• Title/Summary/Keyword: Ulcerative Colitis

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Histopathological Profile of Benign Colorectal Diseases in Al-Madinah Region of Saudi Arabia

  • Albasri, Abdulkader Mohammed
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.18
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    • pp.7673-7677
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    • 2014
  • Background: Patients with long-standing inflammatory bowel disease (IBD) have an increased risk of developing colorectal cancer (CRC). Colon cancer risk in IBD increases with longer duration and greater anatomic extent of colitis, the presence of primary sclerosing cholangitis, family history of CRC and degree of inflammation of the bowel. This study aimed to characterize the histopathological pattern of benign colorectal diseases among Saudi patients and to highlight age and gender variations of lesions as base line data for future studies to investigate the link between benign/IBD and colorectal cancers in the local population. Materials and Methods: The materials consisted of 684 biopsies, reported as benign (excluding malignancies and polyps) at the Department of Pathology, King Fahad Hospital, Madinah, Saudi Arabia from January 2006 to December 2013. Data collected and entered in MS-Excel and were analyzed using SPSS-20. Results: Of 684 colorectal tissues reviewed, 408 specimens (59.6%) were from male patients and 276 specimens (40.4%) were from females giving a male: female ratio of 1.5:1. Age of the patients ranged from 4 to 75 years with a mean of 39.6 years. The most frequent histologic diagnosis was a chronic non specific proctocolitis followed by ulcerative colitis, accounting respectively for 52.6% and 31.7% of all cases. These were followed by Crohn's disease 22 (3.2%), ischemic bowel disease 20 (2.9%), diverticular disease 14 (2%), eosinophilic colitis 12 (1.7%) and solitary rectal ulcer 12 (1.7%). A minority of 21 patients (3.1%) were cases of acute nonspecific proctocolitis, schistosomiasis, tuberculosis, volvulus and pseudomembranous colitis. Conclusions: These data show that although chronic non specific proctocolitis and ulcerative colitis were the dominant diagnoses, Crohn's disease, ischemic bowel disease and diverticular disease also existed to a lesser extent and should be considered in the differential diagnosis of benign colorectal diseases. This study provides a base line data for future studies which would be taken up to investigate the link between benign/IBD and colorectal cancers in the local population.

A Review on Chemical-Induced Inflammatory Bowel Disease Models in Rodents

  • Randhawa, Puneet Kaur;Singh, Kavinder;Singh, Nirmal;Jaggi, Amteshwar Singh
    • The Korean Journal of Physiology and Pharmacology
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    • v.18 no.4
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    • pp.279-288
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    • 2014
  • Ulcerative colitis and Crohn's disease are a set of chronic, idiopathic, immunological and relapsing inflammatory disorders of the gastrointestinal tract referred to as inflammatory bowel disorder (IBD). Although the etiological factors involved in the perpetuation of IBD remain uncertain, development of various animal models provides new insights to unveil the onset and the progression of IBD. Various chemical-induced colitis models are widely used on laboratory scale. Furthermore, these models closely mimic morphological, histopathological and symptomatical features of human IBD. Among the chemical-induced colitis models, trinitrobenzene sulfonic acid (TNBS)-induced colitis, oxazolone induced-colitis and dextran sulphate sodium (DSS)-induced colitis models are most widely used. TNBS elicits Th-1 driven immune response, whereas oxazolone predominantly exhibits immune response of Th-2 phenotype. DSS-induced colitis model also induces changes in Th-1/Th-2 cytokine profile. The present review discusses the methodology and rationale of using various chemical-induced colitis models for evaluating the pathogenesis of IBD.

Lovastatin derivative dehydrolovastatin ameliorates ulcerative colitis in mice by suppressing NF-κB and inflammatory cytokine expression

  • Zhang, Xu;Deng, Qing-Hua;Deng, Jian-Hua;Wang, Sheng-Ju;Chen, Qiu
    • The Korean Journal of Physiology and Pharmacology
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    • v.24 no.2
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    • pp.137-147
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    • 2020
  • Ulcerative colitis (UC) is associated with intestinal immune imbalance and inflammatory response. Because dehydrolovastatin (DLVT), a derivative of lovastatin, has been recently shown to inhibit inflammation and relieve immune arthritis induced by chemical stimuli, we studied its effect and possible mechanism on UC induced by dextran sulfate sodium. The BALB/c mice were classified into six groups: normal control group, model group, DLVT high dose group, DLVT low dose group, salazosulfapyridine (SASP) group and lovastatin (LVT) group. The disease activity indices of UC and pathological changes were investigated. The myeloperoxidase (MPO) activity in colon tissue and inflammatory factors such as IL-6, IL-10, IL-17, and TNF-α in the serum were analyzed by ELISA, while the expression of NF-κB p65 protein in colon tissue was detected by immunohistochemistry and western blot. DLVT relieved the disease activity indices and pathological damage of the UC mice. Furthermore, DLVT significantly decreased MPO activity and improved the imbalance of inflammatory cytokines through inhibiting the expression of NF-κB p65. Meanwhile, the positive drug of SASP has a similar effect to DLVT, but the effect of DLVT in both decreasing IL-17, TNF-α, and increasing IL-10 was significantly stronger than that of SASP. These results suggest that DLVT may ameliorates the symptoms of UC.

