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REVIEW PAPER
Potential possibilities of using selected biologically-active substances in supporting pharmacological treatment of Crohn’s Disease – Review of trial results
 
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Studenckie Koło Naukowe przy Zakładzie Dietetyki, Wydział Nauk o Zdrowiu, Uniwersytet Medyczny, Wrocław
 
2
Zakład Dietetyki, Wydział Nauk o Zdrowiu, Uniwersytet Medyczny, Wrocław
 
 
Corresponding author
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
 
KEYWORDS
ABSTRACT
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.

 
REFERENCES (49)
1.
Bartnik W. Choroby układu pokarmowego. W: Szczeklik A. (red.). Choroby wewnętrzne. Wyd 1. Kraków: Medycyna Praktyczna;2005: 816–862.
 
2.
Rejestr choroby Crohna. http://www.chorobacrohna.pl/ (dostęp 06.02.2015).
 
3.
Hou JK, Abraham B, El-Serag H. Dietary intake and risk of developing inflammatory bowel disease: a systematic review of the literature. Am J Gastroenterol. 2011; 106(4): 563–573.
 
4.
Riordan AM, Hunter JO, Cowan RE, Crampton JR, Davidson AR, Dickinson RJ, i wsp.Treatment of active Crohn’s disease by exclusion diet: East Anglian multicentre controlled trial. Lancet. 1993; 342(8880): 1131–1134.
 
5.
Gearry RB, Irving PM, Barrett JS, Nathan DM, Shepherd SJ, Gibson PR. Reduction of dietary poorly absorbed short-chain carbohydrates (FODMAPs) improves abdominal symptoms in patients with inflam¬matory bowel disease-a pilot study. J Crohns Colitis. 2009; 3(1): 8–14.
 
6.
Levenstein S, Prantera C, Luzi C, D’Ubaldi A. Low residue or normal diet in Crohn’s disease: a prospective controlled study in Italian patients. Gut.1985; 26(10): 989–993.
 
7.
Working Group of the Japanese Society for Pediatric Gastroenterology, Hepatology and Nutrition, Konno M, Kobayashi A, Tomomasa T, Ka¬neko H, Toyoda S i wsp. Guidelines for the treatment of Crohn’s disease in children. Pediatr Int. 2006; 48(3): 349–352.
 
8.
Bernstein C, Fried M, Krabshuis J, Cohen H, Eiakim R, Fedail S. i wsp. World Gastroenterology Organization Practice Guidelines for the Diagnosis and Management of IBD in 2010. Inflamm Bowel Dis. 2010; 16(1): 112–124.
 
9.
Lochs H, Dejong C, Hammarqvist F, Hebuterne X, Leon-Sanz M, Schütz T. i wsp. ESPEN Guidelines on Enteral Nutrition: Gastroenterology. Clin Nutr. 2006; 25(2): 260–274.
 
10.
Nettleton JA. Omega-3 fatty acids and health. New York: Chapman&Hall; 1995.
 
11.
Trebble T, Arden NK, Stroud MA, Wootton SA, Burdge GC, Miles EA, i wsp. Inhibition of tumour necrosis factor-alpha and interleukin 6 production by mononuclear cells following dietary fish-oil supplementation in healthy men and response to antioxidant co-supplementation. Br J Nutr. 2003; 90(2): 405–412.
 
12.
Mantzioris E, Cleland LG, Gibson RA, Neumann MA, Demasi M, James MJ. Biochemical effects of a diet containing foods enriched with n-3 fatty acids. Am J Clin Nutr. 2000; 72(1): 42–48.
 
13.
Sperling RI, Benincaso AI, Knoell CT, Larkin JK, Austen KF, Robinson DR. Dietary omega-3 polyunsaturated fatty acids inhibit phosphoino¬sitide formation and chemotaxis in neutrophils. J Clin Invest. 1993; 91(2): 651–660.
 
14.
Knoch B, Barnett MP, Zhu S, Park ZA, Nones K, Dommels YE, i wsp. Genome-wide analysis of dietary eicosapentaenoic acid- and oleic acid-induced modulation of colon inflammation in interleukin-10 gene-deficient mice. J Nutrigenet Nutrigenomics. 2009; 2(1): 9–28.
 
15.
Amre D, D›Souza S, Morgan K, Seidman G, Lambrette P, Grimard G, i wsp. Imbalances in dietary consumption of fatty acids, vegetables, and fruits are associated with risk for Crohn’s disease in children. Am J Gastroenterol. 2007; 102(9): 2016–2025.
 
16.
Sakamoto N, Kono S, Wakai K, Fukuda Y, Satomi M, Shimoyama T, i wsp. Dietary risk factors for inflammatory bowel disease: a multicenter case-control study in Japan. Inflamm Bowel Dis. 2005; 11(2): 154–163.
 
