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Remote ischemic conditioning in active ulcerative colitis: An explorative randomized clinical trial.

Line E Godskesen1,2,3, Thomas R Lassen4, Nichlas R Jespersen4

  • 1Department of Medical Gastroenterology, Odense University Hospital, Odense, Denmark.

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Remote ischemic conditioning (RIC) did not reduce inflammation in patients with active ulcerative colitis (UC). This study found no significant clinical or anti-inflammatory benefits of RIC for UC patients.

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Area of Science:

  • Gastroenterology
  • Immunology
  • Cardiovascular Physiology

Background:

  • Remote ischemic conditioning (RIC) involves brief limb ischemia/reperfusion to induce organ resistance to injury, partly via anti-inflammatory mechanisms.
  • Ulcerative colitis (UC) is a chronic inflammatory bowel disease requiring effective anti-inflammatory therapies.

Purpose of the Study:

  • To investigate the clinical and anti-inflammatory effects of RIC in patients with active UC.
  • To assess if RIC can modulate inflammatory markers and gene expression in UC patients.

Main Methods:

  • An explorative, randomized, sham-controlled trial involving 22 active UC patients.
  • Patients received daily RIC or sham treatment for 10 days.
  • Evaluated inflammation using fecal calprotectin, CRP, Mayo Score, histological indices, and cytokine levels; assessed mRNA/miRNA profiles and cardiac protective mechanisms.

Main Results:

  • RIC did not significantly alter inflammation markers (fecal calprotectin, CRP, Mayo Score, histological indices, cytokines) compared to sham treatment.
  • No significant changes were observed in mRNA or miRNA expression profiles in UC patients following RIC.
  • The organ protective mechanism induced by RIC could not be confirmed in UC patients using the Langendorff heart model.

Conclusions:

  • Remote ischemic conditioning demonstrated no significant clinical or anti-inflammatory efficacy in active ulcerative colitis patients within this study's parameters.
  • Further research is needed to explore potential alternative mechanisms or patient subgroups for RIC's therapeutic effects in inflammatory conditions.