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Edwin A Deitch - One of the best experts on this subject based on the ideXlab platform.

  • Elemental Diet induced bacterial translocation associated with systemic and intestinal immune suppression
    Journal of Parenteral and Enteral Nutrition, 1998
    Co-Authors: Edwin A Deitch
    Abstract:

    Background: Elemental Diets can lead to a loss of intestinal barrier function, promote bacterial translocation, and impair host immune defenses. The purpose of this study was to determine the effects of IV and orally administered total parenteral nutrition (TPN) solution on systemic and intestinal immunity and to establish whether supplemental cellulose fiber could improve the impaired immune response. Methods: The incidence of bacterial translocation and immune function was quantitated by measuring organ weights, immune cell population levels, and the mitogenic response of lymphocytes from the spleen, mesenteric lymph nodes and Peyer's patches of rats receiving parenteral or enteral TPN solution, with and without fiber supplementation. Results: Parenteral and enterally administered TPN solution promoted bacterial translocation to the mesenteric lymph nodes, reduced immune cell population levels, and decreased the lymphocyte mitogenic response to T- and B-cell mitogens. Supplemental cellulose fiber reduced the incidence of Diet-induced bacterial translocation from 84% to 31% (p <.01) and improved immune cell function. To more closely examine the relationship between bacterial translocation and impaired lymphocyte mitogenic activity, rats receiving TPN orally or IV were separated into two groups based on whether or not bacterial translocation occurred. Rats in which fiber prevented bacterial translocation had normal mitogenic responses, whereas the subgroup of rats in which fiber failed to prevent bacterial translocation had profound decreases in their lymphocyte mitogenic responses. Conclusions: Both parenteral and enteral Elemental Diets induced bacterial translocation and impaired systemic and intestinal immune function. Fiber supplementation was effective in reducing Elemental Diet-induced bacterial translocation and significantly prevented Diet-induced impairment of lymphocyte function.

  • Elemental Diet and iv tpn induced bacterial translocation is associated with loss of intestinal mucosal barrier function against bacteria
    Annals of Surgery, 1995
    Co-Authors: Edwin A Deitch, Markus B Naruhn, David C Deitch, Andrew A Marino
    Abstract:

    OBJECTIVE: The goal of the current study was to directly assess the role of loss of mucosal barrier function in nutritionally induced bacterial translocation. BACKGROUND: Parenteral and certain Elemental enteral Diets have been shown to promote bacterial translocation. The mechanisms underlying this observation, especially the question of whether nutritionally induced bacterial translocation is primarily related to loss of intestinal barrier function, versus an impaired immune system, remain to be fully elucidated. METHODS: Bacterial translocation was measured in vivo, ileal mucosal membranes were harvested, and their electrophysiologic properties and barrier function were measured ex vivo in the Ussing chamber system 7 days after receiving total parenteral nutrition solution parenterally (IV-TPN) or enterally (Elemental Diet). Chow-fed rats served as control subjects. RESULTS: The incidence of bacterial translocation was significantly increased both to the mesenteric lymph nodes in vivo and across the in vitro Ussing chamber-mounted ileal mucosal membranes of the Elemental Diet-fed and IV-TPN-fed rats. The magnitude of Escherichia coli and phenol red transmucosal passage in the Ussing chamber was significantly higher in the IV-TPN-fed rats than in the Elemental Diet-fed or chow-fed animals. The potential differences across the ileal membrane were similar between the three groups at all time points. However, the specific resistances of the ileal membranes of the IV-TPN and Elemental Diet groups were significantly less than the chow-fed animals, indicating increased membrane permeability. CONCLUSIONS: Loss of intestinal barrier function plays a major role in nutritionally induced bacterial translocation, and the loss of mucosal barrier function to both E. coli and phenol red appeared greater in the IV-TPN than the Elemental Diet-fed rats.

