Impacts of long-term enteral nutrition on clinical and endoscopic disease activities and mucosal cytokines during remission in patients with Crohn's disease: A prospective study
✍ Scribed by Takayuki Yamamoto; Maki Nakahigashi; Abbi R. Saniabadi; Takashi Iwata; Yasuki Maruyama; Satoru Umegae; Koichi Matsumoto
- Publisher
- John Wiley and Sons
- Year
- 2007
- Tongue
- English
- Weight
- 165 KB
- Volume
- 13
- Category
- Article
- ISSN
- 1078-0998
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✦ Synopsis
Background:
Long-term enteral nutrition may maintain clinical and endoscopic remission in patients with crohn's disease (cd). the aim of this prospective study was to investigate the impacts of long-term enteral nutrition on clinical and endoscopic disease activities and mucosal tissue cytokines in patients with quiescent cd.
Methods:
Forty patients with cd who achieved clinical remission were included. of these, 20 received continuous elemental diet (elental) infusion during the nighttime and a low-fat diet during the daytime (en group) and 20 received neither nutritional therapy nor food restriction (non-en group). with these regimens, all 40 patients were monitored for 1 year. further, ileocolonoscopy was performed at entry, at 6 and 12 months, and mucosal biopsies were taken for cytokine assays.
Results:
On an intention-to-treat basis, 5 patients (25%) in the en group and 13 (65%) in the non-en group had a clinical relapse during the 1-year observation (p = 0.03). the mean endoscopic inflammation (ei) scores were not significantly different between the groups at both entry and 6 months, but at 12 months ei scores were significantly higher in the non-en group than in the en group (p = 0.04). additionally, the mucosal tissue interleukin (il)-1beta, il-6, and tumor necrosis factor (tnf)-alpha levels significantly increased with time in the non-en group (entry versus 12 months, il-1beta, p = 0.02; il-6, p = 0.002; tnf-alpha, p = 0.001). in the en group these cytokines did not show a significant increase.
Conclusions:
Long-term enteral nutrition in patients with quiescent cd has a clear suppressive effect on clinical and endoscopic disease activities and the mucosal inflammatory cytokine levels.