Effects of mesalazine combined with bifid triple viable on intestinal flora, immunoglobulin and levels of cal, MMP-9, and MPO in feces of patients with ulcerative colitis

X.-E. Jiang, S.-M. Yang, X.-J. Zhou, Y. Zhang

Department of Colon and Rectal Surgery, Fenghua District People’s Hospital, Ningbo, China. yangzhang@jlu.edu.cn

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• Pharmacology

OBJECTIVE: Ulcerative colitis (UC) commonly occurs in young and middle-aged people and is characterized by frequent attacks and difficult cure. Mesalazine is often applied in the initial treatment of UC, but it can lead to serious adverse effects. Its combination with bifid triple viable could mitigate adverse effects. This study aims to explore the effects of mesalazine combined with bifid triple viable on the intestinal flora, immunoglobulin (Ig), and levels of calprotectin (Cal), matrix metalloproteinase-9 (MMP-9), myeloperoxidase (MPO) in feces of UC patients.
PATIENTS AND METHODS: A total of 180 UC patients in our hospital were divided into two groups with 90 cases in each one. Patients in control group were treated with oral mesalazine (1.5 g/d), and those in the treatment group were treated with oral mesalazine (1.5 g/d) combined with bifid triple viable (1.26 g/d) for 2 months. Treatment effects in both groups following the therapeutic period were observed accordingly. Feces of patients in the two groups were collected for detecting intestinal microorganism and the levels of Cal, MMP-9, and MPO. Serum levels of IgG, IgA, and IgM in each patient were detected by enzyme-linked immunosorbent assay (ELISA).
RESULTS: The overall response rate of the treatment group (91.11%) was significantly higher than that of control group (68.89%; p=0.000). The abundances of intestinal microflora, including Bifidobacterium, Actinomycetes, Rikenellaceae, Genus VI of Acidaminococcaceae, and Metascardovia in treatment group were remarkably higher than those in control group. The abundances of intestinal microorganisms such as Phocaeicola, Lawsonia intracelluaris, Streptococcus, Ruminococcaceae, and Clostridium in control group were significantly higher than those in treatment group. After treatment, serum levels of IgG and IgM of patients in treatment group were lower than those in control group, with IgG of (15.14±0.98) (p=0.031) and IgM of (1.50±0.18) (p=0.000). No statistical difference in IgG level was observed between treatment group and control group after treatment (p=0.871). After treatment, the levels of Cal and MMP-9 in feces of patients in treatment group were significantly lower than those in control group with Cal of (79.81±5.42) (p=0.000) and MMP-9 of (4.89±0.98) (p=0.000). There was no statistical difference in the MPO level between treatment group and control group after treatment (p=0.871).
CONCLUSIONS: Mesalazine combined with bifid triple viable is able to enhance the curative effect for UC, improve the composition of intestinal flora, weaken the immune response, and reduce levels of Cal and MMP-9 in the intestinal tract.

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