Clinical efficacy of combining bifico with mesalazine in treatment of mild to moderate ulcerative colitis
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Objective To evaluate the clinical efficacy of bifico combined with mesalazine in patients with mild to moderate ulcerative colitis(UC),and to explore its mechanism.Methods Sixty patients with mild to moderate active UC were randomized to combination group(n=30) and mesalazine group(n=30).The patients were treated by bifico and mesalazine in combination group and only by mesalazine in mesalazine group for 8 weeks.The changes of clinical symptoms and disease activity under endoscopy were evaluated before and after the treatment.The expression of NF-κB in colonic mucosa was also detected by immunohistochemical staining.Results The clinical symptoms and disease activity under endoscopy were improved more in combination group than in mesalazine group(P0.05).The expression of NF-κB significantly lower in combination group than that in mesalazine group(P0.05).Conclusion The combination of bifico and mesalazine is more effective than mesalazine alone in treatment of mild to moderate active UC.Bifico is an effective agent in the treatment of mild to moderate active UC probably by decreasing expression of NF-κB.Keywords:
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Objective To investigate the clinical efficacy of mesalazine combined with bifico in the treatment of ulcerative co -litis （UC） and its effect on toll-like receptor 4 （TLR4） and myeloid differentiation factor 88 （MyD88）.Methods A total of 86 cases of UC was randomly divided into the observation and control groups with 43 cases in each group .The observation group was given me-salazine combined bifico treatment , and the control group was given mesalazine , and eight weeks as a course of treatment .The clinical efficacy was observed .Serum TLR4 and MyD88 were tested.Adverse reaction in treatment was recorded .Results The total effective rate （95.35%） in observation group was significantly higher than that （81.40%） in control group（ P 0.05 ） .Conclusions Mesalazine combined with bifico in the treatment of UC is safe and effective . The effect may be related to regulation of peripheral blood TLR 4 and MyD88 content .
Key words:
Colitis,ulcerative/drug therapy; Mesalamine/therapeutic use; Probiotics/therapeutic use; Toll-like receptor 4/blood; Myeloid differentiation factor 88/blood
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Present investigation is conducted to investigate the clinical efficacy of mesalazine in combination with the Bifid Triple Viable Capsules on the ulcerative colitis (UC) and the resultant effect on the inflammatory factors (TNF-α, IL-8 and IL-10) of UC patients. A total of 120 UC patients who were admitted to this hospital for treatment between May 2014 and February 2018 were enrolled in this study and divided randomly into the research group and control group, with 60 patients in each group. For patients in the two groups, they underwent medication via mesalazine, while those in the research group additionally received the medication by Bifid Triple Viable Capsules. Following treatment, we evaluated the clinical efficacy, as well as the disease activity index (DAI) of UC, score of clinical symptoms, changes in the inflammatory factors (TNF-α, IL-8 and IL-10) and the adverse reactions to drugs before and after treatment. The total effectiveness rate in the research group was 90.0%, significantly higher than 72.5% in the control group, and the difference had statistical significance (P < 0.05). Before treatment, we assessed the UCDAI and clinical symptoms, and found that there were no statistically significant differences in these indicators between two groups (P>0.05); however, after treatment, both of UCDAI and clinical symptoms scores were decreased evidently in two groups (P<0.05), while the decreases in the research group were more significant (P < 0.05). In addition, following treatment, the levels of TNF-α and IL-8 were all decreased in two groups, with an acute increase in IL-10 (all P<0.01), and the alterations in these indicators in the research group were much more significant than those in the control group (all P <0.05). For adverse reactions, the incidence rate in the research group was 6.67%, significantly lower than 33.33% in the control group (P <0.05). Mesalazine in combination with Bifid Triple Viable Capsules shows a magnificent protective effect on the mucosa of UC patients, and curb the UC-related inflammatory reactions effectively. Thus, it is a safe and reliable method that is worthy of being promoted in clinical practice.
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Clinical efficacy
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Objective
To observe the effects of mesalazine combined with Bifidobacterium tetravaccine capsules on ulcerative colitis (UC).
