Abstract
Crohn's disease is a chronic relapsing condition that has no certain cure. Both genetic susceptibility and nutrition have key roles, but their level of involvement varies between patients. Interacting gene pathways influence the probability of disease development, but these are affected by stress and various environmental factors, including diet. In addition, the role of the gut microbiome must not be underestimated, as it is substantially altered in patients with Crohn's disease. Although an elemental diet might lead to disease remission, reintroducing real foods and sustainable diets in patients with Crohn's disease is currently difficult, and would benefit from the sensitivity and rapid feedback provided by the field of nutrigenomics. Nutrigenomics utilizes high-throughput genomics technologies to reveal changes in gene and protein expression that are modulated by the patient's nutrition. The most widely used technique thus far is transcriptomics, which permits measurement of changes in the expression of thousands of genes simultaneously in one sample. Given the volume of numbers generated in such studies, data-basing and bioinformatics are essential to ensure the correct application of nutrigenomics at the population level. These methods have been successfully applied to animal models of Crohn's disease, and the time is right to move them to human studies.
Key Points
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Crohn's disease is an inflammatory condition that develops in genetically predisposed individuals who are exposed to stressors, including certain diets; however, the dietary response cannot currently be predicted with certainty
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Nutrigenetic, metabonomic and proteomic technologies might enable the identification of patients who will or will not respond to a given diet or medicinal food, thereby increasing the likelihood of efficacy
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Metabonomics enables the identification of early and sensitive biomarkers that might facilitate validation of novel diets or medicinal foods that could delay disease development or progression
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Transcriptomics (gene-expression profiling), in combination with advanced bioinformatic methods, might facilitate nonhypothesis-based animal or human trials on the potential effects of certain diets or medicinal foods
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These methods have proved informative in interpreting the effects of long-chain n-3 fatty acids on Crohn's disease in animal models
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It is time to apply these methods to develop an improved rationale for dietary interventions in patients with Crohn's disease
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Acknowledgements
I wish to thank Virginia Parslow, for editorial help, and Valerie Gray, for the illustrations. Nutrigenomics New Zealand (www.nutrigenomics.org.nz) is a collaboration among The University of Auckland, Plant and Food Research Ltd and AgResearch Ltd. It is funded by the New Zealand Ministry of Science and Innovation.
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Ferguson, L. Potential value of nutrigenomics in Crohn's disease. Nat Rev Gastroenterol Hepatol 9, 260–270 (2012). https://doi.org/10.1038/nrgastro.2012.41
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DOI: https://doi.org/10.1038/nrgastro.2012.41