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Ni L, Jing S, Zhu L, Yang X, Wang X, Tu S. The Immune Change of the Lung and Bowel in an Ulcerative Colitis Rat Model and the Protective Effect of Sodium Houttuyfonate Combined With Matrine. Front Immunol 2022; 13:888918. [PMID: 35844499 PMCID: PMC9280623 DOI: 10.3389/fimmu.2022.888918] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Accepted: 05/30/2022] [Indexed: 01/19/2023] Open
Abstract
Objective To explore the immune change of lung injury of Ulcerative colitis (UC) by observing the changes of inherent immunity and adaptive immunity of the lung and bowel in UC rat models after the treatment of Sodium Houttuyfonate combined with Matrine. Method UC rat models were established with the mucous membrane of colon allergize combined with TNBS-alcohol enteroclysis for 1 week and 5 weeks. 1-week experimental rats were divided into normal group and model group, 5/each group. 5-weeks experimental rats were divided into normal group, model group, Sodium Houttuyfonate (2.9mg/ml) combined with Matrine (1.47mg/ml), and positive control sulfasalazine (10mg/ml), 5/each group. All rats were administered by gavage for 5 weeks. The histopathological and fibrotic changes in the lung and bowel were observed, and the expressions of Tumor Necrosis Factor (TNF)- α, interleukin (IL)-8 in the lung, bowel, and serum were detected by radio-immunity and immunohistochemistry, and the mRNA expressions of Toll-like receptor (TLR)-4, nuclear factor kappa (NF-κB), Macrophage migration inhibitory factor (MIF), Mucosal addressing cell adhesion molecule-1 (MadCAM1) and Pulmonary surfactant protein-A (SP-A) in the lung and bowel were detected by Real time-PCR. Result Compared with the normal group, the model rats had significant histopathological and fibrotic changes both in the lung and bowel, and all treatment groups were improved. After treatment, TLR4, IL-8, MIF, and TNF-α in the lung decreased (P<0.05); NF-KB, IL-8, and MIF in the bowel increased (P<0.05); MadCAM1 both in lung and bowel decreased (P<0.05); SP-A decreased in bowel and increased in the lung (P<0.05). Conclusion The cause of lung injury in this model was found to be related to inherent immunity and adaptive immunity, while the cause of bowel injury in this model was found to be mainly related to adaptive immunity. Sodium Houttuyfonate combined with Matrine could improve bowel and lung injury.
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Affiliation(s)
- Lulu Ni
- Department of Basic Medicine, Wuxi School of Medicine, Jiangnan University, Wuxi, China
| | - Shan Jing
- Department of Internal Medicine of Traditional Chinese Medicine (TCM), Nantong Hospital, Nantong, China
| | - Li Zhu
- Department of Internal Medicine of Traditional Chinese Medicine (TCM), Dong- zhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Xue Yang
- Department of Internal Medicine of Traditional Chinese Medicine (TCM), Third Affiliated Hospital of Henan University of Traditional Chinese Medicine, Zhengzhou, China
| | - Xinyue Wang
- Department of Internal Medicine of Traditional Chinese Medicine (TCM), Dong- zhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Su Tu
- Department of Emergency, the Affiliated Wuxi NO 2 People’s Hospital of Nanjing Medical University, Wuxi, China
- *Correspondence: Su Tu,
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Cebrián García A, Ruiz-Clavijo D, Irisarri Garde R, González de la Higuera Carnicer B, García de Galdiano Fernández A, Fraile González M. Bronchiolitis obliterans organizing pneumonia in Crohn's disease. GASTROENTEROLOGIA Y HEPATOLOGIA 2018; 42:496-497. [PMID: 30578017 DOI: 10.1016/j.gastrohep.2018.11.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/07/2018] [Revised: 10/27/2018] [Accepted: 11/05/2018] [Indexed: 11/27/2022]
Affiliation(s)
- Alba Cebrián García
- Servicio de Aparato Digestivo, Hospital García García Orcoyen, Estella, Navarra, España.
