Background: Inflammatory bowel disease (IBD), which includes Crohn’s disease (CD) and ulcerative colitis (UC), severely affects patients’ quality of life. Sodium butyrate (NaB) has been reported to improve IBD manifestations, although its underlying mechanisms remain incompletely understood. Methods: An IBD mouse model was induced with 3% (w/v) dextran sulfate sodium (DSS). Mice were administered NaB (500 mg/kg, gavage), 5-aminosalicylic acid (5-ASA,150 mg/kg, gavage), or the ferroptosis inhibitor ferrostatin-1 (Fer-1, intraperitoneal injection). Western blotting (WB) and real-time quantitative PCR (RT-qPCR) were performed to evaluate ferroptosis-related molecules and target pathway components. Immunofluorescence staining was used to assess ferroptosis in macrophages preliminarily. Results: NaB alleviated clinical symptoms of IBD in mice, including mitigation of body weight loss, restoration of colon length, reduction in disease activity index (DAI), decreased spleen index, and protection of the intestinal barrier. In addition, compared with the DSS model group, NaB downregulated ACSL4 and upregulated GPX4 and SLC7A11, indicating an inhibitory effect on ferroptosis. WB results showed that SIRT1 expression was enhanced in the DSS + NaB group. In addition, immunofluorescence staining demonstrated that compared with the DSS group, GPX4 expression was increased in macrophages in the DSS + NaB group. Conclusions: NaB alleviates IBD by modulating SIRT1-associated signaling molecules and inhibiting ferroptosis, including inhibiting macrophage ferroptosis.

BackgroundNicotinamide riboside (NR) supplementation has been demonstrated efficacy in enhancing female reproductive outcomes, but its regulatory role in sow performance and gut microbiome remains undefined. This study systematically evaluated the impacts of dietary NR supplementation during late gestation and lactation on sow performance and gut microbiome remodeling. A total of 280 sows were randomized assigned to one of four groups: a control group fed basal diet or one of three groups receiving NR-supplemented diets (2, 4, or 8 g/d; n = 70/group). Sow reproductive performance, blood metabolic parameters, milk metabolome, and fecal 16S rRNA sequencing were measured.ResultsMaternal NR supplementation linearly shortened farrowing duration (P < 0.01) and tended to decrease the incidence of intrauterine growth restriction and the number of late gestation mummies (P < 0.1), while concurrently increasing the within-litter uniformity (P = 0.1). Litter weaning weight and average daily gain increased quadratically with NR dosage (P < 0.05). NR supplementation orchestrated plasma metabolite regulation (triglycerides and total cholesterol; P < 0.05), enhanced antioxidant biomarkers (T-AOC, GSH-Px, T-SOD; P < 0.05), and reduced inflammatory cytokines (TNF-α; P < 0.05) across gestation and lactation. Milk yield, colostrum/milk dry matter, crude protein, and crude fat were increased (P < 0.05), together with higher levels of NAD+ metabolites (NAD⁺, NR, nicotinamide) and beneficial bioactive factors (milk polar lipids, 3-aminosalicylic acid, fenugreekine; P < 0.05). Gut microbiota analyses at lactation day 14 revealed NR-enriched beneficial taxa (Bifidobacterium, Ruminococcus, Lachnospiraceae, Subdoligranulum, Clostridium butyricum, Succiniclasticum) across sow-offspring dyads, which was associated with the activation of microbial NAD⁺ enzymes (NadR/NAMPT; P < 0.05) and enhancement of systemic short-chain fatty acid flux, notably an increase in plasma butyrate acid (P < 0.05).ConclusionMaternal supplementation of NR during late gestation and lactation increases sow performance and promotes gut NAD+ metabolic-associated microbiome remodeling. These findings propose maternal NR intervention as a novel strategy to enhance mammary lactogenesis and lactation metabolism in swine production, with potential applications for therapeutic strategies for lactation insufficiency.Graphical

