Effects of the Exclusive Enteral Nutrition on the Microbiota Profile of Patients with Crohn’s Disease: A Systematic Review

Gatti, Simona; Galeazzi, Tiziana; Franceschini, Elisa; Annibali, R.; Albano, V.; Verma, Anil K.; Angelis, Maria De; Lionetti, Maria Elena; Catassi, Carlo

doi:10.3390/nu9080832

Cited by 51 publications

(43 citation statements)

References 58 publications

(127 reference statements)

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“…For example, there are growing suggestions that the gut microbiota might play a significant role in the development of CD in susceptible individuals, with several studies reporting altered gut microflora eliciting an inflammatory response of the intestinal mucosa in subjects with an underlying immunological mucosal defect . There is also an increasing body of evidence suggesting that EEN allows modification of gut microflora to a more favourable state, leading to the functional changes that allow inflammation to be controlled .…”

Section: Discussionmentioning

confidence: 99%

Inducing remission in paediatric Crohn’s disease using nutritional therapies – A systematic review

McVeigh

Payne

2019

J Human Nutrition Diet

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Background Exclusive enteral nutrition (EEN) is known to be a safe and effective treatment option for managing active Crohn’s disease (CD) in children, although no uniform protocol exists. The aim of this systematic review was to evaluate and compare the clinical effectiveness of aspects of EEN protocols to ascertain whether an optimum regimen can be identified. Methods A systematic search of the Cochrane Library, PubMed, MEDLINE, EMBASE, CINAHL and AMED was conducted for studies published between 1998 and 2018 that examined paediatric patients being treated with an enteral nutrition protocol to induce remission. Studies that included patients receiving concurrent medication for active disease were excluded. Quality assessment was performed using separate tools for randomised controlled trials, cohort studies and for studies without a control group. Results Sixteen studies met the inclusion criteria. Of these, six found insufficient evidence to support use of a specific formula. One study examined the route of EEN, finding no difference between oral or nasogastric tube administration with respect to inducing remission. Three examined the use of partial enteral nutrition to induce remission, although conflicting results were seen. No studies explored the effect of length of treatment or energy prescription on remission rates Conclusions An optimum enteral nutrition protocol for inducing remission cannot be identified. Further focused research is required by well designed, adequately powered prospective clinical trials to examine aspects of enteral feeding protocols that remain uncertain, including the use of partial enteral nutrition as a potential alternative to EEN.

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Section: Discussionmentioning

confidence: 99%

Inducing remission in paediatric Crohn’s disease using nutritional therapies – A systematic review

McVeigh

Payne

2019

J Human Nutrition Diet

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“…and Prevotella spp. [ 101 ]. Utilizing fiber to beneficially modulate the gut microbiome and enhance microbial metabolite production, i.e., butyrate, has the potential to dampen down hyperactive immune responses [ 52 , 102 ] and repair intestinal epithelial barrier dysfunction [ 103 , 104 , 105 ] to reduce disease activity in pediatric IBD patients.…”

Section: The Impact Fiber Has On the Gut Microbiome In Pediatric Imentioning

confidence: 99%

Fiber and Prebiotic Interventions in Pediatric Inflammatory Bowel Disease: What Role Does the Gut Microbiome Play?

et al. 2020

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The etiology of inflammatory bowel disease (IBD) is complex but is thought to be linked to an intricate interaction between the host’s immune system, resident gut microbiome and environment, i.e., diet. One dietary component that has a major impact on IBD risk and disease management is fiber. Fiber intakes in pediatric IBD patients are suboptimal and often lower than in children without IBD. Fiber also has a significant impact on beneficially shaping gut microbiota composition and functional capacity. The impact is likely to be particularly important in IBD patients, where various studies have demonstrated that an imbalance in the gut microbiome, referred to as dysbiosis, occurs. Microbiome-targeted therapeutics, such as fiber and prebiotics, have the potential to restore the balance in the gut microbiome and enhance host gut health and clinical outcomes. Indeed, studies in adult IBD patients demonstrate that fiber and prebiotics positively alter the microbiome and improve disease course. To date, no studies have been conducted to evaluate the therapeutic potential of fiber and prebiotics in pediatric IBD patients. Consequently, pediatric IBD specific studies that focus on the benefits of fiber and prebiotics on gut microbiome composition and functional capacity and disease outcomes are required.

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“…However, partial enteral nutrition in which patients receive a polymeric liquid formula supplement rich in transforming growth factor-β2 (TGF-β2) along with their normal diet has proved effective [ 61 ]. EEN acts in part by altering the composition of the gut bacteriome, reducing the abundance of genera that predominate during a flare-up [ 62 ]. However, it has little or no ameliorative effect on pediatric or adult UC or adult CD, but may have general nutritional benefits for these patients [ 63 , 64 ].…”

Section: Influences On Colonizationmentioning

confidence: 99%

Inflammatory Bowel Diseases: Host-Microbial-Environmental Interactions in Dysbiosis

2020

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Crohn’s Disease (CD) and Ulcerative Colitis (UC) are world-wide health problems in which intestinal dysbiosis or adverse functional changes in the microbiome are causative or exacerbating factors. The reduced abundance and diversity of the microbiome may be a result of a lack of exposure to vital commensal microbes or overexposure to competitive pathobionts during early life. Alternatively, many commensal bacteria may not find a suitable intestinal niche or fail to proliferate or function in a protective/competitive manner if they do colonize. Bacteria express a range of factors, such as fimbriae, flagella, and secretory compounds that enable them to attach to the gut, modulate metabolism, and outcompete other species. However, the host also releases factors, such as secretory IgA, antimicrobial factors, hormones, and mucins, which can prevent or regulate bacterial interactions with the gut or disable the bacterium. The delicate balance between these competing host and bacteria factors dictates whether a bacterium can colonize, proliferate or function in the intestine. Impaired functioning of NOD2 in Paneth cells and disrupted colonic mucus production are exacerbating features of CD and UC, respectively, that contribute to dysbiosis. This review evaluates the roles of these and other the host, bacterial and environmental factors in inflammatory bowel diseases.

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Effects of the Exclusive Enteral Nutrition on the Microbiota Profile of Patients with Crohn’s Disease: A Systematic Review

Cited by 51 publications

References 58 publications

Inducing remission in paediatric Crohn’s disease using nutritional therapies – A systematic review

Inducing remission in paediatric Crohn’s disease using nutritional therapies – A systematic review

Fiber and Prebiotic Interventions in Pediatric Inflammatory Bowel Disease: What Role Does the Gut Microbiome Play?

Inflammatory Bowel Diseases: Host-Microbial-Environmental Interactions in Dysbiosis

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