Purpose of the study—to develop a new dosage form—rectal suppositories with vitamin D3 and at the preclinical stage to analyze its clinical and immunological efficacy compared to 5-aminosalicylic acid (5-ASA) in the dynamics of experimental ulcerative colitis (UC) in rats.Materials and methods. UC was simulated by cutaneous and then rectal application of a 3% solution of oxazolone. Original rectal suppositories with 1500ME of vitamin D3 were administered per rectum every 12 hours, in the comparison group with the same interval, rectal suppositories with 50 mg of 5-ASA. To assess the clinical status, the Disease activity index (DAI) scale was used, the serum concentration of IgG, IgM, IL-6, IL-8 was determined by the enzyme immunoassay using rat-specific test systems on days 2 and 6 of the experiment.The results of the study. In experimental UC, DAI rises, and the concentration of IgG, IgM, IL-8 and IL-6 in serum increases on the 2nd and 6th day of the experiment. DAI increases as serum concentrations of IgG, IgM, IL-8 and IL-6 increase. The use of vitamin D3 in UC leads to a decrease in DAI and serum concentrations of IgG, IgM, IL-8, IL-6 mainly on the 6th day of observation. The use of rectal suppositories with 5-ASA in UC leads to a decrease in DAI and the concentration of IgM, IgG, IL-6, IL-8 on the 2nd and 6th day of observation.Conclusion. The efficacy of rectal suppositories containing 1500 IU of vitamin D3 in experimental UC was found to be comparable with the use of rectal suppositories with 5-ASA based on the assessment of the clinical status and serum concentration of IgM, IgG, IL-6, IL-8.

Цель исследования - проведение сравнительного анализа влияния экстракта куркумы длинной и 5-аминосалициловой кислоты (5-АСК) в составе ректальных суппозиториев на клиническую картину и содержание продуктов перекисного окисления липидов (ПОЛ) в слизистой оболочке толстого кишечника при экспериментальной болезни Крона (БК). Методика. Эксперимент выполнен на 70 белых крысах-самцах Wistar. БК моделировали ректальным введением тринитробензосульфоновой кислоты. Ректальные суппозитории (массой 0,3 г каждая) начинали применять через 12 ч. Содержание 5-АСК в суппозиториях составляло 50 мг, 10% экстракта куркумы длинной оригинального состава 0,000075 г. На 3-и, 5-е и 7-е сут после моделирования БК оценивали клинический статус по модифицированной шкале Disease activity index и содержание продуктов ПОЛ в слизистой оболочке толстого кишечника. Результаты. В динамике БК в толстом кишечнике увеличивается содержание первичных, вторичных и конечных продуктов ПОЛ в гептановой и изопропанольной фазах; тяжесть клинических признаков (снижение массы тела, диарея, кровь в каловых массах) нарастает по мере увеличения содержания продуктов ПОЛ. Применение при БК ректальных суппозиториев с экстрактом куркумы снижает выраженность клинических симптомов, уменьшает содержание продуктов ПОЛ преимущественно в изопропанольной фазе липидного экстракта толстого кишечника; установлена корреляция индекса клинической активности БК с содержанием продуктов ПОЛ в толстом кишечнике. Заключение. Эффективность локального применения экстракта куркумы в составе ректальных суппозиториев сопоставима по эффективности с применением ректальных суппозиториев с 5-АСК по показателям индекса клинической активности и по содержанию продуктов ПОЛ в слизистой толстого кишечника. Aim. To compare effects of turmeric extract and 5-aminosalicylic acid (5-ASA) formulated into rectal suppositories on clinical symptoms and content of lipid peroxidation products (LPP) in the mucous membrane of the large intestine in experimental Crohn’s disease (CD). Methods: Experiments were performed on 70 Wistar male rats. CD was modeled by rectal administration of trinitrobenzenesulfonic acid; rectal suppositories (0.3 g each) were used every 12 h. The suppositories contained 5-ASA (50 mg) or 10% turmeric extract with an original composition (0.000075 g). On days 3, 5, and 7 of CD, the clinical status was evaluated with a modified Disease Activity Index scale, and LPP concentrations were measured in the large intestine mucosa. Results. In the course of CD in the colon, concentrations of primary, secondary, and final LPP in the heptane and isopropanol phases increased; severity of clinical signs (weight loss, diarrhea, blood in fecal masses) increased with increasing LPP concentrations. The use of rectal suppositories with turmeric extract alleviated severity of clinical symptoms and reduced LPP content primarily in the isopropanol phase of colon lipid extract. The index of CD clinical activity of CD was correlated with the large intestinal LPP content. Conclusion. Effectiveness of the local application of turmeric extract formulated into rectal suppositories was comparable with that of rectal suppositories with 5-ASA as determined by the Disease Activity Index and the LPP content in the large intestine.

