{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T02:17:08Z","timestamp":1791253028666,"version":"4.1.0"},"reference-count":35,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2023,1,13]],"date-time":"2023-01-13T00:00:00Z","timestamp":1673568000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Women and Children\u2019s Health Research Institute&gt;"},{"DOI":"10.13039\/501100000024","name":"Canadian Institutes of Health Research","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"publisher"}]},{"name":"J.E.V.L"},{"name":"Emma Children\u2019s Hospital"},{"DOI":"10.13039\/100018130","name":"Department of Pediatrics","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100018130","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Amsterdam University Medical Center"},{"name":"Pro-KIIDS Clinical Research Network","award":["#585718"],"award-info":[{"award-number":["#585718"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,5,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Both the Crohn\u2019s disease exclusion diet combined with partial enteral nutrition (CDED+PEN) and exclusive enteral nutrition (EEN) can induce remission in mild-to-moderate pediatric Crohn\u2019s disease and are associated with a marked decrease in fecal kynurenine levels. This suggests a link between clinical outcome of dietary therapy and changes in tryptophan metabolism pathways. Here, we characterize the changes in several fecal tryptophan metabolites induced by CDED+PEN or EEN and their association with remission.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>A total of 21 tryptophan metabolites were quantified in fecal samples from a 12-week prospective randomized trial with CDED+PEN or EEN for induction of remission in mild to moderate pediatric Crohn\u2019s disease. Tryptophan metabolites at week 0 (W0), W6, and W12 of 73 samples were quantitatively measured by liquid chromatography coupled with triple quadrupole mass spectrometry, and data were analyzed according to clinical groups of baselines (W0), induced remission at W6, no remission, sustained remission at W12, and nonsustained remission.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Reduction in components of the kynurenine pathway, such as kynurenine and quinolinic acid, were strongly associated with induced remission with both CDED+PEN and EEN, which were maintained in sustained remission. Specific serotonin pathway metabolites, such as melatonin, N-acetylserotonin, and 5-OH-tryptophan, were significantly increased in fecal samples from patients maintaining remission at W12 with both CDED+PEN and EEN. Importantly, in samples from patients failing to sustain remission, no changes were observed. Remission induction with EEN differs from CDED+PEN, particularly the moderate effects on indole pathway metabolites. The ratios of kynurenine and melatonin and quinolinic acid and melatonin perform well as markers for sustained remission.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>The reduction in specific kynurenine pathway compounds and the increase in serotonin pathway compounds are associated with diet-induced and sustained remission. Further studies are warranted to assess causality and the association of these metabolites with specific diet and lifestyle factors, affecting sustained clinical remission.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ibd\/izac262","type":"journal-article","created":{"date-parts":[[2023,1,14]],"date-time":"2023-01-14T00:55:58Z","timestamp":1673657758000},"page":"684-694","source":"Crossref","is-referenced-by-count":27,"title":["Sustained Diet-Induced Remission in Pediatric Crohn\u2019s Disease Is Associated With Kynurenine and Serotonin Pathways"],"prefix":"10.1093","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2095-371X","authenticated-orcid":false,"given":"Mohammed","family":"Ghiboub","sequence":"first","affiliation":[{"name":"Tytgat Institute for Liver and Intestinal Research, Amsterdam Gastroenterology Endocrinology Metabolism, Academic Medical Center, University of Amsterdam , Amsterdam , Netherlands"},{"name":"Department of Pediatric Gastroenterology and Nutrition, Emma Children\u2019s Hospital, Amsterdam University Medical Centers , Amsterdam , Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rotem Sigall","family":"Boneh","sequence":"additional","affiliation":[{"name":"Division of Pediatric Gastroenterology, Wolfson Medical Centre, Holon, Sackler Faculty of Medicine, Tel Aviv University , Tel Aviv , Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruno","family":"Sovran","sequence":"additional","affiliation":[{"name":"Tytgat Institute for Liver and Intestinal Research, Amsterdam Gastroenterology Endocrinology Metabolism, Academic Medical Center, University of Amsterdam , Amsterdam , Netherlands"},{"name":"Department of Pediatric Surgery, Amsterdam Reproduction and Development Research Institute, Emma Children\u2019s Hospital, Amsterdam UMC, University of Amsterdam and Vrije Universiteit Amsterdam , Amsterdam , the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eytan","family":"Wine","sequence":"additional","affiliation":[{"name":"Division of Pediatric Gastroenterology, Department of Pediatrics, University of Alberta , Edmonton, AB , Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antoine","family":"Lef\u00e8vre","sequence":"additional","affiliation":[{"name":"UMR 1253, iBrain, INSERM, University of Tours , Tours , France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick","family":"Emond","sequence":"additional","affiliation":[{"name":"UMR 1253, iBrain, INSERM, University of Tours , Tours , France"},{"name":"Laboratoire de M\u00e9decine Nucl\u00e9aire In Vitro, Centre Hospitalier R\u00e9gionale Universitaire de Tours , Tours , France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charlotte M","family":"Verburgt","sequence":"additional","affiliation":[{"name":"Tytgat Institute for Liver and Intestinal Research, Amsterdam Gastroenterology Endocrinology Metabolism, Academic Medical Center, University of Amsterdam , Amsterdam , Netherlands"},{"name":"Department of Pediatric Gastroenterology and Nutrition, Emma Children\u2019s Hospital, Amsterdam University Medical Centers , Amsterdam , Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marc A","family":"Benninga","sequence":"additional","affiliation":[{"name":"Department of Pediatric Gastroenterology and Nutrition, Emma Children\u2019s Hospital, Amsterdam University Medical Centers , Amsterdam , Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wouter J","family":"de Jonge","sequence":"additional","affiliation":[{"name":"Tytgat Institute for Liver and Intestinal Research, Amsterdam Gastroenterology Endocrinology Metabolism, Academic Medical Center, University of Amsterdam , Amsterdam , Netherlands"},{"name":"Department of Surgery, University Hospital of Bonn , Bonn , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johan E","family":"Van Limbergen","sequence":"additional","affiliation":[{"name":"Tytgat Institute for Liver and Intestinal Research, Amsterdam Gastroenterology Endocrinology Metabolism, Academic Medical Center, University of Amsterdam , Amsterdam , Netherlands"},{"name":"Department of Pediatric Gastroenterology and Nutrition, Emma Children\u2019s Hospital, Amsterdam University Medical Centers , Amsterdam , Netherlands"},{"name":"Amsterdam Public Health Research Institute, Academic Medical Center, University of Amsterdam , Amsterdam , the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2023,1,13]]},"reference":[{"issue":"2","key":"2023050208143909600_CIT0001","doi-asserted-by":"crossref","first-page":"440","DOI":"10.1053\/j.gastro.2019.04.021","article-title":"Crohn\u2019s disease exclusion diet plus partial enteral nutrition induces sustained 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