Immune activation and nutritional status in adult Crohn's disease patients.
BACKGROUND
Recent attention focused on the effect of inflammatory cytokines on intermediary metabolism contributing to the nutritional disturbances observed in acute or chronic inflammatory diseases.


OBJECTIVE
To examine the interactions between immune activation and nutritional parameters in adult Crohn's disease patients.


METHODS
We analysed anthropometric and biochemical nutritional parameters in 40 Crohn's disease patients and 26 healthy controls, and related them to inflammatory and immune markers.


RESULTS
Weight, body mass index, mid-arm circumference, triceps skinfold thickness, as well as albumin, transthyretin, retinol binding protein, insulin growth factor-I and Vitamin A were significantly decreased in Crohn's disease patients and negatively correlated to disease activity. By contrast, erythrocyte sedimentation rate, fibrinogen, C-reactive protein, alpha1-acylglycoprotein, soluble receptor of interleukin-2, blood neopterin, tumour necrosis factor-alpha and interleukin-1beta concentrations were significantly higher in patients and positively correlated to disease activity. Nutritional parameters and acute phase reactants were linked to tumour necrosis factor-alpha and interleukin-1beta concentrations, and markers of nutritional status were negatively correlated to positive acute phase reactants.


CONCLUSIONS
In Crohn's disease, inflammatory cytokines appear partly responsible for decreased nutritional status. Thus, nutritional intervention to correct nutritional (in particular protein) depletion, and/or therapeutic intervention reducing inflammation and therefore restoring adequate nutritional proteins synthesis, appears a major therapeutic goal in active Crohn's disease.
Reimund
J-M
JM
Service d'Hépato-Gastroentérologie et d'Assistance Nutritive, Hôpitaux Universitaires de Strasbourg, Hôpital de Hautepierre, 67098 Strasbourg Cedex, France. Reimund-jm@chu-caen.fr
Arondel
Y
Y
Escalin
G
G
Finck
G
G
Baumann
R
R
Duclos
B
B
D000328:Adult; D015415:Biomarkers / Q000097:blood; D001798:Blood Proteins / Q000032:analysis; D001799:Blood Sedimentation; D015992:Body Mass Index; D001835:Body Weight / Q000502:physiology; D016022:Case-Control Studies; D003424:Crohn Disease / Q000097:blood* / Q000276:immunology*; D005260:Female; D006801:Humans; D018970:Insulin-Like Growth Factor Binding Protein 1 / Q000097:blood; D007375:Interleukin-1 / Q000097:blood; D008297:Male; D015999:Multivariate Analysis; D019798:Neopterin / Q000097:blood; D009752:Nutritional Status; D015375:Receptors, Interleukin-2 / Q000097:blood; D012995:Solubility; D014801:Vitamin A / Q000097:blood
D015415:Biomarkers; D001798:Blood Proteins; D018970:Insulin-Like Growth Factor Binding Protein 1; D007375:Interleukin-1; D015375:Receptors, Interleukin-2; D014801:Vitamin A; D019798:Neopterin