Evaluation of sucralfate enema in experimental diversion colitis

Abstract

Diversion colitis (DC) is an inflammatory disease that develops in segments with fecal diversion. Sucralfate (SCF) complex, which consists of sucrose octasulfate and polyaluminum hydroxide, has been demonstrated to be effective in the treatment of different forms of colitis. However, until now, the effects of SCF have not been evaluated in DC. Objective to evaluate whether the use of enemas containing SFC improves histological findings in experimental DC. Methods Thirty-six rats underwent right colon bypass procedure through the creation of a proximal colostomy and a distal mucous fistula. The animals were divided into two groups according to the euthanization procedure to be performed two to four weeks after surgery. Each experimental group was divided into three subgroups of six animals, which were submitted to daily application of enemas containing saline solution 0.9% or SCF at concentrations of 1.0 g/kg/day or 2.0 g/kg/day, respectively. The diagnosis of DC in segments with fecal diversion was established by histopathological study considering the following variables epithelial loss, formation of crypt abscesses, the population of goblet cells, inflammatory infiltrate and presence of fibrosis. For statistical analysis, the nonparametric Mann-Whitney and Kruskal-Wallis tests were used, with a significance level of 5% (p <0.05). Results It was observed that the daily application of SCF enemas decreased epithelial loss, formation of colon crypt abscesses, inflammatory infiltrate and tissue fibrosis (p <0.05), unrelated to time of intervention. The intervention with SCF preserves the goblet cell population. The effects of the substance on the preservation of colonic epithelium; the decrease in the inflammatory process and subsequent abscess formation in the colon crypts are associated with the concentration used, whereas tissue fibrosis decrease is associated with the concentration and time of intervention. Conclusion Preventive application of SCF enemas reduces the inflammatory process in the colon with fecal diversion

Evaluation of the application of enemas containing sucralfate in tissue content of neutral and acid mucins in experimental model of diversion colitis

“…In this study we verified that daily use of enemas with SCF decreased epithelial loss, abscess formation in the colon crypts, inflammatory infiltrate and was able to preserve the population of goblet cells 40 .…”

Claudin-3 and occludin content in the glands of colonic mucosa devoid from fecal stream submitted to topical intervention with oil extract of Curcuma longa

“…The surgical methodology used for the induction of exclusion colitis has already been described in previous studies published by our group [1][2][3] . Briefly, all animals were placed under general anesthesia by intramuscular administration of 0.1 mL/100 g of a 1:1 (v/v) ketamine (50 mg/mL) and xylazine (20 mg/mL).…”

“…Several substances have been tested for the treatment of CDC. Most of these drugs exhibit anti-inflammatory and antioxidant effects reducing the epithelial inflammation and oxidative stress [1][2][3]12,13 . Curcumin, the principal active principle present in the rhizome of Curcuma longa, has showed to be a promising substance for the treatment of different groups of inflammatory bowel disease (IBD) because it's anti-inflammatory and antioxidant properties 14 .…”

“…This defense system is formed by different structures, which act as mechanical barrier, and by cells of the immune system, which constitute an immunological barrier [1][2][3] . The mechanical protection are formed by the mucus that recover the intestinal epithelium, the cellular membranes of colonocytes, the mechanisms of intercellular junctions (IJs) and basal membrane 4 .…”

“…zThese substances can reduce the epithelial damage, improve the inflammation and increase the mucous layer that recovers the colonic mucosa devoid of the fecal stream [1][2][3] . Curcumin has been used as a substance for the prevention and treatment of many organ and tissue disorders, most of which are associated with inflammation and oxidative stress 33,34 .…”