A clinical trial of combined use of rosiglitazone and 5-aminosalicylate for ulcerative colitis.

AIM To investigate the therapeutic effects of the combined use of rosiglitazone and aminosalicylate on mild or moderately active ulcerative colitis (UC). METHODS According to the national guideline for diagnosis and treatment of inflammatory bowel disease (IBD) in China, patients with mild or moderately active UC in our hospital were selected from July to November, 2004. Patients with infectious colitis, amoebiasis, or cardiac, renal or hepatic failure and those who had received corticosteroid or immunosuppressant treatment within the last month were excluded. Following a quasi-randomization principle, patients were allocated alternatively into the treatment group (TG) with rosiglitazone 4 mg/d plus 5-ASA 2 g/d daily or the control group (CG) with 5-ASA 2 g/d alone, respectively, for 4 wk. Clinical changes were evaluated by Mayo scoring system and histological changes by Truelove-Richards' grading system at initial and final point of treatment. RESULTS Forty-two patients completed the trial, 21 each in TG and CG. The Mayo scores in TG at initial and final points were 5.87 (range: 4.29-7.43) and 1.86 (range: 1.03-2.69) and those in CG were 6.05 (range: 4.97-7.13) and 2.57 (range: 1.92-3.22) respectively. The decrements of Mayo scores were 4.01 in TG and 3.48 in CG, with a remission rate of 71.4% in TG and 57.1% in CG, respectively. Along with the improvement of disease activity index (DAI), the histological grade improvement was more significant in TG than in CG (P < 0.05). CONCLUSION Combined treatment with rosiglitazone and 5-ASA achieved better therapeutic effect than 5-ASA alone without any side effects. Rosiglitazone can alleviate colonic inflammation which hopefully becomes a novel agent for UC treatment.

[1]  M. Sánchez-Hidalgo,et al.  Rosiglitazone, a PPARγ ligand, modulates signal transduction pathways during the development of acute TNBS-induced colitis in rats , 2007 .

[2]  Hua-qing Liu,et al.  Rosiglitazone enhances fluorouracil-induced apoptosis of HT-29 cells by activating peroxisome proliferator-activated receptor gamma. , 2007, World journal of gastroenterology.

[3]  W. König,et al.  Peroxisome-proliferator-activated receptor-gamma agonists inhibit the release of proinflammatory cytokines from RSV-infected epithelial cells. , 2006, Virology.

[4]  M. Belvisi,et al.  Peroxisome proliferator-activated receptor gamma agonists as therapy for chronic airway inflammation. , 2006, European journal of pharmacology.

[5]  Hong Wu,et al.  Effect of peroxisome proliferator-activated receptor-gamma ligand on inflammation of human gallbladder epithelial cells. , 2005, World journal of gastroenterology.

[6]  K. Morimura,et al.  Peroxisome proliferator activated receptor γ in colonic epithelial cells protects against experimental inflammatory bowel disease , 2005, Gut.

[7]  M. Sánchez-Hidalgo,et al.  Rosiglitazone, an agonist of peroxisome proliferator-activated receptor gamma, reduces chronic colonic inflammation in rats. , 2005, Biochemical pharmacology.

[8]  J. Auwerx,et al.  Intestinal antiinflammatory effect of 5-aminosalicylic acid is dependent on peroxisome proliferator–activated receptor-γ , 2005, The Journal of experimental medicine.

[9]  F. Lu,et al.  Effects of emodin on treating murine nonalcoholic fatty liver induced by high caloric laboratory chaw. , 2005, World journal of gastroenterology.

[10]  D. Straus,et al.  the Peroxisome Proliferator‐Activated Receptor &ggr; Ligand Rosiglitazone Delays the Onset of Inflammatory Bowel Disease in Mice With Interleukin 10 Deficiency , 2005, Inflammatory bowel diseases.

