Mucosal healing and a fall in mucosal pro-inflammatory cytokine mRNA induced by a specific oral polymeric diet in paediatric Crohn's disease

Aliment Pharmacol Ther. 2000 Mar;14(3):281-9. doi: 10.1046/j.1365-2036.2000.00707.x.


Background: Although enteral nutrition is a recognized form of treatment for intestinal Crohn's disease, there are persisting problems with feed palatability and only limited data as to its mode of action.

Aim: To assess the effects of a specific oral polymeric diet (CT3211; Nestle, Vevey, Switzerland), which is rich in transforming growth factor beta2, on the mucosal inflammatory process.

Methods: Twenty-nine consecutive children with active intestinal Crohn's disease were treated with CT3211 as the sole source of nutrition for 8 weeks. Patients were assessed clinically, and endoscopically, whilst cytokine mRNA was measured in mucosal biopsies before and after treatment by quantitative reverse transcriptase polymerase chain reaction.

Results: After 8 weeks 79% of children were in complete clinical remission. Macroscopic and histological healing in the terminal ileum and colon was associated with a decline in ileal and colonic interleukin-1beta mRNA (pre-treatment to post-treatment ratio 0.008 and 0.06: P < 0.001, P = 0.006). In the ileum there was also a fall in interferon gamma mRNA (ratio 0.15, P < 0.001) with a rise in transforming growth factor beta1 mRNA (ratio 10, P = 0.04), whilst in the colon interleukin-8 mRNA fell with treatment (ratio 0.06, P < 0.05).

Conclusions: The clinical response to oral polymeric diet CT3211 is associated with mucosal healing and a down regulation of mucosal pro-inflammatory cytokine mRNA in both the terminal ileum and colon. In the ileum there was also an increase in transforming growth factor beta1 mRNA.

Publication types

  • Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Child
  • Colon / pathology
  • Colonoscopy
  • Crohn Disease / diet therapy*
  • Cytokines / biosynthesis*
  • Enteral Nutrition*
  • Female
  • Food, Formulated*
  • Humans
  • Ileum / pathology
  • Intestinal Mucosa / metabolism
  • Intestinal Mucosa / pathology*
  • Male
  • RNA, Messenger / biosynthesis*
  • Recurrence
  • Tumor Necrosis Factor-alpha / biosynthesis


  • Cytokines
  • RNA, Messenger
  • Tumor Necrosis Factor-alpha