  • the modulatory role of gut hormones in Elemental Diet and intravenous total parenteral nutrition induced bacterial translocation in rats
    Journal of Parenteral and Enteral Nutrition, 1994
    Co-Authors: Yuval Haskel, Edwin A Deitch
    Abstract:

    We have previously shown that parenteral and certain Elemental Diets promote bacterial translocation and that this Diet-induced bacterial translocation can be prevented by the provision of bulk-forming Dietary fiber. The goal of the current study was to test the hypothesis that fiber's protective effect on Diet-induced bacterial translocation was mediated by trophic gut hormones. This hypothesis was tested by using bombesin (which stimulates gut hormone release) or the somatostatin analog Sandostatin (which inhibits gut hormone release) to modulate gut hormone release in rats receiving rat food, intravenous total parenteral nutrition, or an Elemental Diet. Both bombesin and fiber were effective in preventing Elemental Diet-induced bacterial translocation, whereas octreotide acetate abrogated the protective effect of fiber. Bombesin was also effective in limiting bacterial translocation in parenterally fed rats. Although both enteral (Elemental Diet) and parenteral Diet-induced bacterial translocation were...

  • Elemental Diet induced immune suppression is caused by both bacterial and Dietary factors
    Journal of Parenteral and Enteral Nutrition, 1993
    Co-Authors: Edwin A Deitch, Rodney D Berg
    Abstract:

    Because it is unclear whether Elemental Diet-induced immune suppression is an indirect effect caused by the translocating bacteria or is directly caused by the Elemental Diet, we tested whether prevention of Diet-induced bacterial translocation or disruption of the gut microflora ecology would prevent Diet-induced impaired lymphocyte function in a rat Elemental Diet model. Prevention of Diet-induced bacterial translocation was accomplished by the addition of cellulose fiber or oral antibiotics (penicillin and streptomycin) to the Elemental Diet feeding regimen. Control groups consisted of rat food-fed and Elemental Diet-fed (4.25% amino acids; 28% glucose) rats. Immune function was quantitated by measuring the mitogen-induced blastogenic response of peripheral blood or splenic mononuclear cells to the mitogens concanavalin A and phytohemagglutinin. Bacterial translocation from the gut to the mesenteric lymph node and cecal bacterial population levels were measured in all groups. Although the incidence of ...

  • Elemental Diet induced bacterial translocation can be hormonally modulated
    Annals of Surgery, 1993
    Co-Authors: Yuval Haskel, Edwin A Deitch
    Abstract:

    BACKGROUND: The authors have previously documented that feeding mice an Elemental Diet resulted in bacterial translocation (BT) that could be prevented by the provision of Dietary fiber. To test whether the protective effect of fiber was related to the stimulation of trophic gut hormones, the effects of sandostatin and bombesin were tested. METHODS: Mice fed either chow or the Elemental Diet were stratified into several groups and the ability of bombesin (10 micrograms/kg, tid) or sandostatin (100 micrograms/kg bid) to modulate BT was examined. After 14 days, mice were sacrificed and BT, cecal bacterial population levels, mucosal protein, and small bowel weight was measured. Segments of the ileum and jejunum were examined histologically. RESULTS: Incidence of Elemental Diet-induced BT (75%) was reduced by fiber (9%) or the administration of bombesin (13%) (p < 0.01). Although sandostatin did not promote BT in chow-fed mice, it reversed the protective effect of fiber on BT (75%) (p < 0.01). CONCLUSION: Elemental Diet-induced bacterial translocation can be modulated hormonally and the beneficial effects of fiber on Diet-induced BT appears to be hormonally mediated.

Koji Harada - One of the best experts on this subject based on the ideXlab platform.

  • effects of an Elemental Diet elental may differ between healthy oral cells and oral cancer cells
    Oncology Reports, 2020
    Co-Authors: Koji Harada, Tarannum Ferdous, Kenji Watanabe, Yoichi Mizukami, Katsuaki Mishima
    Abstract:

    The effectiveness of an Elemental Diet (ED), Elental®, against radiotherapy‑ or chemoradiotherapy‑induced oral mucositis was previously reported. However, the administration of additional nutrition or an ED in patients with oral cancer may also provide extra nutrition for cancer cells, which could result in cancer development. At present, it remains unclear whether the beneficial effects of an ED are likely to surpass its potential harmful effects on oral cancer treatment. In the present study, we aimed to clarify whether Elental® has different effects on a healthy human oral keratinocyte (HOK) cell line compared with its effects on oral squamous cell carcinoma (OSCC) cell lines (HSC2, HSC3, HSC4). The efficacy of Elental® was compared in relation to the growth and migration ability of HOK and OSCC cell lines using MTT assay and migration assay, respectively. In addition, whole transcriptome analysis and network analysis were performed to determine the difference in the mechanism of action of Elental® between HOK and HSC2 cells. In addition, Elental® promoted growth and migration ability of‑malnourished and 5‑fluorouracil (5‑FU)‑treated damaged HOK cells cultured in low nutrition medium (0% growth supplement). However, Elental® did not affect the growth ability of 5‑FU‑treated damaged HSC2 cell line in low nutrition medium (0 or 1% fetal bovine serum (FBS), as well as the growth ability of HSC3 and HSC4 cell lines in medium containing 0% FBS. Elental® pre‑treatment also enhanced the apoptosis‑inducing effect of anticancer agents against OSCC cells. In addition, whole transcriptome analysis and Ingenuity Pathways Analysis (IPA) data suggested that Elental® may help in the proliferation and survival of HOK through the induction of ERK. Moreover, Elental® added stress to HSC2 cells through the induction of the endoplasmic reticulum stress response marker, BiP and GRP 94. The results showed that Elental® may add stress to HSC2 cells and provide growth stimulation to HOK. These findings suggest that the effects of Elental® on healthy oral cells and oral cancer cells may differ.

  • the elental Elemental Diet for chemoradiotherapy induced oral mucositis a prospective study in patients with oral squamous cell carcinoma
    Current Opinion in Clinical Nutrition and Metabolic Care, 2018
    Co-Authors: Koji Harada, Tarannum Ferdous, Daiju Horinaga, Kenichiro Uchida, Sung Chul Park, Hideki Hanazawa, Haruyasu Minami, Yoshiaki Kato, Hirotsugu Umeda, Shotaro Takahashi
    Abstract:

    Oral mucositis is a common adverse effect of cancer treatment that can increase the risk for local and systemic infection. This prospective study was designed to evaluate the preventive effects of an amino-acid-rich Elemental Diet (ED), Elental®, on radiotherapy- or chemoradiotherapy-induced mucositis in oral squamous cell carcinoma (OSCC) patients. Fifty patients were enrolled in this prospective study, who had received radiation (60-70 Gy) with/without chemotherapy [S-1, UFT, cisplatin (CDDP), docetaxel (DOC) plus CDDP, or Cetuximab]. The Elental® group (25 patients) had received Elental® during treatment, and the control group (25 patients) had not. Multivariate logistic regression analysis was used to identify the factors related to abatement of oral mucositis. A comparison of the rates of completion of chemoradiation treatments as well as the nutritional or inflammatory status between Elental® and control groups was performed. Multivariate analysis indicated that most of the patients who received Elental® suffered from a lower degree of mucositis and showed significantly improved rate of completion of chemoradiation (no interruption) compared to the control group. There was a significant difference between the Elental® group and the control group in terms of the mean change of C-reactive protein (CRP) levels in blood serum; however, there was no significant difference in terms of a mean change of body weight and total protein level in blood serum before and after chemoradiation. Our study shows that the Elental® Elemental Diet could be useful for the treatment of oral mucositis induced by chemoradiation. Elental® might also promote improved completion rates of chemoradiotherapy in OSCC patients.

  • Elemental Diet inhibits pro inflammatory cytokine production in keratinocytes through the suppression of nf κb activation
    Oncology Reports, 2018
    Co-Authors: Koji Harada, Tarannum Ferdous, Yoichi Mizukami, Katsuaki Mishima
    Abstract:

