No abstract

Background Although there are many hypotheses, the pathogenesis of Crohn's disease (CD) is not completely clear so far. Exclusive enteral nutrition (EEN) is a routine measure in the treatment of active CD. We aimed at investigating the impact of EEN on patients with active CD from microbial metabolomics. Methods 16S-rDNA sequencing technology and gas chromatography–mass spectrometer analysis were employed to investigate the modification of the intestinal flora and fecal short-chain fatty acid (SCFA) during the EEN. Results Seven patients with CD, who conducted EEN, were followed up successfully in the present study. The 8-week EEN resulted in a remission of the condition of subjects with active CD, as revealed by a significant decrease in erythrocyte sedimentation rate (ESR) (P = 0.018), C-reactive protein (CRP) (P = 0.028), and Crohn’s disease activity index (CDAI) (P = 0.018). The nutrition of the subjects was improved after an 8-week treatment course with EEN, which was associated with an increase in body mess index (BMI) (P = 0.018) and serum albumin (ALB) (P = 0.018) levels. Furthermore, our investigations revealed a significantly increased abundance of Firmicutes paralleled by decreased levels of Proteobacteria. With respect to the genus, five species of bacteria including Ruminococcus (P = 0.01), Lachnospiraceae (P = 0.02), Anaerotruncus (P = 0.04), Flavonifractor (P = 0.04), and Novosphingobium (P = 0.05) showed significantly increased abundance. This was accompanied by relative changes in fecal short-chain fatty acids levels. Moreover, we successfully constructed a stable model by combining these five significantly different genera to predict the therapeutic effect of EEN on patients with CD (AUC = 0.9598). Conclusions The findings indicated that EEN can alleviate the condition and the nutrition of patients with active CD by regulating the intestinal flora and influencing the expression level of fecal short-chain fatty acids.

Background: Inflammatory bowel disease (IBD) is a chronic inflammatory disease of the digestive tract. The aetiology and pathogenesis of IBD are complex, which may lead to metabolic disorders. As a kind of metabolite, polyunsaturated fatty acid (PUFA) is closely related to IBD. Objectives: The aim of this study was to explore the correlation between the serum PUFAs and the pathogenesis of IBD. Design: The study is a hospital-based case-control study. Methods: The serum free PUFAs of all participants, including 104 patients with IBD and 101 normal controls, were detected by liquid chromatography–mass spectrometry (LC-MS). Results: Compared with the normal control, the levels of C18:2, α-C18:3 (ALA), ɤ-C18:3, C20:4 (AA), C20:5 (EPA), ω-3 C22:5, ω-6 C22:5 and C22:6 (DHA) PUFAs in patients with Crohn’s disease (CD) were obviously decreased. However, in patients with ulcerative colitis (UC), the levels of AA, EPA, ω-3 C22:5, ω-6 C22:5 and DHA were downregulated. The concentrations of seven PUFAs were significantly downregulated in the active CD group. In addition, four PUFAs had comparatively higher levels in the remission UC group. Conclusion: The present study revealed substantial differences in the levels of serum fatty acids between normal controls and patients with IBD. In detail, patients with CD were deficient in PUFAs, including the essential fatty acids. Moreover, as the disease activity aggravated, some PUFAs decreased dramatically.

Background. Bile acid (BA) metabolism may be influenced by gut dysbiosis and alterations of intestinal epithelium in patients with Crohn’s disease (CD). Here, we aimed at investigating the alterations of serum BA profile in CD patients and analyzing the correlation between BAs and CD disease activity. Methods. A total of 62 CD patients (29 active and 33 remission) and 33 healthy volunteers (HVs) were enrolled in this retrospective study. Serum BA profiles were measured by liquid chromatography-tandem mass spectrometry. Results. Levels of primary BAs components, including cholic acid (CA) and chenodeoxycholic acid (CDCA), showed no significant difference when compared with HVs. Secondary BAs (SBA) were significantly decreased in CD patients compared with HVs. Importantly, the deoxycholic acid (DCA) and glycodeoxycholic acid (GDCA) levels were significantly lower in CD active than in CD remission patients. The DCA/(DCA + CA) ratio was also decreased in CD active patients than in CD remission patients while the LCA/(LCA + CDCA) ratio showed no difference between them. Principal component analysis also indicated a clear separation among the three groups, with a total variance of 93.43%. The correlation analysis showed that the SBA, DCA, GDCA levels, and DCA/(DCA + CA) ratio had an inverse relationship with Crohn’s Disease Activity Index. Conclusion. The BA profile exhibits significant alterations in CD patients. The SBA, DCA, GDCA levels, and DCA/(DCA + CA) ratio were significantly decreased in CD active patients. The DCA/(DCA + CA) ratio had an inverse correlation with CD disease activity.