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Fine and ultrafine particles of the diet: influence on the mucosal immune response and association with Crohn’s disease

Published online by Cambridge University Press:  28 February 2007

Miranda C. E. Lomer ,
Richard P. H. Thompson  and
Jonathan J. Powell
Miranda C. E. Lomer*
Affiliation:
Gastrointestinal Laboratory, The Rayne Institute, St Thomas' Hospital, Lambeth Palace Road, London SE1 7EH, UK
Richard P. H. Thompson
Affiliation:
Gastrointestinal Laboratory, The Rayne Institute, St Thomas' Hospital, Lambeth Palace Road, London SE1 7EH, UK
Jonathan J. Powell
Affiliation:
Department of Nutrition, King's College London, Franklin-Wilkins Building, Stamford Street, London SE1 8WA, UK
*
*Corresponding Author: Miranda Lomer, fax +44 20 7960 5710, email [email protected]
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Abstract

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Crohn’s disease is a modern Western disease characterised by transmural inflammation of the gastrointestinal tract. It is of unknown aetiology, but evidence suggests that it results from a combination of genetic predisposition and environmental factors. Bacterial-sized microparticles (0·1–1·0 µm) are potent adjuvants in model antigen-mediated immune responses and are increasingly associated with disease. Microparticles of TiO2 and aluminosilicate accumulate in macrophages of human gut-associated lymphoid tissue where the earliest signs of lesions in Crohn’s disease are observed. Dietary microparticles are of endogenous or exogenous origin. Endogenous microparticles dominate and are calcium phosphate (most probably hydroxyapatite), which precipitates in the lumen of the mid-distal gastrointestinal tract due to secretion of Ca and phosphate in the succus entericus. Exogenous dietary microparticles are contaminants (soil and/or dust) and food additives. TiO2, for example, is a food colourant, and aluminosilicates are anti-caking agents, although some aluminosilicates occur as natural contaminants. Food additives alone account for ingestion of approximately 1012 particles/person per d. Possible mechanisms for the role of exogenous and endogenous dietary microparticles in promoting toleragenic or immune responses of gastrointestinal mucosal phagocytosis are discussed. In a double-blind randomised pilot study we have shown that a diet low in Ca and exogenous microparticles appears to alleviate the symptoms of ileal Crohn’s disease, with a significant (P = 0·002) improvement in the Crohn’s disease activity index. A multi-centre trial and further mechanistic studies at the cellular level are underway.

Keywords

Dietary microparticlesCrohn’s disease
Type
Meeting Report
Information
Proceedings of the Nutrition Society , Volume 61 , Issue 1 , February 2002 , pp. 123 - 130
Copyright
Copyright © The Nutrition Society 2002

