Growth in paediatric Crohn's disease

Growth failure (GF) is one of the major complications affecting children with inflammatory bowel disease. The faltering is temporary in 40-50% of cases and prolonged in 10-20% in Crohn's disease (CD). Such failure is rare in children with ulcerative colitis (5%). This complication is often associated with retarded bone development and delayed onset of sexual maturation. The delayed linear growth has a variety of causes including insufficient intake due to anorexia and the inflammatory process with increased energy and protein expenditure. Other factors are increased intestinal loss, secondary hypopituitarism and treatment with steroids. Therapeutic strategies of CD in children have changed this last decade by introducing new therapeutic agents such as topic steroids, immunosuppressors, anti-TNF (antibody and notably in children enteral nutrition which has shown its efficacy in inducing remissions of active CD, restoring nutritional status and stimulation of linear growth. The results of a recent prospective multicentric study over 2 years in 82 CD show that severe GF (-2 SD) is initially present in 15% (n = 12), among them 11 remain < -2SD after 2 years of follow-up. Six patients who were on the normal range initially increased their GF during the follow-up (< -2SD) (total 21% < -2SD (n = 17) at 2 years). At inclusion in this group there was no difference in growth velocity, used of steroids, enteral nutrition or severity of CD as compared to the group with no GF. It suggests that new treatment strategy should be developed in the future for this specific complication of paediatric CD.     

不同比例肠内联合肠外营养治疗方案对重型颅脑创伤患者的影响

摘要 目的：探讨不同比例的肠内联合肠外营养治疗方案对重型颅脑创伤患者（sTBI）的影响。方法：选择2020年10月-2022年8月重庆市急救医疗中心神经重症监护室收治的sTBI患者为研究对象。将符合纳入和排除标准70例患者随机分为实验组和对照组各35例。计算患者每日所需热量,按不同比例的肠内联合肠外营养方案给予营养支持。实验组为按2：1比例肠内联合肠外营养支持,对照组为按1：1比例肠内联合肠外营养支持。统计比较两组的营养状态指标（血红蛋白、白蛋白、前白蛋白、总蛋白）,免疫功能指标[CD3、CD4、CD4/CD8、免疫球蛋白（Ig）A、IgM、IgG],炎症指标[C-反应蛋白（CRP）、降钙素原（PCT）、白介素-6（IL-6）]并发症的差异。结果：在免疫功能方面,营养支持14 d后实验组患者的CD4、CD4/CD8、IgA水平高于对照组患者,差异有统计学意义（P<0.05）;而在营养状态、炎症指标及并发症等方面两组患者差异无统计学意义（P>0.05）。结论：肠内营养为主的联合营养支持方式更能促进sTBI患者的免疫功能恢复,但不同比例肠内联合肠外营养治疗方案在营养状态、炎症指标及并发症等指标方面无明显差异。     

Pregnancy and inflammatory bowel disease.

Conclusions about the relationship between the pathophysiology and treatment of inflammatory bowel disease and the physiology and management of pregnancy are based on the results of several large physician surveys and retrospective chart reviews. Patients with active disease fare worse than those with inactive disease. There is little evidence that pregnancy affects the course of inflammatory bowel disease or that inactive inflammatory bowel disease affects the course of pregnancy. Judicious medical therapy is effective in controlling inflammatory bowel disease during pregnancy. Sulfasalazine or steroid therapy should not be withdrawn in a patient who needs it to achieve or maintain a quiescent state of inflammatory bowel disease during the course of pregnancy. Immunosuppressive therapy should be avoided. Aggressive medical therapy with total parenteral nutrition in a team approach with a gastroenterologist, surgeon, and perinatologist usually avoids the need for surgical intervention during pregnancy with a good fetal outcome in a patient whose disease is active. Contraception against pregnancy need only be considered in those patients whose disease is so severe that operative therapy is imminent.     

