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Nutrients 2017, 9(3), 286; doi:10.3390/nu9030286

Potential Impact of Diet on Treatment Effect from Anti-TNF Drugs in Inflammatory Bowel Disease

1
Focused Research Unit for Molecular Diagnostic and Clinical Research, IRS-Centre Sonderjylland, Hospital of Southern Jutland, Åbenrå 6200, Denmark
2
Institute of Molecular Medicine, University of Southern Denmark, Odense 5000, Denmark
3
Department of Veterinary and Animal Sciences, University of Copenhagen, Frederiksberg 1871, Denmark
4
Research Unit for Dietary Studies, Parker Institute, Frederiksberg 2000, Denmark
5
Section for General Medicine, Department of Public Health, University of Copenhagen, Copenhagen 1353, Denmark
6
National Institute of Public Health, University of Southern Denmark, Odense 5000, Denmark
*
Author to whom correspondence should be addressed.
Received: 8 February 2017 / Revised: 8 March 2017 / Accepted: 10 March 2017 / Published: 15 March 2017
(This article belongs to the Special Issue Nutrition and Diet in IBD)
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Abstract

We wanted to investigate the current knowledge on the impact of diet on anti-TNF response in inflammatory bowel diseases (IBD), to identify dietary factors that warrant further investigations in relation to anti-TNF treatment response, and, finally, to discuss potential strategies for such investigations. PubMed was searched using specified search terms. One small prospective study on diet and anti-TNF treatment in 56 patients with CD found similar remission rates after 56 weeks among 32 patients with good compliance that received concomitant enteral nutrition and 24 with poor compliance that had no dietary restrictions (78% versus 67%, p = 0.51). A meta-analysis of 295 patients found higher odds of achieving clinical remission and remaining in clinical remission among patients on combination therapy with specialised enteral nutrition and Infliximab (IFX) compared with IFX monotherapy (OR 2.73; 95% CI: 1.73–4.31, p < 0.01, OR 2.93; 95% CI: 1.66–5.17, p < 0.01, respectively). In conclusion, evidence-based knowledge on impact of diet on anti-TNF treatment response for clinical use is scarce. Here we propose a mechanism by which Western style diet high in meat and low in fibre may promote colonic inflammation and potentially impact treatment response to anti-TNF drugs. Further studies using hypothesis-driven and data-driven strategies in prospective observational, animal and interventional studies are warranted. View Full-Text
Keywords: lifestyle factors; chronic inflammatory diseases; treatment result; treatment response; diet; meat intake; dietary pattern; food; mucosa associated bacteria; epithelium-associated bacteria; microbiome; fibre intake; personalized medicine; mucus; sulphate-reducing bacteria; mucin-degrading bacteria; Western style diet; anti-TNF lifestyle factors; chronic inflammatory diseases; treatment result; treatment response; diet; meat intake; dietary pattern; food; mucosa associated bacteria; epithelium-associated bacteria; microbiome; fibre intake; personalized medicine; mucus; sulphate-reducing bacteria; mucin-degrading bacteria; Western style diet; anti-TNF
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Andersen, V.; Hansen, A.K.; Heitmann, B.L. Potential Impact of Diet on Treatment Effect from Anti-TNF Drugs in Inflammatory Bowel Disease. Nutrients 2017, 9, 286.

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