Nutritional modulation of gut inflammation.

Abstract

Chronic inflammation of the intestinal tract remains a common cause of morbidity, reduced quality of life and, in certain cases, may be fatal. Despite intensified research efforts and significant advancements, our understanding of the mechanisms underlying many conditions such as ischemia reperfusion injury of the gut, inflammatory bowel disease (IBD) and sepsis of gut origin remains unclear. Crohn’s disease and ulcerative colitis are phenotypically distinct forms of IBD whose pathogenesis is believed to involve aberrant mucosal immunoregulation, leading to intestinal epithelial cell injury mediated by activated T cells, mononuclear cells and macrophages. Despite the recent identification of disease susceptibility genes, the etiologies of these disorders remain unclear. Although the environmental trigger(s) responsible for disease onset and exacerbations remain unknown, an increasing body of evidence points to an important role of the gut flora and aberrant mucosal permeability. Corticosteroids and immunomodulatory drugs, the mainstays of therapy, often offer less than ideal results. There is a growing scientific rationale for the use of dietary factors, or nutriceuticals, to modulate the inflammatory response in the management of various chronic inflammatory disorders. Increased attention has focused interest on the importance of nutritional factors in the pathogenesis and treatment of IBD. Elemental diets have been employed to control disease activity in Crohn’s disease for almost three decades. Nevertheless, we have a limited understanding of their underlying mechanisms of action. The benefits