Association of vitamin D supplementation and gut microbiome in adults patients suffering from knee osteoarthritis - An interventional study.

Dr. Balamurugan Ramadass, Additional Professor, Department of Biochemistry, AIIMS, Bhubaneswar;Dr. Sujit Kumar Tripathy, Professor, Department of Orthopedics, AIIMS, Bhubaneswar.Osteoarthritis and vitamin D deficiency often co-occur in older adults. There is mounting evidence that vitamin D deficiency may contribute to systemic inflammation, disease progression, and a decline in quality of life through its effects on the gut microbiome, immune regulation, and CD4+ T cell proliferation. Although the microbiota composition, immunological balance, and osteoarthritis outcomes may be improved by vitamin D treatment, its exact function is still unknown, especially in the senior population of India. 60 individuals with knee osteoarthritis who visit the outpatient department at AIIMS Bhubaneswar between July 2021 and December 2022 participated in an observational prospective study to close this gap. Individuals with knee osteoarthritis who are over 60, willing to give informed consent, and available for a six-month follow-up will be included; those with confounding conditions like secondary osteoarthritis, significant deformities, systemic illnesses, inflammatory or metabolic arthritis, gastrointestinal morbidity, chronic infections, recent hospitalization, recent history of antibiotic or immunization, high body mass index, or use of pharmacologic doses of vitamins or minerals will be excluded. To gain important insights into the relationship between vitamin D status, gut microbiota, and disease progression, this study intends to prospectively assess the clinical course and consequences of knee osteoarthritis in this cohort. After fecal DNA was collected, the hypervariable region of the 16S rRNA gene was amplified using the proper primers and PCR conditions. The resulting paired-end reads were then sequenced using the Illumina MiSeq platform. The raw sequence data was processed, and the undesirable sequences were discarded while the desired sequences were retained. Together with the database, a non-redundant gene catalogue was created and annotated. Normalizing read counts to gene length and total mapped reads will be used to determine relative gene abundances. To enable thorough profiling of gut microbial populations, high-quality reads will be mapped to the relevant gene databases to complete taxonomic characterization of each sample. The anticipated conclusion of the microbiome sequencing and diversity study may be that higher vitamin D levels are linked to a greater number of anti-inflammatory bacterial taxa, according to the microbiome sequencing and diversity analysis, suggesting that vitamin D may also have a protective immunomodulatory function in patients with osteoarthritis. On the other hand, probiotic bacterial communities may be relatively more abundant at lower vitamin D levels, suggesting a compensatory microbial response in the absence of vitamin D. These results may point to a possible connection between gut microbial makeup and vitamin D status, which could help control inflammatory pathways in osteoarthritis of the knee.