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Updated: Jun 3, 2026
Evaluating Therapeutic Interventions in the SHIP-deficient Mouse Model of Crohn Disease-like Ileitis and Fibrosis
Published on: October 14, 2025
Enteral feeding therapy for newly diagnosed pediatric Crohn's disease: a double-blind randomized controlled trial
Joanne L Grogan1, David H Casson, Allyson Terry
1Dietetic Department, Alder Hey Children's NHS Foundation Trust, Liverpool, UK.
Insights
Elemental formula (EF) and polymeric formula (PF) showed similar efficacy in inducing remission for pediatric Crohn's disease (CD). One-third of children maintained remission for two years, with subtle changes in fatty acid status observed.
Area of Science:
- Pediatric Gastroenterology
- Clinical Nutrition
- Inflammatory Bowel Disease Research
Background:
- Pediatric Crohn's disease (CD) management often involves nutritional therapy.
- Elemental formulas (EF) and polymeric formulas (PF) are used for nutritional intervention in pediatric CD.
Purpose of the Study:
- To compare the efficacy of EF versus PF in achieving remission in pediatric CD patients.
- To assess long-term remission rates and relapse patterns.
- To evaluate changes in inflammatory markers and plasma fatty acid profiles.
Main Methods:
- Randomized controlled trial involving newly diagnosed pediatric CD patients.
- Intervention with EF or PF for 6 weeks.
- Assessment of Pediatric Crohn's Disease Activity Index (PCDAI), fecal calprotectin, and plasma fatty acids at baseline and 6 weeks.
- Two-year follow-up for remission maintenance and relapse analysis.
Main Results:
- No significant difference in remission rates between EF (93%) and PF (79%) groups.
- Approximately one-third of all patients maintained remission for two years.
- Changes in plasma polyunsaturated fatty acids (PUFAs) were observed, with notable shifts in EPA, AA, and DHA levels.
- Fecal calprotectin decreased but did not normalize by week 6.
Conclusions:
- EF and PF demonstrate comparable efficacy in inducing remission for pediatric CD.
- Long-term remission is achieved by a subset of patients, irrespective of initial formula type.
- PUFA profile alterations warrant further investigation for potential clinical relevance in CD management.
Background:
This study compared the efficacy of an elemental formula (EF) to a polymeric formula (PF) in inducing remission for pediatric Crohn's disease (CD).
Methods:
Newly diagnosed CD children were randomized to EF or PF for 6 weeks. Change in the Pediatric Crohn's Disease Activity Index (PCDAI), fecal calprotectin, and plasma fatty acids were measured at 0 and 6 weeks. Patients were followed up for 2 years. Time and treatment choice for first relapse were documented.
Results:
Thirty-four children completed the study; EF: 15 (7 M, 8 F), PF: 19 (13 M, 6 F). The mean age was (years) EF: 12.6, PF: 11.7. Ninety-three percent of children (14/15) achieved remission in the EF group and 79% (15/19) in the PF group. One-third of patients maintained remission for 2 years. Mean time to relapse (days); EF: 183 (63-286), PF: 162 (53-301). Most children who relapsed used feed as a treatment for that relapse (EF: 9/10 and PF: 8/13). With PF, an increase of eicosapentanoic acid (EPA) and alpha linolenic acid was found with a reciprocal decrease in arachidonic acid (AA). With EF, AA and EPA levels were reduced with a significant decrease in docosahexaenoic acid. Fecal calprotectin measurements decreased significantly but did not normalize at the end of week 6.
Conclusions:
There was no significant difference between EF and PF in inducing remission. One-third of children maintained remission. Changes in plasma polyunsaturated fatty acid status were subtle and may be relevant; however, further evaluation is recommended.
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