Effects of mesalamine: A Synthesis of Findings from 14 Studies

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Original Abstract of the Article

Major Research Findings

Mesalamine, also known as 5-aminosalicylic acid (5-ASA), is a medication commonly used to treat inflammatory bowel disease (IBD). Several studies have explored the effects of mesalamine and its derivatives in various settings related to IBD and other conditions. 6 investigated the impact of mesalamine on immune activation in HIV-infected individuals with incomplete CD4+ T cell recovery. This study found no significant changes in immune activation markers after mesalamine treatment, suggesting that mesalamine may not be effective in addressing the persistent immune activation associated with HIV infection. 12 explored the potential of a nitric oxide (NO)-releasing derivative of mesalamine to enhance anti-inflammatory effects in rats. The researchers suggested that this derivative might offer improved anti-inflammatory activity with reduced gastrointestinal toxicity compared to standard mesalamine. 9 investigated the combined effects of mesalamine and antioxidants in chemically induced colitis in rats. The study found that the combination of mesalamine and antioxidants was more effective in promoting mucosal healing than either agent alone. 2 analyzed the impact of mesalamine on colorectal neoplasia in patients with IBD. The study concluded that mesalamine, at doses greater than 1.2 g per day, may reduce the risk of colorectal cancer in patients with IBD. 7 examined the effects of mesalamine on bacterial gene expression. The study suggested that mesalamine may influence the composition and activity of gut bacteria. 8 investigated the combined effects of N-acetylcysteine (NAC) and mesalamine on inflammation in chemically induced colitis in rats. The results indicated that the combination of NAC and mesalamine was superior to either agent alone in reducing inflammation. 10 explored the effects of a hydrogen sulfide (H2S)-releasing derivative of mesalamine in a model of postinflammatory hypersensitivity. The study suggested that this derivative might have beneficial effects in the treatment of painful intestinal disorders. 5 examined the effects of mesalamine treatment on gut barrier integrity after burn injury. The study found that mesalamine may help maintain normal gut barrier function after burn injury, potentially reducing inflammation and improving recovery. 13 investigated the effects of mesalamine on the heat shock protein (hsp72) stress response in rat intestinal epithelial cells. The study found that mesalamine may modulate the expression of hsp72, potentially contributing to its protective effects. 4 examined the effects of fermentable fiber intake on intestinal pH, transit, and predicted oral mesalamine delivery in patients with ulcerative colitis. The study suggested that fiber intake could influence the delivery and efficacy of mesalamine. 14 investigated the effects of butyrate, mesalamine, and factor XIII in experimental colitis in the rat. The study found that these agents may influence transglutaminase activity, potentially playing a role in mucosal repair. 11 compared the prosecretory effects of various aminosalicylates, including mesalamine, in rabbit distal ileum. The study found that some mesalamine formulations may induce diarrhea due to their effects on ileal secretion. 3 reported two cases of severe mesalamine-induced toxicity, highlighting the potential for adverse effects on the lung and heart. 1 investigated the survival of a probiotic Escherichia coli strain in the gastrointestinal tract when administered with oral mesalamine. The study suggested that mesalamine might have antimicrobial effects on certain probiotics.

Benefits and Risks

Benefits Summary

Mesalamine is a medication commonly used to treat inflammatory bowel disease (IBD), specifically ulcerative colitis. It is generally well tolerated and can be effective in reducing inflammation in the digestive tract. 6 12 9 8 10 5 13 4 14 11

Risk Summary

While generally well tolerated, mesalamine can sometimes cause serious side effects, particularly affecting the lungs and heart. 3

Comparison Between Studies

Commonalities in Studies

Many studies have shown that mesalamine can be an effective treatment for IBD, particularly ulcerative colitis.

Differences in Studies

The efficacy and safety of mesalamine can vary depending on factors such as dosage, specific formulation, and the patient's individual condition. Some studies highlight the potential for mesalamine to have adverse effects on the lungs and heart.

Consistency and Contradictions in Results

The research findings regarding the effects of mesalamine are not always consistent. While it can be a beneficial treatment for some individuals, it may not be effective or may even cause side effects in others.

Considerations for Real-Life Application

Mesalamine can be a valuable treatment option for IBD, but it is important to be aware of potential risks, including lung and heart issues. Always consult a healthcare professional before starting or changing any medication, including mesalamine, and follow their guidance carefully.

