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PRACA PRZEGLĄDOWA
Możliwości zastosowania wybranych substancji biologicznie czynnych we wspomaganiu farmakologicznego leczenia choroby Leśniowskiego-Crohna – przegląd wyników badań
 
Więcej
Ukryj
1
Studenckie Koło Naukowe przy Zakładzie Dietetyki, Wydział Nauk o Zdrowiu, Uniwersytet Medyczny, Wrocław
 
2
Zakład Dietetyki, Wydział Nauk o Zdrowiu, Uniwersytet Medyczny, Wrocław
 
 
Autor do korespondencji
Dorota Różańska   

Zakład Dietetyki, Wydział Nauk o Zdrowiu, Uniwersytet Medyczny we Wrocławiu, ul. Parkowa 34, 51-616 Wrocław
 
 
Med Og Nauk Zdr. 2015;21(4):346-351
 
SŁOWA KLUCZOWE
STRESZCZENIE
Wstęp:
Choroba Leśniowskiego-Crohna (ChLC) to przewlekła i nieuleczalna choroba zapalna jelit, charakteryzująca się występowaniem okresów zaostrzenia i remisji. Nieodpowiednia dieta może pogarszać stan odżywienia, potęgować objawy choroby i skracać czas remisji. Dotychczasowe zalecenia dietetyczne dla pacjentów dotyczą głównie zmniejszenia spożycia produktów zaostrzających objawy choroby, jak również przeciwdziałania niedożywieniu.

Cel pracy:
Przegląd piśmiennictwa dotyczący aktualnego stanu wiedzy na temat możliwości zastosowania substancji biologicznie czynnych we wspomaganiu farmakologicznego leczenia choroby Leśniowskiego-Crohna.

Stan wiedzy:
Niektóre substancje, takie jak: wielonienasycone kwasy tłuszczowe (WNKT) n-3, glutamina i arginina, probiotyki, prebiotyki i krótkołańcuchowe kwasy tłuszczowe (KKT), mogą wykazywać działanie przeciwzapalne, przede wszystkim poprzez regulację liczebności i składu fizjologicznej flory bakteryjnej w jelitach i hamowanie ekspresji prozapalnych cytokin. Chociaż korzystne działanie substancji biologicznie czynnych zostało wykazane w wielu badaniach na hodowlach komórkowych in vitro i ze zwierzętami doświadczalnymi, to wyniki badań z udziałem ludzi są niejednoznaczne. W większości badań wykazano jednak, że substancje te, chociaż stosunkowo rzadko efektywne, są bezpieczne dla chorych, a ich zastosowanie nie wiąże się ze zwiększonym ryzykiem wystąpienia działań niepożądanych ani pogorszenia stanu pacjentów.

Podsumowanie:
Terapia z wykorzystaniem wyżej wymienionych substancji biologicznie czynnych nie ma obecnie zastosowania w rutynowym leczeniu pacjentów z ChLC, a wyniki badań nie są rozstrzygające. Konieczne są dalsze badania w celu oceny skuteczności WNKT n-3, aminokwasów, probiotyków i prebiotyków oraz KKT w leczeniu ChLC.


Introduction:
Crohn’s Disease (CD) is a chronic and incurable, inflammatory bowel disease, that is characterized by periods of remissions and relapses. An improper diet may impair nutritional status, exacerbate the symptoms and shorten the duration of remission. The to-date dietary recommendations for the patients concern mainly the reduction of intake of the products that exacerbate the symptoms, as well as combating malnutrition.

Objective:
Review of the literature concerning the possibility of using certain biologically- active substances in supporting pharmacological treatment of Crohn’s Disease.

Scientific knowledge:
Certain substances, such as polyunsaturated fatty acids n-3, glutamine, probiotics, prebiotics and short-chain fatty acids may exhibit anti-inflammatory properties, primarily by regulating the number and composition of physiological gut microflora and inhibiting the expression of proinflammatory cytokines. Although the beneficial effects of using biologically-active substances have been confirmed in many in vitro and in vivo animal studies, the results of studies in humans are unclear. However, in most studies it has been revealed that those substances, despite their ineffectiveness, are probably safe and their use is not associated with an increased risk of side effects or exacerbation of patient›s condition.

Conclusion:
Therapy with the above-mentioned substances is not used for treatment Crohn’s Disease and the results of studies are inconclusive. Therefore, other studies with polyunsaturated fatty acids n-3, glutamine, probiotics, prebiotics and short-chain fatty acids are needed in order to determine their effectiveness on the treatment of Crohn’s Disease.

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