Ulcerative colitis (UC) is a chronic inflammatory bowel disease with limited therapeutic options and high relapse rates. Live bacterial therapeutics (LBTs) offer a promising alternative by restoring mucosal integrity, modulating immunity, and rebalancing gut microbiota; however, their clinical translation is constrained by poor storage stability, low gastrointestinal survivability, and limited therapeutic functionality. Here, we report a multilevel, modular encapsulation strategy that integrates a metal-polyphenol network (MPN) and silica-based shell with iron-based metal-organic framework (MIL-101(Fe)) nanocomponents to construct a biohybrid probiotic system (Bif@FCSM(A), where "A" denotes 5-aminosalicylic acid). This hierarchical assembly forms an oxygen-shielding, mechanically reinforced shell, resulting in a 41-fold improvement in aerobic storage stability and an 871-fold enhancement in gastric survivability of the anaerobe Bifidobacterium longum. Incorporation of MIL-101(Fe) enables high-capacity drug loading and inflammation-responsive disassembly via transferrin (Tf)-mediated Fe3 + chelation in inflamed colonic tissue, thereby achieving spatiotemporally controlled bacterial activation and drug release. Guided by UC transcriptomic signatures, this combinatorial design concurrently targets immune dysregulation and microbial imbalance. In a dextran sulfate sodium-induced murine UC model, Bif@FCSM(A) markedly alleviated disease severity, suppressed pro-inflammatory cytokines, restored mucosal immune homeostasis, and enriched short-chain fatty acid-producing taxa. This work establishes a programmable, pathology-responsive probiotic platform with translational potential for complex inflammatory diseases.

Thermo-responsive in situ hydrogel enables superior rectal administration and local efficacy of 5-ASA in inflammatory bowel disease.

This study aimed to explore the therapeutic effect and underlying mechanism of α7 nicotinic acetylcholine receptor (α7nAChR) mediated by adeno-associated virus serotype 9 (AAV9) on dextran sulfate sodium (DSS)-induced ulcerative colitis (UC) in mice. Male C57BL/6 mice were randomly divided into the blank control group, model group, AAV-α7nAChR low/medium/high-dose groups, and AAV-GFP group. A chronic UC model was established, with interventions administered via intraperitoneal injection. Meanwhile, an acute UC model was set up, together with control groups treated with the α7nAChR antagonist methyllycaconitine (MLA) and 5-aminosalicylic acid (5-ASA). A series of indicators were detected, including body weight, Disease Activity Index (DAI), colonic pathological changes, inflammatory factors, pathway-related proteins, and T-regulatory (T-reg)/T helper 17 (Th-17) cell balance. Results demonstrated that AAV9-α7nAChR ameliorated UC symptoms in mice in a dose-dependent manner: it relieved body weight loss and hematochezia, restored colon length and spleen weight, and alleviated colonic mucosal damage. Furthermore, it activated the cholinergic anti-inflammatory pathway (CAP), inhibited the NF-κB/NLRP3 inflammatory axis, repaired the intestinal barrier (by upregulating ZO-1 and occludin), and restored the T-reg/Th-17 immune balance. The therapeutic efficacy of the high-dose AAV9-α7nAChR group was superior to that of the 5-ASA group, while MLA could suppress its therapeutic effect. This study preliminarily clarified the multi-target mechanism of AAV9-α7nAChR in treating UC, providing an experimental foundation for the clinical gene therapy of UC.

Inflammatory bowel disease (IBD), particularly ulcerative colitis, involves disruption of the intestinal mucosal barrier due to ecological and metabolic imbalances in the gut as its underlying pathology. Current therapies for Ulcerative colitis (UC) exhibit limited efficacy and adverse effects, necessitating the development of novel treatment strategies. Naringin and osthole are natural herbal compounds that show therapeutic potential in various inflammatory models due to their excellent anti-inflammatory activity. However, their combined therapeutic effects and precise mechanisms in UC remain unreported. This study aimed to explore the therapeutic effectiveness and mechanism of naringin combined with osthole in addressing dextran sodium sulfate (DSS)-induced colitis. The investigation centered on their impact on the disruption of the intestinal epithelial cell barrier, modulation of intestinal flora composition, alteration of metabolites, and inflammation model in vitro. Modal assessment encompassed body weight, disease activity index (DAI) score, colon length, and histopathological examination. Intestinal barrier integrity was evaluated through Quantitative Real-Time PCR, western blotting, and immunofluorescence staining. Microbiota abundance and metabolic levels wereassessed using 16S ribosomal RNA gene sequencing and metabolomics analysis. Protein expression levels ofpertinent pathways and associated receptors were testedthrough network pharmacology prediction and western blot analysis. Naringin and osthole synergistically relieved colitis symptoms in mice compared with either drug alone or 5-aminosalicylic acid, as evidenced by weight loss recovery, DAI scores, and colon length preservation. Mechanistically, naringin combined with osthole down-regulated the expression level of JNK/NF-κB signaling pathway related proteins and repaired intestinal barrier. Furthermore, the combination regulates the composition of the microflora and promotes the restoration of a steady state of the microflora.Metabolomicrevealed amino acid-tryptophan metabolism as a key metabolic pathway. It also reveals the microbiota-tryptophan pathway as a potential therapeutic strategy. Naringin combined with osthole can alleviate DSS-induced colitis more effectively by JNK/NF-κB signaling pathway, repairing barrier function and regulating intestinal microbiota and metabolites. These findings provide a theoretical basis for the combination therapy strategy to enhance the efficacy of potential functional food in treating ulcerative colitis.

