Skip to main content

Partially Hydrolyzed Guar Gum Attenuates the Severity of Pouchitis in a Rat Model of Ileal J Pouch-Anal Anastomosis

Abstract

We aimed to evaluate the efficacy of treatment with partially hydrolyzed guar gum (PHGG) using a rat model of ileal pouch-anal anastomosis and pouchitis. In the J pouch groups, tissue myeloperoxidase activities were significantly higher than native myeloperoxidase activities (P = 0.020; P = 0.015; P = 0.004, respectively). A statistically significant difference in total histological score was detected in the J pouch + 5% dextran sulfate sodium (DSS) group, compared to the J pouch control and the J pouch + 5% DSS + PHGG groups (P < 0.01 and P < 0.01, respectively). There was a significant overgrowth of aerobes and anaerobes in the J pouch + 5% DSS group. This study demonstrated that rectal administration of PHGG attenuates the severity of pouchitis in a rat model. In conclusion, PHGG may be an additional therapeutic strategy for the treatment of pouchitis.

This is a preview of subscription content, access via your institution.

Fig. 1
Fig. 2
Fig. 3

References

  1. Shen B, Fazio VW, Remzi FH, Lashner BA (2005) Clinical approach to diseases of ileal pouch-anal anastomosis. Am J Gastroenterol 100:2796–2807. doi:10.1111/j.1572-0241.2005.00278.x

    PubMed  Article  Google Scholar 

  2. Sandborn WJ (1994) Pouchitis following ileal pouch-anal anastomosis: definition, pathogenesis and treatment. Gastroenterology 107:1856–1860

    PubMed  CAS  Google Scholar 

  3. Fazio VW, Ziv Y, Church JM, Oakley JR, Lavery IC, Milson JW et al (1995) Ileal pouch-anal anastomosis: complications and function in 1005 patients. Ann Surg 222:120–127. doi:10.1097/00000658-199508000-00003

    PubMed  Article  CAS  Google Scholar 

  4. Simchuk EJ, Thirlby RC (2000) Risk factors and true incidence of pouchitis in patients after ileal pouch-anal anastomosis. World J Surg 24:851–856. doi:10.1007/s002680010136

    PubMed  Article  CAS  Google Scholar 

  5. Salemans JM, Nagengast FM, Lubbers EJ, Kuijpers JH (1992) Postoperative and long term results of ileal pouch-anal anastomosis for ulcerative colitis and familial polyposis coli. Dig Dis Sci 37:1882–1889. doi:10.1007/BF01308083

    PubMed  Article  CAS  Google Scholar 

  6. Marcello PW, Roberts PL, Schoetz DJ Jr, Coller JA, Murray JJ, Veidenheimer MC (1993) Long-term results of the ileoanal pouch procedure. Arch Surg 128:500–503

    PubMed  CAS  Google Scholar 

  7. Meagher AP, Farouk R, Dozois RR, Kelly KA, Pemberton JH (1998) J ileal pouch-anal anastomosis for chronic ulcerative colitis: complications and long-term outcome in 1310 patients. Br J Surg 85:800–803. doi:10.1046/j.1365-2168.1998.00689.x

    PubMed  Article  CAS  Google Scholar 

  8. Svaninger G, Nordgren S, Oresland T, Hulten L (1993) Incidence and characteristics of pouchitis in the Kock continent ileostomy and the pelvic pouch. Scand J Gastroenterol 28:695–700. doi:10.3109/00365529309098275

    PubMed  Article  CAS  Google Scholar 

  9. Sandborn WJ (1997) Pouchitis: definition, risk factors, frequency, natural history, classification and public health perspective. In: McLeod RS (ed) Trends in inflammatory bowel disease therapy 1996. Kluwer Academic Publishers, Hingham, MA, USA

    Google Scholar 

  10. Lohmuller JL, Pemberton JH, Dozois RR, Ilstrup D, van Heerden J (1990) Pouchitis and extra intestinal manifestations of inflammatory bowel disease after ileal pouch anal anastomosis. Ann Surg 211:622–627

    PubMed  CAS  Google Scholar 

  11. Hurst RD, Molinari M, Chung TP, Rubin M, Michelassi F (1996) Prospective study of the incidence, timing and treatment of pouchitis in 104 consecutive patients after restorative proctocolectomy. Arch Surg 131:497–500

    PubMed  CAS  Google Scholar 

  12. Gionchetti P, Rizzello F, Venturi A, Brigidi P, Matteuzzi D, Bazzocchi G et al (2000) Oral bacteriotherapy as maintenance treatment in patients with chronic pouchitis: a double-blind, placebo-controlled trial. Gastroenterology 119:305–309. doi:10.1053/gast.2000.9370

