Evaluation of Enemas Containing Sucralfate in Tissue Content of Muc-2 Protein in Experimental Model of Diversion Colitis

Abstract

Background: The effects of topical application of sucralfate (SCF) on the tissue content of MUC-2 protein have not yet been evaluated in experimental models of diversion colitis. Aim: To measure the tissue content of MUC-2 protein in the colonic mucosa diverted from fecal stream submitted to the SCF intervention. Methods: Thirty-six rats underwent derivation of intestinal transit through proximal colostomy and distal mucous fistula. The animals were divided into three groups which were submitted application of enemas with saline, SCF 1 g/kg/day and SCF 2 g/kg/day. Each group was divided into two subgroups, according to euthanasia was done after two or four weeks. The colitis diagnosis was established by histopathological study and the inflammatory intensity was evaluated by previously validated scale. The MUC-2 protein was identified by immunohistochemistry and the tissue content was measured computerized morphometry). Results: The application of enemas with SCF in the concentration of 2 g/kg/day reduced inflammatory score of the segments that were diverted from fecal stream. The content of MUC-2 in diverted colon of the animals submitted to the intervention with SCF, independently of intervention period and the used concentration, was significantly greater than animals submitted to the application of enemas containing saline (p< 0.01). The content of MUC-2 after the intervention with SCF in the concentration of 2 g/kg/day was significantly higher when compared to the animals submitted to the application containing SCF at concentration of 1.0 g/kg/day (p<0.01). The tissue content of MUC-2 reached the highest values after intervention with SCF in the concentration of 2 g/kg/day for four weeks (p<0.01). Conclusion: The preventive application of enemas containing SCF reduces the inflammatory score and avoids the reduction of tissue content of MUC-2, suggesting that the substance is a valid therapeutic strategy to preserve the mucus layer that covers the intestinal epithelium.

Sucralfate enemas reduce the oxidative tissue damage and preserves the contents of E-cadherin and ?-catenin in colonic mucosa without fecal stream

“…Recently, other authors have evaluated the effects of enemas with SCF to treat the experimental DC 14,[27][28][29] . These studies showed that SCF reduces the inflammatory process, decreases neutrophil infiltration and oxidative tissue damage in colonic segments devoid of exposure to the fecal stream 29 .…”

“…In addition to the capacity of SCF to stimulate the production of mucins and EGF, it was demonstrated that the use of SCF enemas stimulates the Table 1 -Tissue content of E-cadherin, β-catenin and MDA in colonic mucosa devoid of fecal stream submitted to intervention with daily enemas with saline or SCF at concentration of 1 or 2 g/kg for two or four weeks. production of different subtypes of colonic mucins by cells of the colonic epithelium, favoring mucosal healing 14,[27][28][29] . These results confirm the effectiveness of SCF in stimulating the production of the mucins and in reducing the oxidative damage and the inflammation of the intestinal mucosa 14,[26][27][28] .…”

“…production of different subtypes of colonic mucins by cells of the colonic epithelium, favoring mucosal healing 14,[27][28][29] . These results confirm the effectiveness of SCF in stimulating the production of the mucins and in reducing the oxidative damage and the inflammation of the intestinal mucosa 14,[26][27][28] . Despite the beneficial effects of SCF enemas for reducing inflammation and oxidative stress of the colonic mucosa without intestinal transit, no study has evaluated the effects of the SCF in preserving the proteins that form the AJs.…”

“…Notwithstanding, few studies have analyzed the effects of SCF in experimental models of DC 14,[27][28][29] . They have showed that the use of SCF clysters to colonic segments without fecal stream reduce the inflammatory process of the intestinal mucosa, increase the tissue contents of different types of mucins, decrease the levels of oxidative tissue damage and the leucocytes infiltrate, and promote the healing of the damage epithelium [27][28][29] . However, the antioxidant effects of the applications of clysters with SCF on preserving the content of the principal proteins constituents of the AJs have never been evaluated in colon mucosa without fecal transit.…”

Efficacy of Baccharis dracunculifolia in the treatment of diversion colitis in rats

“…When temporary, an average of three months is estimated for intestinal reconstruction, however, this timeframe may be extend into years due to multiple factors. 1 The colostomy using Hartmann's procedure, which involves sigmoid colon exteriorization and rectum exclusion from intestinal transit, accounts for half of the total intestinal transit deviations performed, which also makes this type of stoma the one with the highest number of complications, especially in the long run. Thus, in cases where intestinal transit diversion remains for more than 6 months, the number of complications increases, including Disuse Colitis (DC).…”