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Mucosal healing and a fall in mucosal pro‐inflammatory cytokine mRNA induced by a specific oral polymeric diet in paediatric Crohn’s disease
Author(s) -
John Fell,
M Paintin,
F ArnaudBattandier,
R Mark Beattie,
A Hollis,
P Kitching,
Anne Donnet-Hughes,
Thomas T. MacDonald,
J A WalkerSmith
Publication year - 2000
Publication title -
alimentary pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.308
H-Index - 177
eISSN - 1365-2036
pISSN - 0269-2813
DOI - 10.1046/j.1365-2036.2000.00707.x
Subject(s) - ileum , medicine , cytokine , gastroenterology , crohn's disease , enteral administration , interleukin , jejunum , intestinal mucosa , immunology , parenteral nutrition , disease
Background: Although enteral nutrition is a recognized form of treatment for intestinal Crohn’s disease, there are persisting problems with feed palatability and only limited data as to its mode of action. Aim: To assess the effects of a specific oral polymeric diet (CT3211; Nestle, Vevey, Switzerland), which is rich in transforming growth factor β 2 , on the mucosal inflammatory process. Methods: Twenty‐nine consecutive children with active intestinal Crohn’s disease were treated with CT3211 as the sole source of nutrition for 8 weeks. Patients were assessed clinically, and endoscopically, whilst cytokine mRNA was measured in mucosal biopsies before and after treatment by quantitative reverse transcriptase polymerase chain reaction. Results: After 8 weeks 79% of children were in complete clinical remission. Macroscopic and histological healing in the terminal ileum and colon was associated with a decline in ileal and colonic interleukin‐1 β mRNA (pre‐treatment to post‐treatment ratio 0.008 and 0.06: P < 0.001, P = 0.006). In the ileum there was also a fall in interferon γ mRNA (ratio 0.15, P < 0.001) with a rise in transforming growth factor β 1 mRNA (ratio 10, P = 0.04), whilst in the colon interleukin‐8 mRNA fell with treatment (ratio 0.06, P < 0.05). Conclusions: The clinical response to oral polymeric diet CT3211 is associated with mucosal healing and a down regulation of mucosal pro‐inflammatory cytokine mRNA in both the terminal ileum and colon. In the ileum there was also an increase in transforming growth factor β 1 mRNA.