Food induced stimulation of the antisecretory factor can improve symptoms in human inflammatory bowel disease: a study of a concept

Abstract

Background-Antisecretory factor (AF), a 41 kDa cloned and sequenced protein, suppresses intestinal inflammation and hypersecretion in animals. Endogenous AF production can be induced by dietary modifications in several animal species, and this feed has been shown to reduce the incidence of diarrhoeal disease in weaning piglets. The role of AF in intestinal disease in humans is not known. Aims-To study the eVects of hydrothermally processed cereals, optimised for AF induction in animals, added to the diet of patients with longstanding symptoms of inflammatory bowel disease (IBD). Patients-Fifty three patients with IBD (ulcerative colitis and Crohn's disease) were entered into the study, and 50 completed follow up. The experimental group consisted of 16 females (mean age 50 (SEM 5) years) and 10 males (41 (4) years) and the placebo group of 12 women (41 (4) years old) and 12 men (51 (5) years). Methods-Patients were randomised to receive either hydrothermally processed cereals (active treatment) or the same amount of ordinary cereals (placebo treatment) for four weeks in a double blind study design. Baseline diet and medications remained unchanged. Bowel symptoms, plasma levels of AF, and colonic biopsies were evaluated before and after treatment. Results-The active treatment significantly improved subjective ratings of clinical symptoms and increased plasma AF levels compared with placebo. Plasma lipid levels were unaVected. Conclusion-Hydrothermally processed cereals can induce AF production in human IBD. This increase in endogenous AF activity is associated with clinical improvement. Further studies are warranted to clarify the exact role of AF in human intestinal disease. (Gut 2000;46:824-829)

Antisecretory factor as a potential health-promoting molecule in man and animals

“…Curative treatment for IBD has yet to be established; up until now therapeutic focus is on alleviating symptoms (50) . Björck et al (9) evaluated the effect of an increased endogenous AF secretion on the clinical outcome in patients suffering from IBD. Patients with long-lasting ulcerative colitis or Crohn's disease received a diet containing either placebo cereals or SPC, without changing food habits and conventional medical treatment (9) .…”

“…Table 2. Content of sugars and amino acids in cereals before and after the hydrothermal process (from Bjö rck et al (9) ) Content Before the process (mg/g DM) After the process (mg/g DM)…”

“…Induction of endogenous AF through nutritional means, in addition to rehydration therapy and/or pharmacological therapy, has been proved to noticeably reduce fluid loss and bowel movements, resulting in an improvement of patients' well-being (9,12,13) . A patented hydrothermal process allows cereal kernels to reach an optimal concentration of specific amino acids and oligosaccharides, able to induce endogenous AF secretion (5) .…”

“…In rat jejunal loops, AF inhibited the inflammatory response caused by toxin A from Clostridium difficile (4) . Intestinal exposure to bacterial toxins (4) or intake of specific dietary compounds has proved to enhance the antisecretory and anti-inflammatory activity of endogenous AF (9) . Nowadays, diarrhoeal diseases remain a major global health concern, especially in developing countries where the transmission of infectious gastrointestinal pathogens is favoured by poor hygienic conditions.…”

Therapeutic effect of antisecretory factor-rich egg yolk on the late phases of 2,4,6-trinitrobenzenesulphonic acid colitis in mice

“…AF has been associated with clinical improvement in ulcerative colitis, Crohn's disease and hormone-mediated secretory diarrhoea (5,6) . After 2 weeks of supplementary HPC therapy, AF plasma levels may increase 10-fold (5,6) .…”