| | - David Ruiz-Clavijo
- Servicio de Aparato Digestivo, Hospital García García Orcoyen, Estella, Navarra, España
| | - Rebeca Irisarri Garde
- Servicio de Aparato Digestivo, Hospital García García Orcoyen, Estella, Navarra, España
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Huang PH, Kuo CJ, Lin CW, Cheng YM, Hu HC, Lin CY, Su MY, Chiu CT. Mesalazine-related lung disease in a patient with ulcerative colitis: A case report. Medicine (Baltimore) 2018; 97:e13242. [PMID: 30508908 PMCID: PMC6283093 DOI: 10.1097/md.0000000000013242] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
RATIONALE Mesalazine is widely used to treat inflammatory bowel disease (IBD). However, discriminating between pulmonary manifestations of IBD and drug-related lung disease remains a challenge. There were few case reports of mesalazine-related organizing pneumonia so far. PATIENT CONCERNS A 75-year-old female was diagnosed with ulcerative colitis and took mesalazine over a period of 2 years and 8 months. She presented with progressive shortness of breath for 3 days and visited our emergency department. Chest radiography showed increased bilateral infiltrates. During hospitalization her clinical condition deteriorated, and she was transferred to our intensive care unit under noninvasive ventilator support. DIAGNOSIS Computed tomography (CT) scan showed diffuse peribronchial and subpleural consolidations in bilateral lungs. Possible etiologies of interstitial lung disease were surveyed, including various infectious diseases and connective tissue diseases. Transbronchial lung biopsy showed characteristic features of organizing pneumonia. INTERVENTIONS Under the consideration of mesalazine-related lung disease, mesalazine was discontinued early in disease course and steroid therapy was given. OUTCOMES The patient was discharged from hospital with improved clinical symptoms and radiographic images. LESSONS Although this patient suffered a life-threatening adverse event, prompt diagnosis with proper management can result in a favorable outcome.
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Affiliation(s)
- Po-Han Huang
- Department of Gastroenterology and Hepatology, Chang Gung Memorial Hospital
| | - Chia-Jung Kuo
- Department of Gastroenterology and Hepatology, Chang Gung Memorial Hospital
- Chang Gung University, College of Medicine
| | - Chang-Wei Lin
- Chang Gung University, College of Medicine
- Department of Pulmonary and Critical Care Medicine
| | - Yu-Ming Cheng
- Department of Internal Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Han-Chung Hu
- Chang Gung University, College of Medicine
- Department of Pulmonary and Critical Care Medicine
| | - Chun-Yen Lin
- Department of Gastroenterology and Hepatology, Chang Gung Memorial Hospital
- Chang Gung University, College of Medicine
| | - Ming-Yao Su
- Department of Gastroenterology and Hepatology, Chang Gung Memorial Hospital
- Chang Gung University, College of Medicine
| | - Cheng-Tang Chiu
- Department of Gastroenterology and Hepatology, Chang Gung Memorial Hospital
- Chang Gung University, College of Medicine
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Sehgal P, Colombel JF, Aboubakr A, Narula N. Systematic review: safety of mesalazine in ulcerative colitis. Aliment Pharmacol Ther 2018; 47:1597-1609. [PMID: 29722441 DOI: 10.1111/apt.14688] [Citation(s) in RCA: 87] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2017] [Revised: 07/13/2017] [Accepted: 04/05/2018] [Indexed: 02/06/2023]
Abstract
BACKGROUND Mesalazine is the most commonly prescribed medication for mild to moderate ulcerative colitis. It is generally well tolerated with some reported side effects. AIM To summarise adverse drug events to mesalazine and recommend techniques for management. Furthermore, to determine if there is a dose-dependent relationship between high (>2.4 g/day) vs low dosing (≤2.4 g/day) and occurrence of adverse drug events. METHODS A literature search for relevant studies from inception to 1 December 2017 of the MEDLINE database was conducted. Two reviewers screened all titles identified. Data obtained from randomised controlled trials was used to estimate incidence rates of each adverse event. Two reviewers independently assessed methodological risk of bias and performed data extraction. RESULTS 3581 articles were initially considered. Of these, 3573 were screened, 622 reviewed and 91 included. Adverse events attributed to mesalazine included inflammatory reactions, pancreatitis, cardiotoxicity, hepatotoxicity, musculoskeletal complaints, respiratory symptoms, nephropathies and sexual dysfunction. There does not appear to be a dose-dependent relationship of mesalazine and occurrence of adverse events. CONCLUSION Patients on mesalazine should be monitored for worsening of ulcerative colitis and development of new onset organ dysfunction. High-dose mesalazine appears to have similar safety profile as low dose, and is not associated with greater risk of adverse events. Prior to placing a patient on mesalazine, baseline liver and renal function should be evaluated. Renal function should be periodically assessed, whereas other testing should be performed depending on development of symptoms.
