The beneficial effect of combination therapy with sulfasalazine and valsartan in the treatment of ulcerative colitis

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Fereshteh Asgharzadeh
Atieh Yaghoubi
Seyedeh Elnaz Nazari
Alireza Hashemzadeh
Seyed Mahdi Hassanian
Amir Avan
Ali Javandoost
Gordon A. Ferns
Saman Soleimanpour
Majid Khazaei


Inflammatory bowel disease (IBD) is defined by the chronic inflammation of the digestive tract. Ulcerative colitis is one of the most prevalent chronic IBDs. The increase in the mucosal expression of angiotensin II (AT-II) in colitis suggests a possible role of AT-II in colitis-associated inflammation. Here, we examined the potential therapeutic effects of combination therapy regarding valsartan (Val), as an AT-II receptor blocker, with sulfasalazine (SSZ) in a murine colitis model. DSS induced colitis was initiated by the administration of dextran sodium sulfate (DSS) in male C57BL/6 mice for 1 week. Val (160 mg/kg/day, gavage) was given on the third day and continued for seven days. SSZ (100 mg/kg/day) was used as reference drug and also used in combination in one group (Val; 160 mg/kg/day and/or SSZ; 100 mg/kg/day). Colonic mucosal inflammation was evaluated clinically, biochemically, and histologically. The disease activity index in DSS-treated mice, including weight loss, stool consistency, and rectal bleeding, were significantly lower in the group of mice receiving the combination of valsartan and sulfasalazine compared to the DSS-treated group. Valsartan and sulfasalazine treatment was associated with a lower reduction in colon length, diminished colon weight, and high sensitivity C-reactive protein level in mice with DSS-induced colitis. Valsartan and sulfasalazine also reduced markers of oxidative stress after DSS administration. Our findings demonstrate the anti-inflammatory and anti-fibrotic activities of a combination therapy with sulfasalazine and valsartan in experimentally induced colitis, indicating its value as a potential therapeutic option for the treatment of colitis.

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Asgharzadeh, F. ., Yaghoubi, A. ., Nazari, S. E. ., Hashemzadeh, A. ., Hassanian, S. M. ., Avan, A. ., Javandoost, A. ., Ferns, G. A., Soleimanpour, S. ., & Khazaei, M. (2021). The beneficial effect of combination therapy with sulfasalazine and valsartan in the treatment of ulcerative colitis. EXCLI Journal, 20, 236-247.
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