Введение. Востребованным для лечения болезни Крона (БК) является разработка новых, обоснованных с патогенетических позиций и безопасных лекарственных средств преимущественно локального действия эндогенного или растительного происхождения. В этом отношении привлекает внимание экстракт корневищ Куркумы длинной (Curcuma longa), содержащий куркуминоидный комплекс, обладающий плейотропными эффектами. Ранее нами показано, что экстракт куркумы в составе суппозиториев при экспериментальной БК обладaет иммуномодулирующим и местным антиоксидантным действием, что предполагает влияние экстракта куркумы на морфологию очага повреждения в кишечнике при БК. Цель работы - изучение влияния экстракта куркумы в составе оригинальных ректальных суппозиториев на динамику морфологических изменений, экспрессию миелопероксидазы (МПО) и TNF-a в очаге повреждения толстого кишечника при экспериментальной БК. Методика. Эксперимент выполнен на 49 половозрелых крысах-самцах Wistar. БК моделировали введением per rectum спиртового раствора тринитробензосульфоновой кислоты (ТНБС). Оригинальные ректальные суппозитории массой 300 мг на основе полиэтиленгликолей различной молекулярной массы, содержащие 0,075 мг куркумина из экстракта корневищ Curcuma longa L., вводили per rectum каждые 12 ч в течение 7 сут. Клинический статус оценивали по модифицированной шкале Disease activity index (DAI). Морфометрически в стенке кишечника оценивали размер язвенного дефект, выраженность клеточной инфильтрации, рассчитывали индекс тканевого повреждения (tissue damage index, TDI), оценивали экспрессию МПО и TNF-α. Результаты. При экспериментальной БК на 3-и, 5-е и 7-е сут наблюдения в толстом кишечнике обнаруживались язвенные дефекты, выраженный отек тканей, плотная нейтрофильно-лимфоцитарная инифильтрации с примесью эозинофилов, плазмоцитов, гистиоцитов, фибробластов, наблюдалось формирование грануляционной ткани. Индекс тканевого повреждения возрастал, повышалась экспрессия МПО и TNF-α. Размер язвенных дефектов, выраженность инфильтрации, индекс тканевого повреждения соответствовали клинической картине и индексу DAI. Применение оригинальных ректальных суппозиториев с экстрактом куркумы (0,075 мг) приводит к снижению выраженности клинических и морфологических признаков заболевания, максимальный эффект отмечен на 5-е и 7-е сут наблюдения. Заключение. Установленные протекторные свойства куркумина в составе оригинальных ректальных суппозиториев при БК на доклиническом этапе расширяют современные представления о плейотропных эффектах экстракта куркумы и являются предпосылкой для проведения дальнейших исследований и внедрения новой лекарственной формы в клиническую практику. The development of safe, new, pathogenetically justified medicines, mainly with local effects and of endogenous or plant origin, is of great interest for treatment of Crohn’s disease (CD). In this regard, an extract of rhizomes of Curcuma longa, containing a curcuminoid complex with pleiotropic effects, has attracted attention. We showed previously that having turmeric extract in suppositories for treatment of experimental CD would produce immunomodulatory and antioxidant effects. This suggests that turmeric extract affects the morphology of the CD intestinal lesion. The aim of this work was to study the effect of turmeric extract in the composition of novel rectal suppositories on the morphology and expression of myeloperoxidase (MPO) and TNF- α in colon lesions of experimental CD. Methods. Experiments were performed on 49 sexually mature male Wistar rats. CD was modeled by administration per rectum of an alcohol solution of trinitrobenzenesulfonic acid. The newly formulated rectal suppositories weighing 300 mg and based on polyethylene glycols of various molecular weights and containing 0.075 mg of curcumin obtained from Curcuma longa L. rhizome extract were administered per rectum every 12 hours for 7 days. The clinical status was assessed with the modified disease activity index (DAI) scale. The ulcer defect diameter, cell infiltration, tissue damage index (TDI), MPO expression, and TNF-α expression were evaluated. Results. In experimental CD on the 3rd, 5th, and 7th days of observation, a morphometric assessment of the lesion in the large intestine revealed the presence of ulcerative defects, edema, thick neutrophilic lymphocytic infiltration with an admixture of eosinophils, plasmocytes, histiocytes, fibroblasts, the formation of granulation tissue, increased TDI, and increased expression of MPO and TNF-α. The size of ulcerative defects, the degree of wall infiltration by neutrophils, lymphocytes, plasmocytes, histiocytes, and fibroblasts were recorded. The TDI, the expression of MPO, and TNF-α were associated with the DAI. The use of the novel rectal suppositories produced a maximal effect on the 5th and 7th days of observation. The severity of clinical and morphological signs of the disease were reduced. These signs included ulcer size, TDI, intestinal wall infiltration with neutrophils, lymphocytes, eosinophils, plasmocytes, histiocytes, and fibroblasts, and expression of MPO and TNF-α. Conclusion. The results supplement available data on the pathogenesis, the role of the expression of MPO and TNF-α, and the morphology of the lesion in the clinical status in TNBS-induced CD in rats. The demonstrated, protective properties of curcumin in the composition of the novel rectal suppositories at the preclinical stage of CD expand modern understanding of the pleiotropic effects of turmeric extract and are a prerequisite for further research and the introduction of a new dosage form in clinical practice.

