• Journal of Medicine and Life Science
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• v.16 no.2
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• pp.46-51
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• 2019

Inflammatory bowel disease (IBD) is an immune-mediated chronic inflammatory intestinal condition. With development of various treatment options for IBD, 5-aminosalicylic acid (5-ASA) agents became the drugs of choice due to high efficacy and low risk of complication, specifically effective at inducing and maintaining remission in ulcerative colitis(UC). Pancytopenia caused by 5-ASA agents, especially by mesalazine, has been rarely reported compared with azathioprine, which is commonly used for glucocorticoid-dependent IBD and known to have risk of bone marrow suppression. In the present report, we describe the case of a 57-year-old woman diagnosed with UC, who developed pancytopenia due to adverse effect of mesalazine after recovery from azathioprine-induced pancytopenia. After withdrawal of mesalazine, the laboratory values consistent with myelosuppression continued for 3 months while pancytopenia from azathioprine remained only for 2 weeks. Since pancytopenia can be fatal due to its risk of severe bleeding and infection, close monitoring of clinical presentation is important when starting mesalazine and laboratory data should be evaluated whenever the patients present related symptoms. Furthermore, we suggest that complete blood cell counts should be considered when resuming mesalazine following the development of pancytopenia from any cause, as routinely recommended for azathioprine use.

• Tuberculosis and Respiratory Diseases
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• v.51 no.5
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• pp.474-481
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• 2001

Mesalazine(5-Aminosalicylic acid,5-ASA), a component of Sulfasalazine (sulfapyridine bound to 5-ASA), is used to treat inflammatory bowel disease. Most adverse pulmonary effects caused by sulfasalazine have been attributed to sulfapyridine. However, lung toxicity associated with mesalazine(5-ASA) is rare. Here we report a case of eosinophilic pneumonia in a 44-year-old woman with ulcerative colitis, who was treated with mesalazine. She developed symptoms of a dry cough, mild night fever, and exertional dyspnea. Bilateral peripheral pulmonary infiltrates, peripheral blood eosinophilia, and histologic features were consistent with eosinophilic pneumonia. The symptoms improved quite rapidly after the discontinuation of mesalazine and initiation of steroid therapy. Therefore, adverse pulmonary reactions to mesalazine must be considered in a differential diagnosis of pulmonary involvement in patients with inflammatory bowel disease who are receiving with mesalazine therapy.

• Biomolecules & Therapeutics
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• v.23 no.5
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• pp.486-492
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• 2015

Drug metabolism mostly occurs in the liver. Cytochrome P450 (CYP) is a drug-metabolizing enzyme that is responsible for many important drug metabolism reactions. Recently, the US FDA and EU EMA have suggested that CYP enzyme induction can be measured by both enzymatic activity and mRNA expression. However, these experiments are time-consuming and their interassay variability can lead to misinterpretations of the results. To resolve these problems and establish a more powerful method to measure CYP induction, we determined CYP induction by using luminescent assay. Luminescent CYP assays link CYP enzyme activity to firefly luciferase luminescence technology. In this study, we measured the induction of CYP isozymes (1A2, 2B6, 2C9, and 3A4) in cryopreserved human hepatocytes (HMC424, 478, and 493) using a luminometer. We then examined the potential induction abilities (unknown so far) of mesalazine, a drug for colitis, and mosapride citrate, which is used as an antispasmodic drug. The results showed that mesalazine promotes CYP2B6 and 3A4 activities, while mosapride citrate promotes CYP1A2, 2B6, and 3A4 activities. Luminescent CYP assays offer rapid and safe advantages over LC-MS/MS and qRT-PCR methods. Furthermore, luminescent CYP assays decrease the interference between the optical properties of the test compound and the CYP substrates. Therefore, luminescent CYP assays are less labor intensive, rapid, and can be used as robust tools for high-throughput CYP screening during early drug discovery.

• Tuberculosis and Respiratory Diseases
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• v.62 no.1
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• pp.56-61
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• 2007

Pulmonary complications of ulcerative colitis are relatively uncommon and may present as a variety of disorders. Ulcerative colitis-related interstitial lung disease is extremely rare. There are a few case reports of nonspecific interstitial pneumonia in ulcerative colitis worldwide but none in Korea. We report a patient with ulcerative colitis related biopsy-proven nonspecific interstitial pneumonia, who responded to prednisolone (1 mg/kg) and mesalazine therapy.

• Proceedings of the KAIS Fall Conference
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• 2009.12a
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• pp.318-321
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• 2009

The Efficacy of PSB-2061, was investigated in comparision with predinisolone in acetic acid and Picrylsulfonic acid solution (TNBS)-induced rat inflammatory bowel disease (IBD) for 5 days. 5 % TNBS solution were administered with polyethylene (P.E) tube inserted to rats intracolon, which causing colitis to the rats. The TNBS control group (the saline treated colitic rat) exhibited ulceration and inflammation of the distal colon with formation of granuloma and pathologic connections. We checked the inflammatory parameters like rat's weight, food intake quantity change during administration. After 5 days, we sacrificed the rats and checked the colon's length, ulcer and pathologic condition. Oral treatment with PSB-2061 resulted in significant recovery of macroscopic parameters like weight and diet intake change. Especially, PSB-2061 extract had a more potent effect than $mesalazine^{(R)}$ on macroscopic colonic damage score. We can suggest that PSB extract could be a promising drug in the treatment of IBD.