References

Ballegaard, M, Bjergstrom, A, Brondum, S, Hylander, E, Jensen, L & Ladefoged, K (1997) Self-reported food intolerance in chronic inflammatory bowel disease. Scandinavian Journal of Gastroenterology 32, 569–571.CrossRefGoogle ScholarPubMed
Barksdale, J (1996) Titanium – Its Occurence, Chemistry and Technology. New York: Ronald.Google Scholar
Best, WR, Becktel, JM, Singleton, JW & Kern, F (1976) Development of a Crohn's disease activity index. National Cooperative Crohn's Disease Study. Gastroenterology 70, 439–444.CrossRefGoogle ScholarPubMed
Calkins, BM & Mendelhoff, AI (1995) Inflammatory Bowel Disease. Baltimore, MD: Williams & Wilkins.Google Scholar
Churg, A (1996) The uptake of mineral particles by pulmonary epithelial cells. American Journal of Respiratory and Critical Care Medicine 154, 1124–1140.CrossRefGoogle ScholarPubMed
Department of Health (1991). Dietary Reference Values for Food Energy and Nutrients for the United Kingdom. Report on Health and Social Subjects no. 41. London: H.M. Stationery Office.Google Scholar
Desai, MP, Labhasetwar, V, Amidon, GL & Levy, RJ (1996) Gastrointestinal uptake of biodegradable microparticles: effect of particle size. Pharmaceutical Research 13, 1838–1845.CrossRefGoogle ScholarPubMed
Ellingsen, JE (1991) A study on the mechanism of protein adsorption to TiO2. Biomaterials 12, 593–596.CrossRefGoogle Scholar
Ellis, RD, Goodlad, JR, Limb, GA, Powell, JJ, Thompson, RP & Punchard, NA (1998) Activation of nuclear factor kappa B in Crohn's disease. Inflammation Research 47, 440–445.CrossRefGoogle ScholarPubMed
Favus, MJ (1985) Factors that influence absorption and secretion of calcium in the small intestine and colon. American Journal of Physiology 248, 147–157.Google ScholarPubMed
Fiocchi, C (1998) Inflammatory bowel disease: etiology and pathogenesis. Gastroenterology 115, 182–205.CrossRefGoogle ScholarPubMed
Geigy, (1981) Geigy Scientific Tables, vol. 1, Units of Measurement, Body fluids, Composition of the Body, Nutrition. Basle, Switzerland: Ciba-Geigy Ltd.Google Scholar
Govers, MJAP, Termont, DSML, Aken, GAV & Van der Meer, R (1994) Characterization of the adsorption of conjugated and unconjugated bile acids to insoluble, amorphous calcium phosphate. Journal of Lipid Research 35, 741–748.CrossRefGoogle ScholarPubMed
Hampe, J, Cuthbert, A, Croucher, PJ, Mirza, MM, Mascheretti, S, Fisher, S, Frenzel, H, King, K, Hasselmeyer, A, MacPherson, AJ, Bridger, S, Van Deventer, S, Forbes, A, Nikolaus, S, Lennard-Jones, JE, Foelsch, UR, Krawczak, M, Lewis, C, Schreiber, S & Mathew, CG (2001) Association between insertion mutation in NOD2 gene and Crohn's disease in German and British populations. Lancet 357, 1925–1928.CrossRefGoogle ScholarPubMed
Harvey, RSJ, Powell, JJ & Thompson, RPH (1996) A review of the geochemical factors linked to podoconiosis. Environmental Geochemistry and Health 113, 255–260.Google Scholar
Hugot, JP, Chamaillard, M, Zouali, H, Lesage, S, Cezard, JP, Belaiche, J, Almer, S, Tysk, C, O'Morain, CA, Gassull, M, Binder, V, Finkel, Y, Cortot, A, Modigliani, R, Laurent-Puig, P, Gower-Rousseau, C, Macry, J, Colombel, JF, Sahbatou, M & Thomas, G (2001) Association of NOD2 leucine-rich repeat variants with susceptibility to Crohn's disease. Nature 411, 599–603.CrossRefGoogle ScholarPubMed
Jukes, DJ (1997) Food Legislation of the UK. Oxford: Butterworth–Heinemann.Google Scholar
Kohilas, K, Lyons, M, Lofthouse, R, Frondoza, CG, Jinnah, R & Hungerford, DS (1999) Effect of prosthetic titanium wear debris on mitogen-induced monocyte and lymphoid activation. Journal of Biomedical Material Research 47, 95–103.3.0.CO;2-8>CrossRefGoogle ScholarPubMed
Kovacsovics-Bankowski, M, Clark, K, Benacerraf, B & Rock, KL (1993) Efficient major histocompatibility complex class I presentation of exogenous antigen upon phagocytosis by macrophages. Proceedings of the National Academy of Sciences USA 90, 4942–4946.CrossRefGoogle Scholar
Krebs, J (1998) The role of calcium in apoptosis. Biometals 11, 375–382.CrossRefGoogle ScholarPubMed