Abstract Background Inflammatory bowel disease (IBD) is a chronic intestinal inflammatory condition made up of mainly Crohn’s disease and ulcerative colitis. Microscopic colitis (MC) is another distinct form of colitis which is subdivided to lymphocytic and collagenous colitis. While IBD and MC share several pathophysiologic mechanisms, they differ in both endoscopic and histologic findings, along with their method of treatment and management. The co-occurrence of MC in patients with underlying IBD is rare and sparsely reported in literature. Aims We present a unique case of a patient with a diagnosis of Crohn`s disease (CD) on advanced therapy with a change in both clinical pattern and histopathology to support a diagnosis of MC, with a collagenous variant. We also systematically reviewed the current literature on this atypical finding. Methods A search of electronic databases was conducted up to September 2025 for all studies and reviews involving patients with a dual diagnosis of IBD and MC. Results A 47-year-old woman initially presented with a history of diarrhea and abdominal pain beginning at age 18. Due to persistent symptoms, she underwent a colonoscopy with endoscopic and histologic findings supporting a diagnosis of non-stricturing, non-penetrating ileocolonic Crohn’s disease. She was placed on 5-aminosalicylic acid (5-ASA) therapy which was eventually escalated to an advanced biologic therapy, infliximab. Her disease had overall remained quiescent though she experienced mild flares with histology on surveillance describing moderate acute colitis with cryptitis, crypt abscesses, and atrophic glands, supporting Crohn’s disease. One year later, she experienced a recurrent flare-up, though this time pathology revealed lymphoplasmacytic inflammation with cryptitis and crypt epithelial apoptosis, interpreted as drug-induced colitis. Her symptoms continued and she was started on a trial of budesonide. Another year later, following the discontinuation of budesonide, her diarrhea recurred. She underwent colonoscopy for reassessment, which was grossly normal; however, random biopsies demonstrated collagenous colitis with intraepithelial lymphocytosis as well as thickening of the collagen plate, highlighted by Masson’s trichrome. Her concurrent diagnosis of MC had been challenging to manage with ongoing need for budesonide therapy and persistent histology supporting collagenous colitis. As such, her therapeutic regimen was adjusted to a different biologic agent, vedolizumab, and clinical remission was achieved. Conclusions Physicians should consider MC as a differential diagnosis in patients who develop diarrhea despite quiescent colitis, particularly when colonoscopy findings are grossly normal. Accurate diagnosis can help early management of the disease and prevent unnecessary escalation of IBD therapy, unless otherwise clinically indicated. Funding Agencies None

Ulcerative colitis (UC) is a common, chronic, and nonspecific inflammatory bowel disease which significantly impair patients' quality of life, and is characterized by a prolonged disease course and frequent relapses. Due to their localized therapeutic action and low incidence of adverse effects, Chinese herbal enemas have garnered increasing attention in clinical settings. This study aims to systematically evaluate the therapeutic potential of Chinese herbal enemas in UC management. Randomized controlled trials (RCTs) evaluating Chinese herbal enemas for UC, published up to April 19, 2025, were systematically searched. A network meta-analysis was performed using Stata 17.0, and the combined effect sizes were reported as the mean difference or relative risk with corresponding 95% confidence intervals. A total of 41 RCTs involving 2883 UC patients were ultimately included, and data on the risk of bias assessment were reported. When compared with mesalazine (MES) monotherapy, combination therapies, such as MES combined with Qingbai Guanchang Ye or MES combined with Qingchi San, and monotherapies including Huangkui Lianchang Tang and Baitouweng Tang, demonstrated statistically significant improvements in clinical outcomes. Subgroup analyses were also conducted. The clinical effectiveness of these interventions was also influenced by Traditional Chinese Medicine (TCM) syndrome differentiation and disease severity, which underscores the importance of individualized, stratified treatment approaches. Our study data showed that Chinese herbal enema therapy appears to be both clinically effective and safe in the management of UC, and supported both stratified TCM therapy and the refinement of UC treatment guidelines. Future research is needed to prioritize high-quality, large-scale RCTs to validate these findings.

