Dietary Factors in the Modulation of Inflammatory Bowel Disease Activity

Shinil Shah, DO, PGY-1

Disclosures

March 27, 2007

Microparticles

There is an abundance of factors that lead some to believe that diet plays an important role in the etiology of inflammatory bowel disease (IBD). Experts have observed an increased incidence of IBD in urban areas, and some believe that this may be due in part to the fact that urban diets have higher concentrations of so-called microparticles (such as titanium dioxide and aluminosilicates). These substances are believed to be inert but play no role in nutrition. It is believed that these microparticles may combine with other substances in the intestine (such as bacterial components) and form antigenic particles.[3] Microparticles have also been associated with other disease processes such as asthma.[4] The thinking is that these antigens may activate an immune-mediated inflammatory response.[3] It has been shown that a microparticle-free diet decreased Crohn's disease activity.[4]

The discovery of specific antigens, or in this case, microparticles, is a logical progression from the discovery of the gene encoding for the NOD2 protein as being associated with the pathogenesis of Crohn's disease. NOD2 is believed to play a role in the recognition of bacterial particles and subsequent activation of the inflammation cascade by the activation of NF-kappa B.[5] It is possible that other related proteins may be involved in the recognition of other antigenic substrates, and in this case, microparticles.

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