Enhancing Oral 5-ASA Effectiveness in Mild-to-Moderate Ulcerative Colitis through an H. erinaceus-Based Nutraceutical Add-on Multi-Compound: The “HERICIUM-UC” Two-Arm Multicentre Retrospective Study
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design and Setting
2.2. Inclusion/Exclusion Criteria and Study Groups
2.3. Study Variables
2.4. Study Outcomes
2.5. Statistical Analysis
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
Appendix A
Appendix B
References
- Chang, J.T. Pathophysiology of Inflammatory Bowel Diseases. N. Engl. J. Med. 2020, 383, 2652–2664. [Google Scholar] [CrossRef] [PubMed]
- Raine, T.; Bonovas, S.; Burisch, J.; Kucharzik, T.; Adamina, M.; Annese, V.; Bachmann, O.; Bettenworth, D.; Chaparro, M.; Czuber-Dochan, W.; et al. ECCO Guidelines on Therapeutics in Ulcerative Colitis: Medical Treatment. J. Crohns Colitis 2022, 16, 2–17. [Google Scholar] [CrossRef] [PubMed]
- Lamb, C.A.; Kennedy, N.A.; Raine, T.; Hendy, P.A.; Smith, P.J.; Limdi, J.K.; Hayee, B.; Lomer, M.C.E.; Parkes, G.C.; Selinger, C.; et al. British Society of Gastroenterology Consensus Guidelines on the Management of Inflammatory Bowel Disease in Adults. Gut 2019, 68, s1–s106. [Google Scholar] [CrossRef] [PubMed]
- Iheozor-Ejiofor, Z.; Kaur, L.; Gordon, M.; Baines, P.A.; Sinopoulou, V.; Akobeng, A.K. Probiotics for Maintenance of Remission in Ulcerative Colitis. Cochrane Database Syst. Rev. 2020, 3, CD007443. [Google Scholar] [CrossRef] [PubMed]
- Kaur, L.; Gordon, M.; Baines, P.A.; Iheozor-Ejiofor, Z.; Sinopoulou, V.; Akobeng, A.K. Probiotics for Induction of Remission in Ulcerative Colitis. Cochrane Database Syst. Rev. 2020, 3, CD005573. [Google Scholar] [CrossRef]
- Turner, D.; Ricciuto, A.; Lewis, A.; D’Amico, F.; Dhaliwal, J.; Griffiths, A.M.; Bettenworth, D.; Sandborn, W.J.; Sands, B.E.; Reinisch, W.; et al. STRIDE-II: An Update on the Selecting Therapeutic Targets in Inflammatory Bowel Disease (STRIDE) Initiative of the International Organization for the Study of IBD (IOIBD): Determining Therapeutic Goals for Treat-to-Target Strategies in IBD. Gastroenterology 2021, 160, 1570–1583. [Google Scholar] [CrossRef]
- Hill, C.; Guarner, F.; Reid, G.; Gibson, G.R.; Merenstein, D.J.; Pot, B.; Morelli, L.; Canani, R.B.; Flint, H.J.; Salminen, S.; et al. Expert Consensus Document. The International Scientific Association for Probiotics and Prebiotics Consensus Statement on the Scope and Appropriate Use of the Term Probiotic. Nat. Rev. Gastroenterol. Hepatol. 2014, 11, 506–514. [Google Scholar] [CrossRef]
- Gravina, A.G.; Pellegrino, R.; Auletta, S.; Palladino, G.; Brandimarte, G.; D’Onofrio, R.; Arboretto, G.; Imperio, G.; Ventura, A.; Cipullo, M.; et al. Hericium Erinaceus, a Medicinal Fungus with a Centuries-Old History: Evidence in Gastrointestinal Diseases. World J. Gastroenterol. 2023, 29, 3048–3065. [Google Scholar] [CrossRef]
- Hu, S.; Zhao, M.; Li, W.; Wei, P.; Liu, Q.; Chen, S.; Zeng, J.; Ma, X.; Tang, J. Preclinical Evidence for Quercetin against Inflammatory Bowel Disease: A Meta-Analysis and Systematic Review. Inflammopharmacology 2022, 30, 2035–2050. [Google Scholar] [CrossRef]
- Habtemariam, S. Berberine and Inflammatory Bowel Disease: A Concise Review. Pharmacol. Res. 2016, 113, 592–599. [Google Scholar] [CrossRef]