Portugal has one of the highest incidence rates of tuberculosis (TB) in Western Europe and, historically, multidrug-resistant (MDR) cases have been strongly associated with Mycobacterium tuberculosis strains pertaining to the endemic Q1 and Lisboa3 clades. Notwithstanding, the contribution of drug resistance-associated allelic configurations in these clades to differing levels of drug resistance and their relationship with drug efficacy has yet to be uncovered. A representative sample of the drug-resistant M. tuberculosis population in Portugal, comprised of 40 clinical strains were subjected to whole genome sequencing for characterization of allelic combinations of drug resistance-associated mutations and their minimum inhibitory concentrations for 12 anti-TB drugs was determined. Pharmacokinetic (PK) models were generated to ascertain the maximum concentration to which each drug remains efficacious. Drug resistance levels were determined and compared between different allelic configurations. Double inhA and embA/B mutation genotypes contributed with increased isoniazid and ethambutol resistance levels compared with single mutation configurations, respectively. Significant differences in drug resistance levels were observed between phylogenetic groups for rifamycin, streptomycin and ethionamide, largely explained by the presence/absence of unique high-level resistance-associated genotypes. The PK models for isoniazid and moxifloxacin suggest an increase in dosage to be ineffective against strains harboring high-level resistance-conferring double inhA mutations and gyrA/B mutations. Cycloserine and para-aminosalicylic acid are the only drugs predicted to remain efficacious against the majority of tested strains, while the effectiveness of newer drugs like bedaquiline, pretomanid and delamanid have yet to be uncovered. Proper diagnosis of drug resistance-associated mutations provides invaluable insights into the treatment of TB, as different allelic configurations lead to differing drug resistance levels, often rendering drugs ineffective.

Development of anti-inflammatory agents targeting COX and 5-LOX, along with anti-arthritic agents, is a crucial approach in drug discovery. In this study, we designed and synthesized novel azomethine salicylic acid derivatives 2–9 by condensing 4-aminosalicylic acid with various formyl or ketone groups attached to benzylidene or heterocyclic cores. The reaction was carried out under reflux conditions utilizing acetic acid as the solvent. Initially, target prediction was performed, and the results indicated that these derivatives have potential as inhibitors of enzymes, proteases, and kinases. Furthermore, the designed derivatives underwent evaluation to assess their anti-inflammatory activity through COX-1, COX-2, and 5-LOX, as well as their anti-arthritic properties. Three derivatives 2, 4, and 9 demonstrated the most significant activity, with IC50 values of 10.16 ± 0.18, 9.68 ± 0.17, and 10.13 ± 0.18 µg mL−1 for COX-1, and 7.68 ± 0.05, 7.32 ± 0.04, and 7.66 ± 0.05 µg mL−1 for COX-2, respectively. These results exhibited superior activity compared to Aspirin, which had IC50 values of 11.21 ± 0.12 and 8.45 ± 0.05 µg mL−1, while demonstrating competitive activity relative to Naproxen (IC50 = 8.13 ± 0.14 and 6.18 ± 0.04 µg mL−1) and Indomethacin (IC50 = 7.16 ± 0.05 and 5.47 ± 0.04 µg mL−1) for COX-1 and COX-2, respectively. For 5-LOX, compound 4 demonstrated the most potent activity, with an IC50 value of 11.64 ± 0.20 µg mL−1. This value is comparable to that of naproxen (IC50 = 9.65 ± 0.17 µg mL−1) and zileuton (IC50 = 8.43 ± 0.05 µg mL−1), while demonstrating greater efficacy than aspirin (IC50 = 13.68 ± 0.13 µg mL−1). These findings suggest that compound 4 may serve as a potent inflammatory mediator with multiple targets. In terms of arthritic activity, the synthesized derivatives demonstrated the ability to inhibit protein denaturation and proteinase activity, exhibiting moderate inhibitory effects. Finally, in silico toxicity predictions were conducted, demonstrating a safer profile compared to the utilized drugs. Additionally, docking simulations were performed for the most active derivatives, revealing higher binding affinities, supported by hydrogen bonding, arene-cation interactions, and hydrophobic interactions.

