Keywords: Inflammatory bowel disease; Ulcerative colitis; Crohn's disease; Inflammation; Resveratrol
Resveratrol, 3,5,40 -trihydroxy-trans-stilbene, is a natural phenol and phytoalexin that can be found in red wine, grapes, peanuts, and Japanese knotweed. It has been widely researched for its antioxidant properties, most specifically in cancer and cardiovascular diseases [6-9]. In some human studies, resveratrol can decrease signs of inflammation with virtually no side effects [8,10]. No human studies, however, exist to show anti-inflammatory effects of resveratrol in IBD. The objective of this review is to discuss the effects of resveratrol on inflammatory signaling pathways, inflammatory biomarkers, intestinal microflora and clinical symptoms in animal models of experimental IBD. To our knowledge, this is the first review assessing the effect of resveratrol on IBD.
Reactive oxygen species (ROS), bacteria, and inflammatory cytokines activate NF-κB, [14] the pathway specifically linkedto the pathogenesis of UC [12,15,16]. With resveratrol supplementation, NF-κB p65 subunit activity is inhibited through attenuating attenuate nuclear factor of kappa B inhibitor, alpha (IκBα) phosphorylation, IκB kinase beta (IKKβ) activation, extracellular signal-regulated kinases (ERK) phosphorylation, signal transducer and activator of transcription 3 (STAT3) activation and NF-κB DNA binding in animal models [16-18]. Resveratrol also amplifies silent mating type information regulation 1 (SIRT1) gene expression, [18,19] which indirectly inhibitsNF-κB.
Cyclooxygenase (COX) is an enzyme present in sites of inflammation [31,32]. With dextran sodium sulfate (DSS) treatment, COX-2 potentially increases 2.3-fold [30] which can be attenuated by Resveratrol [13,17,18,24,25,28] both directly and through suppressed ROS levels [31]. The effects of resveratrol supplementation on COX-1 have been equivocal; one study showed no significant changes in COX-1[25] while others showed COX-1 was decreased [18,24].
IBD comprises excess CD3+ and CD34+ T-cells; [34] however, as a result of resveratrol they are decreased to normal levels [18,23,28]. Forkhead box P3 cells are typically reduced in IBD, [35] but increase with Resveratrol [23] signifying decreased natural T regulatory cells and reduced severity of IBD [36]. CD11b+ and Gr- 1+ were increased during resveratrol supplementation leading to decreased effector T-cell function and a decline in clinical symptoms [33].
Author, Year
|
Animal Models of IBD
|
Route &Timing of Model |
Dose |
Duration of Resveratrol |
Physical/Clinical Outcomes |
Other Measured Outcomes |
Abdallah et al., 2011[21] |
OXA in Wister albino rats |
r.i., Day 1 |
10 |
7 days |
↓ Ulcerative area ↓Wt. loss ↓Colon wt. ↓Histological score
|
↓MPO activitya ↓MDA activitya ↓1CAM-1a ↓VCAM-1a ↓LPO ↓NOa ↓GSHa |
Abdin et al., 2013[22] |
100 T. gondii cysts in C57BL/10 mice |
c.i., Day 1 |
10 |
14 day |
↓Rectal bleeding ↓Diarrhea ↓Histological score |
↓MPO activityc ↓SphK1 activityc ∄Capase-3 activity |
Bereswill et al., 2010[23] |
DSS in male and female C57BL/6 mice |
o.i., Day 3 |
10 |
10 day |
↓Wt. loss ↓Bacteria translocation ↓Total Bacteria Loada ↓Enterococcic ↓E. Colic ↑Lactobacilli/ Bifidobacteriaa ↑Lt. of small intestines |
↓IL-6a ↓MPO-7+a ↓MCP-1a ↓IFN- γa ↑FOXP3+a ↓CD3+a ↑Ki-67+b ↑IL-10a |
Cui et al., 2010[28] |
DSS in male and female C57BL/6J mice |
o.i., First 7 days |
42 |
70 days |
↓Wt. loss ↑Colon lt.
