunology E-ISSN (2090-2506) Volume 33 (4), October, 2026 Pages: 108–119. www.Ejimmunology.org https://doi.org/10.55133/eji.330410 |
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| Wedad Eldahan1, Mohamed Z. H. Hassan2, Ahmed M. Asaad3, Mohamed Salaheldin4, and Mostafa Elnakib1 |
| 1Department of Medical Microbiology & Immunology, Military Institute of Health & Epidemiology, Military Medical Academy, Cairo, Egypt.
2Department of Medical Microbiology & Immunology, Faculty of Medicine, Tanta University, Egypt. 3Department of Medical Microbiology & Immunology, Faculty of Medicine, Zagazig University, Egypt. 4Department of Internal Medicine, Gastroenterology & Hepatology, Military Medical Academy, Cairo, Egypt. |
Corresponding author: Mostafa Elnakib, Department of Medical Microbiology & Immunology, Military Institute of Health & Epidemiology, Military Medical Academy, Cairo, Egypt. Email: moselnakib@yahoo.com |
Abstract
Ulcerative colitis (UC) is a chronic inflammatory disorder confined to the colonic and rectal mucosa. The disease is marked by infiltration of immune cells, leading to excessive production of inflammatory mediators. A key pro-inflammatory cytokine that plays a vital role in the pathophysiology of ulcerative colitis is tumor necrosis factor-alpha (TNF-α). Low levels of vitamin D have been associated with several autoimmune disorders. This study aimed to assess vitamin D serum levels in UC patients as regard TNF-α serum levels and the Severity of UC (UCDAI). This cross-sectional observational research was carried out at Military healthcare facilities in Cairo, Egypt, over six months, from 1 July 2025 to 31 December 2025. Utilizing a convenience sample of 50 adults aged 15 to 70 years with a confirmed diagnosis of ulcerative colitis, newly diagnosed. They were divided into two groups according to disease severity (UCDAI or Mayo score. 26 patients in the mild group & 24 patients (moderate/ severe) group. Demographic data were collected from patients’ interviews. Colonoscopy for ulcerative colitis disease activity index (UCDAI) score, CBC, ESR, CRP, and Fecal calprotectin (FC) were investigated at Egyptian Military hospitals. Serum levels of 25-hydroxyvitamin D (using CLIA) and TNF-α (using ELISA) were measured at central laboratories of the armed forces and blood bank. Correlation analysis showed Serum Vitamin D had a moderate negative correlation with UCDAI (r = −0.466, p-value= 0.001), and a strong negative correlation with serum TNF-α (r = −0.669, p-value <0.001). Serum TNF-α showed a moderate positive correlation with UCDAI (r = 0.472, p-value= 0.001). Fecal calprotectin had a strong positive correlation with UCDAI (r = 0.704, p-value <0.001) and a weak positive correlation with serum TNF-α (r = 0.388, p-value= 0.005). In conclusion, this study demonstrates that patients with moderate to severe ulcerative colitis had pronounced mucosal and systemic inflammation, reflected by markedly elevated fecal calprotectin and TNF-α levels, concomitant with significantly lower vitamin D concentrations compared with those in mild disease.
Keywords: Ulcerative colitis, Vitamin D, Tumor Necrosis Factor Alpha, Inflammatory bowel disease, Cytokines, Ulcerative colitis disease activity index.
Date received: 19 August 2026; accepted: 04 September 2026
PMID:
0000000
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