Limitations of Current Research

Further research is needed to better understand the long-term safety and effectiveness of mesalamine.

Future Research Directions

Future research should focus on long-term studies to assess the safety and effectiveness of mesalamine, as well as investigate the potential for adverse effects on the lungs and heart.

Conclusion

Mesalamine is a commonly used medication for IBD with potential benefits in reducing inflammation, but it can also have adverse effects. It is essential to discuss potential risks and benefits with your healthcare provider before taking mesalamine. Further research is necessary to better understand the long-term effects and optimize the use of mesalamine in treating IBD.

Literature analysis of 14 papers
Positive Content
14
Neutral Content
0
Negative Content
0
Article Type
2
1
1
1
13
1.

Survival of the probiotic Escherichia coli Nissle 1917 (EcN) in the gastrointestinal tract given in combination with oral mesalamine to healthy volunteers.

Author: Joeres-Nguyen-XuanThai Hoa, BoehmStephan Karl, JoeresLars, SchulzeJuergen, KruisWolfgang

Ulcerative colitis treatment
None mentioned

The combination of E. coli Nissle 1917 (EcN) and mesalamine had no significant effect on the survival of EcN in healthy volunteers.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

2.

Mesalamine, but Not Sulfasalazine, Reduces the Risk of Colorectal Neoplasia in Patients with Inflammatory Bowel Disease: An Agent-specific Systematic Review and Meta-analysis.

Author: OʼConnorAnthony, PackeyChristopher D, AkbariMona, MossAlan C

Colorectal cancer prevention
Not specified

Mesalamine at doses greater than 1.2 g per day has not been previously studied for its specific impact on colorectal cancer in inflammatory bowel disease.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

3.

Mesalamine - A Revered Drug for Inflammatory Bowel Disease With Detrimental Effects on the Lung and Heart.

Author: ChaudhryAhtshamullah, NoorJawad, FatimaGhulam, BatoolSaima, NoorRiwad

IBD remission
Cardiomyopathy
Pneumonitis

This study describes two cases of serious side effects caused by mesalamine, a drug commonly used to treat inflammatory bowel disease (IBD). While mesalamine is generally well-tolerated, it can cause serious side effects such as cardiomyopathy and pneumonitis. Early detection and treatment of these side effects are crucial.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.

Language : English

4.

Effects of fiber intake on intestinal pH, transit, and predicted oral mesalamine delivery in patients with ulcerative colitis.

Author: YaoChu K, BurgellRebecca E, TaylorKirstin M, WardMark G, FriedmanAntony B, BarrettJacqueline S, MuirJane G, GibsonPeter R

UC treatment

This study investigated the effects of fermentable fiber on intestinal pH and transit in patients with ulcerative colitis.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

6.

The immunologic effects of mesalamine in treated HIV-infected individuals with incomplete CD4+ T cell recovery: a randomized crossover trial.

Author: SomsoukMa, DunhamRichard M, CohenMichelle, AlbrightRebecca, Abdel-MohsenMohamed, LieglerTeri, LifsonJeffrey, PiatakMichael, GorelickRobert, HuangYong, WuYuaner, HsuePriscilla Y, MartinJeffrey N, DeeksSteven G, McCuneJoseph M, HuntPeter W

Mesalamine effectiveness
Ulcerative colitis treatment
HIV infection impact

This study investigated the effect of mesalamine on persistent immune activation in HIV-infected individuals. Mesalamine did not significantly impact the immune activation associated with HIV infection.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, N.I.H., ExtramuralResearch funding provided by the NIH to external research institutions and researchers.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

7.

Effects of mesalamine (5-aminosalicylic acid) on bacterial gene expression.

Author: KaufmanJaime, GriffithsTanya A, SuretteMichael G, NessSusan, RiouxKevin P

Colon cancer prevention
IBD treatment

5-Aminosalicylic acid (5-ASA) is a medication used to treat inflammatory bowel disease (IBD). It may also reduce the risk of colon cancer in patients with IBD. This study examined the effects of 5-ASA on the bacteria in the gut, as these bacteria may play a role in IBD.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

8.

Effects of N-acetylcysteine plus mesalamine on prostaglandin synthesis and nitric oxide generation in TNBS-induced colitis in rats.

