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Oral immunoglobulin treatment improved intestinal permeability in children with active Crohn's disease
Author(s) -
Sundqvist Tommy,
Stenhammar Lars,
Tjellström Bo,
Magnusson KarlEric,
Forslund Tony,
Högberg Lotta
Publication year - 2017
Publication title -
acta paediatrica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.772
H-Index - 115
eISSN - 1651-2227
pISSN - 0803-5253
DOI - 10.1111/apa.13747
Subject(s) - medicine , intestinal permeability , crohn's disease , peg ratio , gastroenterology , adverse effect , immunoglobulin a , antibody , barrier function , disease , enteral administration , immunology , parenteral nutrition , immunoglobulin g , mathematical optimization , mathematics , finance , economics
Aim Crohn's disease ( CD ) is a chronic mucosal inflammation that affects the intestinal barrier function, for example, by altering the intestinal permeability. This pilot clinical study investigated the impact of oral human immunoglobulin ( OHIG ) treatment on permeability characteristics in children with active luminal Crohn's disease. Methods The study was performed at the Department of Paediatrics, Norrköping Hospital, Sweden. Intestinal permeability was studied in three boys aged 13, 15 and 18 years with active CD , before and after a six‐week treatment programme with OHIG , using different‐sized polyethylene glycols as the test molecules. Three age‐ and sex‐matched children with active CD treated with exclusive enteral nutrition ( EEN ) were also studied. Results OHIG and EEN resulted in virtually similar reductions in the signs and symptoms of mucosal inflammation. However, OHIG , unlike EEN , appeared to normalise mucosal transfer leading to a normalisation of the maximum permeation of the small PEG molecules, as well as less restrictions of the larger PEG molecules. Conclusion Our study found that OHIG appeared to normalise the mucosal barrier. This suggests that it could offer a new additional and versatile treatment for paediatric CD patients, with a minimal risk of adverse effects.