PubMed · 6574763
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W R Tyldesley. 1983-04-23. Sarcoid gingivitis.. https://doi.org/10.1038/sj.bdj.4805050
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Exclusive enteral nutrition (EEN) is a first-line therapy for pediatric Crohn's disease (CD), but protective mechanisms remain unknown. We established a prospective pediatric cohort to characterize the function of fecal microbiota and metabolite changes of treatment-naive CD patients in response to EEN (German Clinical Trials DRKS00013306). Integrated multi-omics analysis identified network clusters from individually variable microbiome profiles, with Lachnospiraceae and medium-chain fatty acids as protective features. Bioorthogonal non-canonical amino acid tagging selectively identified bacterial species in response to medium-chain fatty acids. Metagenomic analysis identified high strain-level dynamics in response to EEN. Functional changes in diet-exposed fecal microbiota were further validated using gut chemostat cultures and microbiota transfer into germ-free Il10-deficient mice. Dietary model conditions induced individual patient-specific strain signatures to prevent or cause inflammatory bowel disease (IBD)-like inflammation in gnotobiotic mice. Hence, we provide evidence that EEN therapy operates through explicit functional changes of temporally and individually variable microbiome profiles.
A 63-year-old, Dutch, HIV-seronegative man presented with anal pain and itch of 6 months' duration, a perianal ulcer and a solitary colon ulcer. Crohn's disease was suspected; the patient was treated with corticosteroids, but later died. Autopsy revealed disseminated histoplasmosis, a fungal disease rare in the Netherlands. The patient had visited Honduras. This case report illustrates that disseminated histoplasmosis may mimic Crohn's disease leading to a delay in the diagnosis.
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