Efficacy and safety of oral Pentasa (prolonged-release mesalazine) in mild-to-moderate ulcerative colitis: a systematic review and meta-analysis

Paridaens, Kristine; Fullarton, John R.; Travis, Simon

doi:10.1080/03007995.2021.1968813

Cited by 16 publications

(12 citation statements)

References 42 publications

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“…It is shown that it reduces inflammation of the intestinal mucosa acting locally. It is a safe and well-tolerated medication, with proven efficacy in mild to moderate ulcerative colitis [ 20 ]. In this patient, we used mesalamine to lower the inflammatory burden locally in the intestinal mucosa.…”

Section: Discussionmentioning

confidence: 99%

Colitis as the Main Presentation of COVID-19: A Case Report

Fric

Borzan

et al. 2023

Medicina

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The main symptoms of coronavirus disease (COVID-19) are fever, cough, tiredness, and loss of smell and taste. Gastrointestinal symptoms are less common. A 38-year-old female patient, previously healthy, presented with a history of hematochezia up to 8 times per day, followed by abdominal cramps, urgency, and chills for two days. She did not have any respiratory symptoms and was previously vaccinated for COVID-19. She was afebrile, with normal vital signs. Blood samples showed normal complete blood count and increased C-reactive protein (CRP), fibrinogen, and D-dimer levels (66 mg/L, 4.1 g/L, and 2302 μ/L FEU, respectively). Stool samples for stool culture, C. difficile, and viral examination came back negative. On day 3, she reported a mild cough, fever and loss of smell and taste. Nasopharyngeal swab for SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) PCR test came back positive. On day 6, the patient still had hematochezia accompanied by abdominal cramps, but fever and respiratory symptoms withdrew. CRP, fibrinogen, and D-dimers were still elevated, as well as liver enzyme levels. Sigmoidoscopy was performed with biopsies taken from sigmoid and rectum for histology and PCR SARS-CoV-2 testing. CT angiography showed no signs of thrombosis in mesenteric veins or arteries. PCR test for SARS-CoV-2 virus from rectal biopsy sample was positive. Patient was treated with methylprednisolone iv for two days and peroral prednisone afterwards, with mesalamine, metronidazole and enoxaparin. Sigmoidoscopy was repeated after two weeks showing only mild hyperemia. At that time, the patient had normal stool, normal CRP, liver enzyme, fibrinogen, and D-dimer levels, and normocytic anemia (hemoglobin level of 103 g/L). We wanted to show that severe gastrointestinal symptoms, such as hemorrhagic colitis, can be the main presentation of COVID-19, even in young patients with no prior comorbidities. In such a case, PCR test in biopsy samples can be performed to prove SARS-CoV-2 infection of bowel mucosa.

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Section: Discussionmentioning

confidence: 99%

Colitis as the Main Presentation of COVID-19: A Case Report

Fric

Borzan

et al. 2023

Medicina

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“…The primary pathogenic mechanism for UC involves aberrant activation immune responses, which are important defense guard against pathogenic factors but also culprit of disease progression 8 . Mesalazine stands for the current standard regimen in the remission of mild to moderate disease; however, it necessitates up to 15 years of continuous treatment 9 . Other biological agents, such as antitumor necrosis factor‐α (TNF‐α), anti‐integrin and anti‐interleukin (IL) agents, and the nonbiologic small molecule tofacitinib, can be administered in cases where there is an insufficient response to Mesalazine treatment 10 .…”

Section: Introductionmentioning

confidence: 99%

“…8 Mesalazine stands for the current standard regimen in the remission of mild to moderate disease; however, it necessitates up to 15 years of continuous treatment. 9 Other biological agents, such as antitumor necrosis factor-α (TNF-α), anti-integrin and anti-interleukin (IL) agents, and the nonbiologic small molecule tofacitinib, can be administered in cases where there is an insufficient response to Mesalazine treatment. 10 Nevertheless, the overall efficacy was limited by high recurrence rate and specific adverse effects.…”

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confidence: 99%

Alleviating effect of Nexrutine on mucosal inflammation in mice with ulcerative colitis: Involvement of the RELA suppression