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Affiliation(s)
- P Sehgal
- Division of Gastroenterology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - J-F Colombel
- Division of Gastroenterology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - A Aboubakr
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - N Narula
- Department of Medicine, Division of Gastroenterology, Farncombe Family Digestive Health Research Institute, McMaster University, Hamilton, ON, Canada
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Ferrusquía J, Pérez-Martínez I, Gómez de la Torre R, Fernández-Almira ML, de Francisco R, Rodrigo L, Riestra S. Gastroenterology case report of mesalazine-induced cardiopulmonary hypersensitivity. World J Gastroenterol 2015; 21:4069-4077. [PMID: 25852295 PMCID: PMC4385557 DOI: 10.3748/wjg.v21.i13.4069] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2014] [Revised: 11/27/2014] [Accepted: 01/21/2015] [Indexed: 02/06/2023] Open
Abstract
Mesalazine is a 5-aminosalicylic acid derivative that has been widely used to treat patients with inflammatory bowel disease. Accumulating evidence indicates that mesalazine has a very low rate of adverse drug reactions and is well tolerated by patients. However, a few cases of pulmonary and cardiac disease related to mesalazine have been reported in the past, though infrequently, preventing clinicians from diagnosing the conditions early. We describe the case of a 32-year-old man with ulcerative colitis who was admitted with a two-month history of persistent fever following mesalazine treatment initiated 14 mo earlier. At the time of admission, mesalazine dose was increased from 1.5 to 3.0 g/d, and antibiotic therapy was started with no improvement. Three weeks after admission, the patient developed dyspnea, non-productive cough, and chest pain. Severe eosinophilia was detected in laboratory tests, and a computed tomography scan revealed interstitial infiltrates in both lungs, as well as a large pericardial effusion. The bronchoalveolar lavage reported a CD4/CD8 ratio of 0.5, and an increased eosinophil count. Transbronchial biopsy examination showed a severe eosinophilic infiltrate of the lung tissue. Mesalazine-induced cardiopulmonary hypersensitivity was suspected after excluding other possible etiologies. Consequently, mesalazine treatment was suspended, and corticosteroid therapy was initiated, resulting in resolution of symptoms and radiologic abnormalities. We conclude that mesalazine-induced pulmonary and cardiac hypersensitivity should always be considered in the differential diagnosis of unexplained cardiopulmonary symptoms and radiographic abnormalities in patients with inflammatory bowel disease.
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Inoue M, Horita N, Kimura N, Kojima R, Miyazawa N. Three cases of mesalazine-induced pneumonitis with eosinophilia. Respir Investig 2014; 52:209-12. [PMID: 24853024 DOI: 10.1016/j.resinv.2013.12.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2013] [Revised: 12/02/2013] [Accepted: 12/04/2013] [Indexed: 11/27/2022]
Abstract
Oral mesalazine, or 5-aminosalicylate, is one of the first-choice medications for the treatment of ulcerative colitis and is commonly used for both induction and maintenance therapy. In a 6-month period, we treated three cases of mesalazine-induced pneumonitis. In all three cases, computed tomography images revealed upper lobe dominant bilateral peripherally localized consolidations. Such images are commonly observed in patients with cryptogenic organizing pneumonia or chronic eosinophilic pneumonia. Computed tomography images for mesalazine-induced pneumonitis have been rarely reported in the literature.
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Affiliation(s)
- Miyo Inoue
- Department of Respiratory Medicine, Saiseikai Yokohamashi Nanbu Hospital, 3-2-10, Kounandai, Kounan-ku, Yokohama 234-8503, Japan.
| | - Nobuyuki Horita
- Department of Respiratory Medicine, Saiseikai Yokohamashi Nanbu Hospital, 3-2-10, Kounandai, Kounan-ku, Yokohama 234-8503, Japan.
| | - Naoko Kimura
- Department of Respiratory Medicine, Saiseikai Yokohamashi Nanbu Hospital, 3-2-10, Kounandai, Kounan-ku, Yokohama 234-8503, Japan.
| | - Ryota Kojima
- Department of Respiratory Medicine, Saiseikai Yokohamashi Nanbu Hospital, 3-2-10, Kounandai, Kounan-ku, Yokohama 234-8503, Japan.
| | - Naoki Miyazawa
- Department of Respiratory Medicine, Saiseikai Yokohamashi Nanbu Hospital, 3-2-10, Kounandai, Kounan-ku, Yokohama 234-8503, Japan.