Patterns of Ulcerative Colitis Treatments and Factors Affecting the Prescribing of Systemic Corticosteroid using Health Insurance Claims Database (건강보험 청구자료를 이용한 궤양성 대장염 치료제의 처방 양상과 전신 스테로이드 처방에 미치는 영향요인)

  • Kim, Jiyool;Park, So-Hee;Shin, Ju-Young
    • Korean Journal of Clinical Pharmacy
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    • v.30 no.2
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    • pp.102-112
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    • 2020
  • Objective: To analyze the prescription patterns for the treatment of ulcerative colitis (UC) and to investigate factors co-occurring with systemic corticosteroid use. Methods: We used patient-level data from Korean National Health Insurance claims database to identify patients diagnosed with UC (ICD-10 code : K51) and their medications prescribed for UC between January 1 and Decemeber 31, 2017. We found that medications for UC treatment were 5-aminosalicylic acid (5-ASA), immunomodulators, biologics, and corticosteroids. We presented the prescription pattern according to the sex, age group, type of health insurance, site of UC, type of medical institution, and concomitant medication. To evaluate factors associated with prescription of systemic corticosteroids for UC, we used a multivariate logistic regression model to estimate adjusted odds ratios (aORs) and their 95% confidence intervals (CIs). Results: Of 1,469 UC patients, 74.5% used 5-ASA and 15.2% used systemic corticosteroids. 5-ASA constituted 77.5% of all prescriptions and systemic corticosteroids accounted for 13.1%. The most widely used therapy was 5-ASA monotherapy (54.8%), followed by a double therapy with 5-ASA and immunomodulators (8.2%) or 5-ASA and systemic corticosteroids (7.2%). Systemic corticosteroids were more likely to be prescribed with immunomodulators (aOR=1.88, 95% CI=1.54-2.28) and biologics (aOR=2.82, 95% CI=2.28-3.50) than without them. Conclusions: We found that 15.2% of UC patients were prescribed with a systemic corticosteroid, which is less than reported previously. Systemic corticosteroids were more likely to be prescribed with immunomodulators and biologics.

Myositis as an Initial Presentation of Ulcerative Colitis before Gastrointestinal Symptoms

  • Kim, Doo Ri;Kim, DongSub;Choi, SangJoon;Suh, Yeon-Lim;Yoo, So-Young;Kim, Mi Jin;Choe, Yon Ho;Kim, Yae-Jean
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.23 no.3
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    • pp.297-303
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    • 2020
  • The musculoskeletal system can be involved as an extra-intestinal manifestation of inflammatory bowel disease. Among these, myositis in ulcerative colitis (UC) is very rare. A 14-year-old girl was admitted due to severe shoulder tenderness. She had complained of left jaw pain and swelling for the past 10 days. Inflammatory markers were elevated with no evidence of infectious etiology. Myositis was suspected by shoulder magnetic resonance imaging. Three days after admission, she developed hematochezia. Muscle biopsy and colonoscopy was performed due to worsening left mandibular area pain and persistent hematochezia. Colonoscopy showed consistent findings with UC. She was finally diagnosed with UC with myositis as an extra-intestinal manifestation. She showed a dramatic response to UC treatment. Gastrointestinal symptoms were well-controlled. After 14 months, UC symptoms and muscle pain were aggravated, which were relieved after steroid and cyclosporin treatment. We report a unique case of UC initially presented with myositis, preceding gastrointestinal symptoms.