Resultados de la aplicación de un protocolo de valoración nutricional en un centro sociosanitario

The aim of this study was to determine nutritional status in 83 residents of a nursing home and to evaluate outcomes after the application of a nutritional assessment protocol designed by the Department of Social Welfare of the autonomous community of Valencia (Spain).The sample was classified according to body mass index (BMI), hypoalbuminemia and application of the geriatric nutritional risk index. Nutritional interventions consisted of applying general recommendations and follow-up in residents without malnutrition, providing adequate powdered diets in residents with chewing and swallowing disorders and risk of bronchoaspiration, adjusting total enteral nutrition in residents with nasogastric feeding tubes and initiating vitamin supplementation in residents with severe malnutrition.After 3 months, the mean BMI showed a nonsignificant increase (P=.168), reducing the number of residents with malnutrition from 29% to 23%. The number of residents who received nutritional supplements without indication also decreased, resulting in an estimated saving of 965 euros. Active participation of the multidisciplinary team in the coordinated and continuous follow-up of nutritional status in residents contributed to achieving adequate nutritional status and improved the rational use of artificial nutrition in the nursing home.     

不同肠内营养液对老年重度AECOPD机械通气患者肠道屏障功能、免疫功能和炎症因子的影响

摘要 目的：探讨不同肠内营养液对老年重度慢性阻塞性肺疾病急性加重期（AECOPD）机械通气患者营养状况、肠道屏障功能、免疫功能和炎症因子的影响。方法：纳入2019年10月-2021年10月在我院住院治疗的老年重度AECOPD患者90例作为研究对象,采用密封信封法随机分为含膳食纤维肠内营养组（FEN组）及不含膳食纤维肠内营养组（NFEN组）各45例。两组患者均接受重度AECOPD规范治疗,并接受机械通气治疗。FEN组给予能全力进行营养支持治疗,NFEN组给予能全素进行营养支持治疗,两组患者均接受持续30 d的肠内营养。比较两组患者治疗前和治疗30 d后营养状况指标血清白蛋白（ALB）、前白蛋白（PA）、血红蛋白（Hb）,肠道屏障功能指标D-乳酸（DLA）、细菌内毒素（BE）、二胺氧化酶（DAO）,T淋巴细胞亚群（CD4⁺、CD8⁺、CD4⁺/CD8⁺）、体液免疫功能指标免疫球蛋白（Ig）G、IgM、IgA,炎症因子降钙素原（PCT）和白介素-6（IL-6）水平的变化,以及两组患者ICU住院天数、机械通气时间和并发症的差异。结果：治疗30 d后,FEN组ALB、PA和Hb水平均显著高于NFEN组（P<0.05）;FEN组DLA、BE和DAO水平均显著低于NFEN组（P<0.05）;FEN组CD4⁺、CD4⁺/CD8⁺以及IgG、IgA水平均显著高于NFEN组（P<0.05）;FEN组PCT、IL-6水平均显著低于NFEN组（P<0.05）。FEN组患者ICU住院天数、机械通气时间及并发症均显著少于NFEN组,差异有统计学意义（P<0.05）。结论：含膳食纤维肠内营养有利于改善老年重度AECOPD机械通气患者营养状况,修复肠道黏膜屏障功能,提高免疫功能,减轻炎症反应,从而改善预后,含膳食纤维的肠内营养支持治疗效果更佳。     

益生菌在儿童炎症性肠病中的应用

炎症性肠病（inflammatory bowel disease,IBD）是一种原因不明的慢性非特异性肠道炎性疾病,主要包括溃疡性结肠炎（ulcerative colitis,UC）、克罗恩病（Crohn's disease,CD）和未定型的炎症性肠病（IBD-unclassified,IBDU）。随着对肠道微生物与IBD关系认识的不断加深,许多研究发现肠道菌群的生态失调在IBD的发病中起着重要作用。益生菌在儿童IBD治疗中具有良好前景,但仍缺乏有效的证据来确证益生菌疗效,并指导临床对益生菌的种类和剂量等进行选择。现有研究表明,益生菌对儿童IBD的治疗具有特异性,在诱导和维持UC缓解效果明显,但在诱导CD缓解、维持CD缓解和预防术后并发症及复发方面效果并不理想。     

