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Anti-inflammatory effect of exclusive enteral nutrition in patients with juvenile idiopathic arthritis
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Pediatrics.
Karolinska Inst Sodersjukhuset, Sachs Childrens Hosp, Stockholm, Sweden..
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Pediatrics.
2016 (English)In: Clinical and Experimental Rheumatology, ISSN 0392-856X, E-ISSN 1593-098X, Vol. 34, no 5, 941-945 p.Article in journal (Refereed) Published
Abstract [en]

Objective There is extensive evidence for an influence of gut microbiota on the immune system, which has consequences for inflammatory diseases. Exclusive enteral nutrition (EEN), which may change the gut microbiota, is an effective anti-inflammatory treatment for Crohn's disease in children. We wanted to explore the immediate anti-inflammatory effect of EEN in children with juvenile idiopathic arthritis (JIA). Methods Thirteen patients with JIA (7-17 years of age), in a disease flare-up, were included in the study. Six children dropped out within 1.5-2.0 weeks of treatment, and seven patients continued, constituting the study cohort. EEN was given for three to eight weeks, with clinical and laboratory status assessed before and after treatment periods. In addition to conventional laboratory tests, 92 inflammatory proteins were analysed with a multiplex system (Proseek Multiplex Inflammation I, Olink Bioscience). Results EEN had a significant anti-inflammatory effect on active joints (p=0.031), JADAS27 (p=0.016) and morning stiffness (p=0.031). In the multiplex analysis of inflammatory proteins, MMP-1 (matrix metalloproteinase), involved in the degradation of collagens in chondrocytes, decreased significantly (p=0.047), as did MCP-4 (p=0.031) and 4E-BP1 (p=0.031). Conclusion Exclusive enteral nutrition for three to eight weeks had anti-inflammatory effect in all children with JIA that continued with EEN for more than two weeks. The study is only exploratory but the result supports an immunologically important role for the intestinal canal in these patients.

Place, publisher, year, edition, pages
2016. Vol. 34, no 5, 941-945 p.
Keyword [en]
arthritis, juvenile idiopathic arthritis, exclusive enteral nutrition, child, joints
National Category
Pediatrics Rheumatology and Autoimmunity
Identifiers
URN: urn:nbn:se:uu:diva-307294ISI: 000385007500022PubMedID: 27383427OAI: oai:DiVA.org:uu-307294DiVA: diva2:1046040
Available from: 2016-11-11 Created: 2016-11-11 Last updated: 2016-11-11Bibliographically approved

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