    PubMed  Article  CAS  Google Scholar 

  13. Mimura T, Rizzello F, Helwig U, Poggioli G, Schreiber S, Talbot IC et al (2004) Once daily high dose probiotic therapy (VSL #3) for maintaining remission in recurrent or refractory pouchitis. Gut 53:108–114. doi:10.1136/gut.53.1.108

    PubMed  Article  CAS  Google Scholar 

  14. Gionchetti P, Rizzello F, Venturi A, Ferretti M, Brignola C, Peruzzo S et al (1997) Long-term efficacy of bismuth carbomer enemas in patients with treatment-resistant chronic pouchitis. Aliment Pharmacol Ther 11:673–678. doi:10.1046/j.1365-2036.1997.00217.x

    PubMed  Article  CAS  Google Scholar 

  15. Wischmeyer P, Pemberton JH, Phillips SF (1993) Chronic pouchitis after ileal pouch-anal anastomosis: responses to butyrate and glutamine suppositories in a pilot study. Mayo Clin Proc 68:978–981

    PubMed  CAS  Google Scholar 

  16. Cummings JH (1981) Short chain fatty acids in the human colon. Gut 22:763–779. doi:10.1136/gut.22.9.763

    PubMed  Article  CAS  Google Scholar 

  17. Breuer RI, Soergel KH, Lashner BA, Christ ML, Hanauer SB, Vanagunas A et al (1997) Short chain fatty acid rectal irrigation for left-sided ulcerative colitis: a randomised, placebo controlled trial. Gut 40:485–491

    PubMed  CAS  Google Scholar 

  18. Breuer RI, Buto SK, Christ ML, Bean J, Vemia P, Paoluzi P et al (1991) Rectal irrigation with short-chain fatty acids for distal ulcerative colitis: preliminary report. Dig Dis Sci 36:185–187. doi:10.1007/BF01300754

    PubMed  Article  CAS  Google Scholar 

  19. Roediger WEW (1982) Utilization of nutrients by isolated epithelial cells of the rat colon. Gastroenterology. 83:424–429

    PubMed  CAS  Google Scholar 

  20. Roediger WEW (1980) The colonic epithelium in ulcerative colitis: an energy-deficiency disease? Lancet 4:712–715. doi:10.1016/S0140-6736(80)91934-0

    Article  Google Scholar 

  21. Roediger WEW, Duncan A, Kapaniris O, Millard S (1993) Reducing sulfur compounds of the colon impair colonocyte nutrition: implications for ulcerative colitis. Gastroenterology 104:802–829

    PubMed  CAS  Google Scholar 

  22. Patz J, Jacobsohn WZ, Gottschalk-Sabag S, Zeides S, Braverman DZ (1996) Treatment of refractory distal ulcerative colitis with short chain fatty acid enemas. Am J Gastroenterol 91:731–734

    PubMed  CAS  Google Scholar 

  23. Steihart AH, Brzezinski A, Baker JP (1994) Treatment of refractory ulcerative proctosigmoiditis with butyrate enemas. Am J Gastroenterol 89:179–183

    Google Scholar 

  24. Slavin JL, Greenberg NA (2003) Partially hydrolyzed guar gum: clinical nutrition uses. Nutrition 19:549–552. doi:10.1016/S0899-9007(02)01032-8

    PubMed  Article  CAS  Google Scholar 

  25. Shebani KO, Stucchi AF, Fruin B, McClung JP, Gee D, Beer ER et al (2002) Pouchitis in a rat model of ileal J pouch-anal anastomosis. Inflamm Bowel Dis 8:23–34. doi:10.1097/00054725-200201000-00004

    PubMed  Article  Google Scholar 

  26. Bradley PP, Priebat DA, Christersen RD, Rothstein G (1982) Measurement of cutaneous inflammation estimation of neutrophil content with an enzyme marker. J Invest Dermatol 78:206–209. doi:10.1111/1523-1747.ep12506462

    PubMed  Article  CAS  Google Scholar 

  27. Hillegass LS, Griswold DE, Brickson B, Albrightson-Winslow C (1990) Assessment of myeloperoxidase activity in whole rat kidney. J Pharmacol Methods 24:285–295. doi:10.1016/0160-5402(90)90013-B

    PubMed  Article  CAS  Google Scholar 

  28. Onderdonk AB, Richardson JA, Hammer RE, Taurog JD (1998) Correlation of cecal microflora of HLA-B27 transgenic rats with inflammatory bowel disease. Infect Immun 66:6022–6023