益生菌联合早期肠内营养对合并应激性高血糖的重症脑卒中患者血糖调控及预后的影响

目的 探讨益生菌联合早期肠内营养(EEN)对合并应激性高血糖的重症脑卒中患者血糖调控及预后的影响,为此类患者的治疗提供参考。 方法 选择2017年5月1日至2019年5月1日我院神经内科收治的合并应激性高血糖的重症脑卒中患者64例为研究对象,随机分为对照组和观察组,各32例。对照组患者在入院48 h内给予EEN,观察组患者在对照组基础上给予双歧杆菌乳杆菌三联活菌片鼻饲。比较两组患者治疗后血糖变异性、胰岛素使用强度、低血糖发生率、炎症反应指标水平、应激反应指标水平、胃肠道不良反应,5 d内肠内营养达标率、营养状态指标水平、医院获得性肺炎(HAP)发生率及病死率。 结果 治疗后,观察组患者血糖变异性较小,胰岛素使用强度降低,低血糖发生率降低,炎症反应指标、应激反应指标水平均低于对照组;胃肠道不良反应中腹泻发生率降低,肠内营养达标率升高,血清白蛋白、前白蛋白水平均高于对照组,医院获得性肺炎发生率降低。两组患者病死率差异无统计学意义(12.50% vs 18.75%;χ2=0.474,P=0.491)。 结论 对于合并应激性高血糖的重症脑卒中患者,益生菌联合EEN有助于控制血糖稳定性,降低胰岛素使用强度及低血糖发生率,同时降低炎症及应激反应,提高患者肠内营养耐受性,改善患者营养状态,降低HAP发生率。     

Medical treatment of inflammatory bowel disease: new therapies,new drugs.

Ulcerative colitis, ulcerative proctitis and Crohn''s disease are chronic inflammatory conditions that affect the gastrointestinal tract. Conventional treatment has stressed the role of anti-inflammatory agents to suppress the inflammatory response. New compounds that can deliver 5-aminosalicylic acid to the colon have recently been released in Canada. Metronidazole and azathioprine may also be of benefit in Crohn''s disease. Therapy with cyclosporine and clonidine should be based on the results of further clinical trials. The use of nutritional support as primary therapy in Crohn''s disease appears promising. At present, both pharmacologic and nutritional therapies should be considered in the treatment of inflammatory bowel disease.     

益生菌高活菌酸奶联合肠内营养对肝纤维化患者的辅助治疗效果观察

比较观察两种微生态制剂联合肠内营养(EN)对肝纤维化患者的营养效果及肝功能的改善情况。

选择104例通过瞬时弹性成像技术(TE)排除肝硬化的慢性肝病患者, 并且营养风险筛查2002评分(NRS2002)≥3分, 按入院顺序随机数字表法分成观察组(益生菌高活菌数酸奶+EN)54例和对照组(金双歧+EN)50例。两组患者入院后24 h内开始启动肠内营养治疗, 观察组每日补充高活菌益生菌酸奶, 对照组给予肠内营养液加金双歧口服。对比3周后两组患者胃肠道情况、炎性指标、肝功能各项指标、肝纤维化改善程度及营养状况。

观察组与对照组患者在使用益生菌制剂3周后, 胃肠道症状均有改善, 其中观察组恶心、呕吐、腹胀的改善较对照组恢复程度更好(P < 0.05), 腹泻、便秘的缓解两组差异不大(P > 0.05)。通过血浆炎性指标分析, 观察组IL-1β、TNF-α下降较对照组明显(P < 0.05), 血清ALT、AST、GGT、ALP较治疗前降低明显, 与对照组相比血清ALT、GGT、ALP的改善较好, 差异均具有统计学意义(P < 0.05)。在治疗3周后, 肝纤维化指标结果显示, 观察组与对照组血清LN、Ⅳ-C水平均有下降, 观察组下降更为显著(P < 0.05), 但两组患者HA、PC-Ⅲ水平治疗前后均改变不明显, 与入院前相比差异无统计学意义(P > 0.05)。随着肝功能的纠正和肠内营养治疗, 肝脏合成蛋白的能力增强, 两组患者营养不良均有改善, 治疗3周后, 其中观察组血清ALB的提高较对照组显著, 差异有统计学意义(P < 0.05)。

长期服用益生菌酸奶有助于改善慢性肝病患者肠道微生态环境, 对早期肝脏纤维化有一定改善, 但是否有逆转肝纤维化的作用仍需大样本研究。

     

Nutritional modulation of the gut microbiota and immune system in preterm neonates susceptible to necrotizing enterocolitis