A Case of Mesalazine-induced Eosinophilic Pneumonia in a Patient with Ulcerative Colitis (궤양성 대장염 환자에서 메살라진 투여 후 발생한 호산구성 폐렴 1례)

  • Park, Ji-Young;Kang, Hong-Mo;Kim, Su-Young;Han, Yo-Seb;Cho, Yong-Seon;Kim, Hyo-Jong;Yoo, Jee-Hong
    • Tuberculosis and Respiratory Diseases
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    • v.51 no.5
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    • pp.474-481
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    • 2001
  • Mesalazine(5-Aminosalicylic acid,5-ASA), a component of Sulfasalazine (sulfapyridine bound to 5-ASA), is used to treat inflammatory bowel disease. Most adverse pulmonary effects caused by sulfasalazine have been attributed to sulfapyridine. However, lung toxicity associated with mesalazine(5-ASA) is rare. Here we report a case of eosinophilic pneumonia in a 44-year-old woman with ulcerative colitis, who was treated with mesalazine. She developed symptoms of a dry cough, mild night fever, and exertional dyspnea. Bilateral peripheral pulmonary infiltrates, peripheral blood eosinophilia, and histologic features were consistent with eosinophilic pneumonia. The symptoms improved quite rapidly after the discontinuation of mesalazine and initiation of steroid therapy. Therefore, adverse pulmonary reactions to mesalazine must be considered in a differential diagnosis of pulmonary involvement in patients with inflammatory bowel disease who are receiving with mesalazine therapy.

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Synbiotics (mixture of probiotics and prebiotics) ameliorates DSS-induced ulcerative colitis in vivo.

  • Jeon, Yong-Deok;AYE, AYE;Song, Young-Jae;Kang, Sa-Haeng;Soh, Ju-Ryun;Kim, Dae-Ki;Myung, Hyun;Jin, Jong-Sik
    • Proceedings of the Plant Resources Society of Korea Conference
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    • 2019.10a
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    • pp.107-107
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    • 2019
  • Ulcerative colitis (UC) is one of inflammatory bowel disease (IBD), characterized by chronic inflammatory response and dysregulation of immune function. The severity of US has been influenced by environmental factors and food habit. The immune modulatory, anti-inflammatory and steroidal medicine have been used for the treatment of UC. However, long-term administration of those medicine is accompanied with side-effect. So, it is necessary to develop the non side-effect medicine using natural product. Prebiotics influences intestinal condition and food consumption. The heredity, immunity and environmental condition are related with occurrence of UC. In recent study, UC patients had lower level of prebiotics such as Lactobacillus and Bifidobacterium compared with healthy people. Also, previous study announced that imbalance of enteric flora aggravates the severity of UC. The effectiveness of probiotics might affect colon ability and viable bacteria also could promote the proliferation of beneficial intestinal bacteria. Prebiotics, such as herbal medicine, could lead to balance of intestinal bacteria or increase beneficial bacteria. So, proper choice of herbal medicine could control the intestinal condition. This study aimed to investigate the effect of mixture of probiotics and prebiotics (synbiotics) on dextran sulfate sodium (DSS)-induced UC in vivo. The synbiotics consist of Lactobacillus buchneri, Polymnia sonchifolia and Glycine max Merr. in this study. To evaluate the effect of synbiotics, 3% DSS was administered in BALB/c mice and synbiotics was daily administered for experimental days. The administration of synbiotics regulated colon length shortening, body weight change and disease activity index effectively. Also, extract of synbiotics upregulated survival ability of Lactobacillus buchneri in gut condition. These results suggest that mixture of probiotics and prebiotics, called as synbiotics, could influence intestinal condition also regulate the colon disease. Synbiotics might be a therapeutic agent for treatment of UC.

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Histologic features and predicting prognosis in ulcerative colitis patients with mild endoscopic activity

  • Seung Yong Shin;Hee Sung Kim;Kisung Kim;Chang Won Choi;Jung Min Moon;Jeong Wook Kim;Hyun Jin Joo;Jeongkuk Seo;Muhyeon Sung;Chang Hwan Choi
    • The Korean journal of internal medicine
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    • v.39 no.1
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    • pp.68-76
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    • 2024
  • Background/Aims: We aimed to evaluate the histologic features predictive of prognosis and correlate them with endoscopic findings in patients with ulcerative colitis (UC) having complete or partial mucosal healing (MH). Methods: We prospectively collected and reviewed data from patients with UC who underwent colonoscopy or sigmoidoscopy with biopsy. Complete and partial MH were defined as Mayo endoscopic subscores (MESs) of 0 and 1, respectively. Histologic variables, including the Nancy index (NI), predicting disease progression (defined as the need for medication upgrade or hospitalization/surgery), were evaluated and correlated with endoscopic findings. Results: Overall, 441 biopsy specimens were collected from 194 patients. The average follow-up duration was 14.7 ± 7.4 months. There were 49 (25.3%) and 68 (35.1%) patients with MESs of 0 and 1, respectively. Disease progression occurred only in patients with an MES of 1. NI ≥ 3 was significantly correlated with disease progression during follow-up. Mucosal friability on endoscopy was significantly correlated with NI ≥ 3 (61.1% in NI < 3 vs. 88.0% in NI ≥ 3; p = 0.013). Conclusions: Histological activity can help predict the prognosis of patients with UC with mild endoscopic activity. Mucosal friability observed on endoscopy may reflect a more severe histological status, which can be a risk factor for disease progression.

