Steroids or Nutrition?

Gassull, Miquel A.

doi:10.1002/9780470753170.ch15

Cited by 2 publications

(2 citation statements)

References 88 publications

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“…[4][5][6] Composite data from large uncontrolled and controlled series of EN in CD, after excluding non-compliant patients, also provide interesting information. 7 Mean remission rate in adult patients treated for at least two weeks was 79% (42-100%; n=549) with amino acid based diets, and 70% (36-90%; n=124) with whole protein based formulas, indicating that when tolerated, EN is an effective therapy for CD.…”

mentioning

confidence: 95%

Fat composition may be a clue to explain the primary therapeutic effect of enteral nutrition in Crohn's disease: results of a double blind randomised multicentre European trial

Gassull

Fernández‐Bañares

Cabré

et al. 2002

Gut

161

104

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mentioning

confidence: 95%

Fat composition may be a clue to explain the primary therapeutic effect of enteral nutrition in Crohn's disease: results of a double blind randomised multicentre European trial

Gassull

Fernández‐Bañares

Cabré

et al. 2002

Gut

161

104

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“…There is a great deal of interest in these studies, especially by those involved in the management of inflammatory bowel disease, and resources are needed to obtain more data on the basic science behind this therapeutic approach. Further information can be found in several recent publications 51–53 …”

Section: Discussionmentioning

confidence: 99%

The role of nutrition in the treatment of inflammatory bowel disease

2004

Aliment Pharmacol Ther

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Summary Nutrients may be involved in the modulation of the immune response through at least three different mechanisms. First, the intestinal ecosystem plays a pivotal role in the pathogenesis of inflammatory bowel disease, triggering the uncontrolled inflammatory response in genetically predisposed individuals. Nutrients, together with bacteria, are major components of, and can therefore influence, the intestinal environment. Second, as components of cell membranes, nutrients can mediate the expression of proteins involved in the immune response, such as cytokines, adhesion molecules and nitric oxide synthase. The composition of lipids in the cell membrane is modified by dietary changes and can influence cellular responses. Indeed, various epidemiological, experimental and clinical data suggest that the immune response may be sensitive to changes in dietary composition. Finally, suboptimal levels of micronutrients are often found in both children and adults with inflammatory bowel disease, although, with the exception of iron and folate, it is unusual to discover symptoms attributable to these deficits. However, subclinical deficits may have a pathophysiological significance, as they may favour the self‐perpetuation of the disease (due to defects in the mechanisms of tissue repair), cause defective defence against damage produced by oxygen free radicals and facilitate lipid peroxidation. These events can occur even in clinically inactive or mildly active disease, as well as in the development of dysplasia in the intestinal mucosa. Some dietary manipulations have been attempted as primary treatment for rheumatoid arthritis, and specially formulated diets for enteral nutrition have proved to be an effective treatment for Crohn's disease. Most trials, although lacking sufficient patient numbers, have demonstrated a role for dietary manipulation as primary therapy for inflammatory disease. Dietary lipids are one of the most active nutritional substrates modulating the immune response. Recently, it has been demonstrated that lipids may be a key factor explaining the therapeutic effect of clinical nutrition in Crohn's disease.

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Steroids or Nutrition?

Cited by 2 publications

References 88 publications

Fat composition may be a clue to explain the primary therapeutic effect of enteral nutrition in Crohn's disease: results of a double blind randomised multicentre European trial

Fat composition may be a clue to explain the primary therapeutic effect of enteral nutrition in Crohn's disease: results of a double blind randomised multicentre European trial

The role of nutrition in the treatment of inflammatory bowel disease

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