Xu,

Wu,

Wang

et al. 2024

Immunity Inflam & Disease

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BackgroundNexrutine is an herbal extract derived from Phellodendron amurense, known for its anti‐inflammatory, antidiarrheal, and hemostatic properties. However, its effect on ulcerative colitis (UC) remains unclear.MethodsA mouse model of UC was induced by 3% dextran sulfate sodium, while human colonic epithelial cells NCM‐460 were exposed to lipopolysaccharide. Both models were treated with Nexrutine at 300 or 600 mg/kg, with Mesalazine applied as a positive control regimen. The disease activity index (DAI) of mice was calculated, and the pathological injury scores were assessed through hematoxylin and eosin staining. The viability of NCM‐460 cells was determined using the CCK‐8 method. Inflammatory cytokines were detected using ELISA kits. Expression of mucin 3 (MUC3), Claudin‐1, and tight junction protein (ZO‐1) was detected to analyze mucosal barrier integrity. Target genes of Nexrutine were predicted using bioinformatics tools. Expression of RELA proto‐oncogene (RELA) was analyzed using qPCR and western blot assays.ResultsThe Nexrutine treatments significantly alleviated DAI of mice, mitigated pathological changes in their colon tissues, decreased the production of pro‐inflammatory cytokines, enhanced the barrier integrity‐related proteins, and increased NCM‐460 cell viability in vitro. RELA, identified as a target gene of Nexrutine, showed elevated levels in UC models but was substantially suppressed by Nexrutine treatment. Adenovirus‐mediated RELA upregulation in mice or the overexpression plasmid of RELA in cells counteracted the effects of Nexrutine treatments, exacerbating UC‐related symptoms.ConclusionThis study demonstrates that Nexrutine alleviates inflammatory mucosal barrier damage in UC by suppressing RELA transcription.

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“…The first-line therapy of UC initiates with mesalamine (5-aminosalicylic acid), which may also prevent CRC development [8]. If this treatment does not sufficiently affect, corticosteroids, immunosuppressive agents, biologics (such as anti-tumor necrosis factoralpha (TNF-α) antibodies, anti-integrin antibodies, antiinterleukin (IL) 12-23 antibodies), and/or non-biologic small molecule tofacitinib may be applied [9].…”

Section: Introductionmentioning

confidence: 99%

The therapeutic potential of stem cell-derived exosomes in the ulcerative colitis and colorectal cancer

et al. 2022

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Background Mesenchymal stem cells (MSCs) therapy is a novel treatment strategy for cancer and a wide range of diseases with an excessive immune response such as ulcerative colitis (UC), due to its powerful immunomodulatory properties and its capacity for tissue regeneration and repair. One of the promising therapeutic options can focus on MSC-secreted exosomes (MSC-Exo), which have been identified as a type of paracrine interaction. In light of a wide variety of recent experimental studies, the present review aims to seek the recent research advances of therapies based on the MSC-Exo for treating UC and colorectal cancer (CRC). Methods A systematic literature search in MEDLINE, Scopus, and Google Scholar was performed from inception to December 2021 using the terms [(“colorectal cancer” OR “bowel cancer” OR “colon cancer” OR “rectal cancer”) AND (exosome) AND (stem cell) AND (“inflammatory bowel disease” OR “Crohn's disease” OR “colitis”)] in titles and abstracts. Findings Exosomes derived from various sources of MSCs, including human umbilical cord-derived MSCs (hUC-MSCs), human adipose-derived MSCs (hAD-MSCs), human bone marrow-derived MSCs (hBM-MSCs), and olfactory ecto-MSCs (OE-MSCs), have shown the protective role against UC and CRC. Exosomes from hUC-MSCs, hBM-MSCs, AD-MSCs, and OE-MSCs have been found to ameliorate the experimental UC through suppressing inflammatory cells including macrophages, Th1/Th17 cells, reducing the expression of proinflammatory cytokines, as well as inducing the anti-inflammatory function of Treg and Th2 cells and enhancing the expression of anti-inflammatory cytokines. In addition, hBM-MSC-Exo and hUC-MSC-Exo containing tumor-suppressive miRs (miR-3940-5p/miR-22-3p/miR‐16‐5p) have been shown to suppress proliferation, migration, and invasion of CRC cells via regulation of RAP2B/PI3K/AKT signaling pathway and ITGA2/ITGA6. Key messages The MSC-Exo can exert beneficial effects on UC and CRC through two different mechanisms including modulating immune responses and inducing anti-tumor responses, respectively.

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Efficacy and safety of oral Pentasa (prolonged-release mesalazine) in mild-to-moderate ulcerative colitis: a systematic review and meta-analysis

Cited by 16 publications

References 42 publications

Colitis as the Main Presentation of COVID-19: A Case Report

Colitis as the Main Presentation of COVID-19: A Case Report

Alleviating effect of Nexrutine on mucosal inflammation in mice with ulcerative colitis: Involvement of the RELA suppression

The therapeutic potential of stem cell-derived exosomes in the ulcerative colitis and colorectal cancer

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