The gastrointestinal inflammatory disorder, necrotizing enterocolitis (NEC), is among the most serious diseases for preterm neonates. Nutritional, microbiological and immunological dysfunctions all play a role in disease progression but the relationship among these determinants is not understood. The preterm gut is very sensitive to enteral feeding which may either promote gut adaptation and health, or induce gut dysfunction, bacterial overgrowth and inflammation. Uncontrolled inflammatory reactions may be initiated by maldigestion and impaired mucosal protection, leading to bacterial overgrowth and excessive nutrient fermentation. Tumor necrosis factor alpha, toll-like receptors and heat-shock proteins are identified among the immunological components of the early mucosal dysfunction. It remains difficult, however, to distinguish the early initiators of NEC from the later consequences of the disease pathology. To elucidate the mechanisms and identify clinical interventions, animal models showing spontaneous NEC development after preterm birth coupled with different forms of feeding may help. In this review, we summarize the literature and some recent results from studies on preterm pigs on the nutritional, microbial and immunological interactions during the early feeding-induced mucosal dysfunction and later NEC development. We show that introduction of suboptimal enteral formula diets, coupled with parenteral nutrition, predispose to disease, while advancing amounts of mother's milk from birth (particularly colostrum) protects against disease. Hence, the transition from parenteral to enteral nutrition shortly after birth plays a pivotal role to secure gut growth, digestive maturation and an appropriate response to bacterial colonization in the sensitive gut of preterm neonates.     

预消化的肠内营养对ICU危重症患者的营养状况及肠内营养耐受性的影响

目的:研究预消化的肠内营养制剂对ICU危重症患者营养状况及肠内营养耐受性的影响。方法:本试验为前瞻、随机、对照、单盲研究,将符合入组条件的ICU患者随机分为试验组和对照组。试验组给予预消化型肠内营养制剂,而对照组给予整蛋白型肠内营养制剂进行营养支持。比较两组患者入组及营养支持2周后的营养指标、肠内营养耐受性及ICU住院天数等。结果:治疗2周后,试验组前白蛋白、转铁蛋白较对照组明显升高(P0.05),肠内营养不耐受、腹内压升高、腹泻、肠鸣音减弱及胃肠道出血发生率较对照组明显降低(P0.05),ICU住院时间也较对照组明显缩短(P0.05)。结论:预消化的肠内营养制剂对ICU患者有良好的治疗效果,可降低胃肠道不良反应发生率,提高耐受性,明显改善患者营养状况。     

Crohn's disease complicated by hepatitis B virus successfully treated with the use of adsorptive depletion of myeloid lineage leucocytes to suppress inflammatory cytokine profile

Background aimsIn patients with inflammatory bowel disease infected with hepatitis B virus (HBV), immunosuppressive therapy required to suppress active inflammatory bowel disease may promote HBV reactivation.MethodsA 27-year-old corticosteroid-naive woman with Crohn's disease (CD) activity index of 249.8 complicated by HBV infection was offered Entecavir to control HBV reactivation during immunosuppressive therapy for CD. The patient refused Entecavir, fearing that it might adversely affect her pregnancy outcome. Instead, we applied intensive granulocyte/monocyte adsorptive apheresis (GMA) at two sessions per week to deplete inflammatory cytokine-producing leucocytes as an immunosuppressive therapy in this case.ResultsGMA induced stable remission (CD activity index, I 105) and endoscopic improvement without HBV reactivation or safety concern. Furthermore, CD remission was paralleled by suppression of tumor necrosis factor and interleukin as measured in serum samples.ConclusionsImmunosuppressive therapy required to treat an active CD potentially can promote HBV reactivation and worsen liver function. In this study involving a CD case complicated by chronic HBV infection, intensive GMA as a non-pharmacologic treatment intervention was associated with clinical remission and endoscopic improvement without HBV reactivation. Furthermore, GMA was well-tolerated and was without any safety concern. However, suppression of tumor necrosis and interleukin-6by GMA in this clinical setting is potentially very interesting.     

Nutrition and inflammatory events: highly unsaturated fatty acids (omega-3 vs omega-6) in surgical injury.

Given the poor prognosis and high cost of care for patients with acute inflammatory responses (often leading to organ failure and/or allograft rejection), immunomodulation of this hyperresponse represents an important priority for research in nutritional medicine. The primary goal of nutritional support in inflammatory disease is to provide adequate energy, particularly through use of novel lipids (to alter eicosanoid pathway toward a more regulated inflammatory state), and protein to meet endogenous requirements for tissue repair IL-1 production, and restored cellular function, thus preventing secondary infection (52). Manipulation of macrophage eicosanoid production by use of omega-3 PUFA may reduce the cellular immune response (by competing with arachidonic acid, which produces inflammatory eicosanoids of the 2- and 4-series), whereas inclusion of MCT found in coconut oil may lower the arachidonic acid content of membrane phospholipids. As more data are obtained on the use of such tailored therapies in critically ill patients, a new generation of parenteral and enteral diets will be developed to reduce inflammation and immune dysfunction.     