Peucedanum japonicum Thunberg Leaf Alleviates the Symptoms of Dextran Sulfate Sodium Induced Ulcerative Colitis in Mice (식방풍 잎의 DSS로 유도한 궤양성 대장염 완화 효과)

  • Jung, Ho-Kyung;Jung, Won-Seok;Ahn, Byung-Kwan;Kang, Byoung-Man;Yeo, Jun-Hwan;Cha, Seon-Woo;Park, Chun-Geon;Cho, Jung-Hee;Cho, Hyun-Woo
    • Korean Journal of Plant Resources
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    • v.27 no.5
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    • pp.421-428
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    • 2014
  • In general, Reucedani Radix (Peucedanum japonicum Thunbergis: PJ) is the Korean traditional herbal medicine used to remove dampness, to relieve pain, and spasm. So, PJ folium is believed to have the same effects. The aim of this study is to investigate the alleviation of dextran sulfate sodium (DSS) induced ulcerative colitis in mice by PJ folium. 25 mice were divided into 5 groups: normal, DSS, DSS + 100 mg/kg PJ folium (PJ100), DSS + 500 mg/kg PJ folium (PJ500), and DSS + 150 mg/kg 5-amino salicylic acid (5-ASA) groups. Body weights, colon lengths, histological changes in colon tissue, and spleen weights were observed. Inflammatory cytokines such as IL-$1{\beta}$, IL-6, and TNF-${\alpha}$ level in plasma were measured by ELISA. IL-$1{\beta}$, IL-6, and TNF-a mRNA expression in colon tissue were detected by RT-PCR. In the results, body weight lose was inhibited in PJ100, PJ500, and 5-ASA groups, but it was not different compared with DSS group, significantly. PJ500 group showed the preventive effects of colon length shorten and histological changes in colon tissues as good as 5-ASA group. The weight of spleen was increased in DSS group but it reduced in PJ100, PJ500, and 5-ASA groups. Moreover, IL-$1{\beta}$ and TNF-${\alpha}$ cytokine levels in plasma were reduced in PJ500 and 5-ASA groups. IL-$1{\beta}$, IL-6, and TNF-a mRNA expression in colon tissue were inhibited in PJ100, PJ500, and 5-ASA groups and it was significantly different compared with DSS group. In conclusion, PJ folium showed the alleviative effect on DSS induced ulcerative colitis in mice.

Antioxidant Effect of Atractylodes macrocephala Koidzumi in DSS-induced Ulcerative Colitis Model (백출(白朮)의 항산화 효과가 DSS 유발 궤양성 대장염 모델에 미치는 영향)

  • Park, Seok Man;Lee, Se Hui;Jeong, Da un;Cho, Su-Jung;Shin, Mi-Rae;Park, Hae-Jin;Roh, Seong-Soo
    • The Korea Journal of Herbology
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    • v.37 no.1
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    • pp.19-29
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    • 2022
  • Objectives : Although the pharmacological effects of anti-inflammatory and antioxidant action of Atractylodes macrocephala Koidzumi water extract (AM) have been proven from many studies, reports on the antioxidant effect of AM on ulcerative colitis (UC) are scarce. Therefore, we aimed at evaluating the anti-oxidant effect of AM on the DSS-induced UC model. Methods : To induce ulcerative colitis, 8-week-old male Balb/c mice received 5% DSS in drinking water for 1 week. After 1 week of adaptation, mice were divided into four groups (n=8 each) for use as normal (Normal), DSS Control (Control), DSS + AM 100 mg/kg (AM100)-treatment, DSS + AM 200 mg/kg (AM200)-treatment. After 1 week of the experiment, the animals were sacrificed, and the extracted colon tissue was analyzed for protein through western blot. Results : As a result of confirming the macroscopic changes in colon tissues to confirm the therapeutic effects of AM, the decrease in colon length was suppressed in the AM treatment group compared to the control group. In addition, as a result of biochemical analysis, AM administration significantly reduced serum glutamic oxalacetic transaminase, glutamic pyruvate transaminase levels and tissue malondialdehyde levels. As a result of confirming the protein expression level through western blot, AM administration significantly decreased the expression of NADPH-related proteins such as NOX2, p22phox, and iNOS, but significantly increased the expression of SOD, catalase, and GPx-1/2. Conclusions : AM may improve DSS-induced UC in mice by modulating NADPH and antioxidant-related proteins. In conclusion, AM showed an antioxidant effect through the improvement of oxidative stress on UC.