Abstracts of the 25th Congress of the European Intestinal Transport Group
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ABSTRACT
Abstracts of the 25th Congress of the European Intestinal Transport Group 11th–14th April 2013, Bad Herrenalb, Germany
Abstracts of invited talks
The lecithin story: mucosal protection by phosphatidylcholine
Invited talk 1:
Stremmel W
Feeding the developing GI tract: the importance of early life nutrition
University Clinics of Heidelberg, Department of Internal Medicine, Heidelberg, Germany
Bouritius H
The colonic mucus serves a first barrier towards invasion of commensal bacteria in stools to prevent inflammation. One essential component of intestinal mucus is phosphatidylcholine (PC) which represents more than 90 % of the phospholipids in mucus. It is arranged in lamellar structures as surfactant-like particles which provide a hydrophobic surface on top of the hydrated mucus gel to prevent the invasion of bacteria from intestinal lumen. In ulcerative colitis (UC), the mucus PC content is reduced by 70 %, irrespective of the state of inflammation. Thus, it could represent an intrinsic primary pathogenetic condition predisposing to bacterial invasion and the precipitation of inflammation. Since PC was shown to be mainly secreted by the ileal mucosa from where it is assumed to move distally to the colon, the PC content along the colonic wall towards the rectum gradually thins, with the least PC content in the rectum. This explains the start of the clinical manifestation of UC in the rectum and the expansion from there to the upper parts of the colon. In three monocentric clinical trials, when missing mucus PC in UC was supplemented by an oral, delayed release PC preparation, the inflammation improved, and even resolved after a 3-month treatment course. In a recent multicentric randomized clinical phase IIB trial, those previous results could be confirmed in regard to improvement of clinical activity at 3.2 g LT-02 as well as achievement of mucosal healing. The data indicate the essential role of the mucus PC content for protection against inflammation in colon.
Baby Nutrition R&D, Danone, Wageningen Just after birth, the GI tract of a newborn infant experiences full enteral nutrition for the first time. Except a few sips of amniotic fluid the digestive system hardly had to swallow, mix, digest, transport, or absorb any nutrition before. Although only limited information is available about this very sensitive period in human GI tract physiology, it is known that many processes are still in a developing state during the first years of life. Immune function, gut microbiota, intestinal permeability, motility, and gut–brain interactions are important aspects in this context, but also the digestive capacity of stomach and small intestine is subjected to big changes. Some studies have shown that several of the digestive enzymes are scarcely present in the neonate and need months to reach mature levels. This very sensitive period requires a well-orchestrated feeding strategy. Recent studies have shown that at least 50 % of babies suffer from one or more symptoms of gastrointestinal discomfort, such as regur
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