- Erbach, J.; Bonn, F.; Diesner, M.; Arnold, A.; Stein, J.; Schröder, O.; Aksan, A. Relevance of Biotin Deficiency in Patients with Inflammatory Bowel Disease and Utility of Serum 3 Hydroxyisovaleryl Carnitine as a Practical Everyday Marker. J. Clin. Med. 2022, 11, 1118. [Google Scholar] [CrossRef] [PubMed]
- Salem, H.A.; Wadie, W. Effect of Niacin on Inflammation and Angiogenesis in a Murine Model of Ulcerative Colitis. Sci. Rep. 2017, 7, 7139. [Google Scholar] [CrossRef]
- Gravina, A.G.; Pellegrino, R.; Palladino, G.; Coppola, A.; Brandimarte, G.; Tuccillo, C.; Ciardiello, F.; Romano, M.; Federico, A. Hericium Erinaceus, in Combination with Natural Flavonoid/Alkaloid and B(3)/B(8) Vitamins, Can Improve Inflammatory Burden in Inflammatory Bowel Diseases Tissue: An Ex Vivo Study. Front. Immunol. 2023, 14, 1215329. [Google Scholar] [CrossRef]
- Brandimarte, G.; Frajese, G.V.; Bargiggia, S.; Castellani, D.; Cocco, A.; Colucci, R.; Evangelista, E.; Gravina, A.G.; Napoletano, D.; Nardi, E.; et al. Performance of a Multicompounds Nutraceutical Formulation in Patients with Symptomatic Uncomplicated Diverticular Disease. Minerva Gastroenterol. 2022, 68, 216–222. [Google Scholar] [CrossRef] [PubMed]
- Tursi, A.; Elisei, W.; Brandimarte, G.; Giorgetti, G.M.; Inchingolo, C.D.; Nenna, R.; Picchio, M.; Giorgio, F.; Ierardi, E. Musosal Tumour Necrosis Factor α in Diverticular Disease of the Colon Is Overexpressed with Disease Severity. Colorectal Dis. 2012, 14, e258–e263. [Google Scholar] [CrossRef] [PubMed]
- Lewis, J.D.; Chuai, S.; Nessel, L.; Lichtenstein, G.R.; Aberra, F.N.; Ellenberg, J.H. Use of the Noninvasive Components of the Mayo Score to Assess Clinical Response in Ulcerative Colitis. Inflamm. Bowel Dis. 2008, 14, 1660–1666. [Google Scholar] [CrossRef] [PubMed]
- Johnson, A.M.; Harmsen, W.S.; Aniwan, S.; Tremaine, W.J.; Abu Dayyeh, B.K.; Loftus, E.V. Prevalence and Impact of Obesity on Disease-Specific Outcomes in a Population-Based Cohort of Patients with Ulcerative Colitis. J. Crohns Colitis 2021, 15, 1816–1823. [Google Scholar] [CrossRef]
- Khakoo, N.S.; Ioannou, S.; Khakoo, N.S.; Vedantam, S.; Pearlman, M. Impact of Obesity on Inflammatory Bowel Disease. Curr. Gastroenterol. Rep. 2022, 24, 26–36. [Google Scholar] [CrossRef]
- Lynn, A.M.; Harmsen, W.S.; Tremaine, W.J.; Bazerbachi, F.; Dayyeh, B.K.A.; Loftus, E.V. Su1887—Impact of Obesity on Future IBD-Related Complications in a Population-Based Cohort of Crohn’s Disease (CD) and Ulcerative Colitis (UC) Patients. Gastroenterology 2018, 154, S-620–S-621. [Google Scholar] [CrossRef]
- Satsangi, J. The Montreal Classification of Inflammatory Bowel Disease: Controversies, Consensus, and Implications. Gut 2006, 55, 749–753. [Google Scholar] [CrossRef]
- Larizgoitia, I.; Bouesseau, M.-C.; Kelley, E. WHO Efforts to Promote Reporting of Adverse Events and Global Learning. J. Public. Health Res. 2013, 2, e29. [Google Scholar] [CrossRef]
- Jiang, X.-E.; Yang, S.-M.; Zhou, X.-J.; Zhang, Y. Effects of Mesalazine Combined with Bifid Triple Viable on Intestinal Flora, Immunoglobulin and Levels of Cal, MMP-9, and MPO in Feces of Patients with Ulcerative Colitis. Eur. Rev. Med. Pharmacol. Sci. 2020, 24, 935–942. [Google Scholar] [CrossRef] [PubMed]
