Mucosal healing in inflammatory bowel diseases: is there a place for nutritional supplementation?
Level 5 - mechanism / opinion, no new human data
Narrative review synthesizing mechanistic, cellular, and animal research with no new human data or systematic review methodology.
PubMed 25208104 · doi:10.1097/MIB.0000000000000177
What was done
This narrative review synthesized cellular, animal, and sparse clinical literature regarding the biological phases of intestinal mucosal healing in inflammatory bowel diseases (IBD) and evaluated the mechanistic evidence for supplementation with specific amino acids, short-chain fatty acids, lipids, vitamins, and minerals.
What was found
The abstract reports no quantitative metrics or effect sizes. Preclinical findings indicate that specific amino acids (arginine, glutamine, glutamate, threonine, methionine, serine, proline, and polyamines) and short-chain fatty acids promote mucosal healing by facilitating epithelial cell migration, proliferation, differentiation, barrier restoration, and apoptosis regulation. Evidence for omega-3 and omega-6 fatty acids remains controversial, while endogenous prostaglandin synthesis appears necessary. Deficiencies in vitamins A, D3, C, and zinc frequently occur in IBD and supplementation is presumed to favor mucosal repair based on experimental data.
Why it matters
Mucosal healing is a critical therapeutic target in IBD linked to sustained remission and decreased surgical and hospitalization rates; this review organizes mechanistic rationale for prospective clinical nutritional trials.
Limits
This is a non-systematic narrative review providing no original clinical trial data. Most evidence is derived from in vitro and animal models rather than controlled human studies, leaving therapeutic efficacy, safety, and dosing unclear.
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