Oral butyrate for mildly to moderately active Crohn's disease

Abstract

Summary Background : Butyrate exerts anti‐inflammatory effects in experimental colitis and on Crohn's disease lamina propria mononuclear cells in vitro. Aim : To explore the efficacy and safety of oral butyrate in Crohn's disease. Methods : Thirteen patients with mild–moderate ileocolonic Crohn's disease received 4 g/day butyrate as enteric‐coated tablets for 8 weeks. Full colonoscopy and ileoscopy were performed before and after treatment. Endoscopical and histological score, laboratory data, Crohn's disease activity index and mucosal interleukin (IL)‐1β, IL‐6, IL‐12, interferon‐γ, tumour necrosis factor‐α and nuclear factor‐kappa B (NF‐κB) were assessed before and after treatment. Results : One patient withdrew from the study, and three patients did not experience clinical improvement. Among the nine patients (69%) who responded to treatment, seven (53%) achieved remission and two had a partial response. Endoscopical and histological score significantly improved after treatment at ileocaecal level (P < 0.05). Leucocyte blood count, erythrocyte sedimentation rate and mucosal levels of NF‐κB and IL‐1β significantly decreased after treatment (P < 0.05). Conclusions : Oral butyrate is safe and well tolerated, and may be effective in inducing clinical improvement/remission in Crohn's disease. These data indicate the need for a large investigation to extend the present findings, and suggest that butyrate may exert its action through downregulation of NF‐κB and IL‐1β.

Gut microbiota, the pharmabiotics they produce and host health

“…Indeed, SCFA play a key role in the prevention and treatment of metabolic and bowel disorders and certain types of cancer (124)(125)(126)(127)(128) . The positive influence of SCFA treatment on ulcerative colitis and Crohn's disease have been demonstrated in various clinical studies (129)(130)(131)(132)(133) . Butyrate is the primary energy source for cellular metabolism in the colonic epithelium (134) .…”

Dietary supplementation with β-glucan enriched oat bran increases faecal concentration of carboxylic acids in healthy subjects

“…These acids are important energy sources for the colonocytes and may thus improve the condition of the colonic mucosa and, in consequence, decrease the risk of mucosal lesions. Especially butyric acid has been suggested to play a role in the prevention and treatment of colonic diseases, such as ulcerative colitis (Cummings, 1997) and colon cancer (Scheppach et al, 1995), and to some extent Crohn's disease (Di Sabatino et al, 2005). Current knowledge is summarized in recent reviews (Galvez et al, 2005;Wong et al, 2006).…”

Inflammatory Bowel Disease and Cytokine

“…When there is a patient with the Crohn's disease or ulcerative colitis within the family, the risk of occurrence in Crohn's disease in line family members accounts for 10~25%. Additionally, the prevalence rate is higher in biovular twins rather than uniovular twins, and as difference is shown in the prevalence rate amongst diverse racial groups, it provides support for the possibility for genetic factors [9,14,77].…”

“…Additionally, the luminal concentration of butyrate can be 30 mM [10,37,60,61]. As butyrate controlled the balance between the epithelial cell proliferation, differentiation, and apoptosis, it maintains the health and integrity of the intestinal area, and plays an important part for anti-cancer, anti-inflammation, and oxidative stress conditions [14,20,70]. Moreover, butyrate enema or high-fiber dietary increase the density of butyrate within the colon and showed outstanding effects in the inflammation treatment within the colonic mucosa [63].…”

“…Butyrate are mostly short-chained fatty acids which holds 4 carbons created when the carbohydrate of food within the colonic mucosa becomes digested due to bacteria [14,70].…”