RESOLUTION OF MUCOSAL INFLAMMATION AND FALL IN IL-1 BETA mRNA IN ACTIVE CROHN'S DISEASE IN RESPONSE TO POLYMERIC DIET CT3211.

Responsiveness of IGF‐I and IGFBP‐3 to therapeutic intervention in children and adolescents with Crohn's disease

“…There is also evidence that a remission of Crohn's disease induced by enteral nutrition reduces mucosal cytokine production (Breese et al, 1994(Breese et al, , 1995. Using reverse transcriptase polymerase chain reaction enteral feeding has been shown to significantly reduce interleukin 1 in ileal tissue (Fell et al, 1997). The lower basal IGF-I levels in the enteral nutrition patients than the surgical patients may be related to the greater chronicity and wider distribution of the Crohn's disease in the former group.…”

Use of 6-Mercaptopurine/Azathioprine as the Immunomodulator of Choice for Moderately Active Crohnʼs Disease

“…[15][16][17] The use of enteral nutrition also has been studied for patients with moderately active Crohn's disease. As Dr. Griffiths points out, Fell et al 18 were able to achieve remission in 50% of patients at 1 year with the use of a polymeric liquid diet for 8 weeks. Although this is true, it also means that an additional 50% were not in remission and therefore required additional therapies, including perhaps repeated exposures to corticosteroids.…”

Use of 6-Mercapturine/Azathioprine as the Immunomodulator of Choice for Moderately Active Crohnʼs Disease

“…Fell and colleagues4 have observed a 50% relapse rate by 1 year after the successful induction of clinical remission with 8 weeks of a polymeric liquid diet as the sole source nutrition. These two sources of pediatric data, therefore, both demonstrate a 50% rate of maintained clinical remission at 1 year after diagnosis and initial treatment 2,4. Is it better to use AZA/6‐MP as first‐line therapy among all patients with moderate disease, while recognizing that half of those patients will be treated unnecessarily?…”

“…Other available data concerning the natural history of the pediatric onset Crohn's disease, particularly if it was of moderate or greater severity at presentation, are sparse, but in general are supportive of the outcome observed in the control group of the study by Markowitz et al 2 Enteral nutrition has been employed in preference to corticosteroids in children with newly diagnosed moderately active Crohn's disease in the United Kingdom. 3 Fell and colleagues 4 have observed a 50% relapse rate by 1 year after the successful induction of clinical remission with 8 weeks of a polymeric liquid diet as the sole source nutrition. These two sources of pediatric data, therefore, both demonstrate a 50% rate of maintained clinical remission at 1 year after diagnosis and initial treatment.…”

“…These two sources of pediatric data, therefore, both demonstrate a 50% rate of maintained clinical remission at 1 year after diagnosis and initial treatment. 2,4 Is it better to use AZA/6-MP as first-line therapy among all patients with moderate disease, while recognizing that half of those patients will be treated unnecessarily? Or is it better to "wait and see," recognizing that without effective maintenance therapy half of the patients will experience early relapse?…”