title: Exclusive enteral nutrition ameliorates mesenteric adipose tissue alterations in patients with active Crohn's disease.
abstract: OBJECTIVE
  Mesenteric adipose tissue hypertrophy is a hallmark of Crohn's disease and can express various adipokines. Exclusive enteral nutrition could effectively induce remission in Crohn's disease with mechanisms largely unknown. We investigated whether exclusive enteral nutrition could modify mesenteric fat in patients with active Crohn's disease.
  
  
  METHODS
  Sixteen patients who underwent resection for ileum Crohn's disease were studied. As a control group, eight patients without inflammatory bowel disease were enrolled. Before operation, eight Crohn's disease patients received exclusive enteral nutrition for four weeks, and the other patients had no nutritional therapy. The mesenteric fat samples were obtained during operation. Adipocyte size, adipokine production and topical C-reactive protein level were assessed.
  
  
  RESULTS
  The adipocyte size from patients treated with exclusive enteral nutrition was much larger than that from Crohn's disease patients without nutritional therapy. Furthermore, protein levels of proinflammatory adipokines such as TNF-alpha and leptin were lower while protein level of adiponectin was higher in these patients. As to mRNA level, the expression of adiponctin was up-regulated and leptin was down-regulated in the patients received enteral nutrition.
  
  
  CONCLUSIONS
  Exclusive enteral nutrition could ameliorate mesenteric fat alterations which are associated with intestinal injury in patients with Crohn's disease by restoring adipocyte morphology and diminishing the inflammatory environment of mesenteric fat.
authors.affiliation: Department of General Surgery, Jinling Hospital, Medical School of Nanjing University, No. 305 East Zhongshan Rd., Nanjing 210002, People's Republic of China. Electronic address: drfengyun@163.com.
authors.forename: Yun
authors.initials: Y
authors.lastname: Feng
authors.affiliation: Department of General Surgery, Jinling Hospital, Medical School of Nanjing University, No. 305 East Zhongshan Rd., Nanjing 210002, People's Republic of China. Electronic address: liyi1860@126.com.
authors.forename: Yi
authors.initials: Y
authors.lastname: Li
authors.affiliation: Department of General Surgery, Jinling Hospital, Medical School of Nanjing University, No. 305 East Zhongshan Rd., Nanjing 210002, People's Republic of China. Electronic address: meishuqin322@163.com.
authors.forename: Shuqin
authors.initials: S
authors.lastname: Mei
authors.affiliation: Department of General Surgery, Jinling Hospital, Medical School of Nanjing University, No. 305 East Zhongshan Rd., Nanjing 210002, People's Republic of China. Electronic address: drliangzhang@163.com.
authors.forename: Liang
authors.initials: L
authors.lastname: Zhang
authors.affiliation: Department of General Surgery, Jinling Hospital, Medical School of Nanjing University, No. 305 East Zhongshan Rd., Nanjing 210002, People's Republic of China. Electronic address: gongjf03@yahoo.com.cn.
authors.forename: Jianfeng
authors.initials: J
authors.lastname: Gong
authors.affiliation: Department of General Surgery, Jinling Hospital, Medical School of Nanjing University, No. 305 East Zhongshan Rd., Nanjing 210002, People's Republic of China. Electronic address: drgulili@163.com.
authors.forename: Lili
authors.initials: L
authors.lastname: Gu
authors.affiliation: Department of General Surgery, Jinling Hospital, Medical School of Nanjing University, No. 305 East Zhongshan Rd., Nanjing 210002, People's Republic of China. Electronic address: drweizhang@126.com.
authors.forename: Wei
authors.initials: W
authors.lastname: Zhang
authors.affiliation: Department of General Surgery, Jinling Hospital, Medical School of Nanjing University, No. 305 East Zhongshan Rd., Nanjing 210002, People's Republic of China. Electronic address: drzhuweiming@163.com.
authors.forename: Weiming
authors.initials: W
authors.lastname: Zhu
authors.affiliation: Department of General Surgery, Jinling Hospital, Medical School of Nanjing University, No. 305 East Zhongshan Rd., Nanjing 210002, People's Republic of China. Electronic address: proflining@163.com.
authors.forename: Ning
authors.initials: N
authors.lastname: Li
authors.affiliation: Department of General Surgery, Jinling Hospital, Medical School of Nanjing University, No. 305 East Zhongshan Rd., Nanjing 210002, People's Republic of China. Electronic address: lijieshou@163.com.
authors.forename: Jieshou
authors.initials: J
authors.lastname: Li
mesh_terms: D052242:Adiponectin / Q000097:blood; D000273:Adipose Tissue / Q000503:physiopathology*; D000293:Adolescent; D000328:Adult; D015992:Body Mass Index; D002097:C-Reactive Protein / Q000378:metabolism; D003424:Crohn Disease / Q000628:therapy*; D015536:Down-Regulation; D004750:Enteral Nutrition; D005260:Female; D006801:Humans; D015850:Interleukin-6 / Q000097:blood / Q000235:genetics; D020738:Leptin / Q000097:blood; D008297:Male; D012333:RNA, Messenger / Q000235:genetics / Q000378:metabolism; D013048:Specimen Handling; D014409:Tumor Necrosis Factor-alpha / Q000097:blood; D015854:Up-Regulation; D055815:Young Adult
chemical_list: D052242:Adiponectin; D015850:Interleukin-6; D020738:Leptin; D012333:RNA, Messenger; D014409:Tumor Necrosis Factor-alpha; D002097:C-Reactive Protein
keywords: Adipokines; Crohn's disease; Enteral nutrition; Mesenteric adipose tissue