Abstract：
BACKGROUND: The immunological effects of treatment with exclusive enteral nutrition (EEN) in Crohn\'s disease (CD) remain unknown. We characterized the plasma levels of inflammation-related proteins (IRPs) in children with CD and ulcerative colitis (UC) compared with noninflammatory controls (non-IBD) and explored the effect of EEN in CD.
METHODS: Ninety-two IRPs were quantified using Olink proteomics in children with CD (n = 53), UC (n = 11), and non-IBD (n = 19). For 18 children with active CD, IRPs were measured before and after 8 weeks of EEN. Relationships with disease phenotype and response to EEN were studied.
RESULTS: Compared with non-IBD, patients with active UC and CD had different levels of 27 (24 raised, 3 decreased) and 29 (26 raised, 3 decreased) IRPs, respectively. Exclusive enteral nutrition modified the levels of 19 IRPs (13 increased, 6 decreased including CCL23, interleukin-24, interleukin-6, and MMP-1). More pronounced changes in IRP profile were observed in patients with ileal involvement and a ≥50% decrease in fecal calprotectin during EEN compared with those with colonic involvement and a <50% decrease in fecal calprotectin, respectively. A machine-learning model utilizing baseline IRP profile predicted response to EEN with a sensitivity of 89%, specificity of 57%, and accuracy of 73%. Thymic stromal lymphopoietin was the most important IRP in the model, this being higher in responders.
CONCLUSIONS: Inflammation-related proteins may be useful in the differential diagnosis of IBD. Exclusive enteral nutrition extensively modulated IRPs levels in children with active CD with more pronounced effects observed in patients who showed a reduction in FC and had ileal disease involvement.
Plasma inflammation-related proteins are altered in children with inflammatory bowel disease. In active Crohn’s disease, exclusive enteral nutrition modified several of these proteins, particularly in disease involving the ileum and in patients whose fecal calprotectin levels significantly decreased.
METHODS: Ninety-two IRPs were quantified using Olink proteomics in children with CD (n = 53), UC (n = 11), and non-IBD (n = 19). For 18 children with active CD, IRPs were measured before and after 8 weeks of EEN. Relationships with disease phenotype and response to EEN were studied.
RESULTS: Compared with non-IBD, patients with active UC and CD had different levels of 27 (24 raised, 3 decreased) and 29 (26 raised, 3 decreased) IRPs, respectively. Exclusive enteral nutrition modified the levels of 19 IRPs (13 increased, 6 decreased including CCL23, interleukin-24, interleukin-6, and MMP-1). More pronounced changes in IRP profile were observed in patients with ileal involvement and a ≥50% decrease in fecal calprotectin during EEN compared with those with colonic involvement and a <50% decrease in fecal calprotectin, respectively. A machine-learning model utilizing baseline IRP profile predicted response to EEN with a sensitivity of 89%, specificity of 57%, and accuracy of 73%. Thymic stromal lymphopoietin was the most important IRP in the model, this being higher in responders.
CONCLUSIONS: Inflammation-related proteins may be useful in the differential diagnosis of IBD. Exclusive enteral nutrition extensively modulated IRPs levels in children with active CD with more pronounced effects observed in patients who showed a reduction in FC and had ileal disease involvement.
Plasma inflammation-related proteins are altered in children with inflammatory bowel disease. In active Crohn’s disease, exclusive enteral nutrition modified several of these proteins, particularly in disease involving the ileum and in patients whose fecal calprotectin levels significantly decreased.
摘要：
背景：在克罗恩病（CD）中使用专有肠内营养（EEN）治疗的免疫学效果仍然未知。我们表征了CD和溃疡性结肠炎（UC）儿童与非炎症对照（非IBD）的血浆炎症相关蛋白（IRP）水平，并探讨了EEN在CD中的作用。
方法：使用Olink蛋白质组学对CD儿童（n=53）中的92个IRP进行定量，UC（n=11），和非IBD（n=19）。对于18名活跃CD的儿童，在EEN之前和之后8周测量IRP。研究了与疾病表型和对EEN反应的关系。
结果：与非IBD相比，活动性UC和CD患者的水平不同，为27（24个升高，3减少）和29（26增加，3个减少)IRPs，分别。独家肠内营养改变了19个IRPs的水平(13个增加，6降低，包括CCL23，白介素-24，白介素-6和MMP-1）。与结肠受累且粪便钙卫蛋白降低<50％的患者相比，在EEN期间回肠受累且粪便钙卫蛋白降低≥50％的患者中观察到IRP分布的变化更明显，分别。利用基线IRP轮廓的机器学习模型预测对EEN的响应，灵敏度为89%，特异性为57%，准确率为73%。胸腺基质淋巴细胞生成素是模型中最重要的IRP,这在响应者中更高。
结论：炎症相关蛋白可能对IBD的鉴别诊断有用。独家肠内营养可广泛调节活动性CD儿童的IRP水平，在FC减少和回肠疾病受累的患者中观察到更明显的效果。
炎症性肠病患儿血浆炎症相关蛋白发生改变。在活动性克罗恩病中，独家肠内营养修饰了这些蛋白质中的几种，特别是在涉及回肠的疾病和粪便钙卫蛋白水平显着降低的患者中。
方法：使用Olink蛋白质组学对CD儿童（n=53）中的92个IRP进行定量，UC（n=11），和非IBD（n=19）。对于18名活跃CD的儿童，在EEN之前和之后8周测量IRP。研究了与疾病表型和对EEN反应的关系。
结果：与非IBD相比，活动性UC和CD患者的水平不同，为27（24个升高，3减少）和29（26增加，3个减少)IRPs，分别。独家肠内营养改变了19个IRPs的水平(13个增加，6降低，包括CCL23，白介素-24，白介素-6和MMP-1）。与结肠受累且粪便钙卫蛋白降低<50％的患者相比，在EEN期间回肠受累且粪便钙卫蛋白降低≥50％的患者中观察到IRP分布的变化更明显，分别。利用基线IRP轮廓的机器学习模型预测对EEN的响应，灵敏度为89%，特异性为57%，准确率为73%。胸腺基质淋巴细胞生成素是模型中最重要的IRP,这在响应者中更高。
结论：炎症相关蛋白可能对IBD的鉴别诊断有用。独家肠内营养可广泛调节活动性CD儿童的IRP水平，在FC减少和回肠疾病受累的患者中观察到更明显的效果。
炎症性肠病患儿血浆炎症相关蛋白发生改变。在活动性克罗恩病中，独家肠内营养修饰了这些蛋白质中的几种，特别是在涉及回肠的疾病和粪便钙卫蛋白水平显着降低的患者中。
