Hypothesis: Increased consumption of emulsifiers as an explanation for the rising incidence of Crohn's disease
Hypothesis: Increased consumption of emulsifiers as an explanation for the rising incidence of Crohn's disease
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DOI：
10.1016/j.crohns.2013.01.004
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发表时间：
2013-05-01
影响因子：
8
通讯作者：
Rhodes, Jonathan M.
中科院分区：
文献类型：
--
作者：
Roberts, Carol L.;Rushworth, Sarah L.;Rhodes, Jonathan M.
克罗恩病（CD）的发病率在过去的50年中有所增加，但原因尚不清楚。CD可以通过液体肠内喂养缓解，但这种反应的机制尚不清楚。我们认为，加工食品中乳化剂的消费可能会通过增加细菌移位来促进CD。这得到以下证据的支持：（i）CD的地理变异与乳化剂消耗量相关，日本CD的发病率增加也是如此;（ii）尽管CD发病率也与脂肪消耗量相关，但对肠内喂养的反应不受饲料脂肪含量的影响;（iii）极低浓度的乳化剂聚山梨酯80可增强细菌穿过肠上皮的移位。未消化的乳化剂可能会增加细菌移位，特别是在粘液层不连续的小肠中。这一假设应通过有/无乳化剂的肠内喂养试验进行验证。(c)2013年欧洲克罗恩病和结肠炎组织。Elsevier B. V.出版，保留所有权利。
Crohn's disease (CD) incidence has increased over the past fifty years but the explanation is unclear. CD can be brought into remission by liquid enteral feeding, but the mechanism for this response is unknown. We suggest that consumption of emulsifiers in processed foods may promote CD by increasing bacterial translocation. This is supported by evidence that (i) geographical variation in CD correlates with emulsifier consumption as does the increasing incidence of CD in Japan; (ii) although CD incidence also correlates with fat consumption, the response to enteral feeding is not affected by the fat content of the feed and (iii) very small concentrations of the emulsifier polysorbate 80 enhance bacterial translocation across intestinal epithelia. Undigested emulsifiers may increase bacterial translocation, particularly in the small intestine where the mucus layer is discontinuous. The hypothesis should be testable by trials of enteral feeding with/without emulsifiers. (c) 2013 European Crohn's and Colitis Organisation. Published by Elsevier B.V. All rights reserved.