Fecal S100A12 is a novel noninvasive marker that distinguishes children with active IBD from healthy control subjects with high sensitivity and specificity. Fecal S100A12 possesses characteristics that are desirable for a noninvasive disease marker and therefore is a suitable candidate marker for IBD. Further evaluation is required to examine this marker in additional contexts.

Exclusive enteral nutrition using polymeric formula (PF) is a well-established therapeutic option for active Crohn's disease; however, its mechanisms of action are unknown. We investigated the anti-inflammatory effects of PF in an in vitro model of epithelial cell inflammation. PF did not affect cell viability over a range of dilutions, but when PF was added to the culture medium the interleukin (IL)-8 response to proinflammatory stimuli was significantly reduced. This effect was due to PF acting directly on the cells as the IL-8 response was still reduced when PF was separated from the proinflammatory stimuli in a 2-compartment system. In the presence of PF, nuclear factor (NF)-kappaB nuclear migration was not inhibited; however, IkappaBalpha degradation was delayed. PF has direct anti-inflammatory effects upon immortalized colonic enterocytes. Therefore PF may, in part, modulate gut inflammation by directly reducing the inflammatory response of the intestinal epithelium.

Crohn's disease (CD) is a life-long inflammatory process affecting any segment of the gastrointestinal tract. This condition most often presents in childhood and adolescence and almost universally impacts adversely upon the nutritional state of the patient. Weight loss is a common presenting feature and potential long-term adverse outcomes include malnutrition, anaemia, osteopaenia and impaired linear growth. Understanding the nutritional aspects of this disease is especially important in growing children and adolescents entering and advancing through puberty. In addition, a nutritional approach to the management of CD is now well established as a valid and effective treatment to induce and maintain disease remission. The mechanisms of this therapy are beginning to be defined, and include direct antiinflammatory effects and alteration of intestinal microflora. This review focuses upon the role of nutritional therapy in the management of CD in children and adolescents in the context of a comprehensive nutritional approach to managing individuals with this chronic condition.