Protective Effect of Wolfberry Extract on Acetic Acid-induced Colitis in Rats

ABSTRACT Objective: To investigate the protective effect of wolfberry (WB) against acetic acid-induced colitis in rats. Methods: The rats were divided into four groups with eight rats in each group: the control group, WB group, colitis group and WB + colitis group. Distal colitis was induced in rats by intracolonic instillation of 4% acetic acid. Wolfberry + colitis group received 100 mg/kg of WB extract dissolved in saline through the intraperitoneal route for 7 days. Acute colitis was created on the 8th day, and the rats were sacrificed 48 hours later. Colonic damage was assessed by macroscopic and histological criteria as well as biochemical markers. Results: Mean total antioxidant capacity (TAC), total oxidant status (TOS), tumour necrosis factor (TNF)-α, interleukin (IL)-1β and IL-6 levels were significantly higher in the colitis group compared with the control and WB groups (p < 0.05). The WB + colitis group had significantly lower TAC, TOS, TNF-α, IL-1β and IL-6 levels compared with the colitis group (p < 0.05). The analyses of the histopathological findings indicated that the colitis group had a significantly higher histopathological damage score than the control group (3.12 ± 0.45, 0 ± 0.00, respectively; p < 0.05). Histopathological damage score was significantly higher in the WB + colitis group than in the control group and statistically significantly lower than the colitis group (1.62 ± 0.44, 0 ± 0.00, respectively; 3.12 ± 0.45, respectively; p < 0.05 for both comparisons). Conclusion: Wolfberry extract is an agent that is effective for preventing acetic acid-induced colitis in rats.

Pathogenesis of CD8+ T cells in dextran sulfate sodium-induced murine acute colitis / 上海交通大学学报（医学版）

Objective: To investigate the role of CD8+ T cells in the pathogenesis of acute murine colitis induced by dextran sulfate sodium (DSS). Methods: Wild type and CD8 knock-out (CD8-/-) mice with C57BL/6 background were given DSS with concentration of 2% (m/V). The body weight, colon length, pathological changes and disease activity of colitis were observed dynamically. The total RNA was extracted from the distal colon of mice after induction for 10 d. The mRNA expression of inflammatory cytokines Il1b, Il6, Il17a, Ifng, Tnf, Il10 and Tgfb1 were detected by real-time quantitative PCR. Colon tissue sections were stained with hematoxylin-eosin (H-E) and the changes of intestinal histopathology were evaluated, and the infiltration of CD8+ T cells in colon tissue was observed by immunofluorescence staining. The survival rate of mice was observed with 3% and 4% (m/V) DSS solution-induced colitis models. Results: After CD8-/- mice being induced by 2% DSS, the body weight decreased slowly and showed an increasing trend on the 9th day, while the pathological changes of colon tissues of CD8-/- mice were slight. The expression levels of Il1b, Il6, Il17a, Ifng and Tnf mRNA were lower than those of wild-type mice (P<0.05). The number of CD8+ T cells in colonic lamina propria of wild-type mice with 2% DSS induction was higher than that of wild-type mice without DSS treatment (P=0.001). The survival rates of wild-type mice induced by 3% and 4% DSS were 37.5% and 0, and the survival rates of CD8-/- mice were 66.7% and 100%, while the survival rates of CD8-/- mice receiving 3% and 4% DSS were higher than those of wild-type mice (P=0.025, P=0.001). Conclusion: CD8+ T cells can promote the development of murine acute DSS-induced colitis.

Promoting inflammatory lymphangiogenesis by vascular endothelial growth factor-C (VEGF-C) aggravated intestinal inflammation in mice with experimental acute colitis

Angiogenesis and lymphangiogenesis are thought to play a role in the pathogenesis of inflammatory bowel diseases (IBD). However, it is not understood if inflammatory lymphangiogenesis is a pathological consequence or a productive attempt to resolve the inflammation. This study investigated the effect of lymphangiogenesis on intestinal inflammation by overexpressing a lymphangiogenesis factor, vascular endothelial growth factor-C (VEGF-C), in a mouse model of acute colitis. Forty eight-week-old female C57BL/6 mice were treated with recombinant adenovirus overexpressing VEGF-C or with recombinant VEGF-C156S protein. Acute colitis was then established by exposing the mice to 5% dextran sodium sulfate (DSS) for 7 days. Mice were evaluated for disease activity index (DAI), colonic inflammatory changes, colon edema, microvessel density, lymphatic vessel density (LVD), and VEGFR-3mRNA expression in colon tissue. When acute colitis was induced in mice overexpressing VEGF-C, there was a significant increase in colonic epithelial damage, inflammatory edema, microvessel density, and neutrophil infiltration compared to control mice. These mice also exhibited increased lymphatic vessel density (73.0±3.9 vs 38.2±1.9, P<0.001) and lymphatic vessel size (1974.6±104.3 vs 1639.0±91.5, P<0.001) compared to control mice. Additionally, the expression of VEGFR-3 mRNA was significantly upregulated in VEGF-C156S mice compared to DSS-treated mice after induction of colitis (42.0±1.4 vs 3.5±0.4, P<0.001). Stimulation of lymphangiogenesis by VEGF-C during acute colitis promoted inflammatory lymphangiogenesis in the colon and aggravated intestinal inflammation. Inflammatory lymphangiogenesis may have pleiotropic effects at different stages of IBD.