|
↓CD3+a ↓Neutrophilsb ↓COX-2b ↓TNF-αb ↓iNOSb ↓p53b |
Larrosa et al., 2010[41] |
DSS in male Fischer F344rats |
o.i., Last 8 days |
2.1 |
29 days |
↓E. Colia ↓Enterobacteriaa ∄Enterococci ∄Lactobacilli ∄Bifidobacteria ∄Clostridia ∄Wt. loss ∄Colon wt. & lt. |
↓IL-6a ↓Haptoglobina ↓Fibrinogena ↓TNF-αa ↓MIGa ↓MPIP-1γa ∄MPO ↑IL-10a |
Larrosa et al., 2009[30] |
TNBS in male Winstar rats |
o.i., Last 5 days |
1 |
25 days |
↓Enterobacteria a ↓E. Coli a ↓Wt. lossa ↓Histological scoreb ∄Clostridia ↑Food intakeb ↑Colon lt.b ↑Lactobacillic ↑Bifidobacteriac |
↓PGE2 b ↓COX-2 b ↓NO b ↓PTGES b ∄Haptoglobin ∄Albumin
|
Martin et al., 2006[25] |
TNBS in male Winstar rats |
c.i., Day1 |
10 |
14 days |
↓Macroscopic damage score ↓Colon lt. & wt. |
↓MPO activity b ↓TNF-α a ↓NF-κB p65 b ↓COX-2 b ∄COX-1 ∄PGD2 ↑PGE2c |
Martin et al., 2004[24] |
PG-PS in female Lewis rats |
c.i., Day 3 |
10 |
4 days |
↓Macroscopic damage score a ↓Wt. loss ↓Colon lt. & wt. ↓COX-2 in mucosa
|
↓IL-1β c ↓PGD2a ↓MPO a ∄PGE2
|
Rahal et al., 2012[38] |
DSS in female C57BL/6 mice |
b.i., Day 1 |
100 |
27 days |
↓Histologic fibrosis score a ∄Wt. loss |
↓IL-1β b ↓IL-6 a ↓TNF-α b ↓TGF- β1 b |
Sanchez-Fidalgo et al., 2010[13] |
DSS in female C57BL/6 mice |
o.i., Day 30 |
~3 |
30 days |
↓Histological damage ↓Rectal bleeding c ↓Wt. loss a ↓Diarrhea c ↓Colon wt./lt. b
|
↓TNF-α a ↓IL-1β a ↓PGES-1 b ↓COX-2 a ↓iNOS a ↓p38 MAPK a ↑IL-10 a |
Singh et al., 2010[18] |
IL-10 deficient female mice |
o.i., for first 7 days |
100* |
14 days |
↓Histological score ↑Wt. loss b ↑Colon lt.
|
↓SAA b ↓TNF-α b ↓IL-6 b ↓IL-1β b ↓IFN- γ b ↓COX-2 b ↓SIRT1 b ↓CD4+b ↓CD11b+ cells b |
Singh et al., 2012[33] |
DSS in male BALB/c mice |
Naturally developed chronic colitis by day 126 |
100* |
196 days |
↓Wt. loss ↓Histological score |
↓SAA a ↓IgA b ↓IgG b ↓IFN-γ a ↓TNF-α a ↓IL-6 a ↓RANTES a ↓IL-12 a ↓IL-1β a ↓CD4+a ↑CD11b+ Gr-1+ a |
Yao et al., 2010[20] |
DSS in male BALB/c mice |
o.i., First 7 days |
60 |
14 days |
↓Histological score a ↓Disease activity indexa
|
↓MDA activity a ↓MPO activity a ↓TNF-αa ↓IL-8 a ↓IFN-γ a ↓p22phox a ↓gp91phox a ↑SOD activity a ↑GSH-Px a |
Yao et al., 2011[15] |
DSS in male BALB/c mice |
o.i., First 7 days |
35 |
14 days |
↓Disease activity indexa ↓Histological score a |
↓MPO activity a ↓NF-κB a ↓TNF-α a ↓IL-6 a ↓IL-1β a |
Youn et al., 2009[16] |
DSS in male ICR mice |
c.i., 7 days |
10 |
7 days |
↓Wt. loss a ↓Histological changes ∄Fluid intake ↑Colon lt. b |
↓iNOS b ↓NF-κB ↓STAT3 b |
a, p<0.05; b, p<0.01; c, p<0.001; ~, average ad lib dosage; ∄ no significant difference;
*, mg/kg/every other day.(Doses in mg/kg/day).
Anti-inflammatory drugs currently used in the treatment of IBD can induce headache, nausea, pain, diarrhea, sleep disturbance, glucose intolerance, hepatotoxicity, pneumonitis, and tremor [5]. These drugs are used to moderate cytokines, COX-2, and ROS, [5] which, based on current literature, can also be accomplished with resveratrol. In one animal study, 10 mg/ kg/day of resveratrol was equally effective to 300 mg/kg of sulphasalazine in reducing signs of IBD [21]. Although few studies have directly compared the effects of resveratrol to current medical treatments, resveratrol appears to have characteristics that match such treatments. Studies in both animals with IBD and humans without IBD, have determined no adverse effects of Resveratrol [10,43,44]. Its supplementation and effects have not yet been determined for patients with IBD.
Although experimental induced IBD is a well-established animal model, the reviewed studies are limited by the controlled living conditions and diet, which do not mimic the varying stress factors of free-living conditions that can affect intestinal inflammation [45-47]. Additionally, although many studies contained significance values of findings, they did not report exact values, which hindered quantitative synthesis of data. All studies, however, measured both physical and biological markers of IBD, confirming the results and the true progression of the disease. The strength and significance seen in these studies encourages the continuation of research on resveratrol supplementation on IBD.
Resveratrol appears to improve many attributes of IBD in experimental animal models, suggesting resveratrol as a promising complimentary therapy for IBD. Further research is needed to confirm if such attributes remain effective in humans while refining optimal dosage, discovering pro-drug administration and standardizing measures including instillation of resveratrol, supplementation duration and histological scores
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