beta-carotene and Crohn-Disease

Increased oxidative stress has been previously demonstrated in patients with Crohn's disease (CD). However, to date, this parameter has not been assessed in a comparative study of patients in prolonged remission and those with the active disease. We report here our study of lipid peroxidation, antioxidant and inflammation status in serum derived from 16 active CD patients, 27 clinically stable patients, and 15 healthy controls. Results The extent of lipid peroxidation was higher in CD patients than in the healthy controls, while the levels of lipid peroxides (PD) and of thiobarbituric acid-reactive substances (TBARS) were significantly (P < 0.01) higher in serum obtained from patients with active CD (22 and 30%, respectively) than in that obtained from patients in remission. An analysis of the antioxidant status revealed that the beta-carotene levels in sera derived from all CD patients - patients with active or stable CD (49.4 +/- 15 and 95.6 +/- 25 mg% beta-carotene, respectively) - were higher than that in the controls (145 +/- 40 mg%). Serum activity of glutathione peroxidase (GSH-Px) was significantly (P < 0.001) higher (by 31%) in the patients with active CD than in the control group. There was no significant difference in GSH-Px activity between patients in remission and the controls. In terms of the inflammatory status, we found significantly (P < 0.01) higher levels of C-reactive proteins (CRP) and of tumor necrosis factor alpha (TNFalpha) in patients with active CD than in CD patients in remission. There was a significant correlation between those parameters and the extent of lipid oxidation. Neutrophils, which are a potential source of oxygen-free radicals, were activated by incubation with phorbol myristate acetate (PMA). Superoxide and lysozyme release were significantly reduced in neutrophils derived from patients with active CD (by 25 and 28%, respectively) in comparison to the control group. However, stimulated neutrophils from stable patients demonstrated only a minimally non-significant lower release of superoxide and lysozyme compared to the controls. Conclusion The results obtained in this study demonstrate an enhanced inflammatory and oxidative stress and a decreased antioxidant status in patients with active CD. As the patients improved and became clinically stable, the oxidative parameters decreased, approaching normal values. As neutrophil activation was also lower in patients with active disease, neutrophil activation may represen

Topics: Adult; Antioxidants; beta Carotene; C-Reactive Protein; Case-Control Studies; Crohn Disease; Female; Glutathione Peroxidase; Humans; Inflammation Mediators; Lipid Peroxidation; Lipid Peroxides; Male; Middle Aged; Muramidase; Neutrophil Activation; Neutrophils; Oxidative Stress; Respiratory Burst; Superoxides; Thiobarbituric Acid Reactive Substances; Time Factors; Tumor Necrosis Factor-alpha

In Crohn disease (CD), the increased production of reactive oxygen species from activated neutrophils may reduce plasma concentrations of antioxidant vitamins and result in increased oxidative stress.. We compared lipid peroxidation, a measure of reactive-oxygen-species production, and plasma antioxidant vitamin concentrations between CD patients and healthy control subjects.. Thirty-seven nonsmoking CD patients (22 women and 15 men) were compared with an equal number of healthy control subjects who were matched by age, sex, and body mass index. In patients the mean CD activity index (CDAI) was 141.2 +/- 18.7 (range: 9.0-514), and 11 of 37 patients (30%) had a CDAI > or =150. Seventy-eight percent of patients were taking > or = 1 medication. Medication use by subjects included the following: 5-aminosalicylic acid (40% of subjects), antibiotics (22%), oral corticosteroids (30%), and immunosuppressants (19%).. Lipid peroxidation as measured by breath pentane output (CD patients, 7.47 +/- 0.98 pmol x kg(-1) x min(-1); control subjects, 4.97 +/- 0.48 pmol x kg(-1) x min(-1); P < or = 0.025), breath ethane output (CD patients, 11.24 +/- 1.17 pmol x kg(-1) x min(-1); control subjects, 5.46 +/- 0.71 pmol x kg(-1) x min(-1); P < or = 0.0005) and F2-isoprostane (CD patients, 78.6 +/- 8.0 ng/L; control subjects, 60.6 +/- 3.7 ng/L; P < or = 0.047) were significantly higher in CD patients than in control subjects. Plasma antioxidant vitamins (ascorbic acid, alpha- and beta-carotene, lycopene, and beta-cryptoxanthin) were all significantly lower in CD patients than in control subjects. There were no significant differences in macro- and micronutrient intakes between groups.. Patients with CD are oxidatively stressed, which was observed even though 70% of patients had a CDAI < or =150 and 78% of them were taking medications to treat CD.

