Oral butyrate for mildly to moderately active Crohn's disease.
BACKGROUND
Butyrate exerts anti-inflammatory effects in experimental colitis and on Crohn's disease lamina propria mononuclear cells in vitro.


OBJECTIVE
To explore the efficacy and safety of oral butyrate in Crohn's disease.


METHODS
Thirteen patients with mild-moderate ileocolonic Crohn's disease received 4 g/day butyrate as enteric-coated tablets for 8 weeks. Full colonoscopy and ileoscopy were performed before and after treatment. Endoscopical and histological score, laboratory data, Crohn's disease activity index and mucosal interleukin (IL)-1beta, IL-6, IL-12, interferon-gamma, tumour necrosis factor-alpha and nuclear factor-kappa B (NF-kappaB) were assessed before and after treatment.


RESULTS
One patient withdrew from the study, and three patients did not experience clinical improvement. Among the nine patients (69%) who responded to treatment, seven (53%) achieved remission and two had a partial response. Endoscopical and histological score significantly improved after treatment at ileocaecal level (P < 0.05). Leucocyte blood count, erythrocyte sedimentation rate and mucosal levels of NF-kappaB and IL-1beta significantly decreased after treatment (P < 0.05).


CONCLUSIONS
Oral butyrate is safe and well tolerated, and may be effective in inducing clinical improvement/remission in Crohn's disease. These data indicate the need for a large investigation to extend the present findings, and suggest that butyrate may exert its action through downregulation of NF-kappaB and IL-1beta.
Di Sabatino
A
A
First Department of Medicine, IRCCS Policlinico S. Matteo, University of Pavia, Pavia, Italy.
Morera
R
R
Ciccocioppo
R
R
Cazzola
P
P
Gotti
S
S
Tinozzi
F P
FP
Tinozzi
S
S
Corazza
G R
GR
D000284:Administration, Oral; D000328:Adult; D000368:Aged; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage* / Q000009:adverse effects; D001799:Blood Sedimentation / Q000187:drug effects; D002087:Butyrates / Q000008:administration & dosage* / Q000009:adverse effects; D002097:C-Reactive Protein / Q000032:analysis; D003424:Crohn Disease / Q000097:blood / Q000188:drug therapy*; D016207:Cytokines / Q000097:blood; D005260:Female; D006801:Humans; D007413:Intestinal Mucosa / Q000737:chemistry; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D016328:NF-kappa B / Q000032:analysis; D012720:Severity of Illness Index; D016896:Treatment Outcome
D000893:Anti-Inflammatory Agents; D002087:Butyrates; D016207:Cytokines; D016328:NF-kappa B; D002097:C-Reactive Protein