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Serum Concentrations of VEGF and TGF-β1 During Exclusive Enteral Nutrition in IBD

Wedrychowicz, Andrzej*; Kowalska-Duplaga, Kinga*; Jedynak-Wasowicz, Urszula*; Pieczarkowski, Stanislaw*; Sladek, Malgorzata*; Tomasik, Przemyslaw; Fyderek, Krzysztof*

Journal of Pediatric Gastroenterology and Nutrition: August 2011 - Volume 53 - Issue 2 - p 150–155
doi: 10.1097/MPG.0b013e3182144c74
Original Articles: Gastroenterology

Background and Aim: Exclusive enteral nutrition (EEN) is an effective method of treatment in achieving remission in inflammatory bowel disease (IBD); however, its mechanism of action is still poorly understood. The objective of our study was to assess the influence of EEN on serum vascular endothelial growth factor (VEGF) and transforming growth factor-beta 1 (TGF-β1) in children and adolescents with IBD.

Patients and Methods: Thirty-nine children and adolescents with IBD (24 with Crohn disease [CD] and 15 with ulcerative colitis [UC]) and 25 healthy controls were enrolled in the study. VEGF and TGF-β1 were assessed at the baseline and after 2 and 4 weeks of EEN in CD and UC groups and once in controls using enzyme-linked immunosorbent assay immunoassays.

Results: At the baseline, we found increased serum VEGF in the CD versus UC group and controls (P < 0.05) and serum TGF-β1 in the UC versus CD group and controls (P < 0.05). During EEN, VEGF decreased in the UC and CD groups, whereas TGF-β1 increased in the CD group and decreased in the UC group. The CD group achieved disease remission faster than the UC group, and the weight gain of patients with CD during EEN was higher compared with patients with UC. Additionally, TGF-β1 concentration correlated with protein and energies daily intake in the CD group (R = 0.95; P < 0.05).

Conclusions: Different effectiveness of EEN in achieving remission in CD and UC may result from a modification of growth factor production. EEN stimulated TGF-β1 production in CD but not in UC, which possibly resulted in higher effectiveness of EEN in this group of patients.

*Department of Pediatrics, Gastroenterology and Nutrition

Department of Clinical Biochemistry, Polish-American Children's Hospital, Jagiellonian University Medical College, Krakow, Poland.

Address correspondence and reprint requests to Andrzej Wedrychowicz, MD, PhD, Department of Pediatrics, Gastroenterology and Nutrition, Polish-American Children's Hospital, Jagiellonian University Medical College, 265 Wielicka St, 30-663 Krakow, Poland (e-mail:

Received 2 September, 2010

Accepted 5 February, 2011

The study was supported in full by Jagiellonian University Medical College, Krakow, Poland, grant no. K/ZDS/000433.

The preliminary results of the study were reported during the 3rd World Congress of Pediatric Gastroenterology, Hepatology and Nutrition, Iguassu Falls, Brazil, August 16–20, 2008.

The authors report no conflicts of interest.

Copyright 2011 by ESPGHAN and NASPGHAN