Little is known about the metabolic response of pediatric Crohn’s disease (CD) patients to partial enteral nutrition (PEN) therapy and the impact of disease activity and inflammation. We analyzed plasma samples from a nonrandomized controlled intervention study investigating the effect of partial enteral nutrition (PEN) on bone health and growth throughout one year with untargeted metabolomics using high-performance liquid chromatography (HPLC) coupled with high-resolution mass spectrometry (HRMS). Thirty-four paired samples from two time points (baseline and 12 months) were analyzed. Patients (median age: 13.9 years, range: 7–18.9 years, 44% females) were in remission or had mild disease activity. The intervention group received a casein-based formula for 12 months, providing ~25% of estimated daily energy requirements. Sparse partial least squares discriminant analysis (splsda) was applied for group discrimination and identifying sources of variation to identify the impact of PEN. We also investigated the correlation of metabolites with inflammation markers, including erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and fecal calprotectin. After 12 months, our results show substantial difference between PEN and non-PEN groups in the metabolome of CD patients in remission or with mild disease activity. Inflammatory markers were associated with individual compounds and chemical classes such as isoprenoids and phospholipids. Identified compounds comprise metabolites produced by human or bacterial metabolism, as well as xenobiotics recognized as flavoring agents and environmental contaminants and their biotransformation products. Further longitudinal studies that also include patients with higher disease activity are warranted to evaluate the suitability of these metabolic biomarkers for predicting disease activity.

关于儿科克罗恩病 (CD) 患者对部分肠内营养 (PEN) 治疗的代谢反应以及疾病活动和炎症的影响知之甚少。我们使用高效液相色谱 (HPLC) 和高分辨率质谱 (HRMS) 结合非靶向代谢组学分析了一项非随机对照干预研究的血浆样本，该研究调查了部分肠内营养 (PEN) 在一年内对骨骼健康和生长的影响。 。对来自两个时间点（基线和 12 个月）的 34 个配对样本进行了分析。患者（中位年龄：13.9 岁，范围：7-18.9 岁，44% 女性）处于缓解期或患有轻度疾病活动。干预组接受基于酪蛋白的配方奶粉 12 个月，可提供约 25% 的估计每日能量需求。应用稀疏偏最小二乘判别分析 (splsda) 进行群体区分并识别变异来源，以识别 PEN 的影响。我们还研究了代谢物与炎症标志物的相关性，包括红细胞沉降率 (ESR)、C 反应蛋白 (CRP) 和粪便钙卫蛋白。12 个月后，我们的结果显示，缓解或轻度疾病活动性 CD 患者的代谢组在 PEN 组和非 PEN 组之间存在显着差异。炎症标志物与单个化合物和化学类别（例如类异戊二烯和磷脂）相关。已鉴定的化合物包括人类或细菌代谢产生的代谢物，以及被认为是调味剂和环境污染物的异生物质及其生物转化产物。有必要进行进一步的纵向研究，包括疾病活动度较高的患者，以评估这些代谢生物标志物预测疾病活动度的适用性。