Controlled trial of polymeric versus elemental diet in treatment of active Crohn's disease

Giaffer, M. H.; North, Ginnie Lee T.; Holdsworth, C D

doi:10.1016/0140-6736(90)90936-y

Cited by 160 publications

(71 citation statements)

References 14 publications

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“…We also confirmed that oral intake of Ile caused changes in the microflora in CD patients, possibly through the induction of HBD2 expression (data not shown). It was also reported that dexamethasone, a major drug used for the treatment of CD, induced HBD2 in the presence of pro-inflammatory cytokines [35], and use of the elementary diet, which mainly consists of amino acids, relieved the activity of CD [36]. Furthermore, Ile treatment is regarded to exert few adverse effects, because it is a frequently consumed essential amino acid, and influences HBD2 expression only under inflammatory conditions.…”

Section: Discussionmentioning

confidence: 99%

Isoleucine, an Essential Amino Acid, Induces the Expression of Human <i>β</i> Defensin 2 through the Activation of the G-Protein Coupled Receptor-ERK Pathway in the Intestinal Epithelia

Konno¹,

Ashida²,

Inaba³

et al. 2012

FNS

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Anti-microbial peptides are essential for the intestinal innate immunity that protects the intestinal epithelia from attacks by foreign pathogens. Human β-defensin (HBD) is one of the pivotal anti-microbial peptides that are expressed in the colonic epithelia. This study investigated the effect and the signaling mechanism of inducible β-defensin HBD2 by an essential amino acid, isoleucine (Ile) in colonic epithelial cells. Here we examined the expression level of HBD2 on induction of Ile in epithelial cells, and checked this pathway. HBD2 mRNA was induced by co-incubation with IL-1α and Ile in Caco2 cells, but not by Ile alone. An inhibitor of either ERK or Gi, a subunit of G-proteins, reduced the induction of HBD2 mRNA by Ile. The treatment with Ile also increased the intracellular calcium ion concentration, thus suggesting that the GPCR and ERK signaling pathway mediate the effects of Ile. These results indicate that an essential amino acid, Ile, enhances the expression of an inducible β-defensin, namely HBD2, by IL-1α through the activation of GPCRs and ERK signaling pathway. The administration of Ile may therefore represent a possible option to safely treat intestinal inflammation.

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Section: Discussionmentioning

confidence: 99%

Isoleucine, an Essential Amino Acid, Induces the Expression of Human <i>β</i> Defensin 2 through the Activation of the G-Protein Coupled Receptor-ERK Pathway in the Intestinal Epithelia

Konno¹,

Ashida²,

Inaba³

et al. 2012

FNS

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“…The cumulative probability of maintaining remission at six months was 0-67 after treatment with prednisolone compared with 028 after treatment with elemental diet, and at one year the probability of maintaining remission was 035 in the prednisolone group and 0 09 in the elemental diet treated group (p<005; log rank test). At one year, remission was maintained in only one of the 11 elemental diet treated patients compared with six of the 19 912 (3)(4)(5) nutrition'" and are more palatable, but it is wk4 57-1(3-0)…”

Section: Follow Up Of Remissionmentioning

confidence: 97%

Initial response and subsequent course of Crohn's disease treated with elemental diet or prednisolone.

Gorard

Hunt

Payne-James

et al. 1993

Gut

160

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“…Enteral nutrition is usually prescribed from 10 d to 8 weeks. By 10 d there should be a clinical response and patients may even go into disease remission (62) but longer studies indicate that mucosal healing does not occur until later on and 8 weeks or more may be required (63,64) . Enteral nutrition does not provide a primary therapeutic option in UC but can be used for nutritional support (65) .…”

Section: Diet In Active Diseasementioning

confidence: 99%

Dietary and nutritional considerations for inflammatory bowel disease

Lomer

2011

Proc. Nutr. Soc.

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Nutritional assessment and dietary advice are fundamental to inflammatory bowel disease (IBD) patient management and all patients should have access to a dietitian. Newly diagnosed patients often think that their pre-illness diet has contributed to the development of their IBD. However, epidemiological evidence to support diet as a risk factor is lacking. How the diet contributes to the gastrointestinal microbiota is interesting, although the role is not yet clearly defined. Nutritional problems in IBD are common. Malnutrition occurs in up to 85% of patients and weight loss affects up to 80% of patients with Crohn's disease and 18–62% of patients with ulcerative colitis. Nutritional deficiencies are prevalent, particularly in relation to anaemia and osteoporosis. Intestinal strictures can be problematic in Crohn's disease and limiting fibrous foods that may cause a mechanical obstruction in the gastrointestinal tract is helpful. Patients often explore dietary exclusion to alleviate symptoms but such changes may be self-directed or inappropriately advised and can lead to further nutritional deficiencies. Some patients experience concurrent functional symptoms (e.g. abdominal bloating, abdominal pain, flatulence and diarrhoea) that can significantly affect quality of life. Recently, a group of poorly absorbed carbohydrates that occur naturally in the diet called fermentable oligo-, di-, mono-saccharides and polyols have been associated with functional symptoms by intestinal bacterial fermentation leading to rapid gas production, and an osmotic effect increasing fluid delivery to the colon. Emerging evidence indicates that a diet low in fermentable oligo-, di-, mono-saccharides and polyols can alleviate functional symptoms in IBD.

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Controlled trial of polymeric versus elemental diet in treatment of active Crohn's disease

Cited by 160 publications

References 14 publications

Isoleucine, an Essential Amino Acid, Induces the Expression of Human <i>β</i> Defensin 2 through the Activation of the G-Protein Coupled Receptor-ERK Pathway in the Intestinal Epithelia

Isoleucine, an Essential Amino Acid, Induces the Expression of Human <i>β</i> Defensin 2 through the Activation of the G-Protein Coupled Receptor-ERK Pathway in the Intestinal Epithelia

Initial response and subsequent course of Crohn's disease treated with elemental diet or prednisolone.

Dietary and nutritional considerations for inflammatory bowel disease

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Controlled trial of polymeric versus elemental diet in treatment of active Crohn's disease

Cited by 160 publications

References 14 publications

Isoleucine, an Essential Amino Acid, Induces the Expression of Human &lt;i&gt;β&lt;/i&gt; Defensin 2 through the Activation of the G-Protein Coupled Receptor-ERK Pathway in the Intestinal Epithelia

Isoleucine, an Essential Amino Acid, Induces the Expression of Human &lt;i&gt;β&lt;/i&gt; Defensin 2 through the Activation of the G-Protein Coupled Receptor-ERK Pathway in the Intestinal Epithelia

Initial response and subsequent course of Crohn's disease treated with elemental diet or prednisolone.

Dietary and nutritional considerations for inflammatory bowel disease

Contact Info

Product

Resources

About

Isoleucine, an Essential Amino Acid, Induces the Expression of Human <i>β</i> Defensin 2 through the Activation of the G-Protein Coupled Receptor-ERK Pathway in the Intestinal Epithelia

Isoleucine, an Essential Amino Acid, Induces the Expression of Human <i>β</i> Defensin 2 through the Activation of the G-Protein Coupled Receptor-ERK Pathway in the Intestinal Epithelia