    PubMed  CAS  Google Scholar 

  29. Ruseler-van Embden JGH, Schouten WR, van Lieshout LMC (1994) Pouchitis: result of microbial imbalance. Gut 35:658–664. doi:10.1136/gut.35.5.658

    PubMed  Article  CAS  Google Scholar 

  30. Sagar PM, Taylor BA, Godwin P, Holdsworth PJ, Johnston D, Lewis W et al (1995) Acute pouchitis and deficiencies of fuel. Dis Colon Rectum 38:488–493. doi:10.1007/BF02148848

    PubMed  Article  CAS  Google Scholar 

  31. Merrett MN, Owen RW, Jewell DP (1997) Ileal pouch dialysate is cytotoxic to epithelial cell lines, but not to CaCo-2 monolayer. Eur J Gastroenterol Hepatol 9:1219–1226

    PubMed  CAS  Google Scholar 

  32. Naito Y, Takagi T, Katada K, Uchiyama K, Kuroda M, Kokura S et al (2006) Partially hydrolyzed guar gum down-regulates colonic inflammatory response in dextran sulfate sodium-induced colitis in mice. J Nutr Biochem 17:402–409. doi:10.1016/j.jnutbio.2005.08.010

    PubMed  Article  CAS  Google Scholar 

  33. Breider MA, Eppinger M, Gough A (1997) Intercellular adhesion molecule-1 expression in dextran sodium sulfate-induced colitis in rats. Vet Pathol 34:598–604

    PubMed  CAS  Article  Google Scholar 

  34. Natsui M, Kawasaki K, Takizawa H, Hayashi S, Matsuda Y, Sugimura K et al (1997) Selective depletion of neutrophils by a monoclonal antibody, RP-3, suppresses dextran sulphate sodium-induced colitis in rats. J Gastroenterol Hepatol 12:801–808. doi:10.1111/j.1440-1746.1997.tb00375.x

    PubMed  Article  CAS  Google Scholar 

  35. Taniguchi T, Tsukada H, Nakamura H, Kodama M, Fukuda K, Saito T et al (1998) Effects of the anti-ICAM-1 monoclonal antibody on dextran sodium sulphate-induced colitis in rats. J Gastroenterol Hepatol 13:945–949. doi:10.1111/j.1440-1746.1998.tb00766.x

    PubMed  Article  CAS  Google Scholar 

  36. Loria V, Dato I, Graziani F, Biasucci LM (2008) Myeloperoxidase: a new biomarker of inflammation in ischemic heart disease and acute coronary syndromes. Mediators Inflamm 135625 (in process citation). doi:10.1155/2008/135625

  37. Bulois P, Tremaine WJ, Maunoury V, Gambiez L, Hafraouri S, Leteurtre Cortot A et al (2000) Pouchitis is associated with mucosal imbalance between interleukin-8 and interleukin-10. Inflamm Bowel Dis 6:157–164

    PubMed  CAS  Google Scholar 

  38. Mazzucchelli L, Hauser C, Zgraggen K, Wagner H, Hess M, Laissue JA et al (1994) Expression of interleukin-8 gene in inflammatory bowel disease is related to the histological grade of active inflammation. Am J Pathol 144:997–1007

    PubMed  CAS  Google Scholar 

  39. Elson CO, Sartor RB, Tennyson GS, Riddell RH (1995) Experimental models of inflammatory bowel disease. Gastroenterology 109:1344–1367. doi:10.1016/0016-5085(95)90599-5

    PubMed  Article  CAS  Google Scholar 

  40. Kanauchi O, Iwanaga T, Andoh A, Araki Y, Nakamura T, Mitsuyama K et al (2001) Dietary fiber fraction of germinated barley foodstuff attenuated mucosal damage and diarrhea, and accelerated the repair of the colonic mucosa in an experimental colitis. J Gastroenterol Hepatol 16:160–168. doi:10.1046/j.1440-1746.2001.02427.x

    PubMed  Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Koray Atila.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Atila, K., Terzi, C., Canda, A.E. et al. Partially Hydrolyzed Guar Gum Attenuates the Severity of Pouchitis in a Rat Model of Ileal J Pouch-Anal Anastomosis. Dig Dis Sci 54, 522–529 (2009). https://doi.org/10.1007/s10620-008-0377-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10620-008-0377-9

Keywords

  • Dextran sulfate sodium
  • Dietary fiber
  • Guar gum
  • Short chain fatty acid
  • Pouchitis