Recomendaciones nutricionales en las distintas etapas de la vida basadas en la evidencia

We review the scientific evidence available on nutritional recommendations in the distinct stages of life through 10 key questions relating to dietary modifications throughout the life cycle, namely: how long should breast-feeding last? What are the best methods for promoting breast-feeding? Should soya infant formulas be used to prevent allergic diseases in infants at high risk? Is micronutrient supplementation indicated in infants? How should childhood obesity be prevented? Are there any valid strategies for preventing eating disorders in adolescents? Which type of diet should be recommended in pregnant and breast-feeding women? Should nutritional supplements be used in elderly individuals at risk of malnutrition? Should micronutrient supplements be used in the elderly to prevent or treat degenerative diseases?     

微生态制剂联合免疫增强型肠内营养治疗重症肺炎患者的临床研究

摘要 目的：探讨微生态制剂联合免疫增强型肠内营养治疗重症肺炎患者的临床疗效及对患者营养状态、肠道菌群、T淋巴细胞亚群水平及炎症反应指标的影响。方法：选取2018年10月～2022年1月邯郸市中心医院收治的126例重症肺炎患者,以随机数字表法分为观察组、对照组各63例。对照组采用免疫增强型肠内营养治疗,观察组在对照组基础上加用微生态制剂治疗。比较两组临床疗效、症状变化情况、治疗前后营养指标[血红蛋白（HGB）、白蛋白（ALB）、前白蛋白（PA）]、肠道菌群（双歧杆菌、乳酸杆菌、肠球菌、大肠埃希菌、弯曲杆菌）、T淋巴细胞亚群（CD3⁺、CD4⁺、CD8⁺、CD4⁺/CD8⁺）、炎症因子水平[白介素-6（IL-6）、可溶性血管细胞黏附分子1（sVCAM-1）、C反应蛋白（CRP）]。结果：观察组总有效率（93.65%）高于对照组（80.95%）（P＜0.05）;观察组体温恢复正常时间、肺部阴影消失时间、咳嗽改善时间、住院时间较对照组短（P＜0.05）;治疗后观察组HGB、ALB、PA水平较对照组升高（P＜0.05）;治疗后观察组双歧杆菌较对照组高,乳酸杆菌、肠球菌、大肠埃希菌、弯曲杆菌较对照组降低（P＜0.05）;治疗后观察组CD8⁺较对照组降低,CD3⁺、CD4⁺、CD4⁺/CD8⁺较对照组高高（P＜0.05）;治疗后观察组血清IL-6、sVCAM-1、CRP水平较对照组降低（P＜0.05）。结论：微生态制剂联合免疫增强型肠内营养治疗重症肺炎效果显著,可有效促使症状改善,调节肠道菌群、增强机体免疫功能、改善营养状态、减轻机体炎症反应,值得临床借鉴应用。     

早期肠内营养联合微生态制剂对重症急性胰腺炎患者的临床疗效及其对免疫功能的影响

目的 分析早期肠内营养联合微生态制剂对重症急性胰腺炎患者的临床疗效及其免疫功能的影响。 方法 选择我院2017年6月至2020年1月间收治的80例符合标准的重症急性胰腺炎患者为研究对象并随机分为观察组和对照组,每组40例。对照组患者给予早期肠内营养干预。观察组患者采用早期肠内营养加微生态制剂治疗。评估患者疗效,同时评估治疗前、治疗7 d及治疗14 d时患者腹内压、胃肠功能、免疫球蛋白、炎症因子、淀粉酶、血清脂肪酶、血清乳酸脱氢酶及T细胞亚群水平。 结果 观察组患者临床总有效率高于对照组(97.50% vs 80.00%,P+、CD4+水平和CD4+/CD8+比值显著高于对照组,而CD8+水平低于对照组(均P结论 早期肠内营养联合微生态制剂可显著提高重症急性胰腺炎患者的临床疗效,并改善患者免疫功能。     

Differential expression of CD11c by peripheral blood NK cells reflects temporal activity of multiple sclerosis

