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The aim of this investigation was to elucidate retrospectively the therapeutic effect of infliximab in patients with active Crohn's disease (CD) under nutritional therapy.Using a review of the clinical records in 24 nationwide institutions specializing in inflammatory bowel disease, the short-term effect of infliximab in 97 patients with active CD was retrospectively investigated. The Crohn's disease activity index (CDAI) at baseline and after 2 weeks of a single infliximab administration (5 mg/kg) was compared among patients under total parenteral nutrition (TPN group, n=36), those following an elemental or polymeric diet (EN group, n=49) and those without TPN and EN (NN group, n=12). A decrease in CDAIor= 70 or a CDAI value150 at 2 weeks was regarded as effective.There was no difference in CDAI at baseline among the three groups. In each group, CDAI decreased significantly (from 250 (195-290) [median (interquartiles)] to 152 (123-233) in the TPN group, p0.0001; from 259 (200-325) to 180 (130-238) in the EN group, p0.0001; from 278 (222-291) to 164 (132-196) in the NN group, p=0.003). Infliximab was effective in 63.9% of patients in the TPN group, in 55.1% of those in the EN group and in 75% of the NN group. There was no statistical difference in efficacy among the three groups (p=0.4). Multivariate logistic regression analysis revealed younger age to be a significant factor related to the efficacy of infliximab.Infliximab is effective in patients with CD under TPN or EN. Age at infliximab administration may be predictive of response to infliximab.

Although thyrotropin-releasing hormone (TRH) is present in the gastric mucosa and juice, the pathophysiologic significance of TRH is poorly understood at the peripheral level of the stomach. In the present study we analyzed the TRH-induced secretion profiles of somatostatin, histamine, and acid in the rat stomach.The effects of intraluminal perfusion of TRH on somatostatin, histamine, and acid and the influence of the specific anti-TRH receptor antibody were investigated by using the rat gastric intraluminal perfusion model.Intraluminal TRH caused an immediate decrease in somatostatin secretion in a dose-dependent manner, and this change occurred preceding an increase in acid secretion. In contrast, this treatment did not yield any significant changes in histamine contents in the effluent. Pretreatment of the gastric lumen with the anti-TRH receptor antibody caused a complete inhibition of TRH-induced changes in somatostatin and acid secretion.These findings suggest that intraluminal TRH affects somatostatin and acid secretion in a paracrine manner via its specific receptor in the rat stomach.