    An Elemental Diet (ED) has been reported to reduce oral mucositis and dermatitis induced by chemotherapy. However, its molecular mechanism of action as an anti‑inflammatory agent is still unknown. The aim of the present study was to clarify whether ED confers its anti‑inflammatory action via reduction of pro‑inflammatory cytokine production in keratinocytes in vivo and in vitro. We evaluated the efficacy of ED in the treatment of 5‑fluorouracil (5‑FU)‑induced dermatitis of nude mice, and examined the expression of pro‑inflammatory cytokines such as tumor necrosis factor‑α (TNF‑α), interleukin (IL)‑1β and IL‑6 using immunohistochemistry. Moreover, we assessed the expression and production of these pro‑inflammatory cytokines by western blotting and ELISA assays, respectively, in immortalized human keratinocyte cell line, HaCaT. Furthermore, we investigated the effect of ED on a major inflammation‑related factor, nuclear transcription factor‑κB (NF‑κB), since it controls many genes involved in the inflammation pathway. Our results indicated that ED reduced the expression of TNF‑α, IL‑1β and IL‑6. It also inhibited the nuclear transition of p65 NF‑κB, which is known to regulate inflammatory cytokine expression in keratinocytes suffering from 5‑FU‑induced dermatitis. In addition, ED reduced the production of TNF‑α, IL‑1β and IL‑6 in HaCaT cells. Moreover, ED attenuated 5‑FU‑induced transcriptional activation of NF‑κB. These findings revealed that ED suppresses the expression of pro‑inflammatory cytokines by suppressing NF‑κB in keratinocytes, suggesting the potential usefulness of ED in the treatment of various inflammatory diseases of the dermal region.

  • Elemental Diet accelerates the recovery from oral mucositis and dermatitis induced by 5 fluorouracil through the induction of fibroblast growth factor 2
    Integrative Cancer Therapies, 2018
    Co-Authors: Koji Harada, Tarannum Ferdous, Hiroaki Kobayashi, Yoshiya Ueyama
    Abstract:

    Mucositis and dermatitis induced by anticancer agents are common complications of anticancer therapies. In this study, we evaluated the efficacy of Elental (Ajinomoto Pharmaceutical Ltd, Tokyo, Japan), an Elemental Diet with glutamine in the treatment of 5-fluorouracil (5-FU)-induced oral mucositis and dermatitis in vivo and tried to clarify the underlying mechanisms of its action. Oral mucositis and dermatitis was induced through a combination of 5-FU treatment and mild abrasion of the cheek pouch in hamsters and the dorsal skin in nude mice respectively. These animals received saline, dextrin or Elental suspension (18 kcal/100 g) by a gastric tube daily until sacrifice. Elental reduced oral mucositis and dermatitis more effectively than dextrin in the animal model. Moreover, growth facilitating effects of Elental on HaCaT cells were examined in vitro. MTT assay, wound healing assay, and migration assay revealed that Elental could enhance the growth, invasion, and migration ability of HaCaT. ELISA and Western blotting showed upregulated FGF2 in Elental-treated HaCaT. These findings suggest that Elental is effective for the treatment of mucositis and dermatitis, and may accelerate mucosal and skin recovery through FGF2 induction and reepithelization.

  • efficacy of Elemental Diet on prevention for chemoradiotherapy induced oral mucositis in patients with oral squamous cell carcinoma
    Supportive Care in Cancer, 2016
    Co-Authors: Koji Harada, Tarannum Ferdous, Daiju Horinaga, Kenichiro Uchida, Takamitsu Mano, Katsuaki Mishima, Sung Chul Park, Hideki Hanazawa, Shotaro Takahashi, Atsumi Okita
    Abstract:

    Purpose Oral mucositis induced by radiation or chemoradiation can compromise the quality of life of oral squamous cell carcinoma (OSCC) patients. The present study was designed to evaluate the preventive effects of Elemental Diet (ED), Elental®, on radiotherapy- or chemoradiotherapy-induced mucositis in OSCC patients.

Albert J Bredenoord - One of the best experts on this subject based on the ideXlab platform.

