Lipid and Bile Acid Dysmetabolism in Crohn’s Disease

Abstract

Crohn's disease is one of the systemic autoimmune diseases. It commonly affects the small intestine and colon but may involve any portion of the gastrointestinal tract from the mouth to the anus. The most affected area by Crohn's disease is the distal part of the small intestine, in which the bile acid molecules are most efficiently reabsorbed. Bile acids form mixed micelles together with fatty acids, which function as a transport vehicle to deliver fatty acids to the apical membrane of enterocytes for absorption. Therefore, if the terminal ileum is impaired, bile acid malabsorption may occur, which may cause congenital diarrhoea in Crohn's disease. Similarly, the impairment of the terminal ileum also induces fatty acid malabsorption, which may influence the role of fatty acids in Crohn's disease. In contrast, a recent study reported that multidrug resistance protein 1 (MDR1) regulated effector T-cell function in the ileum from bile acid-driven oxidative stress and MDR1 loss of function in a subset of patients with Crohn's disease. However, the role of consumption of fatty acids in Crohn's disease remains to be fully elucidated. This review is aimed at providing an overview of some recent developments in research of Crohn's disease from comprehensive perspective with a focus on the connection between disease location and behaviour, lipid diets, and bile acid malabsorption.

Evaluation of Gas Explosion Injury Based on Analysis of Rat Serum Profile by Ultra-Performance Liquid Chromatography/Mass Spectrometry-Based Metabonomics Techniques

“…The significant increase in taurine and decrease in glycine-conjugated bile compound in rat serum suggested that the cometabolism of gut microbes was altered in rats, and potential changes in the enterohepatic circulation might have also occurred. Moreover, bile acids are closely correlated with lipids, which could have potential regulatory effects on nuclear receptors [24]. The abnormal metabolism of phospholipids can also affect many biological processes, such as inflammation [25].…”

Hyodeoxycholic acid (HDCA) suppresses intestinal epithelial cell proliferation through FXR‐PI3K/AKT pathway, accompanied by alteration of bile acids metabolism profiles induced by gut bacteria

“…Numerous studies have shown that gut microbiota can regulate host physiology by altering BAs metabolism 10‐12 . In addition, the altered BAs metabolism profiles have been considered as a marker of many diseases, such as IBD, Crohn's disease, and Alzheimer's disease 13‐15 …”

Increased Cellular Uptake of Polyunsaturated Fatty Acids and Phytosterols from Natural Micellar Oil

“…Under pathophysiological conditions of fat malabsorption, however, micellization of lipophilic compounds might become especially important for supplementation with essential fatty acids. Fat malabsorption occurs due to gastrointestinal diseases, such as Crohn's disease [35], exocrine pancreatic insufficiency [36], cystic fibrosis [37], or after gastric bypass surgery [38]. Similarly, the use of Orlistat, an anti-obesity drug that limits fat absorption by inhibition of pancreatic lipase, leads to fat malabsorption [39].…”