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Kekilli M, Tunc B, Beyazit Y, Kurt M, Onal IK, Ulker A, Haznedaroglu IC. Circulating CD4+CD25+ regulatory T cells in the pathobiology of ulcerative colitis and concurrent primary sclerosing cholangitis. Dig Dis Sci 2013; 58:1250-5. [PMID: 23306841 PMCID: PMC3661043 DOI: 10.1007/s10620-012-2511-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2012] [Accepted: 12/01/2012] [Indexed: 12/13/2022]
Abstract
BACKGROUND Immunopathogenetic features of primary sclerosing cholangitis (PSC) in ulcerative colitis (UC) still remains unclear. Peripheral blood CD4+CD25+ regulatory T cells have a key role in the induction and maintenance of peripheral self-tolerance and inhibit several organ-specific autoimmune diseases. Therefore, CD4+CD25+ T cells are believed to play an essential role in autoimmune diseases. The aim of the present study is to analyze the role of CD4+CD25+ T cells in the pathogenesis of UC-associated PSC. METHODS This study evaluated the levels of CD4+CD25+ T cells in peripheral blood mononuclear cells (PBMC) of 27 UC patients with PSC and 20 UC patients as controls. CD4+CD25+ T cells were isolated from PBMC with a direct immunofluorescence technique, using mice monoclonal antibodies namely FITC-labeled anti-CD4 and PE-labeled anti-CD25. In each patient, CD4+CD25+ T cells percentage in PBMC were studied by flow cytometry, and then the number of CD4+CD25+ T cells were calculated. RESULTS Twenty-seven UC patients with PSC and 20 UC patients without PSC as controls were enrolled in the present study. The percentage of CD4+CD25+ regulatory T cells among PBMC were significantly elevated in UC + PSC patients compared with UC patients without PSC (p = 0.04). CONCLUSIONS CD4+CD25+ T cells were found to be elevated in UC patients with PSC suggesting a partial role of activated T cell response in the disease pathophysiology. Our findings imply that CD4+CD25+ regulatory T cells may play a key role in the immunopathogenesis of UC-associated PSC and may affect the therapeutic management of these diseases.
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Affiliation(s)
- Murat Kekilli
- Department of Gastroenterology, Turkiye Yuksek Ihtisas Training and Research Hospital, Kızılay Sok. No: 2, 06100 Sıhhıye, Ankara, Turkey
| | - Bilge Tunc
- Department of Gastroenterology, Turkiye Yuksek Ihtisas Training and Research Hospital, Kızılay Sok. No: 2, 06100 Sıhhıye, Ankara, Turkey
| | - Yavuz Beyazit
- Department of Gastroenterology, Turkiye Yuksek Ihtisas Training and Research Hospital, Kızılay Sok. No: 2, 06100 Sıhhıye, Ankara, Turkey
| | - Mevlut Kurt
- Department of Gastroenterology, Turkiye Yuksek Ihtisas Training and Research Hospital, Kızılay Sok. No: 2, 06100 Sıhhıye, Ankara, Turkey
| | - Ibrahim Koral Onal
- Department of Gastroenterology, Turkiye Yuksek Ihtisas Training and Research Hospital, Kızılay Sok. No: 2, 06100 Sıhhıye, Ankara, Turkey
| | - Aysel Ulker
- Department of Gastroenterology, Turkiye Yuksek Ihtisas Training and Research Hospital, Kızılay Sok. No: 2, 06100 Sıhhıye, Ankara, Turkey
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Campregher C, Gasche C. Aminosalicylates. Best Pract Res Clin Gastroenterol 2011; 25:535-46. [PMID: 22122769 DOI: 10.1016/j.bpg.2011.10.013] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2011] [Revised: 08/21/2011] [Accepted: 10/27/2011] [Indexed: 02/08/2023]
Abstract
Aminosalicylates are the most common drugs for the primary treatment of inflammatory bowel disease. Various pro-drugs and formulations were developed in order to improve pharmacological profiles, optimize bioavailability and to gain highest efficacy in the treatment of ulcerative colitis (UC) and Crohn's disease. In vitro studies have greatly contributed to the understanding of the molecular actions in vivo and clinical studies have proven aminosalicylates to be effective and safe. This review summarizes the current knowledge on the molecular, pharmacological and clinical properties of aminosalicylates with respect to chemoprevention for UC-associated colorectal cancer.
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Affiliation(s)
- Christoph Campregher
- Christian Doppler Laboratory for Molecular Cancer Chemoprevention, Division of Gastroenterology and Hepatology, Department of Medicine 3, Medical University of Vienna, Waehringer Guertel 18-20, Vienna, Austria
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