The_mechanism_of_nutritional_therapy_for_Paediatric_Crohn_s_disease

In Europe, 1 in 250 individuals have inflammatory bowel disease (IBD) and one in four of these patients is diagnosed during childhood. Paediatric patients with IBD are especially vulnerable to the physical and psychosocial morbidities of this disorder. Side-effects of standard immunosuppressive therapy, such as facial swelling, excessive weight gain, hair growth, and acne, reduce quality of life and will lead to poor compliance. Nutritional regimens using exclusive Enteral Nutrition (EEN) are a first stage therapy that offers fewer side effects than immunosuppressive treatments. However, because no other food intake is allowed with EEN, compliance is low. In addition, a therapy that acts by an unknown mechanism is less likely to be implemented in clinical practice. In this study, we aim to elucidate the mechanism of EEN therapy, which will contribute towards the clinical need for a well-tolerated nutritional therapy with sustained potential to induce remission. We hypothesize that microbiota-associated metabolic changes in paediatric IBD patients mediate the currently observed success of EEN. We will establish the changes in metabolites and microbial composition and determine the signalling molecules that act on epithelial and immune cells to improve IBD.