Background: Exclusive
enteral nutrition (EEN) provides an effective strategy for the induction of clinical remission in
pediatric Crohn's disease. However, the feasibility of long-term EEN in the management of disease and the underlying mechanism whereby long-term EEN prevents intestinal
inflammation are still not fully understood. Methods: Paired male and female adult wild-type (WT) mice were mated to breed littermates, and these pups were then weaned at 3 weeks of age and randomly allocated into regular diet (RT) feeding group and EEN feeding group (Peptisorb; NUTRICIA), respectively. After feeding until adulthood at the age of 8 weeks, mice were sacrificed and phenotypic analysis of immune cells in spleens and mesenteric lymph nodes (MLNs) was performed by flow cytometry. Fecal pellets were also collected to determine the levels of
immunoglobulins and gut microbiota by ELISA and
16S rRNA sequencing. The role of long-term EEN in the development of
colitis and its underlying mechanisms were evaluated in a TNBS-induced
colitis model in mice. Results: Feeding with EEN decreased the percentages of
IgA- and
IgG-coated bacteria and the levels of soluble
IgA and
IgG in the feces of EEN-feeding mice compared with the controls, but did not affect the compositions of different immune cells including CD4+, CD8+ T cells and B220+ B cells in the spleens and MLNs. An in-depth analysis of the gut microbiota revealed a decrease of the general diversity of the gut microbiota, but a significant change of the composition of the gut microbiota after EEN feeding, characterized by an increase of the beneficial bacteria including Bacteroides, Parabacteroides, and Alistipes, but a decrease of the detrimental bacteria such as Escherichia-Shigella. Moreover, we found that EEN feeding markedly improved intestinal
inflammation in the TNBS-induced
colitis model compared to RT feeding, as evidenced by decreased levels of inflammatory
cytokines and fecal soluble
immunoglobulins and improved microbial community composition. Conclusions: Our data indicate that long-term EEN feeding remodels the composition of gut microbiota and alleviates intestinal mucosal
inflammation. It provides new guidance using EEN for the management of gut
inflammation.