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Title: Immunological effects of elemental diets in inflammatory bowel disease
Author: Mwantembe, Obedy
Awarding Body: University of Edinburgh
Current Institution: University of Edinburgh
Date of Award: 1993
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Inflammatory bowel diseases (IBD), Crohn's disease (CD) and ulcerative colitis (UC), are disorders of the gastro-intestinal system whose aetiology and pathogenesis remain unknown. It has long been known that changes in the diet can be beneficial and elemental diets (ED), devoid of polypeptide antigens, have been successfully used in the management of these conditions. Thus, the aim of this thesis was to study the role of food antigens and the effect of their withdrawal on IBD immune activity by the use of ED. Humoral immunity was studied by measuring total immunoglobulins and antibodies to: ovalbumin, B-lactoglobulin and gliadin in serum, whole gut lavage fluid (WGLF) and parotid saliva. T-cell activity was studied by measuring soluble interleukin-2 receptor in WGLF (LIL2R) and in serum (SIL2R). Macrophage activity was studied by measuring tumour necrosis factor (TNF) in WGLF and a-1 acid glycoprotein (a-1) in serum and WGLF. Comparisons were made between levels of these parameters in active and inactive IBD and healthy controls. Disease activity was quantified by measuring the concentration of immunoglobulin (Ig)G in WGLF. Patients with active IBD were prescribed ED for at least 7 days. During the course of the ED, WGLF and serum were collected prior to and after the 7th day and assayed for the above mentioned factors. There was no difference in serum immunoglobulins and antibodies between IBD patients and controls. Total IgM and IgG in WGLF were higher in active IBD than in controls. Food antibodies were also higher in CD, but not in UC patients compared with controls. However, there was no change in the level of immunoglobulins and food antibodies in serum, WGLF or parotid saliva in patients treated with ED, regardless of the outcome. LIL2R and SIL2R were higher in active IBD compared to controls. Patients with high initial LIL2R responded to ED and showed reduction of LIL2R with improvement of disease. a-1 was raised in all IBD (active and inactive) patients in both serum and WGLF compared to controls. a-1 changes in IBD patients on ED were unrelated to disease response. TNF levels werehigher in active IBD patients than in controls. Patientswith high levels did worse on ED.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available