Department of Gastroenterology, University of Liverpool, Duncan Building, Daulby Street, L69 3GA, United Kingdom.
J Crohns Colitis. 2013 May;7(4):338-41. doi: 10.1016/j.crohns.2013.01.004. Epub 2013 Jan 27.
Crohn's disease (CD) incidence has increased over the past fifty years but the explanation is unclear. CD can be brought into remission by liquid enteral feeding, but the mechanism for this response is unknown. We suggest that consumption of emulsifiers in processed foods may promote CD by increasing bacterial translocation. This is supported by evidence that (i) geographical variation in CD correlates with emulsifier consumption as does the increasing incidence of CD in Japan; (ii) although CD incidence also correlates with fat consumption, the response to enteral feeding is not affected by the fat content of the feed and (iii) very small concentrations of the emulsifier polysorbate 80 enhance bacterial translocation across intestinal epithelia. Undigested emulsifiers may increase bacterial translocation, particularly in the small intestine where the mucus layer is discontinuous. The hypothesis should be testable by trials of enteral feeding with/without emulsifiers.
克罗恩病（CD）的发病率在过去五十年中有所增加，但原因尚不清楚。液体肠内喂养可以使 CD 缓解，但这种反应的机制尚不清楚。我们认为，加工食品中乳化剂的摄入可能通过增加细菌易位而促进 CD 的发生。这一观点得到了以下证据的支持：（i）CD 的地理变异与乳化剂的摄入有关，与日本 CD 的发病率上升有关；（ii）尽管 CD 的发病率也与脂肪摄入有关，但肠内喂养的反应不受饲料脂肪含量的影响；（iii）非常小浓度的乳化剂聚山梨酯 80 增强了细菌穿过肠上皮的易位。未消化的乳化剂可能会增加细菌易位，特别是在小肠中，那里的粘液层是不连续的。该假说可以通过有无乳化剂的肠内喂养试验来验证。
