The use of exclusive enteral nutrition for induction of remission in children with Crohn’s disease demonstrates that disease phenotype does not influence clinical remission

Buchanan, Evan G.; Gaunt, W. W.; Cardigan, Tracey; Garrick, Vikki; McGrogan, Paraic; Russell, Richard K.

doi:10.1111/j.1365-2036.2009.04067.x

Cited by 153 publications

(148 citation statements)

References 28 publications

Supporting

Mentioning

135

Contrasting

Unclassified

Order By: Relevance

“…Enteral nutrition is widely used in the management of pediatric CD, achieving high rates of remission in all phenotypes ( 40 ). Its mode of action remains to be explained fully, although published studies to date suggest that changes in the microbiota parallel clinical response ( 41 ).…”

Section: Microbiota Of Pediatric Ibd By Pyrosequencingmentioning

confidence: 99%

Microbiota of De-Novo Pediatric IBD: Increased Faecalibacterium Prausnitzii and Reduced Bacterial Diversity in Crohn's But Not in Ulcerative Colitis

Hansen

Russell

Reiff³

et al. 2012

American Journal of Gastroenterology

248

180

View full text Add to dashboard Cite

The gastrointestinal microbiota is considered important in infl ammatory bowel disease (IBD) pathogenesis. Discoveries from established disease cohorts report reduced bacterial diversity, changes in bacterial composition, and a protective role for Faecalibacterium prausnitzii in Crohn ' s disease (CD). The majority of studies to date are however potentially confounded by the effect of treatment and a reliance on established rather than de-novo disease. METHODS:Microbial changes at diagnosis were examined by biopsying the colonic mucosa of 37 children: 25 with newly presenting, untreated IBD with active colitis (13 CD and 12 ulcerative colitis (UC)), and 12 pediatric controls with a macroscopically and microscopically normal colon. We utilized a dual-methodology approach with pyrosequencing (threshold >10,000 reads) and confi rmatory real-time PCR (RT-PCR). RESULTS:Threshold pyrosequencing output was obtained on 34 subjects (11 CD, 11 UC, 12 controls). No signifi cant changes were noted at phylum level among the Bacteroidetes, Firmicutes, or Proteobacteria. A signifi cant reduction in bacterial α -diversity was noted in CD vs. controls by three methods (Shannon, Simpson, and phylogenetic diversity) but not in UC vs. controls. An increase in Faecalibacterium was observed in CD compared with controls by pyrosequencing (mean 16.7 % vs. 9.1 % of reads, P = 0.02) and replicated by specifi c F. prausnitzii RT-PCR (36.0 % vs. 19.0 % of total bacteria, P = 0.02). No disease-specifi c clustering was evident on principal components analysis. CONCLUSIONS: Our results offer a comprehensive examination of the IBD mucosal microbiota at diagnosis, unaffected by therapeutic confounders or changes over time. Our results challenge the current model of a protective role for F. prausnitzii in CD, suggesting a more dynamic role for this organism than previously described.SUPPLEMENTARY MATERIAL is linked to the online version of the paper at

show abstract

Section: Microbiota Of Pediatric Ibd By Pyrosequencingmentioning

confidence: 99%

Microbiota of De-Novo Pediatric IBD: Increased Faecalibacterium Prausnitzii and Reduced Bacterial Diversity in Crohn's But Not in Ulcerative Colitis

Hansen

Russell

Reiff³

et al. 2012

American Journal of Gastroenterology

248

180

View full text Add to dashboard Cite

show abstract

“…In the above cohort, it was notable that those with isolated terminal ileal disease had a lower rate of remission -however, there were only four children with this disease location at diagnosis [16]. Otherwise, disease location did not influence the outcomes in this report.…”

Section: Efficacy Of Een In Induction Of Remissionmentioning

confidence: 35%

“…The standard length of EEN used in various different countries varies between 4 and 12 weeks [13]. Some data suggest that most anti-inflammatory and nutritional benefits have occurred by 4 weeks, and that 8 weeks of therapy are not required [16]. Other data suggest continued benefits beyond this time in many children with further improvements in inflammatory markers and weight gains [14].…”

Section: Length Of Eenmentioning

confidence: 99%

See 1 more Smart Citation

Exclusive enteral nutrition and induction of remission of active Crohn’s disease in children

Day¹,

Burgess

2013

Expert Review of Clinical Immunology

View full text Add to dashboard Cite

“…However, due to the limited number of retrospective studies available (53,54), questions remain regarding the utility of EN in pediatric CD. For example, the influence of disease location on patient response to EN requires further evaluation (47,55) as does the relapse rate after initial treatment with EN in long-term outcome studies.…”

Section: Nutritional Induction Therapymentioning

confidence: 99%

Nutritional treatment in inflammatory bowel disease: An update

Guagnozzi

González-Castillo

Olveira

et al. 2012

Rev. esp. enferm. dig.

View full text Add to dashboard Cite

Background and aims: enteral (EN) and parenteral (TPN) nutrition exert variable therapeutic effects on the induction and maintenance of remission in inflammatory bowel disease (IBD).This review aims to provide an updated discussion on the complex relationship between diet and IBD.Methods: medline, Cochrane and Scopus database searches were conducted. Sources cited in the articles obtained were also searched to identify other potential sources of information.Results: nutritional status is significantly compromised in IBD patients, especially those with Crohn's disease (CD). Apart from restoring malnourishment, dietary components contribute to modulate intestinal immune responses. Nutritional treatment is divided into support therapy and primary therapy to induce and maintain remission through TPN and EN. EN is considered a first-line therapy in children with active CD whereas it is usually used in adult CD patients when corticosteroid therapy is not possible. TPN has limited effects on IBD.En formula composition, in terms of carbohydrates, nitrogen source and bioactive molecules supplementation, differentially influence on IBD treatment outcomes. Other dietary components, such as poorly absorbed short-chain carbohydrate, polyols, and exogenous microparticles, also participate in the etiopathogenesis of IBD. Finally, new approaches to understanding the complex relationship between IBD and diet are provided by nutrigenenomic.Conclusion: further long-term, well-powered studies are required to accurately assess the usefulness of nutrition in treating IBD. In future research, the potential role of nutrient-gene interaction in drug trials and specific dietary formula compositions should be investigated in order to incorporate new knowledge about the etiopathology of IBD into nutritional intervention.

show abstract

The use of exclusive enteral nutrition for induction of remission in children with Crohn’s disease demonstrates that disease phenotype does not influence clinical remission

Abstract: SUMMARY BackgroundExclusive enteral nutrition (EEN) achieves variable remission rates in patients with Crohn's disease (CD).

Cited by 153 publications

References 28 publications

Microbiota of De-Novo Pediatric IBD: Increased Faecalibacterium Prausnitzii and Reduced Bacterial Diversity in Crohn's But Not in Ulcerative Colitis

Microbiota of De-Novo Pediatric IBD: Increased Faecalibacterium Prausnitzii and Reduced Bacterial Diversity in Crohn's But Not in Ulcerative Colitis

Exclusive enteral nutrition and induction of remission of active Crohn’s disease in children

Nutritional treatment in inflammatory bowel disease: An update

Contact Info

Product

Resources

About