Methods
A total of 124 patients with UC treated in the Fifth People’s Hospital of Datong from May 2017 to April 2018 were selected as research objects, and they were divided into two groups by the random number table method, with 62 cases in each group. The control group was treated with mesalazine, and the observation group was treated with Bifidobacterium tetravaccine capsules and mesalazine. Clinical efficacy, inflammatory immune response and adverse reactions of the two groups were observed before and after treatment.
Results
After treatment, the total efficiency of the observation group was 93.55% (58/62), higher the 79.03% (49/62) of the control group, and the difference was statistically significant (P 0.05). After treatment, the levels of IgA, IgG and TNF-a in the observation group were (1.32±0.58)g/L, (8.16±0.54)g/L, (271.59±32.34)ng/L, respectively, lower than the (1.75±0.34)g/L, (10.59±0.47)g/L, (346.65±40.08)ng/L in the control group (P 0.05).
Conclusions
Methalazine combined with Bifidobacterium tetravaccine capsules in the treatment of UC patients is more helpful to suppress inflammatory response, improve immune function, and it is safe and effective.
Key words:
Ulcerative colitis; Mesalazine; Bifidobacterium tetravaccine capsules; Inflammatory immune response
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Background:The relapse rate of ulcerative colitis (UC) is high. The efficacy of combined diosmectite and mesalazine treatment for active mild-to-moderate UC was investigated. Material andMethods:A total of 120 patients with UC were enrolled in this randomized, single-blind, placebo-controlled study. Sixty patients were assigned to the Diosmectite group (diosmectite and mesalazine) and 60 were assigned to Placebo group (placebo and mesalazine). In the induction phase, the primary end point was the clinical remission rate at 8 weeks; secondary end points were clinical response, endothelial mucosal healing, Mayo score, erythrocyte sedimentation rate, C-reactive protein levels, and defecation frequency. In the maintenance phase, the primary end point was clinical remission at 52 weeks; secondary end points were clinical response, endothelial mucosal healing, Mayo score, erythrocyte sedimentation rate, and defecation frequency. Results:At 8 weeks, the Diosmectite group had a significantly higher clinical remission rate (68.3% vs. 50%) and mucosal healing rate (66.7% vs. 48.3%) compared with the Placebo group. There were no significant differences in clinical response rates, Mayo score, erythrocyte sedimentation rate, C-reactive protein, or defecation frequency. At 52 weeks, the Diosmectite group had a significantly higher clinical remission rate (61.7% vs. 40%) and mucosal healing rate (60% vs. 38.3%) compared with the Placebo group. Defecation frequency was lower, but this was not significant. Conclusions:Combined diosmectite and mesalazine treatment successfully induced and maintained the treatment of active mild-to-moderate UC as indicated by higher rates of clinical remission and mucosal healing.
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Objective To investigate the influence of rosiglitazone and mesalazine combination on IL-1β and TNF-α in mild to moderate active ulcerative colitis.Methods 52 patients with mild to moderate active ulcerative colitis were enrolled our study,who were randomly divided into three groups:treatment group(n=18)with rosiglitazone and mesalazine oral,control group1(n=17) with mesalazine oral only,control group 2(n=17) with mesalazine oral and dexamethasone retention enema.After 4weeks,the changes of IL-1βand TNF-α in the serum of the 3 groups were detected by enzyme-linked immunosorbent assay(ELISA).Results The levels of IL-1β and TNF-α in 3 groups decreased significantly after treatment(P0.05).The descent in treatment group was more significantly than those of the two control groups(P0.05),but the difference between the two control groups was not significant(P0.05).Conclusion The combination of rosiglitazone and mesalazine has a protective effect on UC.The effectiveness is better than that of mesalazine oral only or mesalazine oral and dexamethasone retention enema.The mechanism might come by regulating the immunologic balance.
