Rectal administration of d-alpha tocopherol for active ulcerative colitis： A preliminary report

• Published in: World journal of gastroenterology : WJG Vol. 14; no. 39; pp. 5990 - 5995
• Main Authors: Mirbagheri, Seyed-Amir, Nezami, Behtash-Ghazi, Assa, Solmaz, Hajimahmoodi, Mannan
• Format: Journal Article
• Language: English
• Published: United States Amir-Alam hospital, Tehran University of Medical Sciences, Tehran 13145-784, Iran%Department of Drug and Food Control, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran 13145-784, Iran 21.10.2008; The WJG Press and Baishideng
• Subjects: Administration, Rectal; Adult; alpha-Tocopherol - administration & dosage; alpha-Tocopherol - adverse effects; Antioxidants - administration & dosage; Antioxidants - adverse effects; Clinical Research; Colitis, Ulcerative - drug therapy; Dose-Response Relationship, Drug; Enema; Female; Humans; Male; Middle Aged; Severity of Illness Index; Treatment Outcome; 免疫性疾病; 治疗方法; 维生素E; 肠溃疡; Inflammatorybowel disease; Vitamin E; Activity index; Ulcerative colitis; Enema
• ISSN: 1007-9327; 2219-2840
• DOI: 10.3748/wjg.14.5990

AIM： To investigate the anti-oxidant and antineutrophil recruitment effects of rectal d-alpha （d-α） tocopherol administration on mild and moderately active ulcerative colitis （UC）. METHODS： Fifteen patients with mild and moderately active ulcerative colitis were enrolled in an openlabel study of d-α tocopherol enema （8000 U/d） for 12 wk. All patients were receiving concomitant therapy with 5-aminosalicylic acid derivatives （5-ASA） and/or immunomodulator medications. Endoscopic evaluation was performed at baseline and after 4th and 12th weeks. Disease activity was measured with the Mayo disease activity index （DAI） and remission was defined as DAI of ≤ 2 with no blood in stool. Clinical response was defined as a DAI reduction of ≥ 2. RESULTS： At the end of 12th week, the average DAI score significantly decreased compared to the beginning of the study （2.3 ± 0.37 vs 8 ± 0.48, P 〈 0.0001）. One patient was withdrawn after 3 wk for being unavailable to follow-up. On the 4th week of therapy, 12 patients showed clinical response, 3 of whom （21.4%） achieving remission. After 12 wk, all 14 patients responded clinically to the therapy and remission was induced in 9 of them （64%）. No patient reported adverse events or was hospitalized due to worsened disease activity. CONCLUSION： This preliminary report suggests that rectal d-α tocopherol may represent a novel therapy for mild and moderately active UC. The observed results might be due to the anti-inflammatory and anti-oxidative properties of vitamin E.