  • esophageal and small intestinal mucosal integrity in eosinophilic esophagitis and response to an Elemental Diet
    The American Journal of Gastroenterology, 2017
    Co-Authors: Marijn J Warners, B J Vliegboerstra, Joanne Verheij, Patricia Van Hamersveld, Bram D Van Rhijn, Marleen T J Van Ampting, Lucien F Harthoorn, Wouter J De Jonge, A J P M Smout, Albert J Bredenoord
    Abstract:

    Objectives The esophageal mucosal integrity is impaired in eosinophilic esophagitis (EoE) and it has been suggested that the duodenal permeability is increased. The absence of food allergens may restore the integrity. The aims of this study were to assess duodenal permeability in EoE and to evaluate the effect of an Elemental Diet on the esophageal and duodenal integrity. Methods In this prospective study 17 adult EoE patients and 8 healthy controls (HC) were included. Esophageal biopsy specimens were sampled before and after 4 weeks of Elemental Diet to measure eosinophil counts and gene expression of tight junction and barrier integrity proteins. Esophageal and duodenal impedance were measured by electrical tissue impedance spectroscopy and Ussing chambers were used to measure transepithelial resistance (TER) and transepithelial molecule flux. Small intestinal permeability was measured using a test, measuring lactulose/mannitol (L/M) ratios. Results In EoE patients, the esophageal but not the duodenal integrity was impaired, compared with HC. We observed no significant difference between L/M ratios of HC and EoE patients. After Diet, eosinophil counts decreased significantly, which was paralleled by normalization of esophageal impedance and transepithelial molecule flux. The esophageal TER improved significantly, but did not reach values seen in HC. Esophageal expression of genes encoding for barrier integrity proteins filaggrin and desmoglein-1 was impaired at baseline and restored after Diet. Conclusions An Elemental Diet restores esophageal integrity, suggesting that it is at least partly secondary to allergen exposure. Duodenal integrity seems not to be affected in EoE, and possibly plays a minor role in its pathophysiology.

  • Elemental Diet decreases inflammation and improves symptoms in adult eosinophilic oesophagitis patients
    Alimentary Pharmacology & Therapeutics, 2017
    Co-Authors: Marijn J Warners, B J Vliegboerstra, Joanne Verheij, Lucien F Harthoorn, A J P M Smout, B D Van Rhijn, M T J Van Ampting, W J De Jonge, Albert J Bredenoord
    Abstract:

    BACKGROUND: Eosinophilic oesophagitis (EoE) is a chronic disease, driven by food allergens. Elemental Diets are effective for the management of children with EoE, but studies on the effect of Elemental Diets in adults are scarce and poor palatability challenges Dietary adherence. AIMS: To assess the effect of an Elemental Diet (Neocate, Nutricia, Utrecht, the Netherlands) on the inflammation, symptoms and endoscopic signs in adult EoE patients. METHODS: In this prospective study, 21 patients with active EoE, confirmed by biopsies showing ≥15 eosinophils per microscopic high power field (HPF) and symptoms of oesophageal dysfunction were included. Patients underwent endoscopy before and 4 weeks after Diet. Histological disease activity (peak eosinophil count/HPF), and endoscopic signs were scored by physicians. Symptoms and adherence to the Diet were evaluated by questionnaires. Serum total IgE levels and total eosinophil counts were determined and the expression of inflammatory cytokines was analysed by qPCR. RESULTS: In total, 17 (81%) of the patients completed the Diet, of whom 12 (71%) showed complete histological response (≤15 eosinophils/HPF) and 4 (24%) showed partial histological response (≥50% reduction of baseline eosinophil count). Peak eosinophil counts decreased significantly after the Diet from 40 to 9 per HPF (P ≤ 0.001). A marked improvement in endoscopic signs was observed. Symptoms decreased significantly in all subjects, and 15 patients (88%) became completely asymptomatic (P ≤ 0.001). In 14 patients (82%), blood eosinophil count and serum IgE decreased (P ≤ 0.05). CONCLUSION: Elemental Diet reduces eosinophilic inflammation and induces clinical remission in adult patients with eosinophilic oesophagitis.

  • elimination and Elemental Diet therapy in eosinophilic oesophagitis
    Best Practice & Research in Clinical Gastroenterology, 2015
    Co-Authors: M J Warners, B J Vliegboerstra, Albert J Bredenoord
    Abstract:

    Eosinophilic oesophagitis (EoE) is a chronic immune-mediated disorder of the oesophagus. The incidence of EoE has been raised substantially and EoE has recently become the most prevalent cause of dysphagia among the adolescents. Food and aeroallergens are believed to play a major role in the pathogenesis. Current treatment includes topical steroids and Dietary therapy. Dietary therapy with elimination of causative allergens could provide a durable long-term solution. Dietary therapy in EoE consists of in Elemental and empiric elimination Diets. Elemental Diet with amino acid-based formula is most effective in achieving disease remission but poor taste makes adherence challenging. Empiric elimination Diet based on avoidance of most common food allergens offers moderate response rates, the usefulness of allergy test-directed elimination Diets is questioned by low response rates. In conclusion, Dietary treatments for EoE seem promising, but further refinement is required before it can become standard care.

