Nutritional support and dietary interventions for patients with ulcerative colitis: current insights

Hill, Rebecca J.

doi:10.2147/nds.s68126

Cited by 3 publications

(2 citation statements)

References 83 publications

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“…EEN is not routinely used in active UC patients because it is less efficacious in this patient group. 9 A reason for the lower efficacy may be related to the lack of indigestible substrates (ie, fiber or prebiotics) found in the EEN formula predominately used; therefore, by the time the EEN reaches the inflamed colon of UC patients, most of the beneficial nutrients have already been absorbed in the small bowel. Even among CD patients, the benefits of EEN are variable, with up to 30% of patients not responding clinically and up to 50% of patients not responding endoscopically to EEN.…”

mentioning

confidence: 99%

Prebiotic Enriched Exclusive Enteral Nutrition Suppresses Colitis via Gut Microbiome Modulation and Expansion of Anti-inflammatory T Cells in a Mouse Model of Colitis

Healey

Tsai

Schick

et al. 2021

Cellular and Molecular Gastroenterology and Hepatology

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Background & Aims Exclusive enteral nutrition (EEN) is used to treat pediatric Crohn’s disease (CD), but therapeutic benefits are variable, and EEN can lead to microbial dysbiosis. Because of reported lower efficacy EEN is not routinely used to treat pediatric ulcerative colitis (UC). Inulin-type fructans (IN) beneficially modulate the gut microbiome and promote expansion of anti-inflammatory immune cells. We hypothesized that enriching EEN with IN (EEN IN) would enhance treatment efficacy. To test this, we examined the effects of EEN IN on colitis development, the gut microbiome, and CD4 + T cells using an adoptive T-cell transfer model of colitis. Methods TCR-β deficient ( -/- ) mice were randomized to 1 of 4 groups: (1) Control, (2) Chow, (3) EEN, and (4) EEN IN, and naive CD4 + T cells were adoptively transferred into groups 2–4, after which mice were monitored for 5 weeks before experimental endpoint. Results Mice fed EEN IN showed greater colitis protection, with colonic shortening, goblet cell, and crypt density loss reduced compared with EEN fed mice and reduced disease activity and immune cell infiltration compared with chow fed mice, and less crypt hyperplasia and higher survival compared with both groups. EEN IN mice had less deterioration in the colonic mucus layer and had increased levels of Foxp3 + IL-10 + and Rorγt + IL-22 + and reduced levels of Tbet + IFNγ + and Tbet + TNF + CD4 + T cells. EEN IN also led to higher butyrate concentrations, Bifidobacterium spp. and Anaerostipes caccae relative abundance, and lower [ Clostridium ] innocuum group spp. and Escherichia-Shigella spp. relative abundance. Conclusions The EEN IN group showed reduced colitis development as compared with the chow and EEN groups. This highlights the potential benefits of EEN IN as a novel induction therapy for pediatric CD and UC patients.

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mentioning

confidence: 99%

Prebiotic Enriched Exclusive Enteral Nutrition Suppresses Colitis via Gut Microbiome Modulation and Expansion of Anti-inflammatory T Cells in a Mouse Model of Colitis

Healey

Tsai

Schick

et al. 2021

Cellular and Molecular Gastroenterology and Hepatology

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“…The mechanism(s) by which EEN achieves these benefits is unknown, but changes in the gut microbiota 5 , inflammatory mediators 6,7 and intestinal barrier function 8 are likely implicated. EEN is not routinely used in active UC patients as it is less efficacious in this patient group 9 . A reason for the lower efficacy may be related to the lack of indigestible substrates (i.e.…”

Section: Introductionmentioning

confidence: 99%

An Inulin-Type Fructan Enriched Exclusive Enteral Nutrition Formula Suppresses Colitis Through Gut Microbiome Modulation and Promoting Expansion of Anti-Inflammatory T Cell Subsets

Tsai

et al. 2021

Preprint

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Background & Aims: Exclusive enteral nutrition (EEN) is used to treat pediatric Crohns disease (CD), but therapeutic benefits are not long lasting. Due to reported lower efficacy EEN is not routinely used to treat pediatric ulcerative colitis (UC). Inulin-type fructans (IN) beneficially modulate the gut microbiome and promote expansion of anti-inflammatory immune cells. We hypothesised that enriching EEN with IN (EEN-IN) would enhance treatment efficacy. To test this, we examined the effects of EEN-IN on colitis development, the gut microbiome and CD4+ T cells using an adoptive T cell transfer model of colitis. Methods: TCR-beta deficient mice were randomised to one of four groups: 1) Control, 2) Chow, 3) EEN and 4) EEN-IN, and naive CD4+ T cells were adoptively transferred into groups 2-4, after which mice were monitored for 5-weeks prior to experimental endpoint. Results: Mice fed EEN-IN showed greater colitis protection, with colonic shortening, goblet cell and crypt density loss reduced over that of EEN fed mice and reduced disease activity and immune cell infiltration compared to chow fed mice, and less crypt hyperplasia and higher survival compared to both groups. EEN-IN mice maintained colonic mucus layer thickness and had increased levels of Foxp3+IL-10+ and Roryt+IL-22+ and reduced levels of Tbet+IFNy+ and Tbet+TNF+ CD4+ T cells. EEN-IN also lead to higher butyrate, Bifidobacterium spp. and Bacteroides spp. concentrations. Conclusion: The EEN-IN group showed reduced colitis development as compared to the chow and EEN groups. This highlights the potential benefits of EEN-IN as a novel induction therapy for pediatric CD and UC patients.

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Recent advances in nanocarrier systems for ulcerative colitis: A new era of targeted therapy and biomarker integration

Chauhan,

Harwansh

2024

Journal of Drug Delivery Science and Technology

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Nutritional support and dietary interventions for patients with ulcerative colitis: current insights

Cited by 3 publications

References 83 publications

Prebiotic Enriched Exclusive Enteral Nutrition Suppresses Colitis via Gut Microbiome Modulation and Expansion of Anti-inflammatory T Cells in a Mouse Model of Colitis

Prebiotic Enriched Exclusive Enteral Nutrition Suppresses Colitis via Gut Microbiome Modulation and Expansion of Anti-inflammatory T Cells in a Mouse Model of Colitis

An Inulin-Type Fructan Enriched Exclusive Enteral Nutrition Formula Suppresses Colitis Through Gut Microbiome Modulation and Promoting Expansion of Anti-Inflammatory T Cell Subsets

Recent advances in nanocarrier systems for ulcerative colitis: A new era of targeted therapy and biomarker integration

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