Effect Of Olsalazine Research Articles

Determination of thiopurine methyltransferase activity in isolated human erythrocytes does not reflect putative in vivo enzyme inhibition by sulfasalazine.

Determination of thiopurine S -methyltransferase (TPMT; EC 2.1.1.67) activity is intended to screen patients before therapy with thiopurine drugs (6-mercaptopurine, 6-thioguanine, and azathioprine) to rule out a deficiency in this enzyme. The enzyme catalyzes the S-methylation of these medicinal agents, a metabolic pathway that competes with the formation of pharmacologically active 6-thioguanine nucleotides (6-TGNs), thereby modulating their therapeutic and toxic effects (1)(2). Individuals with low TPMT activity are known to be at high risk for severe thiopurine-induced myelodepression. In addition to a genetic polymorphism of TPMT alleles, which is responsible for the wide interindividual differences in TPMT activity, cotherapy with various drugs, including aminosalicylates, has been shown to influence enzyme activity (1)(2). In vitro kinetic studies with recombinant human TPMT demonstrated that sulfasalazine, 5-aminosalicylic acid, balsalazide, and olsalazine (3)(4)(5) inhibit the enzyme activity in a noncompetitive manner. Therefore, simultaneous therapy with both thiopurines and aminosalicylates was postulated to create a “phenocopy” of individuals with a low TPMT activity genotype (1). In line with this hypothesis, Lewis et al. (3) described a case of a patient with Crohn disease and TPMT activity in the low normal range who had severe bone marrow dysfunction while receiving treatment with 6-mercaptopurine and olsalazine. The authors speculated that the TPMT activity determined ex vivo represented the patient’s baseline TPMT activity in vivo because the inhibitory effect of olsalazine would be removed by dilution in the assay. Subsequently, several groups (6)(7)(8) investigated this drug–drug interaction in clinical studies with more cases. As indicators of an inhibitory effect, ex vivo determination of erythrocyte TPMT activity and erythrocyte 6-TGNs were chosen. No changes in TPMT activity, but significantly increased 6-TGN concentrations, were observed under combined thiopurine/aminosalicylate therapy (6)(8). Whereas Lowry et al. (6) speculated …

Endogenous antioxidant status in neoplastic and adjacent tissues in 1,2-dimethylhydrazine-induced colon cancer in rats: effects of olsalazine.

There is much evidence suggesting a possible role of reactive oxygen-derived substances in the pathogenesis of both ulcerative colitis and colon cancer. The antioxidant effects of 5-aminosalicylic acid (the active moiety of olsalazine) on induction of colon cancer in an experimental model using 1,2-dimethylhydrazine were studied in male Wistar rats. The levels of reduced glutathione were significantly (P < 0.01) decreased (by approximately 50%) in neoplastic tissues of rats receiving 1,2-dimethylhydrazine alone and olsalazine treatment significantly (P < 0.01) reduced the extent of this alteration. Adjacent tissues from rats receiving either carcinogen alone or carcinogen and olsalazine showed comparable levels of glutathione and these were significantly (P < 0.01) lower than corresponding control values and higher than corresponding values from neoplastic tissues. Activity of the glutathione regenerating enzyme glutathione reductase was significantly (P < 0.01) decreased (by approximately 40%) in neoplastic colonic tissue and this alteration was unaffected by olsalazine treatment. Neither carcinogen nor olsalazine treatment caused alterations in activity of glutathione reductase in adjacent tissue as compared with corresponding control values. Activity of the glutathione utilizing enzyme glutathione peroxidase was significantly (P < 0.01) increased (almost doubled) in neoplastic tissue of rats treated with carcinogen alone. Olsalazine treatment significantly (P < 0.01) reduced the elevation in glutathione peroxidase activity in neoplastic tissues of rats treated with the carcinogen. Glutathione peroxidase showed comparable activity in adjacent tissue from rats treated with either carcinogen alone or a combination of carcinogen and olsalazine and these values were significantly (P < 0.01) lower than corresponding control values. Colonic neoplastic tissues from all experimental groups of animals showed a small, but statistically significant (P < 0.05), decrease in superoxide dismutase activity compared with that in corresponding tissues from control animals.

Effect of olsalazine and mesalazine on human ileal and colonic (Na+ + K+)-ATPase. A possible diarrhogenic factor?