Topics: Adult; Alkenes; Antioxidants; Ascorbic Acid; beta Carotene; Breath Tests; Carotenoids; Case-Control Studies; Crohn Disease; Dinoprost; Ethane; F2-Isoprostanes; Female; Humans; Lipid Peroxidation; Lycopene; Male; Oxidative Stress; Reactive Oxygen Species

Malnutrition is observed frequently in patients with inflammatory bowel disease (IBD). Knowledge of the nutritional status in patients with recently diagnosed IBD is limited. The aim of this study was to establish a comprehensive picture of the nutritional status in recently diagnosed IBD patients.. Sixty-nine IBD patients (23 Crohn's disease (CD) and 46 with ulcerative colitis (UC)) within 6 months of diagnosis and 69 age- and sex-matched population controls were included in the study.. The nutritional status was assessed by: (1) body composition (anthropometry and dual-energy X-ray absorptiometry); (2) dietary intake (dietary history); (3) biochemical indexes of nutrition; and (4) muscle strength (isokinetic dynamometer).. Body weight and body mass index were significantly lower in UC patients compared with controls. The mean daily intake of carbohydrates was significantly higher in CD patients and the intakes of protein, calcium, phosphorus, and riboflavin were significantly lower in UC patients compared with controls, respectively. Serum concentrations of several nutrients (beta-carotene, magnesium, selenium and zinc) were significantly lower in UC patients compared with controls. Serum vitamin B12 concentration was significantly lower in CD patients. Muscle strength did not significantly differ between IBD patients and controls.. This study showed that the nutritional status of IBD patients was already affected negatively at time of diagnosis. It needs to be elucidated whether nutritional supplementation in recently diagnosed IBD patients may improve the clinical course of the disease.

Topics: Adult; beta Carotene; Body Composition; Body Mass Index; Body Weight; Calcium, Dietary; Colitis, Ulcerative; Crohn Disease; Diet; Dietary Carbohydrates; Dietary Proteins; Female; Humans; Male; Minerals; Muscle, Skeletal; Nutritional Status; Phosphorus, Dietary; Riboflavin; Vitamin B 12

Malnutrition is observed frequently and is an important complication in patients with Crohn disease (CD). The pathophysiology of malnutrition in this disorder is complex. To obtain a comprehensive picture of nutritional status in patients with long-standing CD that was clinically in remission, we assessed four measures of nutritional status in 32 patients (18 women and 14 men) and 32 matched healthy control subjects: 1) body composition, 2) dietary intake, 3) biochemical indexes of nutrition, and 4) and muscle strength (as a functional index). Mean daily intakes of fiber and phosphorus were significantly lower in CD patients than in control subjects. Serum concentrations of several nutrients (beta-carotene, vitamin C, vitamin E, selenium, and zinc) and activity of the enzyme glutathione peroxidase were also significantly lower in CD patients, as were antioxidant status and serum concentrations of magnesium and vitamin D. Percentage body fat and hamstring muscle strength were significantly lower in male CD patients than in control subjects, whereas muscle strength of the quadriceps was preserved. In conclusion, this study showed a variety of nutritional and functional deficiencies in patients with long-standing CD in remission, especially in male patients with a high lifetime prednisone dose. A comprehensive nutritional assessment seems superior to the assessment of a single dimension of nutritional status.

Topics: Adult; beta Carotene; Biomarkers; Body Composition; Case-Control Studies; Crohn Disease; Data Interpretation, Statistical; Diet; Energy Intake; Female; Humans; Male; Middle Aged; Muscle, Skeletal; Nutrition Disorders; Nutritional Status; Physical Endurance; Remission Induction; Time Factors; Vitamin A

The value of serum beta-carotene concentration as an indicator of steatorrhoea was investigated in 50 patients with steatorrhoea (fecal fat greater than 7 g/day), 53 controls, and 22 patients with gastrointestinal disease without steatorrhoea. In the control group, beta-carotene concentrations were normally distributed when plotted logarithmically. The mean value was 131 micrograms/dl. The lower limit of normal, based on a 2-SD confidence interval, was 47 micrograms/dl. beta-Carotene concentrations and fecal fat excretion were correlated in a reciprocal, hyperbolic function (r = -0.66). Twenty-nine of the 50 patients with steatorrhoea had beta-carotene concentrations less than 47 micrograms/dl (sensitivity 58%; specificity 93%). Referring to an additional cut-off point of 100 micrograms/dl, beta-carotene concentration had a sensitivity of 88%. These data show that low plasma beta-carotene concentrations (less than 47 micrograms/dl) can be regarded a specific and useful indicator of steatorrhoea and thus obviate fecal fat analysis. Values greater than 47 micrograms/dl, however do not exclude steatorrhoea. Based on a two-step interpretation beta-carotene is thus both a useful screening test for steatorrhoea (with a cut-off point of 100 micrograms/dl) and, more important, a valid, simple, and clinically practical alternative for fecal fat analysis (if values are less than 47 micrograms/dl).

Topics: beta Carotene; Carotenoids; Celiac Disease; Colitis, Ulcerative; Crohn Disease; Diagnosis, Differential; Fats; Feces; Humans; Pancreatitis; Spectrophotometry