Author: AnchaHanumantha R, KurellaRavi R, McKimmeyChristine C, LightfootStanley, HartyRichard F

Reduces PGE2
Reduces colitis
Reduces nitrate
Suppresses COX2

A combination of N-acetylcysteine (NAC) and mesalamine (5-ASA) was more effective than either drug alone in reducing inflammation in rats with colitis.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

9.

Luminal antioxidants enhance the effects of mesalamine in the treatment of chemically induced colitis in rats.

Author: AnchaHanumantha R, KurellaRavi R, McKimmeyChristine C, LightfootStanley, HartyRichard F

Promotes mucosal healing
Reduces colitis

This study investigates the effectiveness of three antioxidants plus mesalamine compared to 5-ASA alone in treating colitis induced by trinitrobenzene sulfonic acid (TNBS) in rats.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
Research Support, U.S. Gov't, Non-P.H.S.Research funding provided by US government agencies other than the Public Health Service.

Language : English

10.

5-Amino-2-hydroxybenzoic acid 4-(5-thioxo-5H-[1,2]dithiol-3yl)-phenyl ester (ATB-429), a hydrogen sulfide-releasing derivative of mesalamine, exerts antinociceptive effects in a model of postinflammatory hypersensitivity.

Author: DistruttiEleonora, SediariLuca, MencarelliAndrea, RengaBarbara, OrlandiStefano, RussoGiuseppe, CaliendoGiuseppe, SantagadaVincenzo, CirinoGiuseppe, WallaceJohn L, FiorucciStefano

IBS treatment

ATB-429, a novel H2S-releasing derivative of mesalamine, effectively attenuated colorectal distension (CRD)-induced hypersensitivity in healthy and postcolitic rats. ATB-429's antinociceptive effects were mediated by ATP-sensitive K+ (KATP) channels and involved downregulation of inflammatory markers. These findings suggest that H2S-releasing drugs may be beneficial for the treatment of painful intestinal disorders.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

11.

Comparative analysis of the in vitro prosecretory effects of balsalazide, sulfasalazine, olsalazine, and mesalamine in rabbit distal ileum.

Author: KlesKeri A, VavrickaStephan R, TurnerJerrold R, MuschMark W, HanauerStephen B, ChangEugene B

Decrease inflammation
Improve absorption
Diarrhea

Aminosalicylates are commonly used for mild-to-moderate ulcerative colitis, and pro-drug formulations like olsalazine have been associated with dose-dependent diarrhea in 17% of patients. This study investigates whether the azo linkages in these pro-drugs are responsible for increased secretion.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, N.I.H., ExtramuralResearch funding provided by the NIH to external research institutions and researchers.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
Research Support, U.S. Gov't, P.H.S.Research funding provided by the Public Health Service (PHS).

Language : English

12.

Enhanced anti-inflammatory effects of a nitric oxide-releasing derivative of mesalamine in rats.

Author: WallaceJ L, VergnolleN, MuscaráM N, AsfahaS, ChapmanK, McKnightW, Del SoldatoP, MorelliA, FiorucciS

Enhanced anti-inflammatory activity

A nitric oxide (NO)-releasing derivative of mesalamine, NCX-456 (NO-mesalamine), was significantly more effective than mesalamine in reducing the severity of colitis in a rat model. NO-mesalamine suppressed leukocyte adherence to the vascular endothelium in vivo and inhibited interleukin (IL)-1beta and interferon (IFN)-gamma release and caspase 1 activity in splenocytes.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

13.

Effects of mesalamine on the hsp72 stress response in rat IEC-18 intestinal epithelial cells.

Author: BurressG C, MuschM W, JurivichD A, WelkJ, ChangE B

Cell protection

This study investigated the potential of mesalamine to increase intestinal epithelial hsp72 expression, as a mechanism of cell protection.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, U.S. Gov't, P.H.S.Research funding provided by the Public Health Service (PHS).

Language : English

14.

Butyrate, mesalamine, and factor XIII in experimental colitis in the rat: effects on transglutaminase activity.

Author: D'ArgenioG, CosenzaV, SorrentiniI, De RitisF, GattoA, Delle CaveM, D'ArmientoF P, MazzaccaG

Butyrate colitis efficacy
Factor XIII colitis efficacy
Transglutaminase ulcer healing role

Sodium butyrate and factor XIII improved colitis in rats, with sodium butyrate plus mesalamine reducing early thromboxane B2 synthesis. Transglutaminase(s) played a role in ulcer healing.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

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