Crohn's Disease
Conditions
Keywords
Crohn's Disease, gut brain axis, reduced appetite
Brief summary
Crohn's disease (CD) is becoming more common, specifically in the western world. One of the main features of this disease is weight loss and malnutrition. Although clinically common, these problems are not well understood. Loss of appetite and symptoms such as tummy aches and bloating are common causes for weight loss in this group of patients. This problem has a strong negative effect on the patients' quality of life and significantly increases the cost of treating CD. Enteroendocrine cells are nutrient sensors in the bowel that relay to the brain to control food intake. Recent evidence has showed that these cells increase in number in active CD and secrete more hormones that negatively affect appetite. The increased levels of these hormones should have an overall negative effect on the brain and thus decrease food intake, bloating, symptoms of sickness. All these symptoms lead to malnutrition. These are hypotheses that require further proof. Current technological advances in magnetic resonance imaging (MRI) has enabled the mapping of changes in activity in important areas in the brain that control food intake. The involvement of the brain in control of food intake is still not fully understood. This work will be the first step in the right direction to start targeting the problems of appetite, weight loss and a poor quality of life.
Interventions
OTHERDodecanoate acid and saline
Test drink
Sponsors
University of Nottingham
Study design
Allocation
NON_RANDOMIZED
Intervention model
CROSSOVER
Primary purpose
BASIC_SCIENCE
Masking
SINGLE (Subject)
Eligibility
Sex/Gender
ALL
Age
16 Years to 75 Years
Healthy volunteers
Yes
Inclusion criteria
1. Age 16-75 years 2. Ulceration seen at ileocolonoscopy, aiming for a simple endoscopic score for Crohn's disease (SES-CD) of 4-19, in the absence of stricturing disease or, 3. Intestinal inflammation or deep ulceration seen on CT or MR enterography, with the disease activity quantified via the MaRIA score or, 4. Faecal calprotectin of \>250µg/g 5. C-Reactive protein \>5mg/dl 6. Harvey-Bradshaw index score of 5-16 7. Body mass index (BMI) 18-35 8. As for HV participants, inclusion criteria 1 and 7 will apply.
Exclusion criteria
1. Malignant disease 2. BMI \<18 and \>35 3. Significant cardiovascular or respiratory disease 4. Diabetes mellitus 5. Current Infection 6. Neurological or cognitive impairment; significant physical disability 7. Significant hepatic disease or renal failure 8. Abnormal blood results other than those explained by CD including bleeding diatheses (apart from in the case of HV where all unexplained blood results are an
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Changes in Blood Oxygenation Level Dependent (BOLD) response in the brain following a fatty acid test meal in Crohn's patients and healthy controls | 3 years |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Changes in arterial spin labeling measures of cerebral blood flow and changes in gut peptide levels following the fatty acid test meal. | 3 years | The increase or decrease in BOLD signal of the brain following the fatty acid stimuli will be correlated to the gut peptide levels which are listed as follows: 1. CCK (pmol/ml) 2. GLP-1 (pM) 3. PYY (pg/ml) 4. Ghrelin (ng/ml) |
Countries
United Kingdom
Outcome results
None listed