Dietary Treatment of Crohn's Disease

克罗恩病的饮食治疗

• 批准号: 6968984
• 负责人: ECE A. MUTLU
• 金额: $ 21.48万
• 依托单位: RUSH UNIVERSITY MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2005
• 资助国家: 美国
• 起止时间: 2005-09-01 至 2008-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6968984
• 关键词: Crohn' s disease; alternative medicine; antioxidants; clinical research; clinical trials; diet therapy; dietary supplements; enteric bacteria; fructose; human subject; human therapy evaluation; inflammation; microorganism growth; oligosaccharides; oxidative stress; patient oriented research

DESCRIPTION (provided by applicant): Our long-term objective is to show that CAM techniques can improve management of inflammatory bowel disease (ibd) which includes Ulcerative Colitis (UC) and Crohn's Disease (CD). Our immediate objective is to determine whether a specific dietary intervention or a fructooligosaccharide (FOS) supplement has anti-oxidant or prebiotic effects and whether it is beneficial in the treatment of CD. Supporting a strong link between diet and CD, several epidemiological studies and therapeutic observations in the complementary and alternative medicine (CAM) literature suggest that diet is key to development of CD and its treatment. We took advantage of these CAM recommendations and designed a diet encompassing recommendations common to these CAM systems with particular attention to increasing the intake of dietary foodstuffs that have antioxidant and prebiotic effects. Using this diet together with a FOS supplement, our preliminary studies showed that our diet intervention is acceptable and well-tolerated and results in improvement of 66% of patients, reducing symptoms and/or the degree of inflammation. This finding now needs to be validated by a study with a stronger design, and the mechanisms underlying the effects of dietary manipulation-such as potential effects on microflora- need to be elucidated. In another pilot study using amplicon length heterogeneity, we demonstrated that the intestinal microflora of patients with CD differ significantly from healthy individuals. Whether we can normalize the microflora of CD patients, however, remains to be determined. Accordingly, we designed a study to test the hypotheses that: (1) dietary manipulation with either diet or a FOS supplement is an effective CAM therapy that prevents CD relapse (leads to maintenance of remission) and (2) such dietary manipulation can normalize the microflora of CD patients and decrease mucosal oxidative damage. Aim 1. To determine in a pilot, open-label study, whether dietary manipulation with a specific dietary therapy (that encompasses recommendations of various CAM practices) or a FOS supplement prevents flare-up in patients with inactive CD. Aim 2. To determine a) whether the same dietary manipulation with a specific dietary therapy or FOS normalizes colonic microflora and prevents mucosal oxidative damage in CD; and b) whether the observed changes correlate with clinical maintenance of remission. Significance. This study could provide information to suggest diet as a safe therapy for IBD and lay the groundwork for more definitive, randomized, controlled trials.

描述（由申请人提供）：我们的长期目标是证明 CAM 技术可以改善炎症性肠病 (ibd) 的治疗，其中包括溃疡性结肠炎 (UC) 和克罗恩病 (CD)。我们的近期目标是确定特定的饮食干预或低聚果糖 (FOS) 补充剂是否具有抗氧化或益生元作用，以及是否有益于 CD 的治疗。补充和替代医学 (CAM) 文献中的几项流行病学研究和治疗观察表明饮食是 CD 及其治疗的关键，这支持了饮食与 CD 之间的密切联系。我们利用这些 CAM 建议，设计了一种包含这些 CAM 系统常见建议的饮食，特别注意增加具有抗氧化和益生元作用的膳食食品的摄入量。我们的初步研究表明，将这种饮食与低聚果糖补充剂一起使用，我们的饮食干预是可以接受的且耐受性良好，并且使 66% 的患者得到改善，减轻症状和/或炎症程度。这一发现现在需要通过一项设计更强有力的研究来验证，并且需要阐明饮食控制影响的潜在机制（例如对微生物群落的潜在影响）。在另一项利用扩增子长度异质性的初步研究中，我们证明 CD 患者的肠道菌群与健康个体存在显着差异。然而，我们能否使克罗恩病患者的微生物群落正常化仍有待确定。因此，我们设计了一项研究来检验以下假设：(1) 使用饮食或 FOS 补充剂进行饮食控制是一种有效的 CAM 疗法，可以预防 CD 复发（导致维持缓解）；(2) 这种饮食控制可以使 CD 正常化。 CD 患者的微生物群落并减少粘膜氧化损伤。 目标 1. 在一项试点、开放标签研究中确定特定饮食疗法（包括各种 CAM 实践的建议）或 FOS 补充剂的饮食控制是否可以预防非活动性 CD 患者的病情发作。目标 2. 确定 a) 相同的饮食操作与特定饮食疗法或低聚果糖是否可以使 CD 患者的结肠微生物群正常化并预防粘膜氧化损伤； b) 观察到的变化是否与临床缓解的维持相关。意义。这项研究可以提供信息，建议饮食作为 IBD 的安全疗法，并为更明确、随机、对照试验奠定基础。