• Clinical and Experimental Pediatrics
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• v.49 no.1
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• pp.107-111
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• 2006

Crohn disease (CD) is rare, but the incidence of CD has been increasing over the past ten years. We found two cases of CD, associated with myelodysplastic syndrome (MDS), for the first time in children. In the first patient, MDS was diagnosed at three years of age and CD developed later at eight years of age. The patient presented with recurrent abdominal pain, diarrhea, bloody stools and failure to thrive. Colonoscopy revealed cobble stone like mucosa and mass like lesions with superficial ulceration and inflammatory exudates, observed from the cecum to ascending colon. Ileo-cecal biopsy samples showed ulcers with skipped areas and lymphoid infiltrations. The patient was started on treatment with mesalazine and deflazacort, and symptoms remitted. In the second patient, MDS was diagnosed at nine years of age and CD developed at 13 years of age. This patient has recurrent hematochezia, abdominal pain, vomiting and fever. Colonoscopy revealed a large, deep indurative ulceration on the cecal side of the ileo-cecal valve. Ileocecectomy was done, and histology revealed ulceration with transmural inflammation and lymphoid aggregates. Symptoms improved after ileocecectomy.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.8 no.1
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• pp.70-75
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• 2005

Crohn's disease of the perineum is notably resistant to treatment. We describe our experiences of tacrolimus ointment application in three patients with intractable perianal Crohn's disease. At the time of diagnosis patients showed anal fissure with ulcer, anal fistula, or perianal abscess, respectively. These lesions did not respond to steroid, metronidazole, mesalazine, or azathioprine, though the pediatric Crohn's disease activity index was markedly improved during the treatment period (4 to 12 months). Topical tacrolimus was applied and resulted in marked healing and a rapid granulation of cavity edges within 6 weeks to 3 months. Topical tacrolimus at a low dose shows a promise for the management of childhood perianal Crohn's disease. Further controlled studies are required to assess the efficacy and safety of this treatment.

• Biomolecules & Therapeutics
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• v.5 no.2
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• pp.165-173
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• 1997

This study was conducted to investigate the effect of DA-9601, an extract of Artemisiae Herba, which is known to possess mucoprotective action either by free radical scavenging effect or increase of mucus secretion, against animal models of inflammatory bowel disease (IBD) induced by trinirobenzene sulfonic acid (TNBS) or other noxious agents. Experimental colitis was induced by intracolonic administration of TNBS in 50% ethanol, or 1 ml of 7% acetic acid solution (AA), by subcutaneous injection of indomethacin (INDO) in rats, or by supplementing drinking water with 5% dextran sodium sulfate (DSS) in albino mice. DA-9601 was treated orally for 4 to 7 days. Animals were euthanized 1 day after the last treatment for morphological and biochemical analysises. All the noxious agents including TNBS, AA, INDO and DSS elicited severe colitis. The animals treated with DA-9601 showed a consistent, dose-related reduction in the severity of colitis, grossly and histologically. The reduction was significant (p<0.05) after administration of DA-9601 at dose range of 10 mg/kg or above. In TNBS-induced colitis, the rats receiving DA-9601 showed significantly decreased mucosal myeloperoxidase (MPO) and thiobarbituric acid-reactive substances (TBA-RS), when compared to control and mesalazine groups. Mucosal proinflammatory cytokine levels were also decreased after DA-9601 treatment. In conclusion, DA-9601 ameliorated macroscopic and histologic scores in experimental colitis either through decreasing oxidative stress or by attenuating cytokines involved in inflammation. DA-9601 could be a promising drug for the therapy of IBD.

• Biomolecules & Therapeutics
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• v.21 no.5
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• pp.398-404
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• 2013

During a screening program to search the anticolitic herbal medicines, 80% ethanol extract of the rhizome of Anemarrhena asphodeloides (AA) was found to potently inhibit the expression of proinflammatory cytokines TNF-${\alpha}$ and IL-1${\beta}$, as well as the activation of NF-${\kappa}B$ in LPS-stimulated colonic macrophages, followed by that of the rhizome of C. chinensis (CC). AA also potently inhibited TNBS-induced colitic markers, shortening of the colon and increase of macroscopic score, myeloperoxidase activity, TNF-${\alpha}$, IL-1${\beta}$, and IL-6, in mice. The synergistic effect of CC against the anticolitic effect of AA was investigated. CC synergistically inhibited the anticolitic effect of AA. AC-mix (AA+CC, 1:1) potently inhibited them. AC-mix also inhibited the activation of NF-${\kappa}B$, as well as the expression of TNF-${\alpha}$, IL-1${\beta}$, IL-6, iNOS and COX-2. The effects of AC-mix against oxazolone-induced colitis were investigated in mice. AC-mix also potently inhibited oxazolone-induced inflammatory markers, colon shortening, macroscopic score, myeloperoxidase activity, NF-${\kappa}B$ activation and proinflammatory cytokines. Overall, the anti-colitic effect of AC-mix was superior to that of mesalazine. Based on these findings, AC-mix may improve colitis by inhibiting NF-${\kappa}B$ activation.

• Journal of Yeungnam Medical Science
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• v.25 no.2
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• pp.182-186
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• 2008

Ulcerative colitis (UC) is a chronic inflammatory disorder of the gastrointestinal tract that affects the large bowel. Its etiology remains controversial. However, an infectious or immunologic origin is considered the primary cause. The onset of UC is typically slow and insidious, but some patients may present acutely with symptoms mimicking infectious colitis. We report a case of ulcerative colitis mimicking acute hemorrhagic colitis at initial presentation. A 60-year-old man was referred to Yeungnam University Hospital for bloody diarrhea and abdominal pain. Sigmoidoscopy revealed mildly edematous mucosa in the rectum and hyperemic mucosa with petechiae in the sigmoid colon. The patient was treated with antibiotics for several days, and his symptoms improved. However, after one month, his bloody diarrhea relapsed. Follow-up sigmoidoscopy revealed mucosal friability in the rectum and sigmoid colon. He was diagnosed with ulcerative colitis, and his symptoms were improved with mesalazine and a steroid enema.