NORMALISATION OF MUCOSAL CYTOKINE mRNA IN ASSOCIATION WITH CLINICAL IMPROVEMENT IN CHILDREN WITH CROHN'S DISEASE TREATED WITH POLYMERIC DIET.

Abstract

34 Enteral nutrition (EN) is an established therapy in the treatment of active Crohn's disease (CD), although the mechanism of its action is uncertain. Terminal ileal and transverse colonic mucosal biopsies were obtained from 29 children (age 8.1-17.1 yrs) with Crohn's disease before and after 8 weeks of treatment with a polymeric diet (CT3211) and 7 controls. IL-1β, IL-8, IL-10, Interferon γ, and TGFβ mRNA was estimated by quantitative RT-PCR, together with T cell receptor α as a positive control. Clinically 27/29 children responded to treatment with complete remission in 23 (Paediatric Crohn's disease activity index <10). C reactive protein declined from median 19 to 1.0 mg/l, p<0.0001. Median mucosal cytokines, expressed as transcripts x103 / μg RNA:TableClinical improvement in Crohn's disease in response to the Polymeric diet CT3211 is associated with a fall in mucosal pro-inflammatory cytokine IL-1β. The fall in IFNγ and rise in TGFβ with treatment evident in the ileum may represent a change in the balance between Th1 and Th2 cytokines.