Potential for amino acids supplementation during inflammatory bowel diseases.
The pathophysiology of inflammatory bowel diseases (IBDs) is multifactorial and involves interactions of gut luminal content with mucosal barrier and especially immune cells. Malnutrition is a frequent issue during IBD flares, especially in Crohn's disease (CD) patients, and nutritional support is frequently used to treat malnutrition but also in an attempt to modulate intestinal inflammation. The use of oral or enteral nutrition intervention in IBDs may be effective, alone or in combination with drugs, to achieve and maintain remission. However, standard diets are less effective than new-generation biotherapies and could be improved by supplementation with specific immunomodulatory amino acids. Experimental studies evaluating glutamine, the preferential substrate for enterocytes, are promising. Some clinical studies with oral glutamine in CD are until now disappointing, but new formulations and targeting could enhance glutamine efficacy at the site of mucosal lesions. The role of arginine, involved in nitric oxide and polyamines synthesis, still remains debated. However, the effects of these amino acids in IBD have been poorly documented in humans. Other candidates like glycine, cysteine, histidine, or taurine should also be evaluated in the future.
Coëffier
Moïse
M
Appareil Digestif Environnement Nutrition (ADEN EA4311), Institute for Biomedical Research, European Institute for Peptide Research (IFRMP 23), Rouen University and Rouen University Hospital, Rouen, France. moise.coeffier@univ-rouen.fr
Marion-Letellier
Rachel
R
Déchelotte
Pierre
P
D000596:Amino Acids / Q000627:therapeutic use*; D003093:Colitis, Ulcerative / Q000178:diet therapy* / Q000503:physiopathology; D003424:Crohn Disease / Q000178:diet therapy* / Q000503:physiopathology; D019587:Dietary Supplements; D006801:Humans; D044342:Malnutrition / Q000178:diet therapy* / Q000503:physiopathology
D000596:Amino Acids