Abstract
Inflammatory bowel diseases, such as ulcerative colitis, cause significant morbidity and decreased quality of life. The currently available treatments are not effective in all patients, can be expensive and have potential to cause severe side effects. This prompts the need for new treatment modalities. Enoxaparin, a widely used antithrombotic agent, is reported to possess anti-inflammatory properties and therefore we evaluated its therapeutic potential in a mouse model of colitis. Acute colitis was induced in male C57BL/6 mice by administration of dextran sulfate sodium (DSS). Mice were treated once daily with enoxaparin via oral or intraperitoneal administration and monitored for colitis activities. On termination (day 8), colons were collected for macroscopic evaluation and cytokine measurement, and processed for histology and immunohistochemistry. Oral but not intraperitoneal administration of enoxaparin significantly ameliorated DSS-induced colitis. Oral enoxaparin-treated mice retained their body weight and displayed less diarrhea and fecal blood loss compared to the untreated colitis group. Colon weight in enoxaparin-treated mice was significantly lower, indicating reduced inflammation and edema. Histological examination of untreated colitis mice showed a massive loss of crypt architecture and goblet cells, infiltration of immune cells and the presence of edema, while all aspects of this pathology were alleviated by oral enoxaparin. Reduced number of macrophages in the colon of oral enoxaparin-treated mice was accompanied by decreased levels of pro-inflammatory cytokines. Oral enoxaparin significantly reduces the inflammatory pathology associated with DSS-induced colitis in mice and could therefore represent a novel therapeutic option for the management of ulcerative colitis.
Highlights
Ulcerative colitis (UC) is a chronic inflammatory condition with millions of sufferers worldwide [1]
We have described the therapeutic potential of the low molecular weight heparin, enoxaparin, for the amelioration of acute colitis
Oral enoxaparin reduced the severity of clinical activity, histological damage and the immunological response associated with colitis
Summary
Ulcerative colitis (UC) is a chronic inflammatory condition with millions of sufferers worldwide [1]. Pharmacological and surgical interventions are the two main management approaches for UC [2] Drugs such as corticosteroids, aminosalicylates, and immunosuppresants, which aim to decrease inflammation, show limited effectiveness for long term remission and are associated with significant side effects [3]. Aminosalicylates, and immunosuppresants, which aim to decrease inflammation, show limited effectiveness for long term remission and are associated with significant side effects [3] Monoclonal antibodies, such as infliximab, that inhibit tumour necrosis factor (TNF-α) have shown considerable success [4]. Surgery is reserved for about 20–30% of patients who are unresponsive to medication and develop life-threatening complications such as perforation, refractory rectal bleeding, toxic megacolon and fulminant colitis [2]. Patients are predisposed to the risk of complications such as small bowel obstruction, anastomotic strictures, pouchitis and pouch failure [3]
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