Plantain and Broccoli May Inhibit Crohn's Relapse, Polysorbate 80 May Increase Risks

Background Crohn's disease is common in developed nations where the typical diet is low in fibre and high in processed food. Primary lesions overlie Peyer's patches and colonic lymphoid follicles where bacterial invasion through M-cells occurs. We have assessed the effect of soluble non-starch polysaccharide (NSP) and food emulsifiers on translocation of Escherichia coli across M-cells.

Methods To assess effects of soluble plant fibres and food emulsifiers on translocation of mucosa-associated E coli isolates from Crohn's disease patients and from non-Crohn's controls, we used M-cell monolayers, generated by co-culture of Caco2-cl1 and Raji B cells, and human Peyer's patches mounted in Ussing chambers.

Results

E coli translocation increased across M-cells compared to parent Caco2-cl1 monocultures; 15.8-fold (IQR 6.2–32.0) for Crohn's disease E coli (N=8) and 6.7-fold (IQR 3.7–21.0) for control isolates (N=5). Electron microscopy confirmed E coli within M-cells. Plantain and broccoli NSP markedly reduced E coli translocation across M-cells at 5 mg/ml (range 45.3–82.6% inhibition, p<0.01); apple and leek NSP had no significant effect. Polysorbate-80, 0.01% vol/vol, increased E coli translocation through Caco2-cl1 monolayers 59-fold (p<0.05) and, at higher concentrations, increased translocation across M-cells. Similarly, E coli translocation across human Peyer's patches was reduced 45±7% by soluble plantain NSP (5 mg/ml) and increased 2-fold by polysorbate-80 (0.1% vol/vol).

Conclusions

Translocation of E coli across M-cells is reduced by soluble plant fibres, particularly plantain and broccoli, but increased by the emulsifier Polysorbate-80. These effects occur at relevant concentrations and may contribute to the impact of dietary factors on Crohn's disease pathogenesis.

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Soluble plant fibres, particularly those present in plantain and broccoli, are shown to inhibit translocation of Crohn's mucosa-associated E coli isolates across M-cells, at concentrations that should be readily achievable in vivo. This implies that dietary supplementation with such fibres might have a protective effect against Crohn's disease relapse by preventing bacterial invasion of the mucosa. NSP from plantain, as from other plant sources, might also have a conventional prebiotic effect via encouragement of probiotic bacteria that would not be relevant to the effects seen in these in vitro models. We feel that the ability of soluble plant fibres to block epithelial attachment and translocation by bacteria may be at least as important as any prebiotic effect, particularly in the small intestine. It also suggests that further investigation is warranted to assess whether soluble dietary fibre might have a more generalised beneficial effect on intestinal health, including bowel cancer and diarrhoeal disease, as a consequence of this ability to block interaction between intestinal bacteria and the epithelium.

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What is a Plantain?

Plantains are a member of the banana family. They are a starchy, low in sugar variety that is cooked before serving as it is unsuitable raw. It is used in many savory dishes somewhat like a potato would be used and is very popular in Western Africa and the Caribbean countries. It is usually fried or baked.

Plantains are native to India and are grown most widely in tropical climates. Plantains are sometimes referred to as the pasta and potatoes of the Caribbean. Sold in the fresh produce section of the supermarket, they usually resemble green bananas but ripe plantains may be black in color. This vegetable-banana can be eaten and tastes different at every stage of development. The interior color of the fruit will remain creamy, yellowish or lightly pink. When the peel is green to yellow, the flavor of the flesh is bland and its texture is starchy. As the peel changes to brown or black, it has a sweeter flavor and more of a banana aroma, but still keeps a firm shape when cooked.

The plantain averages about 65% moisture content and the banana averages about 83% moisture content. Since hydrolysis, the process by which starches are converted to sugars, acts fastest in fruit of higher moisture content it converts starches to sugars faster in bananas than it does in plantains. A banana is ready to eat when the skin is yellow whereas a plantain is not ready to eat "out of hand" until hydrolysis has progressed to the point where the skin is almost black.

Plantains grow best in areas with constant warm temperatures and protection from strong winds. They have been grown in scattered locations throughout Florida since the 16th century. Because of the occasional freezes, Florida is considered a marginal area for plantain production. They are available year round in the supermarket.

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David said:

Wow jenjen! Once you left Ghana, did your lack of symptoms persist or did they come back? If they did come back, after how long?

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kiny said:

The brocoli dose they used in mice was really high though, unless you decide to eat a few tons of brocoli a day it doesn't help. There was a company who was going to make a concentrate though.

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Karma said:

Where in the paper is the dose of broccoli required to give levels above 0.5mg/ml? Surely it can't be that high compared to plantains?

"Likewise, broccoli NSP significantly inhibited bacterial translocation across M-cells in a dose-dependent manner, at concentrations of ≥ 0.5 mg/mL (figure 3B)."

With the plantains it says:

10 g fibre/day would produce NSP concentrations of 10 and 7.5 mg/ml in the caecum and rectum respectively.

Would 10g of broccoli produce similar levels? is there somewhere to find this out?

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