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Abstract Background Ulcerative colitis is a common non-specific chronic disease. Supplementing probiotics has become an important method for the treatment of ulcerative colitis. This study aimed to explore the effect of supplementing bifid triple viable capsules on background mesalazine plus somatostatin on plasma inflammatory factors and T cell frequency in ulcerative colitis patients. Methods A total of 130 ulcerative colitis patients admitted to our hospital from August 2018 to March 2020 were included and divided into the experimental group (65 patients with mesalazine plus somatostatin and bifid triple viable capsules for treatment) and the control group (65 patients treated with mesalazine plus somatostatin) using the random number table method. Bifid triple viable bacteria capsules were given orally, 420 mg each time, with 3 times a day for 2 months. Results Before treatment, the plasma levels of IL-6, IL-8, hs-CRP, TNF-α, D-lactic acid, and endotoxin (ET), CD4+, CD8+, CD4/CD8 ratio, diamine oxidase (DA0), emotional ability, social ability, intestinal and systemic symptoms were not significantly different between the two groups (all P > 0.05). After treatment, the plasma levels of IL-6, IL-8, hs-CRP, and TNF-α decreased in both groups, and were lower in the experimental group than those in the control group (all P < 0.05). The levels of CD4+ and CD4/CD8 ratio increased, and were higher in the experimental group than those in the control group ( P < 0.05); the CD8+ levels were reduced, and were lower in the experimental group than those in the control group ( P < 0.05). The plasma D-lactic acid, ET, and DA0 levels were decreased, and were lower in the experimental group than those in the control group; emotional ability, social ability, intestinal and systemic symptoms were improved, and were higher in the experimental group than those in the control group (all P < 0.05). During the course of treatment, 2 cases of abdominal discomfort and 1 case of rash occurred in the experimental group, with an adverse event rate of 4.62% (3/65); 3 cases of abdominal discomfort and 2 cases of rash occurred in the control group, with an adverse event rate of 7.69% (5/65). Conclusion The supplementary treatment of bifid triple viable capsules can effectively enhance the curative effect in ulcerative colitis patients, reduce plasma inflammatory factors, and regulate T cell frequency, which is worthy of clinical application.
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Objective: To study the effects of probiotic bacterial preparation in combination with low-dose sulfasalazine (SASP)in the treatment of patients suffering from active mild to moderate ulcerative colitis, and compare with standard doses of SASP. Methods: Sixty patients with active mild to moderate ulcerative colitis from January 2002 to March 2007 were randomized into low-dose group(34 cases)and standard-dose group(26 cases). Low-dose group was received SASP(1.0,bid)and Bifico(420 mg,tid.a high-concentration probiotic preparation of three live freeze-dried bacterial species that are normal components of the human gastrointestinal microflora).Standard-dose group was received SASP(1.0,qid).Intestinal bacteria flora analysis and clinical effect were detected. Results:Clinical symptom grade in low-dose group was significantly lower than those in the standard-dose group in 4th week(P 0.05).Cure rate in 4th week has no significantly difference in two groups(P0.05).Compared with standard-dose group, effective rate and intestinal bacteria analysis were also significantly increased in low-dose group(P0.05). Adverse effects in low-dose group was markedly lower than in the standard-dose group(P0.05). Conclusion: Probiotic bacterial preparation in combination with low-dose SASP was more effective and safty than standard doses of SASP in the treatment of acute mild to moderate ulcerative colitis.
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Objective To investigate the effect of curcumin combined with mesalazine on the treatment of ulcerative colitis in mice and its mechanism.Methods Fifty mice were divided into 5 groups:normal group,model group,curcumin combined with mesalazine treatment group,curcumin treatment group and mesalazine treatment group.The mouse models with ulcerative colitis were copied by dextran sulfate so-dium traditional method.Since the model was successfully constructed,the next day,curcumin combined received mesalazine treatment group received curcumin enema treatment and mesalazine orally fed of each;curcumin treatment group received curcumin enema treatment;mesalazine treatment group received mesalazine orally fed;normal group and model group were treated with correspondingly 9 g·L-1 saline.All once every day,a total for 10 d.Ten days after administration,the pathological changes were observed,and flow cytometry was used to detect the apo-ptosis of colonic epithelial cells,ELISA was used to detect the serum IL-2 and IL-10 levels.Results The colonic damage scores,histolo-gical scores and the apoptosis rate in curcumin combined with mesalazine treatment group were significantly lower than those in model group(Pa0.01).Compared with the curcumin treatment group and mesalazine treatment group,the injury score,histological score and the apoptosis rate in curcumin combined with mesalazin treatment group decreased,and the differences were statistically significant(Pa0.05).Compared with model group,IL-10 levels decreased and IL-2 levels increased significantly in curcumin combined with mesalazine treatment group and the curcumin treatment group and mesalazine treatment group(Pa0.01).Compared with the curcurnin treatment group and mesalazine treatment group,IL-10 levels decreased and IL-2 levels increased significantly in curcumin combined with mesalazine treatment group(Pa0.05).Conclusion Curcumin combined with mesalazine therapy is better than using mesalazine alone on mice with ulcerative colitis,and also effective in decreasing IL-10 level and increasing IL-2 level compared with using mesalazine alone.
