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Polyphenols in the treatment of inflammatory bowel disease and acute pancreatitis
  1. Haim Shapiro1,
  2. Pierre Singer2,
  3. Zamir Halpern1,
  4. Rafael Bruck1
  1. 1Gastroenterology Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; The Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
  2. 2General Intensive Care Department, Rabin Medical Center, Campus Beilinson, Petah Tiqva, Israel
  1. Correspondence to:
    Professor R Bruck
    Gastroenterology Institute, Tel Aviv Sourasky Medical Center, Weizmann 6, Tel Aviv 64239, Israel; rafib{at}tasmc.health.gov.il

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Polyphenols are phytochemicals that are abundant in food and beverages derived from plants. Although no deficiency state has been described for them, increased intake of polyphenols appears to protect against disease in virtue of their anti-inflammatory and vasculoprotective properties. This article focuses on four polyphenols with established anti-inflammatory properties: resveratrol, epigallocatechin gallate, curcumin and quercetin. In rodents, ingestion or systemic administration of these agents inhibits nuclear factor κ B-dependent gene expression and induces phase II antioxidant and detoxifying proteins. Conditions prevented and/or ameliorated by these polyphenols include inflammatory colitis and acute pancreatitis. Polyphenols also attenuate ischaemia-reperfusion injury and endotoxemic sepsis, which has a role in the development of multiple organ dysfunction in severe acute pancreatitis. Enteral nutrition has an important role in the management of inflammatory bowel disease (IBD)—mainly of Crohn’s disease, and of acute pancreatitis. Parenteral nutrition is reserved for refractory cases and disease-associated complications. Artificial nutrition attempts to safely administer the essential and otherwise beneficial constituents of food to patients with an impaired ability to ingest or digest food; yet, polyphenols are not included in the formulas. We suggest that the addition of polyphenols to artificial nutritional formulas would improve the outcome of patients with IBD and acute pancreatitis in need of enteral or parenteral nutrition.

POLYPHENOLS, A GROUP OF SECONDARY PLANT METABOLITES, ARE NON-ESSENTIAL NUTRIENTS THAT PROBABLY CONTRIBUTE TO HUMAN HEALTH

Plants, like other unicellular and multicellular organisms, contain ubiquitous organic molecules (eg, amino acids, carbohydrates and fatty acids) termed primary metabolites that are essential to cell structure and basic metabolism. These compounds also serve as substrates for the synthesis of an array of chemicals called secondary plant metabolites, which are accumulated at lower concentrations and are more variably distributed among different species. Once thought to be waste products, these agents are now considered to have a role in ecological interactions with friendly and hostile microorganisms and macroorganisms, and protection from environmental stressors. …

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