Background Inflammatory bowel disease (IBD) is often diagnosed during reproductive age, requiring adequate management during pregnancy. Physiological changes during pregnancy affect liver enzymes, complicating interpretation in a population prone to liver test abnormalities. This study aims to investigate liver enzyme trends throughout pregnancy in women with IBD. Methods A retrospective cohort study was conducted in three Dutch university hospitals. Pregnant women with IBD were included; liver enzyme levels were analyzed throughout pregnancy using Bayesian modeling. The association between liver enzymes and IBD disease activity, medication, pregnancy and adverse pregnancy outcomes was assessed, with estimated marginal means (EMMs) reported across trimesters and clinical subgroups. Results Liver enzyme levels exhibited significant trimester-specific variations in pregnant individuals with IBD. Levels of aminotransferases, γ-glutamyl transferase (γGT) and bilirubin generally declined, particularly in the second trimester, whereas alkaline phosphatase (ALP) levels increased markedly in the third trimester, mirroring physiological changes observed in healthy pregnancies. Adverse pregnancy outcomes were not associated with differences in liver enzyme levels. Several medications – particularly ustekinumab, vedolizumab, thiopurines, corticosteroids and amino salicylates – were associated with liver enzyme values or interacted with pregnancy, modulating the direction or magnitude of change. However, these effects were generally modest and remained within reference values. Conclusions In pregnant women with IBD, changes in liver enzyme levels reflect physiological gestational adaptations rather than pharmacologic effects. Although medication-specific interactions were detected, their clinical significance appears limited. Marked elevations in liver enzymes during pregnancy cannot routinely be attributed to IBD activity or medication and warrant urgent analysis.

Ulcerative Colitis (UC) is a chronic illness that commonly demands the use of medication, sometimes for long term. In a DSS mouse model, we examined 5-aminosalicylic acid (5ASA) in comparison to a defined polyphenol-rich herbal mixture CSPG: Cirsium japonicum, Scutellaria baicalensis, Paeonia japonica, and Glycyrrhizae radix, using a two-phase approach. In phase 1 (days 1-14, without DSS stimulation), the herbal formula CSPG produced a more gut-friendly preventive profile compared to 5ASA in non-inflammatory condition:Unlike 5-ASA, which decreases microbial diversity as previously reported, CSPG preserved overall diversity and maintained protective taxa such as Ruminococcaceae uncultured ; and reduced inflammatory metabolites (uracil, glyceric acid, succinic acid) more effectively than 5ASA. Next, in phase 2 (days 15-24, with DSS inflammatory stimulation), CSPG matched first-line 5-ASA in suppressing inflammation (reduced colon shortening and procalcitonin). Its PI3K-Akt upregulation-together with NF-κB repression-was associated with more continuous ZO-1/ZO-2/occludin proteins expression and normalization of claudin-2 and MUC1/MUC2/MUC4, indicating barrier-repair capacity, a result supported by in vitro HT-29 experiments. Simultaneously, CSPG corrected DSS-induced dysbiosis more effectively than 5ASA: it increased SCFA-linked taxa (Prevotellaceae UCG-001 and Ruminococcus; 5ASA also rose but to a lesser extent), and reduced inflammation-associated groups ( [Eubacterium] siraeum group, and Erysipelotrichaceae). CSPG restored SCFAs and elevated glycine, proline, pyruvate, and myo-inositol, while reducing succinate and uracil-with stronger effects than 5-ASA for pyruvate, myo-inositol, and succinate, and comparable effects for butyrate. Although CSPG is not a single-target, rationally designed drug like 5ASA, it achieved comparable anti-inflammatory and barrier-repair effects and, unlike 5ASA, also improved gut microbiota composition and metabolite profiles, indicating potential advantages for long-term UC management.

