T1144 Results of a Long-Term Follow-Up Treatment with Delayed Release Phosphatidylcholine in Chronic-Active Ulcerative Colitis

Karner, Max; Schmieg, Verena; Hanemann, Anja; Zahn, Alexandra; Braun, Annika; Karner, Heather; Merle, Uta; Ehehalt, Robert; Stremmel, Wolfgang

doi:10.1016/s0016-5085(08)62303-3

Cited by 5 publications

(3 citation statements)

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“…In addition, phospholipase A2 (PLA2) that catalyzes the degradation of PC to lysoPC [52], showed elevated content and activity in animal models of colitis and in actively inflamed colonic mucosa of UC patients compared to the inactively inflamed mucosa and the control [53][54][55][56]. The upregulation of PLA2 is consistent with the higher lysoPC-to-PC ratio in UC despite decreased overall PC content (lysoPC + PC) [57].…”

Section: Discussionmentioning

confidence: 65%

In vivo analysis of mucosal lipids reveals histological disease activity in ulcerative colitis using endoscope-coupled Raman spectroscopy

Ding

Dupont

Singhal

et al. 2017

Biomed. Opt. Express

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Abstract:The goal of this study is to evaluate endoscopic Raman spectroscopy as a noninvasive technique to determine histological inflammatory status of colitis. Colon mucosal composition was investigated in vivo from patients with ulcerative colitis (UC) and from ageand body mass index (BMI) matched controls using endoscope-coupled Raman spectroscopy. The results were co-registered with histological assessment of inflammatory status at the same locations. Substantial decreases (50-60%) in the content of phosphotidylcholines (PCs) and total lipids were observed in inflamed colon tissue (histology grade 1, 2 and 3) compared to those from the quiescent (histology grade 0) and from the controls. No significant difference was observed in lipids or PC contents between control and grade 0, or among grades 1 -3. The degree of lipid unsaturation increased in the inflamed tissue regardless of disease severity. The inflammation-associated alterations in lipids and PC are observed independent of BMI or the anatomical locations for data collection. Multivariate analysis using support vector machine (SVM) algorithm classified the spectra of the controls or the inactive colitis from those of inflamed tissue with a sensitivity of 83.5% and 97.1% respectively. Our results showed that mucosal lipid content is related to the microscopic disease activity, and thus could serve as a valuable spectral marker to differentiate active colitis from the quiescent. References and links1. E. V. Loftus, Jr., "Clinical epidemiology of inflammatory bowel disease: Incidence, prevalence, and environmental influences," Gastroenterology 126(6), 1504-1517 (2004). 2. J. Misiewicz, J. Lennard-Jones, A. Connell, J. Baron, and F. A. Jones, "Controlled trial of sulphasalazine in maintenance therapy for ulcerative colitis," Lancet 285(7378), 185-188 (1965

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Section: Discussionmentioning

confidence: 65%

In vivo analysis of mucosal lipids reveals histological disease activity in ulcerative colitis using endoscope-coupled Raman spectroscopy

Ding

Dupont

Singhal

et al. 2017

Biomed. Opt. Express

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“…In a second trial from the same group, phosphatidylcholine was superior to placebo in steroid-refractory ulcerative colitis and the endoscopic activity was significantly improved as well [18]. Long-term follow-up of patients from 3 randomized controlled trials showed a difference after follow-up of 26 months [19]. A dose-finding study from the same group found that 1 g/day was the effective dose [20].…”

Section: Phosphatidylcholinementioning

confidence: 99%

Trichuris suis Ova, Lecithin and Other Fancy Molecules

Schölmerich

2014

Dig Dis

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During the last 20 years, treatment paradigms as well as drugs used for IBD have changed significantly. However, there are still many unmet needs and a significant number of patients needing better therapy. It is obvious from this situation that many attempts have been made to implement new drugs and treatment algorithms including biologicals, new formulations of old drugs and ‘fancy molecules or approaches'. For about 10 years, the application of Trichuris suis ova has been promoted and used in quite a number of patients. Two early studies suggested positive effects in ulcerative colitis as well as in Crohn's disease. These studies were based on experimental data in animal models as well as in vitro experiments. However, two large randomized controlled trials were not able to provide significant clinical effects in active Crohn's disease as compared to placebo, although a biological reaction (eosinophilia) was found. Another approach is the use of locally released phosphatidylcholine in ulcerative colitis. This approach is based on decreased phosphatidylcholine concentrations in the colonic mucus in patients, and showed positive effects in a number of monocentric trials in steroid-refractory and chronic active ulcerative colitis. A dose-finding study gave a positive signal in the highest-dose group and this approach is being tested further in controlled trials. Many other ‘fancy molecules' including cannabis, vitamin D, thalidomide, hyaluronic acid, lidocaine, clonidine, chondroitin sulfate, naltrexone and melatonin have been tested in patients with claims of success. For most of those, however, controlled data in appropriate studies are lacking. Many more substances have been used in animal models and are probably applied in individual patients. Results of preliminary studies on some of the molecules mentioned are presented.

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“…Patients participating in the abovementioned trials were offered an open-label follow-up treatment after completion of each of the trials. After a mean follow-up time of 26 months, continuous remission was maintained in 33% of the PC-treated patients versus 10% of the controls (p=0.004) 33. Finally, the results of a phase IIb placebo-controlled dose-finding study with an optimised highly enriched PC preparation (LT-02; 0.8 g, 1.6 g and 3.2 g) in 156 patients with mesalazine-refractory UC were recently presented.…”

Section: Innovative Therapeutic Targets In Ucmentioning

confidence: 99%