Ricerc@Sapienza

Crohn's disease (CD), a chronic relapsing intestinal disorder, causes severe morbidity and poor quality of life. It belongs to the inflammatory bowel disease (IBD). While previously considered rare in children, IBD has emerged as a global disease in developed and developing nations. Epidemiological data from western countries indicate that 25% of all cases are diagnosed in childhood, with an incidence 10-12 new cases/100.000/year in a range age from 0 to 18 years.
There is a widely agreed view, supported by experimental studies, that an abnormal interplay between environment, genetic, intestinal immunity and gut microbiota (GM) plays a role in mechanisms of CD. The observed increase in the disease incidence in rapidly industrialized countries has highlighted that CD may have a strong environmental component.
Recently, experimental data have shown that western diet (characterized by overconsumption of refined sugars, saturated fats, animal proteins and low intake of plant-based fibers) damages the epithelial barrier and negatively impacts the composition and functionality of GM, with indirect effects on immunological homeostasis of the gut. This has suggested that dietary factors have a plausible role in triggering CD mechanisms.
Interestingly, specific diet programs, such as exclusive enteral nutrition (EEN) with a polymeric formula, and partial enteral nutrition (PEN) including polymeric formulae with an oral diet excluding specific foods, have been shown to play a therapeutic role in inducing and maintaining remission of CD, respectively. However, despite these clinical evidences, the exact mechanism of action of nutritional intervention in CD is uncertain.
Thus, we aim at investigating in children with CD, treated with PEN for maintaining remission, the impact of this strategy on molecular profile of gut microbiota and on fecal metabolome, the latter providing a functional readout of microbial activity. Intestinal Immunological scenario will also be studied.