Management of ulcerative colitis: a clinical update / Tratamento da retocolite ulcerativa: atualização clínica

The objective of this study was to evaluate the consensus of expert societies and published guidelines on the management of ulcerative colitis, and to compare with the experience of the authors, in order to standardize procedures that would help the reasoning and decision- making process of the physician. A search was performed in scientific literature, specifically in electronic databases: Medline/Pubmed, SciELO, EMBASE and Cochrane, and the following descriptors were used: ulcerative colitis, acute colitis, clinical treatment, surgery and ran- domized trial. It can be concluded that the goals of therapy in ulcerative colitis are clinical and endoscopic remission, deep, sustained remission without corticosteroids, prevention of hospitalizations and surgeries, and improved quality of life. The surgical indications are reserved for selected cases, ranging from medical intractability, complications (severe refractory acute colitis, toxic megacolon, perforation and hemorrhage) and malignancy. Information in this review article must be submitted to evaluation and criticism of the spe- cialist responsible for the conduct to be followed, in the face of his/her reality and the clinical status of each patient. The degree of recommendation and strength of evidence were based using the GRADE sys- tem (The Grades of Recommendation, Assessment, Development, and Evaluation) described below: 1. A: Experimental or observational studies of higher consistency. 2. B: Experimental or observational studies of lower consistency. 3. C: Case reports (non-controlled studies). 4. D: Opinion without critical evaluation, based on consensus, physiological studies or animal models. (AU)

RESUMO O objetivo deste trabalho foi avaliar os consensos de sociedades de especialistas e guidelines publicados sobre o manejo da retocolite ulcerativa, e confrontar com a experiência dos autores, a fim de padronizar condutas que auxiliem o raciocínio e a tomada de decisão do médico. Foi realizada busca na literatura científica, mais precisamente nas bases de dados eletrônicos: Medline/Pubmed, SciELO, EMBASE e Cochrane, tendo sido utilizado os descritores: ulcerative colitis, acute colitis, clinical treatment, surgery e randomized trial. Pode-se concluir que os objetivos da terapia na retocolite ulcerativa são: remissão clínica e endoscópica, a remissão profunda sustentada sem corticosteróides, evitar hospitalizações e cirurgias, e melhora na qualidade de vida. As indicações cirúrgicas ficam reservadas para casos selecionados que variam de intratabilidade clínica, complicações (Colite aguda grave refratária, megacólon tóxico, perfuração e hemorragia) e malignização. As informações contidas neste artigo de revisão devem ser submetidas à avaliação e à crítica do médico especialista, responsável pela conduta a ser seguida, frente à sua realidade e ao estado clínico de cada paciente. O grau de recomendação e força de evidência foram baseados usando o GRADE system (The Grades of Recomendation, Assessment, Development, and Evaluation), descrito abaixo: A: Estudos experimentais ou observacionais de melhor consistência. B: Estudos experimentais ou observacionais de menor consistência. C: Relatos de casos (estudos não controlados). D: Opinião desprovida de avaliação crítica, baseada em consensos, estudos fisiológicos ou modelos animais. (AU)

A Case of Dieulafoy-like Lesion with Massive Bleeding at Ileocecal Valve Following Acute Infectious Colitis in a Pediatric Patient / 대한소화기내시경학회지

The common causes of lower gastrointestinal bleeding in children are intussusception, rectal juvenile polyp, chronic inflammatory colitis and Meckel's diverticulum. Bleeding from Dieulafoy's ulcer at the lower gastrointestinal tract is rare, but this often occurs in the rectum. So far, there has been no report that a Dieulafoy lesion in the ileocecal valve might be formed after acute colitis in a pediatric patient. In this case report, a Dieulafoy-like lesion at the ileocecal valve caused lower gastrointestinal bleeding in an asymptomatic 14-year-old woman. A careful history taking and medical examination are mandatory to identify the bleeding focus in the GI tract and this can be treated by endoscopy.

Development of Two Cases of Acute Colitis after Soap Enemas / 대한소화기내시경학회지

Acute diarrhea is caused by many situations such as infections, drugs, autoimmune diseases, immunodeficiency, ischemia and toxins. In addition, enema induced-colitis also causes acute diarrhea. Damage to the colon has been reported after exposure to a number of rectally administered agents, the better known of which are soaps and detergents used as cleansing enemas. Soap enemas cause corrosive colitis due to the saponification reaction as well as toxic materials. We report two cases of acute colitis induced by soap enemas administered in preparation for cesarean sections.