The aim was to study the effectiveness of the use of turmeric extract in the composition of the original rectal suppositories in experimental Crohn’s disease (CD) based on the assessment of the clinical picture and indicators of the immune status.Materials and methods. The work was performed on 70 rats of the Wistar line. CD was unduced by the rectal administration of a trinitrobenzenesulfonic acid solution, rectal suppositories with 0.000075 mg of curcumin based on an alcohol solution of rhizome extract with turmeric roots were used after 12 hours for 7 days, in the comparison group rectal suppositories with 50 mg of 5-aminosalicylic acid were used (5-ASA). To assess the clinical status, the Disease activity index scale was used, the population spectrum of leukocytes, CD3 + and CD45RA + lymphocytes, the concentration of IgG, IgM, IL-23 on the 3, 5 and 7 days of the experiment were determined.Results: In CD, the clinical signs of the disease progress from 3 to 7 days, the total number of leukocytes in the blood increases due to monocytes, lymphocytes, including CD3 +, CD45RA +, the concentration of IL-23, IgM, Ig G. Local use of turmeric extract in CD reduces the severity of clinical symptoms on days 5 and 7, restores the total number of leukocytes, lymphocytes, including CD3 +, the concentration of IgM on days 3, 5, 7, and IL-23 on days 5 and 7, partially restores serum concentration of IgG on the 3-rd, 5th, 7th day, IL-23—on the 3-rd day of observation. The eff ect of CD in the composition of rectal suppositories of turmeric extract is comparable to the eff ect of 5-ASA on the 3-rd, 5th, 7th day of observation in relation to the severity of clinical symptoms, the number of leukocytes, lymphocytes, CD3 + in the blood, the concentration of IgM and IgG; less pronounced in relation to the concentration of IL-23 on day 3.Conclusion. The clinical and immunological efficacy of local application of turmeric extract every 12 hours as part of the original rectal suppositories in experimental CD has been demonstrated, comparable with the use of rectal suppositories with 5-ASA.

Crohn’s disease is an urgent problem of modern gastroenterology due to increasing prevalence, severity of complications and side effects of the basic therapy, in particular upon treatment with 5-aminosalicylic acid (5-ASA). Searching, development and trials of new effective drugs with minimal side effects in Crohn’s disease is an urgent task. Curcuma longa is one of the initial substances containing curcumin with antioxidant, cytoprotective, anti-inflammatory properties. Its effectiveness has been demonstrated in few studies with its systemic use in Crohn’s disease treatment. Our aim was to perform a comparative analysis of curcumin and 5-ASA effect applied as a composition of rectal suppositories, studying clinical signs and indices of immune status in experimental Crohn’s disease. The study was performed on 70 Wistar male rats. Crohn’s disease was modeled by introduction of a 50% alcohol solution of trinitrobenzene sulfonic acid (TNBS) per rectum, and verified by clinical and morphological methods. Rectal suppositories, each containing 50 mg of 5-ASA and original suppositories containing 0.075 mg of curcumin were used over 12 hours during 7 days. The studies were performed on the 3rd , 5th and 7th days of Crohn’s disease.In the course of experimental TNBS-induced Crohn’s disease in animals, an increased frequency of bowel motility, appearance of blood in the stool, decreased body weight progressed from the 3rd to the 7th days of observation, along with increased number in CD3+, CD45RA+ lymphocytes in blood, higher number of segmented neutrophils, lower absorption and NBT-reducing activity of blood neutrophils, increased serum concentrations of IL-23, IgM, IgG. Composition of the new medication form was justified; production technology and standardization of the suppositories containing curcumin for the treatment for Crohn’s disease were developed. Usage of rectal suppositories with curcumin is associated with decreased severity of clinical signs, decrease and partial restoration of segmented neutrophils, CD3+ lymphocyte numbers in blood, recovery of absorption and NBT-reducing ability of blood neutrophils, and decrease of IL-23, IgM, IgG concentrations in serum. The effectiveness of rectal suppositories with curcumin is compared to the effectiveness of the use of rectal suppositories with 5-ASA in terms of disease activity index, the number of neutrophils and CD3+ lymphocytes in the blood, serum concentrations of IL-23, IgM and IgG, in, at lesser extent, in terms of absorption and NBT- reducing ability of blood neutrophils.The composition and production technology of rectal suppositories with curcuminwas developed; the leukocyte populations, CD3+, CD45RA+ lymphocytesin blood were assesed, neutrophil absorption and NBT-reducing ability, IL-23, IgM and IgG concentrations were determined; the use of rectal suppositories with curcumin in experimental Crohn’s disease is comparable with the effectiveness of rectal suppositories with 5-ASA.