17.
Lorenz-Meyer H, Bauer P, Nicolay C, Schulz B, Purrmann J, Fleig WE, i wsp. Omega-3 fatty acids and low carbohydrate diet for maintenance of remission in Crohn’s disease. A randomized controlled multicenter trial. Study Group Members (German Crohn’s Disease Study Group). Scand J Gastroenterol. 1996; 31(8): 778–785.
 
18.
Geerling BJ, Badart-Smook A, van Deursen C, van Houwelingen AC, Russel MG, Stockbrügger RW, i wsp. Nutritional supplementation with N-3 fatty acids and antioxidants in patients with Crohn’s disease in remission: effects on antioxidant status and fatty acid profile. Inflamm Bowel Dis. 2000; 6(2): 77–84.
 
19.
Feagan B, Sandborn W, Mittmann U, Bar-Meir S, D’Haens G, Bradette M, i wsp. Omega-3 free fatty acids for the maintenance of remission in Crohn disease: the EPIC Randomized Controlled Trials. JAMA 2008; 299(14): 1690–1697.
 
20.
Uchiyama K, Nakamura M, Odahara S, Koido S, Katahira K, Shiraishi H, i wsp. N-3 polyunsaturated fatty acid diet therapy for patients with in¬flammatory bowel disease. Inflamm Bowel Dis. 2010; 16(10): 1696–1707.
 
21.
Lev-Tzion R, Griffiths AM, Leder O, Turner D. Omega 3 fatty acids (fish oil) for maintenance of remission in Crohn’s disease. Cochrane Database Syst Rev. 2014; 28:2: CD006320.
 
22.
Turner D, Zlotkin S, Shah P, Griffiths AM. Omega 3 fatty acids (fish oil) for maintenance of remission in Crohn’s disease. Cochrane Database Syst Rev. 2009; (1): CD006320.
 
23.
Coëffier M, Miralles-Barrachina O, Le Pessot F, Lalaude O, Daveau M, Lavoinne A, i wsp. Influence of glutamine on cytokine production by human gut in vitro. Cytokine. 2001; 13(3): 148–154.
 
24.
Marion R, Coëffier MM, Gargala G, Ducrotté P, Déchelotte PP. Glutamine and CXC chemokines IL-8, Mig, IP-10 and I-TAC in human intestinal epithelial cells. Clin Nutr. 2004; 23(4): 579–585.
 
25.
Evans ME, Jones DP, Ziegler TR. Glutamine prevents cytokine-induced apoptosis in human colonic epithelial cells. J Nutr. 2003; 133(10): 3065–3071.
 
26.
Phanvijhitsiri K, Musch MW, Ropeleski MJ, Chang EB. Heat induction of heat shock protein 25 requires cellular glutamine in intestinal epithelial cells. Am J Physiol Cell Physiol. 2006; 291(2): C290–299.
 
27.
Lecleire S, Hassan A, Marion-Letellier R, Antonietti M, Savoye G, Bôle-Feysot C, i wsp. Combined glutamine and arginine decrease pro-inflammatory cytokine production by biopsies from Crohn’s patients in association with changes in nuclear factor-kappaB and p38 mitogen-activated protein kinase pathways. J Nutr. 2008; 138(12): 2481–2486.
 
28.
Den Hond E, Hiele M, Peeters M, Ghoos Y, Rutgeerts P. Effect of long-term oral glutamine supplements on small intestinal permeability in patients with Crohn’s disease. J Parenter Enteral Nutr. 1999; 23(1): 7–11.
 
29.
Akobeng A, Miller V, Stanton J, Elbadri AM, Thomas AG. Double-blind randomized controlled trial of glutamine-enriched polymeric diet in the treatment of active Crohn’s disease. J Pediatr Gastroenterol Nutr. 2000; 30(1): 78–84.
 
30.
Ockenga J, Borchert K, Stüber E, Lochs H, Manns MP, Bischoff SC. Glutamine-enriched total parenteral nutrition in patients with in-flammatory bowel disease. Eur J Clin Nutr. 2005; 59(11): 1302–1309.
 
31.
Sellon RK, Tonkonogy S, Schultz M, Dieleman LA, Grenther W, Balish E, i wsp. Resident Enteric Bacteria Are Necessary for Development of Spontaneous Colitis and Immune System Activation in Interleukin-10-Deficient Mice. Infect Immun. 1998; 66(11): 5224–5231.
 
32.
Vijay-Kumar M, Gewirtz AT. Guardians of the gut: newly appreciated role of epithelial toll-like receptors in protecting the intestine. Gastroenterology. 2008; 135(2): 351–354.
 
33.
Lodes MJ, Cong Y, Elson CO, Mohamath R, Landers CJ, Targan SR, i wsp. Bacterial flagellin is a dominant antigen in Crohn disease. J Clin Invest. 2004; 113(9): 1296–1306.
 
