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Sustained modulation of intestinal bacteria by exclusive enteral nutrition used to treat children with Crohn's disease
Open accessAbstract
BACKGROUND: The use of exclusive enteral nutrition to treat paediatric Crohn's disease (CD) is widely accepted, although the precise mechanism(s) of action remains speculative. AIM: To investigate the changes to key intestinal bacterial groups of Eubacteria, Bacteroides, Clostridium coccoides, Clostridium leptum and Bifidobacteria, during and after exclusive enteral nutrition treatment for CD in paediatric patients and correlate these changes to disease activity and intestinal inflammation. METHODS: Stool was collected from six children at diagnosis of CD, during exclusive enteral nutrition and 4 months post-therapy, and from seven healthy control children. The diversity of bacteria was assessed by polymerase chain reaction-denaturing gradient gel electrophoresis with changes to bacterial diversity measured by Bray-Curtis similarity, intestinal inflammation assessed by faecal S100A12 and the disease activity assessed by PCDAI. RESULTS: A significantly greater change in intestinal bacterial composition was seen with exclusive enteral nutrition treatment compared with controls. Further, the intestinal bacteria remained altered 4 months following exclusive enteral nutrition completion. Changes in the composition of Bacteroides were associated with reduced disease activity and inflammation. CONCLUSIONS: Exclusive enteral nutrition reduces bacterial diversity and initiates a sustained modulation of all predominant intestinal bacterial groups. Exclusive enteral nutrition may reduce inflammation through modulating intestinal Bacteroides species. The implications of these results for exclusive enteral nutrition therapy and CD pathogenesis should now be the subject of further investigation.
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Literature suggests a profound change in the fecal microbiota after EEN therapy.
“Literature on this subject suggests that there is a profound change in the fecal microbiota following EEN therapy80, 81.”
From Diet and the Intestinal Microbiome: Associations, Functions, and Implications for Health and Disease (2014) · cites this paper as [80]
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Metadata
- Authors
- LEACH, S. T., MITCHELL, H. M., ENG, W. R., ZHANG, L., & DAY, A. S.
- Affiliations
- UNSW Sydney (AU)
- Sydney Children's Hospital (AU)
- Corresponding author
- DAY, A. S.
- Venue
- Alimentary Pharmacology & Therapeutics
- Publisher
- Wiley
- Published
- 2008-08-20
- Volume
- 28
- Issue
- 6
- Pages
- 724-733
- ISSN
- 0269-2813 (ISSN-L)
- 1365-2036
- OpenAlex
- W2086136703
- Cited by
- 164
- References
- 28
- Citations by year
- 2026: 3 · 2025: 8 · 2024: 9 · 2023: 10 · 2022: 9 · 2021: 16 · 2020: 4 · 2019: 7 · 2018: 12 · 2017: 17 · 2016: 11 · 2015: 7 · 2014: 12 · 2013: 11 · 2012: 17
- FWCI
- 2.09
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Alimentary Pharmacology & Therapeutics (publishedVersion)
- PubMed (publishedVersion)
- Funders
- University of New South Wales
- Topics
- Health Sciences › Medicine › Gastroenterology › Inflammatory Bowel Disease
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Gut microbiota and health
- Health Sciences › Nursing › Nutrition and Dietetics › Clinical Nutrition and Gastroenterology
- Keywords
- exclusive enteral nutrition, pediatric Crohn's disease, gut microbiota, Bacteroides, Clostridium coccoides, Clostridium leptum, Bifidobacterium, bacterial diversity, intestinal inflammation, disease activity, Pediatric Crohn's Disease Activity Index
- MeSH terms
- Child, Child, Preschool, Crohn Disease, DNA, Bacterial, Electrophoresis, Agar Gel, Enteral Nutrition, Feces, Female, Humans, Male, Case-Control Studies, Polymerase Chain Reaction, Treatment Outcome
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