[11]  A. Minagar,et al.  Troglitazone, a PPAR-γ activator prevents endothelial cell adhesion molecule expression and lymphocyte adhesion mediated by TNF-α , 2005, BMC Physiology.

[12]  J. Bassaganya-Riera,et al.  Activation of PPAR γ and δ by conjugated linoleic acid mediates protection from experimental inflammatory bowel disease , 2004 .

[13]  J. Burke Targeting I kappa B kinase for the treatment of inflammatory and other disorders. , 2003, Current opinion in drug discovery & development.

[14]  Ming-yi Li,et al.  PPARgamma pathway activation results in apoptosis and COX-2 inhibition in HepG2 cells. , 2003, World journal of gastroenterology.

[15]  Johan Auwerx,et al.  Impaired expression of peroxisome proliferator-activated receptor γ in ulcerative colitis , 2003 .

[16]  Dallas Jones,et al.  Emerging roles of PPARS in inflammation and immunity , 2002, Nature Reviews Immunology.

[17]  H. Aburatani,et al.  Peroxisome Proliferator-Activated Receptor Gamma Agonist Ligands Stimulate a Th2 Cytokine Response and Prevent Acute Colitis , 2002, Inflammatory bowel diseases.

[18]  J. Dayer,et al.  Regulation of the interleukin-1 receptor antagonist in THP-1 cells by ligands of the peroxisome proliferator-activated receptor gamma. , 2002, Cytokine.

[19]  E. Furth,et al.  An open-label trial of the PPARγ ligand rosiglitazone for active ulcerative colitis , 2001, American Journal of Gastroenterology.

[20]  Philippe Gosset,et al.  Peroxisome proliferator‐activated receptor γ  activators affect the maturation of human monocyte‐derived dendritic cells , 2001 .

[21]  B. Brüne,et al.  Delayed activation of PPARγ by LPS and IFN-γ attenuates the oxidative burst in macrophages , 2001 .

[22]  Sander Kersten,et al.  Roles of PPARs in health and disease , 2000, Nature.

[23]  Satoshi Tanaka,et al.  PPARγ Mediates High-Fat Diet–Induced Adipocyte Hypertrophy and Insulin Resistance , 1999 .

[24]  J. Vamecq,et al.  Medical significance of peroxisome proliferator-activated receptors , 1999, The Lancet.

[25]  B. Spiegelman,et al.  Adipogenesis and Obesity: Rounding Out the Big Picture , 1996, Cell.

[26]  W. Tremaine,et al.  Coated oral 5-aminosalicylic acid therapy for mildly to moderately active ulcerative colitis. A randomized study. , 1987, The New England journal of medicine.

[27]  S. Truelove,et al.  Biopsy Studies in Ulcerative Colitis , 1956, British medical journal.

[28]  M. Sánchez-Hidalgo,et al.  Rosiglitazone, a PPARgamma ligand, modulates signal transduction pathways during the development of acute TNBS-induced colitis in rats. , 2007, European journal of pharmacology.

[29]  X. Thuru,et al.  PPARgamma as a new therapeutic target in inflammatory bowel diseases. , 2006, Gut.

[30]  K. Morimura,et al.  Peroxisome proliferator activated receptor gamma in colonic epithelial cells protects against experimental inflammatory bowel disease. , 2006, Gut.

[31]  J. Bassaganya-Riera,et al.  Activation of PPAR gamma and delta by conjugated linoleic acid mediates protection from experimental inflammatory bowel disease. , 2004, Gastroenterology.

[32]  J. Auwerx,et al.  Impaired expression of peroxisome proliferator-activated receptor gamma in ulcerative colitis. , 2003, Gastroenterology.

[33]  E. Furth,et al.  An open-label trial of the PPAR-gamma ligand rosiglitazone for active ulcerative colitis. , 2001, The American journal of gastroenterology.

[34]  S. Aizawa,et al.  PPAR gamma mediates high-fat diet-induced adipocyte hypertrophy and insulin resistance. , 1999, Molecular cell.