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A prospective pilot study of a gluten-free diet for primary sclerosing cholangitis and associated colitis

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A prospective pilot study of a gluten-free diet for primary sclerosing cholangitis and associated colitis. / Liwinski, Timur; Hübener, Sina; Henze, Lara; Hübener, Peter; Heinemann, Melina; Tetzlaff, Marcus; Hiller, Marie I; Jagemann, Bettina; Surabattula, Rambabu; Leeming, Diana; Karsdal, Morten; Monguzzi, Erika; Schachschal, Guido; Rösch, Thomas; Bang, Corinna; Franke, Andre; Lohse, Ansgar W; Schuppan, Detlef; Schramm, Christoph.

In: ALIMENT PHARM THER, Vol. 57, No. 2, 01.2023, p. 224-236.

Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review

Harvard

Liwinski, T, Hübener, S, Henze, L, Hübener, P, Heinemann, M, Tetzlaff, M, Hiller, MI, Jagemann, B, Surabattula, R, Leeming, D, Karsdal, M, Monguzzi, E, Schachschal, G, Rösch, T, Bang, C, Franke, A, Lohse, AW, Schuppan, D & Schramm, C 2023, 'A prospective pilot study of a gluten-free diet for primary sclerosing cholangitis and associated colitis', ALIMENT PHARM THER, vol. 57, no. 2, pp. 224-236. https://doi.org/10.1111/apt.17256

APA

Liwinski, T., Hübener, S., Henze, L., Hübener, P., Heinemann, M., Tetzlaff, M., Hiller, M. I., Jagemann, B., Surabattula, R., Leeming, D., Karsdal, M., Monguzzi, E., Schachschal, G., Rösch, T., Bang, C., Franke, A., Lohse, A. W., Schuppan, D., & Schramm, C. (2023). A prospective pilot study of a gluten-free diet for primary sclerosing cholangitis and associated colitis. ALIMENT PHARM THER, 57(2), 224-236. https://doi.org/10.1111/apt.17256

Vancouver

Liwinski T, Hübener S, Henze L, Hübener P, Heinemann M, Tetzlaff M et al. A prospective pilot study of a gluten-free diet for primary sclerosing cholangitis and associated colitis. ALIMENT PHARM THER. 2023 Jan;57(2):224-236. https://doi.org/10.1111/apt.17256

Bibtex

@article{2b7b0c306d8a451abd50d3a832584d07,
title = "A prospective pilot study of a gluten-free diet for primary sclerosing cholangitis and associated colitis",
abstract = "BACKGROUND: Primary sclerosing cholangitis (PSC) is a progressive bile duct disease associated with inflammatory bowel disease (PSC-IBD).AIM: To investigate whether patients with PSC-IBD benefit from a gluten-free and amylase trypsin inhibitor (ATI)-free diet (GFD).METHODS: We performed a prospective clinical pilot study administering an eight-week GFD. The primary outcomes were colonic inflammation assessed by proctosigmoidoscopy, and liver stiffness (surrogate for fibrosis, inflammation and cholestasis) measured by transient elastography before and after GFD. Amongst the secondary (exploratory) outcomes were colonic mucosal and serum cytokine/chemokine changes, the intestinal microbiome and transcriptome dynamics, and shifts in serum markers of hepatic fibrogenesis.RESULTS: Fifteen patients with PSC-IBD completed the study. The study did not meet its primary outcome: the endoscopic score and liver stiffness remained unchanged. However, the expression of pro-inflammatory mucosal cytokines and chemokines such as IL6, IL8, CCL2, and TNFα was significantly down-regulated. Two critical markers of liver fibrosis and matrix remodelling, thrombospondin-2 and -4, decreased significantly. The microbiota composition changed slightly, including a decrease in the pathogen Romboutsia ilealis. The intestinal transcriptome indicated a gut barrier improvement. Pruritus, fatigue, overall well-being, faecal calprotectin levels, and serum alkaline phosphatase did not change significantly.CONCLUSIONS: This study did not demonstrate a clinical improvement with short-term GFD in patients with PSC-IBD. However, a gluten/ATI-free diet may improve biomarkers of intestinal inflammation and barrier function in these patients with associated changes in the enteric microbiota. Further investigation of the therapeutic potential of the GFD in PSC-IBD is warranted.",
author = "Timur Liwinski and Sina H{\"u}bener and Lara Henze and Peter H{\"u}bener and Melina Heinemann and Marcus Tetzlaff and Hiller, {Marie I} and Bettina Jagemann and Rambabu Surabattula and Diana Leeming and Morten Karsdal and Erika Monguzzi and Guido Schachschal and Thomas R{\"o}sch and Corinna Bang and Andre Franke and Lohse, {Ansgar W} and Detlef Schuppan and Christoph Schramm",
note = "{\textcopyright} 2022 The Authors. Alimentary Pharmacology & Therapeutics published by John Wiley & Sons Ltd.",
year = "2023",
month = jan,
doi = "10.1111/apt.17256",
language = "English",
volume = "57",
pages = "224--236",
journal = "ALIMENT PHARM THER",
issn = "0269-2813",
publisher = "Wiley-Blackwell",
number = "2",

