S100A12 is a member of the S100 family of calcium-binding proteins with important extracellular activities. In recent years, investigators across a number of fields have delineated the patterns of S100A12 expression in a variety of conditions. These data suggest that S100A12 can be used as a valuable serum inflammatory marker.

Summary: Background  The use of exclusive enteral nutrition to treat paediatric Crohn’s disease (CD) is widely accepted, although the precise mechanism(s) of action remains speculative.Aim  To investigate the changes to key intestinal bacterial groups of Eubacteria, Bacteroides, Clostridium coccoides, Clostridium leptum and Bifidobacteria, during and after exclusive enteral nutrition treatment for CD in paediatric patients and correlate these changes to disease activity and intestinal inflammation.Methods  Stool was collected from six children at diagnosis of CD, during exclusive enteral nutrition and 4 months post‐therapy, and from seven healthy control children. The diversity of bacteria was assessed by polymerase chain reaction‐denaturing gradient gel electrophoresis with changes to bacterial diversity measured by Bray–Curtis similarity, intestinal inflammation assessed by faecal S100A12 and the disease activity assessed by PCDAI.Results  A significantly greater change in intestinal bacterial composition was seen with exclusive enteral nutrition treatment compared with controls. Further, the intestinal bacteria remained altered 4 months following exclusive enteral nutrition completion. Changes in the composition of Bacteroides were associated with reduced disease activity and inflammation.Conclusions  Exclusive enteral nutrition reduces bacterial diversity and initiates a sustained modulation of all predominant intestinal bacterial groups. Exclusive enteral nutrition may reduce inflammation through modulating intestinal Bacteroides species. The implications of these results for exclusive enteral nutrition therapy and CD pathogenesis should now be the subject of further investigation.

Exclusive enteral nutrition (EEN) is well-established as a first line therapy instead of corticosteroid (CS) therapy to treat active Crohn's disease (CD) in children. It also has been shown to have benefits over and above induction of disease remission in paediatric populations. However, other than in Japanese populations, this intervention is not routinely utilised in adults. To investigate potential reasons for variation in response between adult studies of EEN and CS therapy. The Ovid database was searched over a 6-mo period. Articles directly comparing EEN and CS therapy in adults were included. Eleven articles were identified. EEN therapy remission rates varied considerably. Poor compliance with EEN therapy due to unpalatable formula was an issue in half of the studies. Remission rates of studies that only included patients with previously untreated/new CD were higher than studies including patients with both existing and new disease. There was limited evidence to determine if disease location, duration of disease or age of diagnosis affected EEN therapy outcomes. There is some evidence to support the use of EEN as a treatment option for a select group of adults, namely those motivated to adhere to an EEN regimen and possibly those newly diagnosed with CD. In addition, the use of more palatable formulas could improve treatment compliance.