Sistema Gastrointestinal e Digestivo

Abstrato

Characterization of Selected Metabolic and Immunologic Markers Following Exclusive Enteral Nutrition of Pediatric Crohn’s Disease Patients

Viral Brahmbhatt, Ivan Montoliu, Nabil Bosco, François-Pierre Martin, Phillipe Guy, Manuel Oliveira, Stephanie Schatz, Katharina Werkstetter, Eduardo Schiffrin, Berthold Koletzko, Jalil Benyacoub, Sibylle Koletzko

Objectives: Exclusive enteral nutrition (EEN) is one of the first-line therapeutic options for pediatric patients with active Crohn’s disease (CD). However, only sparse data exist on plasma metabolic changes from patients on EEN therapy. Thus to gain mechanistic insights, we have characterized selected markers in pediatric CD patients treated with EEN for induction of disease remission. Methods: Plasma levels of 18 cytokines and chemokines and 163 metabolites in 10 pediatric CD patients receiving 8 weeks of EEN therapy were measured. Measurements were performed at three time points: a) at baseline (V0); b) during EEN intervention at week 4 (V4) and; c) at 4 weeks after completion of EEN therapy at week 12 (V12). Results: Comparisons between V0 and V4 levels identified changes in 20 different molecules, including increases in 7 metabolites of the diacyl phosphatidylcholine (PC) class and 6 metabolites of the alkylacyl PC class. However, most of these changes were not sustained after returning to a normal diet, i.e. only 7 out of the 20 molecules with significant changes between V0 and V4 still retained significance upon comparing V0 and V12. Conclusions: The changes in the plasma levels of various phospholipids at different time-points reflect the nutritional intervention and improved health status of pediatric CD patients.