Stefan Pierzynowski - One of the best experts on this subject based on the ideXlab platform.

  • the growth of exocrine pancreatic insufficient young pigs fed an Elemental Diet is dependent on enteral pancreatin supplementation
    Livestock Science, 2010
    Co-Authors: Sofia Rengman, Olexandr Fedkiv, Jos Botermans, Jorgen Svendsen, Bjorn Westrom, Stefan Pierzynowski
    Abstract:

    Young exocrine pancreas insufficient (EPI) pigs given a commercial feed (polymeric Diet) show growth retardation that can be reversed by Dietary supplementation with pancreatic enzymes. Our aim was to investigate if providing an Elemental Diet, mimicking a pre-digested Diet, can support body growth in EPI-pigs. Thus, EPI-pigs, pancreatic duct-ligated at 12.2 +/- 2.6 weeks of age (15.3 +/- 4.8 kg), were fed for 6 days either a commercial polymeric pig feed or infused i.v. with an Elemental Diet, with or without oral supplementation with a porcine enzyme preparation (Creon (R)). The body weight (BW) gain was then compared at day 7. Control pigs (with intact pancreata) showed a 14.0 +/- 1.3% increase in BW independent of the Diet, while EPI-pigs given the same Diets either lost (polymeric Diet) or slightly increased (Elemental Diet) their BW. In contrast, EPI-pigs fed the polymeric feed with Creon supplementation showed a normalised growth and EPI-pigs given the Elemental Diet with Creon supplementation gained 8.5 +/- 0.7% in BW. In conclusion, control pigs maintained a normal growth, independently of the Diet being given in polymeric or Elemental form, while EPI-pigs showed an impaired growth when receiving the same Diets without oral enzyme supplementation. This suggests that pancreatic juice or enzyme preparations, in addition to their digestive properties, stimulate nutrient assimilation and anabolic processes in young fast-growing pigs. (C) 2010 Elsevier B.V. All rights reserved. (Less)

  • an Elemental Diet fed enteral or parenteral does not support growth in young pigs with exocrine pancreatic insufficiency
    Clinical Nutrition, 2009
    Co-Authors: Sofia Rengman, Olexandr Fedkiv, Jos Botermans, Jorgen Svendsen, Bjorn Westrom, Stefan Pierzynowski
    Abstract:

    Summary Background & aims Young individuals with exocrine pancreatic insufficiency (EPI) show growth reduction that can be reversed by Dietary pancreatic enzyme supplementation. Here we investigated whether feeding an Elemental Diet could replace the growth-promoting effect of enzyme supplementation in EPI pigs. Methods Weaned pigs with intact pancreas (control) or pancreatic duct-ligated (EPI pigs) were given a commercial pig feed, a fat-enriched Diet, or an Elemental Diet, intragastrically and intravenously, with or without porcine pancreatin (Creon®) supplementation for 1 week. Results Control pigs, irrespective of receiving pig feed or an Elemental Diet, increased their body weight by 13.4–20.1%, while EPI pigs showed negligible weight gain. Giving a fat-enriched Diet did not improve growth of the EPI pigs. However, if the EPI pigs were supplemented with pancreatin in combination with fat-enriched feed or the Elemental Diet, i.v., their body weight increased by 16.6 %and 8.5%, respectively. Conclusion Control pigs maintained normal growth, independently of the Diet being given in polymeric or Elemental form, while EPI pigs showed impaired growth when receiving the same Diets without enzyme supplementation. Pancreatic juice and enzyme preparations, in addition to their digestive properties, also appear to affect nutrient assimilation and anabolism in young individuals.

Mustafa H Giaffer - One of the best experts on this subject based on the ideXlab platform.