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Objective To observe the clinical efficacy of mesalazine and bifid-triple viable combination therapy in patients with ulcerative colitis (UC).Methods Thirty-eight UC patients were evenly divided into mesalazine group and combination group. Patients in mesalazine group were administrated with mesalazine (1.0 g/time,four times/day),and on the basis of this,the patients in combination group were added into bifid-triple viable (420 mg/time,three times/day).The course of treatment was eight weeks.The improvement of patients' clinical symptom and manifestation under colonoscope were observed at second day after hospitalization and eight weeks after medication.Mayo disease activity index was used for scoring.Before and after the treatment,the expression of intestinal mucosa nuclear factor kappa B (NF-κB),tumor necrosis factor-α (TNF-a) and cyclooxygenase-2 (COX-2) were tested by immunohistochemical staining and the levels of serum TNF-α,interleukin-8 (IL-8), interleukin-10 (IL-10) were determined by double antibody sandwich enzyme-linked immunosorbent assay.The level of serum superoxide dismutase (SOD) and malondialdehyde (MDA) was detected by nitrite method and thiobarbituric acid coloration method.Before and after treatment was compared with paired t-test,and qualitative data was analyzed with ordinal rank sum test.Results Mayo disease activity index score of the combination group decreased from 7.16±2.01 to 1.63± 1.30 while the mesalazine group from 7.42 ± 1.95 to 3.00 ± 1.25.The difference of reduction was statistically significant (t =2.093,P =0.043).The efficiency of the combination group was higher than that of mesalazine group (16/19 vs 10/19,Fisher's exact test,P=0.039).After treatment,the expressions of NF-κB,TNF-α and COX-2 in colonic mucosa of two groups were both lower than those of before treatment,and in combination group the decrease were more significant (t value was 2.262,2.607 and 2.522 respectively,P value was 0.027,0.012 and 0.014 respectively).After treatment,the concentration of IL-8 of mesalazine group and the combination group both significantly decreased,however IL-10 significantly increased. The difference between these two groups was statistically significant (t value of TNF-α,IL-8 and IL-10 was 4.244,6.858 and 6.802 respectively,all P＜ 0.01). After treatment,both SOD vitality of two groups increased compare with that before treatment,however the level of MDA was lower than that before treatment and the changes of combination group were more significant.Conclusion The combination therapy with mesalazine and bifid-triple viable can effectively suppress inflammatory response in mild and moderate ulcerative colitis,and bifid-triple viable may play a role as adjuvant therapy for patients with UC.
Key words:
Colitis, ulcerative; Cytokines; Reactive oxygen species; Mesalamine; Bifidobacterium ; Probiotics
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【Objective】To study the effects of sulfasalazine and mesalazine on TLR4, NF-κb expression in intestinal mucosa of patients with ulcerative colitis.【Methods】Ulcerative colitis patients received mesalazine therapy were enrolled in observation group, the patients received sulfasalazine in the same period were enrolled in control group. The clinical symptoms, intestinal mucosal score were compared and m RNA levels of TLR4, NF-κb were detected by real-time PCR.【Results】The abdominal pain, diarrhea, pus and blood stool, mucosal score of patients in observation group were lower than that in control group. After treatment, the m RNA levels of TLR-4, NF-κb were lower than those before treatment. The levels of TLR-4 m RNA and NF-κb m RNA in observation group were significantly lower than that in control group(P 0.05). The m RNA levels of TLR4, NF-κb were positively correlated with abdominal pain, diarrhea, pus and blood stool, mucosal score(P 0.05).【Conclusion】Mesalazine could effectively improve clinical symptoms and intestinal mucosa condition, and it might play a role through inhibiting expression of TLR4, NF-κb in intestinal mucosa.
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Sulfasalazine
Intestinal mucosa
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