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Characterization of the Ascending Colon Fluids in Ulcerative Colitis

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ABSTRACT

Purpose

To characterize the fluid composition in ascending colon of fasted adults with ulcerative colitis in relapse and in remission with a view to predicting variations on dosage form performance in the lower inflamed gut.

Methods

Twelve patients participated in a two-phase, crossover study. Enrolment to the relapse phase (Phase A) and designation of the remission state for the second colonoscopy (Phase B) were based on Clinical Rachmilewicz Index values. Samples were analyzed for pH and buffer capacity immediately upon collection. After ultracentrifugation, osmolality, surface tension, soluble protein, soluble carbohydrates, and the levels of ten bile acids, seven short-chain fatty acids (SCFAs), three long-chain fatty acids, triglycerides, diglycerides, monoglycerides, phosphatidylcholine, and cholesterol were measured.

Results

Total SCFAs are significantly decreased in relapse, but pH remains unaffected. Regardless of remission/relapse status, pH and isobutyric acid levels are lower than in healthy adults. Buffer capacity, osmolality, and soluble protein are higher than in healthy adults. Treatment with prednisolone increases the volume of intracolonic contents.

Conclusion

Variations in fluid composition of the ascending colon with activity and severity of ulcerative colitis may have an impact on the performance of orally administered products that are targeted to release the therapeutic agent in the colon.

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ACKNOWLEDGMENTS

Part of this work was presented as a poster at Digestive Disease Week, May 30–June 4, 2009, McCormick Place, Chicago, Illinois [Gastrointestinal Endoscopy 69: AB302 (2009)].

Author information

Authors and Affiliations

  1. Laboratory of Biopharmaceutics and Pharmacokinetics, National and Kapodistrian University of Athens, Athens, Greece

    Maria Vertzoni & Christos Reppas

  2. Red Cross Hospital of Athens, Athens, Greece

    Konstantinos Goumas & Androniki Poulou

  3. Pharmaceutical Development, AstraZeneca R&D, Mölndal, Sweden

    Erik Söderlind & Bertil Abrahamsson

  4. Institute of Pharmaceutical Technology, Goethe University of Frankfurt, Frankfurt, Germany

    Jennifer B. Dressman

  5. Laboratory of Biopharmaceutics and Pharmacokinetics, Faculty of Pharmacy, National & Kapodistrian University of Athens, Panepistimiopolis, 157 71, Zografou, Greece

    Christos Reppas

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  1. Maria Vertzoni
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  2. Konstantinos Goumas
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  4. Bertil Abrahamsson
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Correspondence to Christos Reppas.

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Vertzoni, M., Goumas, K., Söderlind, E. et al. Characterization of the Ascending Colon Fluids in Ulcerative Colitis. Pharm Res 27, 1620–1626 (2010). https://doi.org/10.1007/s11095-010-0158-y

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  • DOI: https://doi.org/10.1007/s11095-010-0158-y

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