CDTREAT – a new personalized diet emulating exclusive enteral nutrition

Asker Brejnrod | Mar 2020 | Gastroenterologi |

Asker Brejnrod
Novo Nordic Center for Basic Metabolic Research,
SUND,
University of Copenhagen,
Copenhagen, Denmark

Konstantinos Gerasimidis
School of Medicine,
Dentistry & Nursing,
University of Glasgow,
Glasgow, GB

RESUME Crohn’s disease (CD) is a chronic inflammatory disease with inflammation of the gut. Exclusive enteral nutrition (EEN) is an established treatment in pediatric CD. It consists of a six to eight weeks course of a liquid-only diet. CD-TREAT is a prescriptive diet consisting of regular foodstuffs that mimics the composition of EEN. An on-going open-label trial in pediatric Crohn’s patients have shown promising results in improving clinical remission and reducing markers of gut inflammation. Crohn’s disease (CD) is a chronic inflammatory disease characterized by inflammation of the gut. The etiology is currently unknown, but a wide array of factors such as genetics, diet, environment and the microbiome have been implicated. Exclusive enteral nutrition (EEN) is an established treatment in pediatric CD. It consists of a six to eight weeks course of a liquid-only diet. It has been shown to be effective for inducing clinical remission in 80% of cases. It has significantly less side effects than corticosteroid treatment and is cheaper than anti-TNFα. Unfortunately, it isn’t palatable for adults and acceptability is low. The mechanism of both IBD and mode of action of EEN remains unclear, but the gut microbiome have been implicated both via observational studies1 and by interventions using antibiotics.2The exact mediating component remains elusive for now, but could very well be associated with a set of metabolites produced by the gut microbiome. For this reason, attention in the field have turned to untargeted fecal metabolomics, the study of as comprehensive a set of metabolites from feces as technically possible to study. Indeed, studies have paradoxically associated the metabolome and microbiome in children successfully treated with EEN to markers that are traditionally associated with gut dysbiosis such as low bacterial diversity and reduction in production of butyrate. CD-TREAT3is a nutritional intervention that mimics EEN in terms of nutrient...