Amino acid-based enteral nutrition is effective for pediatric Crohn’s disease:a multicenter prospective study  

作　　者：Qingfan Yang Ting Zhang Na Diao Kang Chao Huijun Shu Jie Wu Dexiu Guan Li Wang Xiwei Xu Zhenghong Li Xiang Gao 

机构地区：[1]Department of Gastroenterology,The Sixth Affiliated Hospital,Sun Yat-sen University,Guangzhou,P.R.China [2]Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases,The Sixth Affiliated Hospital,Sun Yat-sen University,Guangzhou,P.R.China [3]Biomedical Innovation Center,The Sixth Affiliated Hospital,Sun Yat-sen University,Guangzhou,P.R.China [4]Department of Gastroenterology,Hepatology and Nutrition,Shanghai Children’s Hospital,School of Medicine,Shanghai Jiao Tong University,Shanghai,P.R.China [5]Department of Gastroenterology,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing,P.R.China [6]Department of Gastroenterology,Beijing Children’s Hospital,Capital Medical University,National Center for Children’s Health,Beijing,P.R.China [7]Department of Epidemiology and Biostatistics,Institute of Basic Medical Sciences Chinese Academy of Medical Sciences,School of Basic Medicine Peking Union Medical College,Beijing,P.R.China [8]Department of Pediatrics,State Key Laboratory of Complex Severe and Rare Diseases,Peking Union Medical College Hospital,Chinese Academy of Medical Science and Peking Union Medical College,Beijing,P.R.China

出　　处：《Gastroenterology Report》2024年第1期3-10,共8页胃肠病学报道(英文)

基　　金：supported by the Guangdong Provincial Key Laboratory of Microecological Preparations[grant number 2022B1212020004];the Medical Scientific Research Foundation of Guangdong Province of China[grant number A2022099];the program of Guangdong Provincial Clinical Research Center for Digestive Diseases[grant number 2020B1111170004].

摘　　要：Background:Exclusive enteral nutrition(EEN)therapy effectively induces remission in pediatric Crohn’s disease(CD).However,this may depend on the type of enteral formula used.Moreover,data on the efficacy of amino acid-based EEN are limited.Thus,we aimed to prospectively evaluate the efficacy of amino acid-based formulas for EEN in pediatric patients with active CD.Methods:Patients with active CD aged between 6 and 17years were recruited into this prospective study from four hospitals in China between March 2019 and December 2021.Patients received EEN for 8weeks.Inflammatory and nutrition-associated indices were evaluated at 0,4,and 8weeks after treatment.Paired t-tests and Wilcoxon signed-rank tests were used to compare continuous and categorical variables before and after intervention,respectively.Results:Twenty-four patients were included in the analysis.After an 8-week intervention period,the CD activity index significantly decreased(26.3±12.2 vs 7.1±8.3,P<0.001).Most patients(66.7%)achieved complete clinical remission.Among the 22 patients who had ulcers and erosions diagnosed endoscopically at baseline,10(45.5%)achieved complete mucosal healing.The degree of thickening of the intestinal wall was significantly reduced after EEN intervention,with a transmural healing rate of 42.9%.Furthermore,the serum inflammatory markers decreased and there was a significant improvement in the nutrition-related indices(P<0.05).There were no severe adverse effects.Conclusions:Amino acid-based EEN is effective and safe for treating pediatric-onset CD.Studies with larger sample sizes and mechanistic and follow-up studies are required to further validate these findings.

关 键 词：pediatric Crohn’s disease exclusive enteral nutrition amino acid-based enteral formula prospective study effectiveness nutrition improvement 

分 类 号：R725.7[医药卫生—儿科] R574.62[医药卫生—临床医学]