Inflammatory Bowel Diseases (IBD) such as Crohn's disease are thought to result from an interplay between genetics, and altered-microbiome, and a defective gut barrier.
These factors seem to be core drivers of the disease process. as they drive a state of dysbiosis (undergrowth or imbalance of supportive microbiota; while harmful microbiota overgrow).
We will be talking all about this in my upcoming Beyond SIBO course
Recently, research is showing that Intestinal Alkaline Phosphatase (IAP) , a hydrolase enzyme that mainly expresses in the duodenum of the small intestine, may be a key part of the IBD process. IBD patients (likely specifically Crohn's patients) may be genetically predisposed to low IAP. (Singh,et.al,)
IAP plays several key roles in regulating the gut barrier such as:
Regulating bicarbonate secretion (involved in intestinal Ph,
Detoxifying lipopolysaccharide (LPS) which are the potential harmful cell wall debris of gram negative bacteria
Regulating gut microbes
Dephosphorylating proinflammatory peptides (nucleotides).
Exhibiting anti-inflammatory effects via Toll-like Receptor-4 (TLR-4) dependent manner.
In a sense one of its key roles is autophagy.; which is a self regulating mechanism in organisms that remove old cells and recycles waste products.
Source: (Estaki,et.al )
IAP levels found higher in Type 0, and Type B blood types and lowest in type A.
Nonetheless , having healthy levels of IAP may be seen as a key protector against Dysbiosis
Interestingly enough , In mouse models , the administration of exogenous IAP has been shown to reduce Small Intestinal Bacterial Overgrowth (Singh,et.al, 2020)
Are there foods, supplements, and dietary factors that may influence IAP levels?
The short answer is ": "likely and more information is to come".
Dietary factors to alter IAP have been inconsistent in the research likely so I can’t comfortably say how to modify it with diet at this point other than fiber in the diet will likely increase it. In rodent studies the consumption of Non-digestible Oligosaccharides (ie. GOS, FOS) elevated colonic levels of IAP in rats fed a high fat diet. (Okazaki,et.al)
Other dietary influences on IAP can be postulated and these approaches might be worth looking into especially in resistant to treatment Crohn's Disease
In the IBD patient these are generally good principles any ways
Maximize consumption of IAP activators
Butter (likely due to its source of butyrate
Dietary Fiber (due to prebiotic supply and butyrate supply)
Healthy Omega-6 sources (sunflower seeds, walnuts, pumpkin seeds)
Minimize consumption of IAP inhibitors
Artificial sweeteners (a source of phenylalanine)
Hard and Processed cheese
Highly saturated fats
Phytates (which can be minimized by soaking grains and legumes overnight prior to consumption)
Note: currently in the literature it highlights the importance of Omega 3/Omega 6 balance in optimizing the effect of IAP (Estaki,et.al)
There likely will be day soon where IAP is given as an exogenous medicine in the meantime these dietary principles are guidepost to follow. They happen to align with a healthy Mediterranean style diet anyway.
Estaki, M., DeCoffe, D., & Gibson, D. L. (2014). Interplay between intestinal alkaline phosphatase, diet, gut microbes and immunity.World Journal of Gastroenterology,20(42), 15650.https://doi.org/10.3748/wjg.v20.i42.15650
Okazaki, Y., & Katayama, T. (2019). Consumption of non-digestible oligosaccharides elevates colonic alkaline phosphatase activity by up-regulating the expression of IAP-I, with increased mucins and microbial fermentation in rats fed a high-fat diet. The British journal of nutrition, 121(2), 146–154. https://doi.org/10.1017/S0007114518003082
Singh, S. B., Carroll-Portillo, A., Coffman, C., Ritz, N. L., & Lin, H. C. (2020). Intestinal Alkaline Phosphatase Exerts Anti-Inflammatory Effects Against Lipopolysaccharide by Inducing Autophagy. Scientific reports, 10(1), 3107. https://doi.org/10.1038/s41598-020-59474-6