Hauso Øyvind, Martinsen Tom Christian, Waldum Helge
Department of Cancer Research and Molecular Medicine, Norwegian University of Science and Technology , Trondheim , Norway.
Scand J Gastroenterol. 2015 Aug;50(8):933-41. doi: 10.3109/00365521.2015.1018937. Epub 2015 Mar 2.
The etiology of the inflammatory bowel diseases is unknown, although genetic factors play a role, and tobacco smoking has opposite effect on the two entities. Inflammation is central in the pathogenesis, and treatment is aiming to suppress it. The active part of salazopyrin, the oldest drug in use in the treatment of ulcerative colitis, is 5-aminosalicylic acid (5-ASA). In the present paper, we wanted to discuss the etiology and pathogenesis of ulcerative colitis in relation to the beneficial effects of 5-ASA and particularly whether this compound has a specific effect on ulcerative colitis.
METHODS/RESULTS: 5-ASA seems to have a selective positive effect on ulcerative colitis in inducing remission, preventing relapse and possibly reducing the risk of cancer. In contrast to other agents used in the treatment of ulcerative colitis, 5-ASA does not have any known anti-inflammatory effect on other organs or other colonic inflammatory diseases like diverticulitis. Moreover, the effect on experimental colitis in rodents is not convincing.
5-ASA seems to have a specific effect on the inflammation in ulcerative colitis. Research on the mechanism of its action may give information on the etiology of ulcerative colitis. 5-ASA is a first-line treatment that should be given once daily in high doses and for long term to reduce the possibility of recurrence and risk of colonic cancer. Side effects with 5-ASA are rare, and every patient with ulcerative colitis who tolerate this drug, should be treated with 5-ASA.
炎症性肠病的病因尚不清楚，尽管遗传因素起一定作用，且吸烟对这两种疾病有相反影响。炎症在发病机制中起核心作用，治疗旨在抑制炎症。柳氮磺胺吡啶是治疗溃疡性结肠炎最古老的药物，其活性成分是5-氨基水杨酸（5-ASA）。在本文中，我们想探讨溃疡性结肠炎的病因和发病机制与5-ASA的有益作用之间的关系，特别是该化合物是否对溃疡性结肠炎有特异性作用。
方法/结果：5-ASA似乎对溃疡性结肠炎在诱导缓解、预防复发以及可能降低癌症风险方面具有选择性积极作用。与用于治疗溃疡性结肠炎的其他药物不同，5-ASA对其他器官或其他结肠炎症性疾病如憩室炎没有任何已知的抗炎作用。此外，其对啮齿动物实验性结肠炎的作用也不令人信服。
5-ASA似乎对溃疡性结肠炎的炎症有特异性作用。对其作用机制的研究可能会为溃疡性结肠炎的病因提供信息。5-ASA是一线治疗药物，应每日大剂量长期给药，以降低复发可能性和结肠癌风险。5-ASA的副作用很少见，每一位能耐受该药的溃疡性结肠炎患者都应接受5-ASA治疗。