Lapré, JA, De Vries, HT & Van der Meer, R (1991) Dietary calcium phosphate inhibits cytotoxicity of fecal water. American Journal of Physiology 261, 907–912.Google ScholarPubMed
Liou, SH, Shih, WY, Chen, YP & Lee, CC (1996) Pneumoconiosis and pulmonary function defects in silica-exposed fire brick workers. Archives of Environmental Health 51, 227–233.CrossRefGoogle ScholarPubMed
Lomer, MC, Harvey, RS, Evans, SM, Thompson, RP & Powell, JJ (2001) Efficacy and tolerability of a low microparticle diet in a double blind, randomized, pilot study in Crohn's disease. European Journal of Gastroenterology and Hepatology 13, 101–106.CrossRefGoogle Scholar
Lomer, MC, Thompson, RP, Commisso, J, Keen, CL & Powell, JJ (2000) Determination of titanium dioxide in foods using inductively coupled plasma optical emission spectrometry. Analyst 125, 2339–2343.CrossRefGoogle ScholarPubMed
Maloy, KJ, Donachie, AM, O'Hagan, DT & Mowat, AM (1994) Induction of mucosal and systemic immune responses by immunization with ovalbumin entrapped in poly(lactide-co-glycolide) microparticles. Immunology 81, 661–667.Google ScholarPubMed
Mansfield, JC, Giaffer, MH & Holdsworth, CD (1995) Controlled trial of oligopeptide versus amino acid diet in treatment of active Crohn's disease. Gut 36, 60–66.CrossRefGoogle ScholarPubMed
Martini, GA & Brandes, JW (1976) Increased consumption of refined carbohydrates in patients with Crohn's disease. Klinische Wochenschrift 54, 367–371.CrossRefGoogle ScholarPubMed
Metintas, M, Hillerdal, G & Metintas, S (1999) Malignant mesothelioma due to environmental exposure to erionite: follow-up of a Turkish emigrant cohort. European Respiratory Journal 13, 523–526.CrossRefGoogle ScholarPubMed
Ministry of Agriculture Fisheries and Food (1993). Dietary Intake of Food Additives in the UK: Initial Surveillance. Food Surveillance Paper no. 37. London: H.M. Stationery Office.Google Scholar
Neutra, MR (1998) Current concepts in mucosal immunity v. role of M cells in transepithelial transport of antigens and pathogens to the mucosal immune system. American Journal of Physiology 274, 785–791.Google Scholar
O'Morain, C, Segal, AW & Levi, AJ (1984) Elemental diet as primary treatment of acute Crohn's disease: a controlled trial. British Medical Journal 288, 1859–1862.CrossRefGoogle ScholarPubMed
Ogura, Y, Bonen, DK, Inohara, N, Nicolae, DL, Chen, FF, Ramos, R, Britton, H, Moran, T, Karaliuskas, R, Duerr, RH, Achkar, JP, Brant, SR, Bayless, TM, Kirschner, BS, Hanauer, SB, Nunez, G & Cho, JH (2001) A frameshift mutation in NOD2 associated with susceptibility to Crohn's disease. Nature 411, 603–606.CrossRefGoogle ScholarPubMed
Okada, M, Yao, T, Yammamoto, K, Takenaka, K, Imamura, K, Maeda, K & Fujita, K (1990) Controlled trial comparing an elemental diet with prednisolone in the treatment of active Crohn's disease. Hepatogastroenterology 37, 72–80.Google ScholarPubMed
Phillips, SF & Giller, J (1973) The contribution of the colon to electrolyte and water conservation in man. Journal of Laboratory and Clinical Medicine 81, 733–746.Google ScholarPubMed
Powell, JJ, Ainley, CC, Harvey, RS, Mason, IM, Kendall, MD, Sankey, EA, Dhillon, AP & Thompson, RP (1996) Characterisation of inorganic microparticles in pigment cells of human gut associated lymphoid tissue. Gut 38, 390–395.CrossRefGoogle ScholarPubMed
Powell, JJ, Harvey, RS, Ashwood, P, Wolstencroft, R, Gershwin, ME & Thompson, RP (2000) Immune potentiation of ultrafine dietary particles in normal subjects and patients with inflammatory bowel disease. Journal of Autoimmunity 14, 99–105.CrossRefGoogle ScholarPubMed
Powell, JJ, Jugdaohsingh, R & Thompson, RP (1999 a) The regulation of mineral absorption in the gastrointestinal tract. Proceedings of the Nutrition Society 58, 147–153.CrossRefGoogle ScholarPubMed
Powell, JJ, Whitehead, MW, Ainley, CC, Kendall, MD, Nicholson, JK & Thompson, RP (1999 b) Dietary minerals in the gastrointestinal tract: hydroxypolymerisation of aluminium is regulated by luminal mucins. Journal of Inorganic Biochemistry 75, 167–180.CrossRefGoogle ScholarPubMed
