Clinical pharmacology of inflammatory bowel disease therapies

Abstract

Knowledge about the clinical pharmacology of medical therapy of inflammatory bowel disease has incrementally advanced. Small studies with mesalamine have suggested that intestinal mucosal concentrations of mesalamine may predict clinical response to mesalamine therapy. Increased expression of glucocorticoid receptor beta and increased expression of the multidrug resistance drug pump P-glycoprotein 170 have been proposed as markers of drug resistance to glucocorticoids. A baseline determination of thiopurine methyltransferase phenotype or genotype may predict early leukopenia in patients treated with azathioprine or 6- mercaptopurine. Serial measurement of erythrocyte 6-thioguanine nucleotides may be useful in tailoring the dose of these medications. A loading dose of intravenous azathioprine does not accelerate the time to response in patients with steroid-treated Crohn's disease; however, standard azathioprine may work more quickly than previously reported. Methotrexate, 15 to 25 mg/wk, is effective for the treatment of Crohn's disease (active or in remission), and there is no significant difference in the erythrocyte concentrations of methotrexate polyglutamate in patients with inflammatory bowel disease receiving 15 mg, compared with 25 mg, subcutaneously on a weekly basis.

Molecular Mechanisms of the Anti-Obesity and Anti-Diabetic Properties of Flavonoids

“…Although numerous commercial drugs are available for treating obesity and diabetes, many of these are unavailable to a large number of sufferers and can cause adverse effects. The utilization of medicinal plants and their phytochemicals for treating obesity and diabetes is not only a priority for developing safer alternatives to pharmaceuticals, which transitorily lower blood glucose and prevent high blood pressure and cardiovascular disease, but also enhance the antioxidant system, insulin action, and secretion [ 12 ]. Therefore, identifying dietary constituents that can regulate body fat deposition and blood glucose levels is very important.…”

Antioxidative potential of chrysin, a flavone in streptozotocin–nicotinamide-induced diabetic rats

“…They possess antioxidant potential both in vivo and in vitro by scavenging ROS [8,9] Chrysin, a 5,7-dihydroxyflavone ( Fig. 1), is a naturally wide distributed flavonoid that occurs naturally in many plants, passiflora, pelargonium, pinacaeae, silver linden, some geranium species and in honey, bee pollen and propolis [10][11][12] and, in low concentrations, in fruits, vegetables, and beverages [13,14]. Chrysin is the main component of Oroxylum indicum, which is one of the most common herbal medicines used by China and other East Asian countries.…”

Effects of glucocorticoids on weight change during the treatment of Wegener's granulomatosis

“…Common conditions such as obstructive and reactive airway diseases are frequently treated with intermittent, short courses of GCs to maintain disease control (1, 2). Other conditions such as inflammatory bowel disease, systemic lupus erythematous, and systemic vasculitis require prolonged courses of GCs to induce remission or prevent relapses (3–6). In developed countries, the prevalence of GC use is nearly 1% (7–9).…”