Olsalazine (azodisalicylate) and mesalazine (5-aminosalicylic acid) have recently been developed as new treatment modalities for inflammatory bowel disease to avoid sulfasalazine-related side effects. However, there are reports regarding new and hitherto unexpected side effects in some patients receiving olsalazine or mesalazine, such as watery diarrhea. Since sodium pump activities play an important role in the pathogenesis of water and electrolyte disturbances, we investigated the influence of olsalazine and mesalazine on human ileal and colonic (Na+ + K+)-ATPase and its specific [3H]-ouabain binding. We found a concentration-dependent inhibition of ileal and colonic (Na+ + K+)-ATPase by olsalazine with an IC50 of 4.1 mM and 4.8 mM, respectively. Mesalazine inhibited this enzyme in the ileum with an IC50 of 4.0 mM and in the sigmoid colon with an IC50 3.5 mM. In addition, [3H]-ouabain binding was inhibited by mesalazine with an IC50 of 3.6 mM. The maximal inhibition, however, did not exceed 80% under any conditions (up to 10 mM drug concentration). Olsalazine and mesalazine induce inhibition of the ileal and colonic sodium pump activities that may (in addition to other possible mechanisms) mediate impaired water and electrolyte absorption. This is possibly of clinical relevance in patients with severely damaged mucosa. In patients with milder forms of mucosal inflammation, this inhibition most likely is of minor importance because of the great capacity of the (Na+ + K+)-ATPase and the incomplete inhibition leaving at least 20% of the enzyme activity intact.

Experimental colitis in mice: Effects of olsalazine on eicosanoid production in colonic tissue

Experimental colitis in mice: Effects of olsalazine on eicosanoid production in colonic tissue

Experimental colitis in mice: Effects of olsalazine on eicosanoid production in colonic tissue

In rodents colitis can be induced by adding 2% (w/v) carrageenan (CARR) for 4 weeks or 10% (w/v) dextran sulphate sodium (DSS) for 7 days to their drinking water. These models are suitable to test anti-inflammatory drugs used in inflammatory bowel disease in man. Mice were treated with olsalazine (400 mg/kg body wt) starting 7 days before the DSS or CARR administration. Colonic tissues were incubated with [1-14C]-arachidonic acid and stimulated with A23187 and, thereafter, the pattern of eicosanoids was determined by separation on HPLC. DSS and CARR produced a marked diffuse inflammatory response in the colon and a subsequent 5-fold increase of all eicosanoids after DSS, whereas after CARR only a 2-fold increase of PGs was observed. Olsalazine treatment decreased all cyclooxygenase and lipoxygenase products to baseline levels.

Olsalazine-related diarrhoea: does rat intestine adapt in vivo?

Diarrhoea may occur in up to 10% of patients with ulcerative colitis treated with olsalazine, the azolinked dimer of 5-aminosalicylic acid. However, this symptom often disappears despite continued drug medication. To examine reversibility of and adaptation to olsalazine effects on intestinal absorption, rats were fed olsalazine (4 mg/100 g body weight/day) for 0 (controls), 12, 24, and 32 days. Jejunal, ileal, and colonic loops were perfused in situ with buffer or olsalazine (11.6 mM) in a pendular perfusion system. Water and electrolyte absorption was inhibited in all intestinal segments (p less than 0.001). In the proximal small intestine, however, sodium absorption was inhibited by 61%, whereas chloride and potassium absorptions were turned into net secretion. In contrast, in ileal and colonic segments sodium, chloride, and potassium absorptions were turned into a net secretion. All inhibitory effects were reversible within a short time. Intestinal absorption remained inhibitable compared with controls (p = not significant) after chronic administration of olsalazine even for 1 month. Jejunal monosaccharide absorption was not altered by acute olsalazine perfusion. In the ileum, glucose absorption was significantly inhibited, but the inhibitory capacity of acute olsalazine application decreased significantly (p less than 0.05) depending on duration of olsalazine pretreatment (51% (controls) versus 38% (32 days)). These results point to a complex, acute, but fully reversible effect of olsalazine on intestinal passive and chloride-coupled absorptive processes. Since a mucosal adaptation to these diarrheogenic effects does not occur, the resulting increase in fluid load on the diseased colon may be important in the pathogenesis of olsalazine-related diarrhoea.

Effects of olsalazine and sulphasalazine on jejunal and ileal water and electrolyte absorption in normal human subjects

Effects of olsalazine and sulphasalazine on jejunal and ileal water and electrolyte absorption in normal human subjects

Effects of olsalazine and sulphasalazine on jejunal and ileal water and electrolyte absorption in normal human subjects.

The effect of sulphasalazine and olsalazine on jejunal and ileal water and electrolyte absorption was investigated in normal subjects by a steady state intestinal perfusion of a physiological glucose bicarbonate electrolyte solution in the absence and presence of increasing concentrations of each drug. (Olsalazine 0.25 g/l, 1.0 g/l, jejunum; 0.5 g/l, 1.0 g/l, ileum; sulphasalazine 0.25 g/l, 0.5 g/l, 2.0 g/l jejunum; 1.0 g/l, 2.0 g/l, ileum.) In the jejunum olsalazine at 1.0 g/l significantly inhibited water, sodium, chloride, and potassium absorption (p less than 0.05). In the ileum olsalazine at 0.5 and 1 g/l significantly inhibited glucose uptake (p less than 0.04) and water absorption (p less than 0.03). In the jejunum sulphasalazine had a dose related and significant inhibitory effect on water, bicarbonate, and sodium absorption and at 2.0 g/l an inhibitory effect on chloride, potassium (p less than 0.005), and glucose (p less than 0.05) absorption. In the ileum sulphasalazine had no significant effect on water and electrolyte absorption. All inhibitory effects were rapidly reversible. These data show that unexplained diarrhoea in patients with ulcerative colitis treated with olsalazine may occur as a consequence of inhibition of water and electrolyte absorption in the small intestine and that the mechanisms of inhibition of sulphasalazine and olsalazine are different.