Multiple sclerosis (MS) is an autoimmune disease, showing a great degree of variance in temporal disease activity. We have recently demonstrated that peripheral blood NK cells biased for secreting IL-5 (NK2 bias) are associated with the remission state of MS. In this study, we report that MS patients in remission differentially express CD11c on NK cell surface (operationally defined as CD11chigh or CD11clow). When we compared CD11chigh or CD11clow patients, the expression of IL-5 and GATA-3 in NK cells supposed to endow a disease-protective NK2 phenotype was observed in CD11clow but not in CD11chigh patients. In contrast, the CD11chigh group showed a higher expression of HLA-DR on NK cells. In vitro studies demonstrated that NK cell stimulatory cytokines such as IL-15 would up-regulate CD11c expression on NK cells. Given previous evidence showing an association between an increased level of proinflammatory cytokines and temporal disease activity in MS, we postulate that inflammatory signals may play a role in inducing the CD11chigh NK cell phenotype. Follow-up of a new cohort of patients showed that 6 of 10 CD11chigh MS patients developed a clinical relapse within 120 days after evaluation, whereas only 2 of 13 CD11clow developed exacerbated disease (p = 0.003). As such, a higher expression of CD11c on NK cells may reflect the temporal activity of MS as well as a loss of regulatory NK2 phenotype, which may allow us to use it as a potential biomarker to monitor the immunological status of MS patients.     

肠内营养支持治疗对炎症性肠病患者肠黏膜屏障功能及炎症反应的影响

目的 探讨早期肠内营养（EN）支持治疗对炎症性肠病（IBD）患者肠黏膜屏障功能及炎症反应的影响。方法 将80例IBD患者按营养支持治疗途径分为EN组（48例）和肠外营养（PN）组（32例）,在常规治疗的基础上分别给予早期EN、PN支持治疗。比较治疗前后2组患者营养学相关指标[白蛋白（ALB）、前白蛋白（PA）、转铁蛋白（TF）]、肠黏膜屏障功能指标（内毒素、D-乳酸）及炎症相关指标[C-反应蛋白（CRP）、降钙素原（PCT）、粪便钙卫蛋白（FCP）]水平。结果 治疗前,2组患者各观察指标水平差异无统计学意义（P>0.05）;治疗后,与治疗前相比,2组患者血清ALB、PA及TF水平均显著升高（P0.05）。结论 在常规治疗的基础上,早期EN支持治疗对IBD患者肠黏膜屏障功能的改善及炎症缓解作用优于PN支持治疗。     

Drug therapy: dose-response relationship of oral mesalazine in inflammatory bowel disease.

Mesalazine is widely used in the treatment of inflammatory bowel disease. Little is known about the dose-response relationship and about possible dose related side effects. In ulcerative colitis higher dosages of mesalazine (3 g) are more effective in maintaining a remission than lower dosages (1.5 g). In mild to moderately active ulcerative colitis, studies also indicate that higher dosages might be more effective in inducing remission. Dose-comparing studies in Crohn''s disease are even more sparse, but the available results indicate higher efficacy at higher dose levels. None of the known side effects of mesalazine are clearly dose-related. A pH-dependent release system, however, can cause a sudden release of high doses of mesalazine. Consequent peak levels in serum have been implicated in mesalazine induced nephrotoxicity. In conclusion, despite the current practice of using increasing dosages of mesalazine in inflammatory bowel disease, both efficacy and safety have been established tentatively.     

Bioactive dietary peptides and amino acids in inflammatory bowel disease

Inflammatory bowel disease (IBD), most commonly ulcerative colitis (UC) and Crohn’s disease (CD), is a chronic inflammation of the gastrointestinal tract. Patients affected with IBD experience symptoms including abdominal pain, persistent diarrhea, rectal bleeding, and weight loss. There is no cure for IBD; thus treatments typically focus on preventing complications, inducing and maintaining remission, and improving quality of life. During IBD, dysregulation of the intestinal immune system leads to increased production of pro-inflammatory cytokines, such as TNF-α and IL-6, and recruitment of activated immune cells to the intestine, causing tissue damage and perpetuating the inflammatory response. Recent biological therapies targeting specific inflammatory cytokines or pathways, in particular TNF-α, have shown promise, but not all patients respond to treatment, and some individuals become intolerant to treatment over time. Dietary peptides and amino acids (AAs) have been shown to modulate intestinal immune functions and influence inflammatory responses, and may be useful as alternative or ancillary treatments in IBD. This review focuses on dietary interventions for IBD treatment, in particular the role of dietary peptides and AAs in reducing inflammation, oxidative stress, and apoptosis in the gut, as well as recent advances in the cellular mechanisms responsible for their anti-inflammatory activity.