The formation of interfacial charge transfer (ICT) complexes between phenolic ligands and metal oxide surfaces enables surface functionalization strategies with potential applications in catalysis and bioconjugation. In this study, magnetite (Fe3O4) nanoparticles were modified with two phenolic ligands, 5-aminosalicylic acid (5ASA) and caffeic acid (CA), to generate ICT complexes capable of covalent or non-covalent enzyme immobilization, respectively. The modified nanomaterials were structurally characterized using X-ray diffraction (XRD), transmission electron microscopy (TEM), and Fourier-transform infrared spectroscopy (FTIR). Horseradish peroxidase (HRP) was immobilized on these functionalized supports using varying nanoparticle amounts (10–30 mg) and initial enzyme concentrations (25–250 µg mL−1). Catalytic activity was evaluated using pyrogallol oxidation assays. The Fe3O4/5ASA–HRP system exhibited a maximum activity of 2.5 U per 20 mg of support (approximately 125 U g−1), whereas Fe3O4/CA showed minimal activity under the same conditions. Enzyme loading studies confirmed that 5ASA-enabled covalent attachment resulted in significantly higher immobilization efficiency (up to 1068 mg g−1) compared to the CA system. Reusability tests demonstrated that the Fe3O4/5ASA system retained high absolute catalytic activity during the initial reaction cycles and consistently outperformed the non-covalently immobilized Fe3O4/CA system upon repeated reuse. The magnetic properties of Fe3O4 allowed rapid recovery of the biocatalysts using an external magnetic field. These results highlight the effectiveness of ICT-based functionalization for enzyme immobilization, positioning Fe3O4/5ASA as a promising platform for robust and reusable biocatalysts in environmental and industrial applications.

Investigation of solid-state forms between p-aminosalicylic acid and adenine: Exploring salts, cocrystals and their polymorphism

Synergistic co-processing of heat-moisture treated resistant rice starch with HPMC and Eudragit® S100: A novel multifunctional excipient for direct compression and colon-targeted delivery.

We evaluated the efficacy and safety of ozanimod after 5-aminosalicylic acid (5-ASA) failure in advanced therapy (AT)-naive patients with moderate ulcerative colitis (UC) in True North and its open-label extension (OLE). True North was a randomized, 52-week, phase 3 trial with an optional OLE. Efficacy was assessed in True North and the OLE; safety was assessed through OLE week 190. Overall, 203 AT-naive True North patients had moderate UC (Mayo endoscopic subscore of 2 + modified Mayo score of 4-6 + rectal bleeding subscore ≥1). Of these, 139 were also immunomodulator-naive and not receiving corticosteroids (5-ASA-exposed only) at baseline. Patients with moderate UC receiving ozanimod vs placebo achieved greater efficacy rates for all week 10 and week 52 outcomes, regardless of prior immunomodulator/corticosteroid use (eg, week 10 clinical remission: AT-naive = 36.8% vs 10.6%; 5-ASA-exposed only = 37.9% vs 17.2%). Higher symptomatic response rates were achieved by week 2 with ozanimod in AT-naive patients with moderate UC vs the overall AT-naive population (50.5% vs 38.7%); similar trends were observed in patients exposed only to 5-ASA. Efficacy was maintained through OLE week 190 in patients who entered OLE as True North week 52 ozanimod clinical responders. Of those entering OLE as True North week 10 ozanimod clinical nonresponders, 69.0% of AT-naive patients and 68.4% of patients exposed only to 5-ASA achieved symptomatic response by week 5. No new safety signals emerged. Ozanimod was safe, effective, and durable up to ∼5 years in AT-naive patients with moderate UC who failed conventional therapy. ClinicalTrials.gov: NCT02435992, NCT02531126.

Design, synthesis, and biological evaluation of novel NIK inhibitors for the treatment of inflammatory bowel disease and sepsis.

P0733 Safety and efficacy of 5-aminosalicylic acid (5-ASA) for treatment of Ulcerative Colitis in adults: A systematic literature review

This report presents a rare case of 5-aminosalicylic acid (5-ASA)-induced colitis in a 76-year-old man with no history of inflammatory bowel disease (IBD). The patient, who was undergoing treatment for rheumatoid arthritis, developed persistent diarrhea and fever following sulfasalazine (SASP) administration and later experienced a high fever shortly after taking mesalazine. The drug-induced lymphocyte stimulation test result was positive for mesalazine and weakly positive for SASP, thereby supporting the diagnosis of 5-ASA intolerance. This case emphasizes that 5-ASA-induced colitis may occur in patients without IBD. Clinicians should consider this possibility when unexplained gastrointestinal symptoms appear after starting 5-ASA therapy even in patients without any prior IBD.

P1123 The Practical Utility of Janus Kinase Inhibitors in Ulcerative Colitis: A Real-World Multicentre Study