Olsalazine Induced Secretion in Rabbit IIeal Mucosa

Olsalazine has been observed to induce diarrhoea in 4.9% of patients. In vivo trials in rat ileum and colon suggest stimulation of secretion by olsalazine. The in vitro effect of olsalazine was examined on active anion secretion by rabbit distal ileum compared to sulphasalazine and 5-aminosalicylic acid (5-ASA). Rabbit terminal ileal strips were mounted in Ussing chambers, and the mucosal and serosal surfaces were selectively exposed to 3.0, 5.0, 1.0, 0.1 and 0.001 mM of olsalazine, sulphasalazine and 5-ASA. The maximal short circuit current (Isc, a measure of active anion secretion) was determined for each concentration. Olsalazine significantly stimulated anion secretion at concentrations above 0.001 mM with a more pronounced effect (approximate ED50 of 0.5 mM) when added to the mucosal surface. In contrast, sulphasalazine and 5-ASA demonstrated no secretory effect. Additional studies of transmucosal fluxes and chemical mediation of these effects are in progress and will be reported. Olsalazine stimulat...

Influence of Olsalazine and Sulphasalazine on Gastrointestinal Transit

The effect of olsalazine and sulphasalazine on stool output and transit of a solid radiolabelled meal through the stomach, small intestine and colon was measured. In six patients with ulcerative colitis intolerant of sulphasalazine, olsalazine, 250 mg q.d.s., significantly accelerated gastric emptying, mouth to caecum transit time and whole gut transit time. No significant changes were seen in the mean daily stool weight or in the mean daily stool frequency. In six normal subjects, sulphasalazine, 1 g t.d.s., had no significant effect on gastric emptying, mouth to caecum transit, whole gut transit or stool output. All six patients tolerated olsalazine without any adverse effects. In conclusion, olsalazine accelerated gastric and intestinal transit, and this effect on intestinal motor activity could be responsible for the diarrhoea reported in some patients taking this drug.

Influence of olsalazine on gastrointestinal transit in ulcerative colitis.

The effect of olsalazine on stool output and the transit of a solid radiolabelled meal through the stomach, small intestine and colon was studied in six patients with ulcerative colitis intolerant of sulphasalazine. Olsalazine 250 mg four times daily significantly accelerated gastric emptying (mean +/- SD; 45.3 +/- 24.2 min v 67.3 +/- 33.1 min, p less than 0.05), mouth to caecum transit time (242 +/- 41 min v 325 +/- 33 min, p less than 0.02) and whole gut transit time (60.5 +/- 26 h v 37.8 +/- 17.8 h, p less than 0.05). No significant changes were seen in mean daily stool weight (215 +/- 41 g v 162 +/- 62 g) and mean daily stool frequency (2.2 +/- 0.6 v 2.4 +/- 1.8). None of these patients developed diarrhoea, but acceleration of gastric and intestinal transit may be responsible for the diarrhoea reported in some patients taking this drug.

Effects of olsalazine in the jejunum of the rat.

Olsalazine (ADS) is the azo-linked dimer of 5-aminosalicylic acid (5-ASA). It is of value for the management of patients with ulcerative colitis but may be associated with increasing diarrhoea in a few. This study examines the effect of 5-ASA and ADS on small intestinal transport systems of the rat. Krebs-Ringer-bicarbonate solution was circulated through the lumen of a jejunal segment and the appearance of fluid, glucose and lactate on the serosal surface was shown to be linear over a two hour period. Addition of 5-ASA (10 mmol/l) or ADS (5 mmol/l and 10 mmol/l) caused a significant inhibition both of fluid transport (p less than 0.001), and of the appearance of glucose (p less than 0.001) and lactate (p less than 0.001 for 5 mmol/l and 10 mmol/l ADS, p less than 0.01 for 10 mmol/l 5-ASA). The uptake of glucose by rings of rat jejunum was shown to be markedly reduced by ADS. Experiments substituting glucose with either sucrose of 2-aminoisobutyric acid showed that ADS (5 mmol/l, 10 mmol/l) also inhibited the serosal appearance of fructose and the amino acid. These results show that 5-ASA and ADS, at concentrations which could be expected in the jejunum of patients receiving therapeutic doses, are able to inhibit small intestinal transport systems. The resulting increase in load on the diseased colon could be important for the pathogenesis of diarrhoea.