High Affinity of Ecabet Sodium for Inflamed Colonic Mucosa in Ulcerative Colitis

Excerpt

To the Editor: The pathogenesis of ulcerative colitis (UC) is unknown, but may be associated with inability of the colonic mucosa to protect itself from luminal challenges and/or with inappropriate effective repair following colonic injury. Therapeutic approaches aiming to promote the repair of the injured mucosa have included the use of mucosal protectants. Ecabet sodium, purified from pine resin, has been used widely in Japan as a nonabsorbable protectant in treating gastric ulcer [1]. Recently, benefit from ecabet sodium given by enema has been reported in treatment of UC [2] as well as in experimental colitis [3]. In the stomach, ecabet sodium has been found to adhere selectively to ulcerated gastric mucosa, showing a high affinity for injured gastric epithelium. In gastric ulcer, this agent promotes mucosal integrity, possibly by enhancing epithelial restitution, facilitating mucus synthesis and secretion, inducing prostaglandin production, and increasing mucosal blood flow [4, 5]. In intestinal epithelial cells in vitro, ecabet sodium activated extracellular signal-regulated kinases 1 and 2, and also induced cyclooxygenase-2 [6]. However, whether ecabet sodium adheres preferentially to inflamed colon as it does to ulcerated stomach remains unclear. We, therefore, evaluated the affinity of ecabet sodium for colonic mucosa in patients with UC. …