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Gut inflammation in children with cystic fibrosis on high-dose enzyme supplements
N M Croft1, T G Marshall, A Ferguson
1Department of Medicine, University of Edinburgh, Western General Hospital, UK.
Insights
This study investigated subclinical gut inflammation in children with cystic fibrosis using a whole-gut perfusion technique. Abnormal results were observed in children with distal intestinal obstruction syndrome, potentially linked to Nutrizym 22 treatment.
Area of Science:
- Pediatric Gastroenterology
- Gastrointestinal Inflammation
- Cystic Fibrosis Research
Background:
- Cystic Fibrosis (CF) can affect the gastrointestinal tract.
- Subclinical gut inflammation is not well understood in CF patients.
- Distal intestinal obstruction syndrome (DIOS) is a known complication in CF.
Purpose of the Study:
- To investigate subclinical gut mucosal inflammation in children with CF.
- To identify potential risk factors for this inflammation.
- To evaluate a whole-gut perfusion technique for assessing gut health.
Main Methods:
- Whole-gut perfusion technique applied to 18 CF patients and 12 controls.
- Assay of various biomarkers including hemoglobin, IgG, albumin, alpha-1-antitrypsin, granulocyte elastase, IL-1 beta, and IL-8 in lavage fluid.
- Comparison of results between CF patients and controls, and correlation with DIOS and Nutrizym 22 treatment.
Main Results:
- Subclinical gut mucosal inflammation was detected in a subset of CF children.
- Two children with DIOS, both on Nutrizym 22, showed markedly abnormal results.
- Biomarker concentrations varied, suggesting inflammatory processes.
Conclusions:
- A whole-gut perfusion technique can reveal subclinical gut inflammation in CF.
- Distal intestinal obstruction syndrome and Nutrizym 22 treatment may be associated with increased risk.
- Further research is warranted to elucidate the role of these factors in CF gastrointestinal health.
Abstract:
We used a whole-gut perfusion technique to study subclinical gut inflammation in children with cystic fibrosis (18 elective tests, three lavages to treat distal intestinal obstruction syndrome); and in 12 control children with constipation or pre-colonoscopy. We assayed for haemoglobin, IgG, albumin, alpha-1-antitrypsin, granulocyte elastase, interleukin-1 beta (IL-1 beta) and IL-8 concentrations in whole-gut lavage fluid. Results for two children with distal intestinal obstruction syndrome, the only children in the series taking Nutrizym 22, were strikingly abnormal. This new test has revealed subclinical gut mucosal inflammation in a minority of CF children, for which distal intestinal obstruction syndrome, Nutrizym 22 treatment, or both, may be risk factors.