Effect of honey on TNBS-induced colitis in rats: histological and immunohistochemical study

IBD is a chronic relapsing and nonspecific disorder characterized by colonic mucosal disruption and ulceration. Drugs currently used to manage IBD have potentially serious side effects that limit their use. Developing new drug treatment is, therefore, an important goal in treating IBD. Honey has known wound healing, antimicrobial and even antitumouricidal properties, hence, it could represent an alternate, safer treatment for IBD. The aim of this study was to investigate the potential therapeutic role of honey in an experimental model of inflammatory bowel disease [IBD]. After the induction of colitis with 2,4,6-trinitrobenzene sulphonic acid [TNBS] in rats, physiological saline, honey or prednisolone enemas were applied to the rats once daily for 3 days [short-term treatment groups, acute colitis model] or 14 days [long-term treatment groups, chronic colitis model]. Control groups received only ethanol [the solvent of TNBS] and saline enemas. Rats were killed on the 4[th] or 15[th] days and colonic mucosal damage was assessed histologically, histochemically [goblet cell area% in Alcian blue-stained sections] and immunohistochemically [COX-2 immunostaining]. Histological evaluation of colon specimens revealed that prednisolone was superior to honey in the short-term model. However, in the long-term model honey appeared to be more effective treatment than prednisolone as it had stronger effects on inflammation. Honey significantly attenuated the damage score, corrected the disturbances in morphology associated to TNBS-induced colitis and significantly increased the amount of mucous stained by Alcian blue, but it did not affect mucosal mast cell numbers. Immunohistochemical results showed that short-term therapy with either honey or prednisolone, did not reduce the upregulated COX-2 immunoreactivity associated to TNBS administration, however, long-term treatment with honey markedly reduced COX-2 expression in the colon mucosa compared with prednisolone. Long-term intrarectal administration of honey appeared to be as effective method of treatment as prednisolone, in an experimental model of chronic colitis simulating human IBD

Radical chemoradiotherapy in the treatment of young and elderly patients of muscle invading transitional cell carcinoma of the bladder

This study which was conducted from January 1995 to December 1999 included two groups of patients, the young group [n 19] <50 Y [Range 30-50Y and Median 43Y] and the old group [n 18] >50Y [Range 52-70Y and Median 62Y]. All patients had pathologically documented muscle invasive transitional cell carcinoma of the bladder and all had a Karnofsky performance status of >70. Treatment protocol included cytoreductive transurethral resection of the tumor, 2 cycles of MVAC chemotherapy [methotrexate, vinblastine, doxorubicin and cisplatin] and radiotherapy [45 grays [GY] on pelvic volume with concurrent cisplatin [20mg/m[2] on days 1-5]. Response was determined by cytoscopic examination with tumor site biopsy and urine cytology. If there was a complete response, radiotherapy continued to a total dose of 65GY, if there was no complete response, cystectomy was performed. Of the young group [n 19] 12 patients 63% had complete response, 5 [26%] had partial response and 2 [11%] had no response. In the old group [n 18], 9 patients [50%] had complete response, 6 [33%] had partial response and 3 [17%] had no response. A significant difference in response to treatment was detected between T2 and T3a and between Bilharzial and non Bilharzial groups of patients P [0.037] and P [0.002] respectively. Overall survival for the young group was 50%, 39%, 30% in the 2[nd], 3[rd] and 5[th] years of follow up respectively, while in the old group it was 45%, 35%, and 30% for the 2[nd], 3[rd], 5[th] years of follow up respectively. Severe toxicity was uncommon. The most frequent toxicities being emesis and cystitis in both groups. The difference between both groups regarding toxicity, tolerability and response to treatment was not statistically significant. This protocol of treatment can be used for both young and elderly patients of muscle invading transitional cell carcinoma of the bladder especially in low stage non Bilharzial cancer despite a few well tolerated short term complications