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Mesalazine (5-aminosalicylic acid) alters faecal bacterial profiles, but not mucosal proteolytic activity in diarrhoea-predominant irritable bowel syndrome.
Aliment Pharmacol Ther. 2011 Aug; 34(3):374-83.AP

Abstract

BACKGROUND

Imbalances in gut luminal bacteria may contribute to the pathogenesis of irritable bowel syndrome (IBS).

AIM

To explore select bacteriological and anti-inflammatory effects of mesalazine (mesalamine; 5-aminosalicylic acid or 5ASA) and their relation to potential therapeutic effects in IBS.

METHODS

Prospective pilot study of 12 women with diarrhoea-predominant IBS. Patients received oral mesalazine (1.5 g b.d.) for 4 weeks followed by a 4-week washout phase. Molecular profiling of stool bacterial communities and IBS symptoms were assessed before, during and after mesalazine treatment. Colonic mucosal biopsies were assessed for proteolytic activity. Qualitative and quantitative effects of mesalazine on stool microbiota, mucosal proteolytic activity and IBS symptoms were assessed.

RESULTS

Faecal bacteria decreased by 46% on mesalazine treatment (P = 0.014), but returned to baseline during washout. Firmicutes and Bacteroidetes represented 95% of identified phylotypes, with a trend towards an increase in the proportion of Firmicutes at week 4 in symptomatic responders [median (IQR) 14% (49) increase] compared with nonresponders [median 5% (11) decrease, P = 0.088]. Rectosigmoid mucosal proteolytic activity did not change between baseline and treatment [median 23.2 (17.9) vs. 19.5 (46.7) mU activity/mg tissue, P = 0.433]. Eight of 12 (67%) patients responded favourably to mesalazine based on a global relief questionnaire, with significant decreases in days with discomfort and increases in bowel movement satisfaction.

CONCLUSIONS

Mesalazine treatment is associated with a decrease in faecal bacteria abundance and rebalancing of the major constituents of the microbiota. Further study of the bacteriological and anti-inflammatory properties of mesalazine in IBS is warranted.

Authors+Show Affiliations

Division of Gastroenterology, Department of Medicine, University of Calgary, Calgary, AB, Canada. candrews@ucalgary.caNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

21671966

Citation

Andrews, C N., et al. "Mesalazine (5-aminosalicylic Acid) Alters Faecal Bacterial Profiles, but Not Mucosal Proteolytic Activity in Diarrhoea-predominant Irritable Bowel Syndrome." Alimentary Pharmacology & Therapeutics, vol. 34, no. 3, 2011, pp. 374-83.
Andrews CN, Griffiths TA, Kaufman J, et al. Mesalazine (5-aminosalicylic acid) alters faecal bacterial profiles, but not mucosal proteolytic activity in diarrhoea-predominant irritable bowel syndrome. Aliment Pharmacol Ther. 2011;34(3):374-83.
Andrews, C. N., Griffiths, T. A., Kaufman, J., Vergnolle, N., Surette, M. G., & Rioux, K. P. (2011). Mesalazine (5-aminosalicylic acid) alters faecal bacterial profiles, but not mucosal proteolytic activity in diarrhoea-predominant irritable bowel syndrome. Alimentary Pharmacology & Therapeutics, 34(3), 374-83. https://doi.org/10.1111/j.1365-2036.2011.04732.x
Andrews CN, et al. Mesalazine (5-aminosalicylic Acid) Alters Faecal Bacterial Profiles, but Not Mucosal Proteolytic Activity in Diarrhoea-predominant Irritable Bowel Syndrome. Aliment Pharmacol Ther. 2011;34(3):374-83. PubMed PMID: 21671966.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Mesalazine (5-aminosalicylic acid) alters faecal bacterial profiles, but not mucosal proteolytic activity in diarrhoea-predominant irritable bowel syndrome. AU - Andrews,C N, AU - Griffiths,T A, AU - Kaufman,J, AU - Vergnolle,N, AU - Surette,M G, AU - Rioux,K P, Y1 - 2011/06/14/ PY - 2011/6/16/entrez PY - 2011/6/16/pubmed PY - 2011/12/23/medline SP - 374 EP - 83 JF - Alimentary pharmacology & therapeutics JO - Aliment Pharmacol Ther VL - 34 IS - 3 N2 - BACKGROUND: Imbalances in gut luminal bacteria may contribute to the pathogenesis of irritable bowel syndrome (IBS). AIM: To explore select bacteriological and anti-inflammatory effects of mesalazine (mesalamine; 5-aminosalicylic acid or 5ASA) and their relation to potential therapeutic effects in IBS. METHODS: Prospective pilot study of 12 women with diarrhoea-predominant IBS. Patients received oral mesalazine (1.5 g b.d.) for 4 weeks followed by a 4-week washout phase. Molecular profiling of stool bacterial communities and IBS symptoms were assessed before, during and after mesalazine treatment. Colonic mucosal biopsies were assessed for proteolytic activity. Qualitative and quantitative effects of mesalazine on stool microbiota, mucosal proteolytic activity and IBS symptoms were assessed. RESULTS: Faecal bacteria decreased by 46% on mesalazine treatment (P = 0.014), but returned to baseline during washout. Firmicutes and Bacteroidetes represented 95% of identified phylotypes, with a trend towards an increase in the proportion of Firmicutes at week 4 in symptomatic responders [median (IQR) 14% (49) increase] compared with nonresponders [median 5% (11) decrease, P = 0.088]. Rectosigmoid mucosal proteolytic activity did not change between baseline and treatment [median 23.2 (17.9) vs. 19.5 (46.7) mU activity/mg tissue, P = 0.433]. Eight of 12 (67%) patients responded favourably to mesalazine based on a global relief questionnaire, with significant decreases in days with discomfort and increases in bowel movement satisfaction. CONCLUSIONS: Mesalazine treatment is associated with a decrease in faecal bacteria abundance and rebalancing of the major constituents of the microbiota. Further study of the bacteriological and anti-inflammatory properties of mesalazine in IBS is warranted. SN - 1365-2036 UR - https://www.unboundmedicine.com/medline/citation/21671966/Mesalazine__5_aminosalicylic_acid__alters_faecal_bacterial_profiles_but_not_mucosal_proteolytic_activity_in_diarrhoea_predominant_irritable_bowel_syndrome_ DB - PRIME DP - Unbound Medicine ER -