}

RIS

TY - JOUR

T1 - A prospective pilot study of a gluten-free diet for primary sclerosing cholangitis and associated colitis

AU - Liwinski, Timur

AU - Hübener, Sina

AU - Henze, Lara

AU - Hübener, Peter

AU - Heinemann, Melina

AU - Tetzlaff, Marcus

AU - Hiller, Marie I

AU - Jagemann, Bettina

AU - Surabattula, Rambabu

AU - Leeming, Diana

AU - Karsdal, Morten

AU - Monguzzi, Erika

AU - Schachschal, Guido

AU - Rösch, Thomas

AU - Bang, Corinna

AU - Franke, Andre

AU - Lohse, Ansgar W

AU - Schuppan, Detlef

AU - Schramm, Christoph

N1 - © 2022 The Authors. Alimentary Pharmacology & Therapeutics published by John Wiley & Sons Ltd.

PY - 2023/1

Y1 - 2023/1

N2 - BACKGROUND: Primary sclerosing cholangitis (PSC) is a progressive bile duct disease associated with inflammatory bowel disease (PSC-IBD).AIM: To investigate whether patients with PSC-IBD benefit from a gluten-free and amylase trypsin inhibitor (ATI)-free diet (GFD).METHODS: We performed a prospective clinical pilot study administering an eight-week GFD. The primary outcomes were colonic inflammation assessed by proctosigmoidoscopy, and liver stiffness (surrogate for fibrosis, inflammation and cholestasis) measured by transient elastography before and after GFD. Amongst the secondary (exploratory) outcomes were colonic mucosal and serum cytokine/chemokine changes, the intestinal microbiome and transcriptome dynamics, and shifts in serum markers of hepatic fibrogenesis.RESULTS: Fifteen patients with PSC-IBD completed the study. The study did not meet its primary outcome: the endoscopic score and liver stiffness remained unchanged. However, the expression of pro-inflammatory mucosal cytokines and chemokines such as IL6, IL8, CCL2, and TNFα was significantly down-regulated. Two critical markers of liver fibrosis and matrix remodelling, thrombospondin-2 and -4, decreased significantly. The microbiota composition changed slightly, including a decrease in the pathogen Romboutsia ilealis. The intestinal transcriptome indicated a gut barrier improvement. Pruritus, fatigue, overall well-being, faecal calprotectin levels, and serum alkaline phosphatase did not change significantly.CONCLUSIONS: This study did not demonstrate a clinical improvement with short-term GFD in patients with PSC-IBD. However, a gluten/ATI-free diet may improve biomarkers of intestinal inflammation and barrier function in these patients with associated changes in the enteric microbiota. Further investigation of the therapeutic potential of the GFD in PSC-IBD is warranted.

AB - BACKGROUND: Primary sclerosing cholangitis (PSC) is a progressive bile duct disease associated with inflammatory bowel disease (PSC-IBD).AIM: To investigate whether patients with PSC-IBD benefit from a gluten-free and amylase trypsin inhibitor (ATI)-free diet (GFD).METHODS: We performed a prospective clinical pilot study administering an eight-week GFD. The primary outcomes were colonic inflammation assessed by proctosigmoidoscopy, and liver stiffness (surrogate for fibrosis, inflammation and cholestasis) measured by transient elastography before and after GFD. Amongst the secondary (exploratory) outcomes were colonic mucosal and serum cytokine/chemokine changes, the intestinal microbiome and transcriptome dynamics, and shifts in serum markers of hepatic fibrogenesis.RESULTS: Fifteen patients with PSC-IBD completed the study. The study did not meet its primary outcome: the endoscopic score and liver stiffness remained unchanged. However, the expression of pro-inflammatory mucosal cytokines and chemokines such as IL6, IL8, CCL2, and TNFα was significantly down-regulated. Two critical markers of liver fibrosis and matrix remodelling, thrombospondin-2 and -4, decreased significantly. The microbiota composition changed slightly, including a decrease in the pathogen Romboutsia ilealis. The intestinal transcriptome indicated a gut barrier improvement. Pruritus, fatigue, overall well-being, faecal calprotectin levels, and serum alkaline phosphatase did not change significantly.CONCLUSIONS: This study did not demonstrate a clinical improvement with short-term GFD in patients with PSC-IBD. However, a gluten/ATI-free diet may improve biomarkers of intestinal inflammation and barrier function in these patients with associated changes in the enteric microbiota. Further investigation of the therapeutic potential of the GFD in PSC-IBD is warranted.

U2 - 10.1111/apt.17256

DO - 10.1111/apt.17256

M3 - SCORING: Journal article

C2 - 36266939

VL - 57

SP - 224

EP - 236

JO - ALIMENT PHARM THER

JF - ALIMENT PHARM THER

SN - 0269-2813

IS - 2

ER -