Frontiers in nutrition · 2026
Therapeutic response to exclusive enteral nutrition correlates with suppressed IL-17 signaling activity and diminished IL-1β secretion in pediatric Crohn's disease.
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Tang Wenjuan, Wang Yuhuan, Tang Zifei, Zheng Cuifang, Shi Jieru, Meng Yingying, Huang Ying
Аннотация
BACKGROUND: To identify molecular correlates associated with therapeutic outcomes of exclusive enteral nutrition (EEN) in pediatric Crohn's disease (PCD).
METHODS: This prospective observational cohort study recruited 27 treatment-naive pediatric patients with endoscopically active PCD. Intestinal mucosal tissues were collected via endoscopy at baseline and after EEN treatment. RNA sequencing, principal component analysis (PCA), protein-protein interaction (PPI) analysis, and quantitative real-time polymerase chain reaction (qRT-PCR) were performed to identify and validate differentially expressed genes (DEGs). Patients were classified into mucosal healing [MH, Simple Endoscopic Score for Crohn's Disease (SES-CD) < 3, n = 13] and non-mucosal healing (NMH, SES-CD ≥ 3 with ulcers, n = 14) groups according to post-treatment SES-CD.
RESULTS: PCA revealed partial transcriptomic segregation between the MH and NMH groups after EEN. Bioinformatic enrichment analysis identified the IL-17 signaling pathway as the most significantly enriched pathway, encompassing nine core DEGs. Integrated qRT-PCR validation and PPI network analysis pinpointed IL-1β as the key target gene. Correlation analysis demonstrated that intestinal mucosal IL-1β expression was moderately and positively correlated with SES-CD scores (P = 0.001, r = 0.42, 95% CI: 0.17-0.63), Lewis scores (P < 0.001, r = 0.65, 95% CI: 0.41-0.79), and weighted Pediatric Crohn's Disease Activity Index (wPCDAI) values (P < 0.001, r = 0.51, 95% CI: 0.26-0.69). Moreover, compared with the NMH group, the MH group exhibited lower mucosal expression levels of IL-17A [MH: 0.50 (1.42) vs. NMH: 2.58 (2.05), P = 0.03], IL-17RA (MH: 0.95 ± 0.37 vs. NMH: 1.34 ± 0.53, P = 0.04), and IL-17RB [MH: 1.18 (0.54) vs. NMH: 1.64 (1.32), P < 0.01] after EEN treatment.
CONCLUSIONS: EEN attenuates intestinal inflammation in PCD, and this therapeutic response may associate with suppressed IL-17 signaling activity and reduced IL-1β secretion.
METHODS: This prospective observational cohort study recruited 27 treatment-naive pediatric patients with endoscopically active PCD. Intestinal mucosal tissues were collected via endoscopy at baseline and after EEN treatment. RNA sequencing, principal component analysis (PCA), protein-protein interaction (PPI) analysis, and quantitative real-time polymerase chain reaction (qRT-PCR) were performed to identify and validate differentially expressed genes (DEGs). Patients were classified into mucosal healing [MH, Simple Endoscopic Score for Crohn's Disease (SES-CD) < 3, n = 13] and non-mucosal healing (NMH, SES-CD ≥ 3 with ulcers, n = 14) groups according to post-treatment SES-CD.
RESULTS: PCA revealed partial transcriptomic segregation between the MH and NMH groups after EEN. Bioinformatic enrichment analysis identified the IL-17 signaling pathway as the most significantly enriched pathway, encompassing nine core DEGs. Integrated qRT-PCR validation and PPI network analysis pinpointed IL-1β as the key target gene. Correlation analysis demonstrated that intestinal mucosal IL-1β expression was moderately and positively correlated with SES-CD scores (P = 0.001, r = 0.42, 95% CI: 0.17-0.63), Lewis scores (P < 0.001, r = 0.65, 95% CI: 0.41-0.79), and weighted Pediatric Crohn's Disease Activity Index (wPCDAI) values (P < 0.001, r = 0.51, 95% CI: 0.26-0.69). Moreover, compared with the NMH group, the MH group exhibited lower mucosal expression levels of IL-17A [MH: 0.50 (1.42) vs. NMH: 2.58 (2.05), P = 0.03], IL-17RA (MH: 0.95 ± 0.37 vs. NMH: 1.34 ± 0.53, P = 0.04), and IL-17RB [MH: 1.18 (0.54) vs. NMH: 1.64 (1.32), P < 0.01] after EEN treatment.
CONCLUSIONS: EEN attenuates intestinal inflammation in PCD, and this therapeutic response may associate with suppressed IL-17 signaling activity and reduced IL-1β secretion.