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Related Concept Videos

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Ulcerative colitis is a chronic inflammatory condition primarily affecting the colon and rectum. The primary drugs used in the treatment of ulcerative colitis are aminosalicylates. They exhibit anti-inflammatory and immunosuppressive properties. They modulate inflammatory mediators and inhibit the activity of nuclear factor κB (NF-κB). Aminosalicylates also reduce inflammation by inhibiting prostaglandin and leukotriene production and decreasing neutrophil chemotaxis and superoxide...
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Crohn's disease is an inflammatory bowel disorder marked by chronic inflammation of the GI tract. Various treatment strategies for Crohn's disease are employed, such as immunomodulatory agents, glucocorticoids, and biologics or anti-TNF therapy. Azathioprine (Imuran), a commonly used immunomodulatory drug for Crohn's disease, is converted in the body to mercaptopurine, which inhibits purine biosynthesis and cell proliferation. Both are utilized in severe cases of Inflammatory Bowel...
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Upon diagnosis, managing Inflammatory Bowel Disease (IBD) involves addressing several crucial aspects. The primary goals include resting the bowel, correcting malnutrition, and providing symptomatic relief. Resting the bowel may consist of medications to reduce inflammation and promote healing. Correcting malnutrition is essential, often requiring dietary adjustments and nutritional supplements. Symptomatic relief aims to ease pain, diarrhea, and other discomforts in IBD.
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Various diagnostic tests are employed in the diagnostic process for Inflammatory Bowel Disease (IBD), particularly to differentiate between Crohn's disease and ulcerative colitis.
Diagnostic studies
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Glucocorticoids, a class of anti-inflammatory drugs, are pivotal in treating moderate to severe Crohn's disease by inducing remission. They exhibit their anti-inflammatory action by inhibiting the production of inflammatory cytokines such as tumor necrosis factor (TNF)-α, interleukin (IL)-1, and chemokines like IL-8. In addition, they reduce the expression of inflammatory cell adhesion molecules and inhibit gene transcription of nitric oxide synthase, phospholipase A2, cyclooxygenase-2...
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Surgical interventions for inflammatory bowel disease (IBD), which includes ulcerative colitis and Crohn's disease, are essential in managing symptoms and addressing complications. The selection of surgical procedures is contingent upon the specific conditions and complications that stem from these illnesses.
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Fast Inspection of Quality of Indigo Naturalis by Multiple Light Scattering
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Treatment-refractory ulcerative colitis responsive to indigo naturalis.

Julie P Saiki1, Johan Ol Andreasson2, Kevin V Grimes1

  • 1Department of Chemical and Systems Biology, Stanford University School of Medicine, Stanford, California, USA.

BMJ Open Gastroenterology
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Summary

Indigo naturalis (IN) shows promise for ulcerative colitis treatment, with 91% of patients responding. This herbal medicine

Keywords:
clinical trialsinflammatory bowel diseaseulcerative colitis

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Area of Science:

  • Gastroenterology
  • Pharmacology
  • Immunology

Background:

  • Indigo naturalis (IN) is an herbal medicine used for ulcerative colitis (UC).
  • Its mechanism of action is unclear, but key components indigo and indirubin activate the aryl hydrocarbon receptor (AhR).
  • This study investigates IN's safety, efficacy, and AhR activity in UC patients.

Purpose of the Study:

  • To assess the safety and efficacy of oral Indigo naturalis (IN) in patients with treatment-refractory ulcerative colitis (UC).
  • To evaluate the impact of IN on colon aryl hydrocarbon receptor (AhR) activity.
  • To explore the role of AhR in IN's therapeutic effects using an AhR antagonist in a murine colitis model.

Main Methods:

  • An open-label, dose-escalation study treated 11 UC patients with IN (500 mg/day or 1.5 g/day) for 8 weeks.
  • Efficacy was measured by clinical response (total Mayo score), remission, endoscopic severity, and quality of life.
  • Colon AhR activity was assessed via cytochrome P450 1A1 (CYP1A1) RNA expression.

Main Results:

  • 91% of patients achieved clinical response, including those refractory to conventional therapies and biologics.
  • Three patients achieved clinical remission, and all showed improved endoscopic scores and quality of life.
  • Colon CYP1A1 RNA expression increased significantly, and an AhR antagonist blocked IN's benefits in a mouse model.

Conclusions:

  • Indigo naturalis (IN) appears to be a safe and effective therapy for treatment-refractory ulcerative colitis.
  • The therapeutic benefits of IN are likely mediated through the activation of the aryl hydrocarbon receptor (AhR).