Powell, JJ, Whitehead, MW, Lee, S & Thompson, RPH (1994) Mechanisms of gastrointestinal absorption: Dietary minerals and the influence of beverage ingestion. Food Chemistry 51, 381–388.CrossRefGoogle Scholar
Price, EW (1990) Podiconiosis: Non-filarial Elephantiasis. Oxford: Oxford University Press.Google Scholar
Riordan, AM, Hunter, JO, Cowan, RE, Crampton, JR, Davidson, AR, Dickinson, RJ, Dronfield, MW, Fellows, IW, Hishon, S & Kerrigan, GN (1993) Treatment of active Crohn's disease by exclusion diet: East Anglian multicentre controlled trial. Lancet 342, 1131–1134.CrossRefGoogle ScholarPubMed
Russel, MG, Engels, LG, Muris, JW, Limonard, CB, Volovics, A, Brummer, RJ & Stockbrugger, RW (1998) Modern life in the epidemiology of inflammatory bowel disease: a case-control study with special emphasis on nutritional factors. European Journal of Gastroenterology and Hepatology 10, 243–249.CrossRefGoogle ScholarPubMed
Rutgeerts, P, Goboes, K, Peeters, M, Hiele, M, Penninckx, F, Aerts, R, Kerremans, R & Vantrappen, G (1991) Effect of faecal stream diversion on recurrence of Crohn's disease in the neoterminal ileum. Lancet 338, 771–774.CrossRefGoogle ScholarPubMed
Samet, JM, Dominici, F, Curriero, FC, Coursac, I & Zeger, SL (2000) Fine particulate air pollution and mortality in 20 U.S. cities, 1987–1994. New England Journal of Medicine 343, 1742–1749.CrossRefGoogle ScholarPubMed
Schedl, HP, Osbaldiston, GW & Mills, IH (1967) Role of intraluminal precipitation in secretion of small intestinal calcium and phosphate in the dog. Nature 215, 198–199.CrossRefGoogle ScholarPubMed
Schedl, HP, Osbaldiston, GW & Mills, IH (1968) Absorption, secretion, and precipitation of calcium in the small intestine of the dog. American Journal of Physiology 214, 814–819.CrossRefGoogle ScholarPubMed
Sedlik, C, Deriaud, E & Leclerc, C (1997) Lack of Th1 or Th2 polarization of CD4+ T cell response induced by particulate antigen targeted to phagocytic cells. International Immunology 9, 91–103.CrossRefGoogle ScholarPubMed
Shepherd, NA, Crocker, PR, Smith, AP & Levison, DA (1987) Exogenous pigment in Peyer's patches. Human Pathology 18, 50–54.CrossRefGoogle ScholarPubMed
Song, R & Harding, CV (1996) Roles of proteasomes, transporter for antigen presentation (TAP), and β2-microglobulin in the processing of bacterial or particulate antigens via an alternative class I MHC processing pathway. Journal of Immunology 156, 4182–4190.CrossRefGoogle ScholarPubMed
Stryhn, A, Pedersen, L, Romme, T, Olsen, AC, Nissen, MH, Thorpe, CJ & Buus, S (1996) pH dependence of MHC class I-restricted peptide presentation. Journal of Immunology 156, 4191–4197.CrossRefGoogle ScholarPubMed
Tagliarino, C, Pink, JJ, Dubyak, GR, Nieminen, AL & Boothman, DA (2001) Calcium is a key signaling molecule in beta-lapachone-mediated cell death. Journal of Biological Chemistry 276, 19150–19159.CrossRefGoogle ScholarPubMed
Thornton, JR, Emmett, PM & Heaton, KW (1985) Smoking, sugar, and inflammatory bowel disease. British Medical Journal 290, 1786–1787.CrossRefGoogle ScholarPubMed
Vidard, L, Kovacsovics-Bankowski, M, Kraeft, SK, Chen, LB, Benacerraf, B & Rock, KL (1996) Analysis of MHC class II presentation of particulate antigens by B lymphocytes. Journal of Immunology 156, 2809–2818.CrossRefGoogle ScholarPubMed
Welberg, JWM, Kleibeuker, JH, Van der Meer, R, Kuipers, F, Cats, A, Van Rijsbergen, HDSMLT, Boersma-Van Ek, W, Vonk, RJ, Mulder, NH & De Vries, EGE (1993) Effect of oral calcium supplementation on intestinal bile and cytolytic activity of fecal water in patients with adenomatous polyps of the colon. European Journal of Clinical Investigation 23, 63–68.CrossRefGoogle ScholarPubMed
Wilschanski, M, Sherman, P, Pencharz, P, Davis, L, Corey, M & Griffiths, A (1996) Supplementary enteral nutrition maintains remission in paediatric Crohn's disease. Gut 38, 543–548.CrossRefGoogle ScholarPubMed
Zoli, G, Care, M, Parazza, M, Spano, C, Biagi, PL, Bernardi, M & Gasbarrini, G (1997) A randomized controlled study comparing elemental diet and steroid treatment in Crohn's disease. Alimentary Pharmacology and Therapeutics 11, 735–740.CrossRefGoogle ScholarPubMed