Azathioprine and mesalazine-induced effects on the mucosal flora in patients with IBD colitis

Abstract

Azathioprine and 5-ASA induce opposite effects on the mucus barrier. Concomitant therapy of 5-ASA and azathioprine mutually neutralizes the effects of both on the mucosal flora and the barrier function.

The effect of probiotic Escherichia coli strain Nissle 1917 lipopolysaccharide on the 5-aminosalicylic acid transepithelial transport across Caco-2 cell monolayers

“…Authors of this study found no significant effect of 5-ASA on the survival of EcN in healthy volunteers. In contrast to this findings Swidsinski et al (2007) described a significant reduction of amenability, adherence, and concentrations of mucosal bacteria in the 5-ASA-treated patients with IBD. As drug´s fate in the intestinal barrier depends among others on absorption and first pass metabolism, we focused on the study of the effect of EcN bacterial lipopolysaccharide (LPS), a glycolipid of the cell wall of gram-negative bacteria, and EcN bacteria-free supernatant on the 5-ASA intestinal transport (i.e.…”

Survival of the probiotic Escherichia coli Nissle 1917 (EcN) in the gastrointestinal tract given in combination with oral mesalamine to healthy volunteers

“…However, in vitro data have shown that mesalamine does have antimicrobial properties and reduces the concentration of mucosal bacteria in patients with UC, 21,22 pointing to the possibility that probiotics administered simultaneously with mesalamine might get inactivated. Therefore, the present study was designed to investigate whether orally given EcN survives gastrointestinal passage in healthy volunteers when mesalamine is administered orally during the same period.…”

Effects of mesalamine (5-aminosalicylic acid) on bacterial gene expression

“…14 In patients with UC, 5-ASA treatment was associated with significantly decreased concentrations of mucosally adherent bacteria compared with untreatedor azathioprine-treated patients. 16 However, this finding was independent of any antibacterial effect of 5-ASA, as suspensions of fecal bacteria incubated with 5-ASA did not result in subsequent impairment of growth of various aerobes and anaerobes on selective media. 16 These findings suggest that 5-ASA does not have potent effects on growth of isolated enteric bacteria, but definitive studies are needed and should be performed in the context of gut bacterial communities exposed to concentrations of 5-ASA that are more clinically relevant (10 -100 mM).…”

“…paratuberculosis, 15 a microbe that for many years has been causally implicated in CD. In mucosal biopsies from patients with IBD, Swidsinski et al 16 found that 5-ASA treatment was associated with significantly decreased concentrations of mucosal bacteria as well as decreased bacterial vitality and epithelial adherence compared with untreated IBD patients and healthy subjects. In these studies, however, there was no effect of 5-ASA on fecal bacterial growth.…”

“…In these studies, however, there was no effect of 5-ASA on fecal bacterial growth. 16 Using molecular methods for profiling fecal bacterial communities, oral 5-ASA was noted to change the composition of the fecal microbiota in healthy mice compared with untreated controls after as few as 7 days of treatment, but the baseline microbiota was reconstituted in 5-ASA-treated animals within 1 month of drug washout. 17 Independent of measurable growth effects on bacteria, various naturally occurring small molecules and pharmaceuticals have been shown to change bacterial gene expression and function.…”