34.
Gophna U, Sommerfeld K, Gophna S, Doolittle WF, Veldhuyzen van Zanten SJ. Differences between Tissue-Associated Intestinal Microfloras of Patients with Crohn’s Disease and Ulcerative Colitis. J Clin Microbiol. 2006; 44(11): 4136–4141.
 
35.
Guarner F, Khan A, Garisch J, Eliakim R, Gangl A, Thomson A, i wsp. Probiotics and Prebiotics. World Gastroenterology Organisation Global Guidelines 2011. http://www.worldgastroenterolo... userfiles/Probiotics_FINAL_20110116.pdf (dostęp: 20.02.2015).
 
36.
Guslandi M, Mezzi G, Sorghi M, Testoni PA. Saccharomyces boulardii in maintenance treatment of Crohn’s disease. Dig Dis Sci. 2000; 45(7): 1462–1464.
 
37.
Lindsay J, Whelan K, Stagg A, Gobin P, Al Hassi HO, Rayment N, i wsp. Clinical, microbiological, and immunological effects of fructo-oligosaccharide in patients with Crohn’s disease. Gut. 2006; 55(3): 348–355.
 
38.
Fujimori S, Tatsuguchi A, Gudis K, Kishida T, Mitsui K, Ehara A, i wsp. High dose probiotic and prebiotic cotherapy for remission in-duction of active Crohn’s disease. J Gastroenterol Hepatol. 2007; 22(8): 1199–1204.
 
39.
Prantera C, Scribano ML, Falasco G, Andreoli A, Luzi C. Ineffecti¬veness of probiotics in preventing recurrence after curative resection for Crohn’s disease: a randomised controlled trial with Lactobacillus GG. Gut. 2002; 51(3): 405–409.
 
40.
Schultz M, Timmer A, Herfarth H, Balfour Sartor R, Vanderhoof JA, Rath HC. Lactobacillus GG in inducing and maintaining remission of Crohn’s disease. BMC Gastroenterol. 2004; 4: 5.
 
41.
Bousvaros A, Guandalini S, Baldassano RN, Botelho C, Evans J, Ferry GD, i wsp. A randomized, double-blind trial of Lactobacillus GG versus placebo in addition to standard maintenance therapy for children with Crohn’s disease. Inflamm Bowel Dis. 2005; 11(9): 833–839.
 
42.
Marteau P, Lémann M, Seksik P, Laharie D, Colombel JF, Bouhnik Y, i wsp. Ineffectiveness of Lactobacillus johnsonii LA1 for prophylaxis of postoperative recurrence in Crohn›s disease: a randomised, double blind, placebo controlled GETAID trial. Gut. 2006; 55(6): 842–847.
 
43.
Demigne C, Remesy C, Morand C. Short Chain Fatty Acids. W: Gibson G.R., Roberfroid MB, (red.). Colonic Microbiota, Nutrition and Heath. Dordrecht: Kluwer Academic Publishers; 1999: 55–69.
 
44.
Segain JP, de la Blétière DR, Bourreille A, Leray V, Gervois N, Rosales C, i wsp. Butyrate inhibits inflammatory responses through NFκB inhibition: implications for Crohn’s disease. Gut. 2000; 47: 397–403.
 
45.
Russo I, Luciani A, De Cicco P, Troncone E, Ciacci C. Butyrate attenuates lipopolysaccharide-induced inflammation in intestinal cells and Crohn’s mucosa through modulation of antioxidant defense machinery. PLoS One. 2012; 7(3): e32841.
 
46.
Lara-Villoslada F, de Haro O, Camuesco D, Comalada M, Velasco J, Zarzuelo A, i wsp. Short-chain fructooligosaccharides, in spite of being fermented in the upper part of the large intestine, have anti¬-inflammatory activity in the TNBS model of colitis. Eur J Nutr. 2006; 45(7): 418–425.
 
47.
Pan XD, Chen FQ, Wu TX, Tang HG, Zhao ZY. Prebiotic oligosaccharides change the concentrations of short-chain fatty acids and the microbial population of mouse bowel. J Zhejiang Univ Sci B. 2009; 10(4): 258–263.
 
48.
Fernández-Bañares F, Hinojosa J, Sánchez-Lombraña JL, Navarro E, Martínez-Salmerón JF, García-Pugés A, i wsp. Randomized clinical trial of Plantago ovata seeds (dietary fiber) as compared with mesalamine in maintaining remission in ulcerative colitis. Spanish Group for the Study of Crohn’s Disease and Ulcerative Colitis (GETECCU). Am J Gastroenterol. 1999; 94(2): 427–433.
 
49.
Breuer RI, Soergel KH, Lashner BA, Christ ML, Hanauer SB, Vanagunas A, i wsp. Short chain fatty acid rectal irrigation for left-sided ulcerative colitis: a randomised, placebo controlled trial. Gut. 1997; 40(4): 485–491.
 
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