Effects of budesonide and probiotics enemas on the systemic inflammatory response of rats with experimental colitis

Comparison of the efficiency of different enemas on patients with distal ulcerative colitis

Objectives

Rectal application of steroids and 5‐aminosalicylic acid (5‐ASA) is associated with few side effects and has a high therapeutic efficacy in left‐sided colitis. Previous studies have shown that rectal administration of both steroids and 5‐ASA is superior to one single alone. However, some reports are still controversial. Therefore, it is necessary to investigate the treatment choice and efficacy of these different enemas in distal ulcerative colitis (UC) patients.

Materials and Methods

Questionnaire survey and a retrospective study were carried out in Chinese hospitals to investigate the efficacy of 5‐ASA or hydrocortisone/dexamethasone or their combination enema in patients with distal active UC. Dextran sodium sulphate (DSS)‐induced colitis model in mice was also utilized to evaluate the effects in vivo.

Results

The results from questionnaire survey showed that majority of physicians would prefer oral 5‐ASA with topical 5‐ASA therapy for distal UC patients. However, 43.01% of physicians would like to choose oral 5‐ASA and topical hydrocortisone/dexamethasone with or without 5‐ASA enema. A retrospective study demonstrated that 5‐ASA enema or 5‐ASA combined with hydrocortisone/dexamethasone enema therapy was superior to hydrocortisone/dexamethasone enema to decrease C‐reactive protein, erythrocyte sedimentation rate (ESR), Mayo score and induce clinical remission and clinical response. No superiority of combination therapy was further proved in DSS‐induced colitis in mice.

Conclusions

Although 43.01% of physicians would like to choose hydrocortisone/dexamethasone with or without 5‐ASA enema for the treatment of distal UC, the combination was not superior to 5‐ASA enema. Hydrocortisone/dexamethasone enema with 5‐ASA enema is not recommended for distal active UC patients.

Probiotics protect the intestinal wall of morphological changes caused by malnutrition

This study sought to morphometrically analyze the jejunal wall of protein-malnourished rats administered a probiotic supplement. The sample consisted of recently weaned Wistar rats (Rattus norvegicus) distributed among four groups: animals given a commercial diet (G1, n = 4); animals given the same ration as G1 plus a probiotic supplement (G2, n = 4); animals given a 4% protein diet (G3, n = 4); and animals given the same ration as G3 plus a probiotic supplement (G4, n = 4). After 12 weeks, part of the jejunum was harvested and subjected to routine histological processing. Transverse sections with a thickness of 3 µm were stained with HE, and histochemical techniques were used to assay for glycoconjugates, including staining with periodic acid-Schiff (PAS) + diastase, Alcian Blue (AB) solution at pH 2.5, and Alcian Blue solution at pH 1.0. Morphometric analysis of the bowel wall showed that the probiotic culture used in this study induced hypertrophy of several layers of the jejunal wall in well-nourished animals and reduced the bowel wall atrophy usually observed in protein-malnourished animals. Neither malnutrition nor the use of probiotics altered the relationship between the number of goblet cells and the number of enterocytes.

Serum calprotectin levels correlate with biochemical and histological markers of disease activity in TNBS colitis

BACKGROUND AND AIM

Serum calprotectin is elevated in patients with inflammatory bowel disease (IBD). Whether it correlates other markers of disease activity is unknown. The aim of this study was to correlate serum calprotectin with biochemical and histological measures of intestinal inflammation.

MATERIALS AND METHODS

TNBS colitis was induced in wistar rats, and serial blood samples were collected at 0, 3, and 12 days. Animals were subsequently sacrificed for pathological evaluation at day 12. Serum calprotectin and cytokines were measured by ELISA. Pathologic changes were classified at the macroscopic and microscopic levels.

RESULTS

TNBS colitis induced elevated serum calprotectin, TNF and IL-6 within 24 h. Levels of serum calprotectin remained elevated in parallel to persistence of loose stool and weight loss to day 12. Serum calprotectin levels correlated with serum levels of TNF-α and IL6 (p < 0.001), but not CRP. Animals with liquid stool had significantly higher levels of serum calprotectin than control animals. There was a correlation between macroscopic colitis scores, and levels of serum calprotectin.

CONCLUSION

Serum calprotectin levels correlate with biochemical and histological markers of inflammation in TNBS colitis. This biomarker may have potential for diagnostic use in patients with IBD.

Probiotics prevent growth deficit of colon wall strata of malnourished rats post-lactation

The objective of this study was to analyze morphometrically the colon wall strata of malnourished rats supplemented with probiotics. Sixteen recently weaned Wistar rats (Rattus norvegicus) were distributed into four groups: animals that received commercial chow (G1, n = 4); animals that received the same feed as G1 and were supplemented with probiotics (G2, n = 4); animals that received chow with 4% of proteins (G3, n = 4); animals that received the same feed as G3 and were supplemented with probiotics (G4, n = 4). After 12 weeks, the proximal colon was collected and submitted to histological processing. Three-µm cuts were stained with H.E., Periodic Acid Schifff (P.A.S.) + diasthasis solution and Alcian Blue (A.B.) pH 2.5 and pH 1.0. The morphometric analysis of the intestinal wall showed that the supplementation with ABT-4 probiotic culture prevents the growth deficit of colon wall strata that normally occurs in malnourished rats right after lactation. Besides, no alteration was observed in the proportion of the number of globet cells in relation to the number of enterocytes in malnourished rats, regardless of the supplementation with probiotics.