- Kruis, W.; Fric, P.; Pokrotnieks, J.; Lukás, M.; Fixa, B.; Kascák, M.; Kamm, M.A.; Weismueller, J.; Beglinger, C.; Stolte, M.; et al. Maintaining Remission of Ulcerative Colitis with the Probiotic Escherichia Coli Nissle 1917 Is as Effective as with Standard Mesalazine. Gut 2004, 53, 1617–1623. [Google Scholar] [CrossRef]
- Barnes, E.L.; Agrawal, M.; Syal, G.; Ananthakrishnan, A.N.; Cohen, B.L.; Haydek, J.P.; Al Kazzi, E.S.; Eisenstein, S.; Hashash, J.G.; Sultan, S.S.; et al. AGA Clinical Practice Guideline on the Management of Pouchitis and Inflammatory Pouch Disorders. Gastroenterology 2024, 166, 59–85. [Google Scholar] [CrossRef] [PubMed]
- Naeck-Boolauky, P.; Adio, J.; Burch, J. Review of Normal Gastrointestinal Tract, Ulcerative Colitis, Proctitis and Rectal Medication Adherence. Br. J. Nurs. 2020, 29, 805–811. [Google Scholar] [CrossRef] [PubMed]
- Ford, A.C.; Khan, K.J.; Achkar, J.-P.; Moayyedi, P. Efficacy of Oral vs. Topical, or Combined Oral and Topical 5-Aminosalicylates, in Ulcerative Colitis: Systematic Review and Meta-Analysis. Am. J. Gastroenterol. 2012, 107, 167–176; author reply 177. [Google Scholar] [CrossRef] [PubMed]
- Murray, A.; Nguyen, T.M.; Parker, C.E.; Feagan, B.G.; MacDonald, J.K. Oral 5-Aminosalicylic Acid for Induction of Remission in Ulcerative Colitis. Cochrane Database Syst. Rev. 2020, 8, CD000543. [Google Scholar] [CrossRef]
- Rufino, M.N.; da Costa, A.L.; Jorge, E.N.; Paiano, V.F.; Camparoto, M.L.; Keller, R.; Bremer-Neto, H. Synbiotics Improve Clinical Indicators of Ulcerative Colitis: Systematic Review with Meta-Analysis. Nutr. Rev. 2022, 80, 157–164. [Google Scholar] [CrossRef]
- Xie, X.-Q.; Geng, Y.; Guan, Q.; Ren, Y.; Guo, L.; Lv, Q.; Lu, Z.-M.; Shi, J.-S.; Xu, Z.-H. Influence of Short-Term Consumption of Hericium Erinaceus on Serum Biochemical Markers and the Changes of the Gut Microbiota: A Pilot Study. Nutrients 2021, 13, 1008. [Google Scholar] [CrossRef]
- Parada Venegas, D.; De la Fuente, M.K.; Landskron, G.; González, M.J.; Quera, R.; Dijkstra, G.; Harmsen, H.J.M.; Faber, K.N.; Hermoso, M.A. Short Chain Fatty Acids (SCFAs)-Mediated Gut Epithelial and Immune Regulation and Its Relevance for Inflammatory Bowel Diseases. Front. Immunol. 2019, 10, 277. [Google Scholar] [CrossRef]
- Facchin, S.; Bertin, L.; Bonazzi, E.; Lorenzon, G.; De Barba, C.; Barberio, B.; Zingone, F.; Maniero, D.; Scarpa, M.; Ruffolo, C.; et al. Short-Chain Fatty Acids and Human Health: From Metabolic Pathways to Current Therapeutic Implications. Life 2024, 14, 559. [Google Scholar] [CrossRef] [PubMed]
- Facchin, S.; Vitulo, N.; Calgaro, M.; Buda, A.; Romualdi, C.; Pohl, D.; Perini, B.; Lorenzon, G.; Marinelli, C.; D’Incà, R.; et al. Microbiota Changes Induced by Microencapsulated Sodium Butyrate in Patients with Inflammatory Bowel Disease. Neurogastroenterol. Motil. 2020, 32, e13914. [Google Scholar] [CrossRef]
- Fernandes, A.; Nair, A.; Kulkarni, N.; Todewale, N.; Jobby, R. Exploring Mushroom Polysaccharides for the Development of Novel Prebiotics: A Review. Int. J. Med. Mushrooms 2023, 25, 1–10. [Google Scholar] [CrossRef] [PubMed]
- Yang, Y.; Zhao, C.; Diao, M.; Zhong, S.; Sun, M.; Sun, B.; Ye, H.; Zhang, T. The Prebiotic Activity of Simulated Gastric and Intestinal Digesta of Polysaccharides from the Hericium erinaceus. Molecules 2018, 23, 3158. [Google Scholar] [CrossRef]
- Jing, J.; Guo, J.; Dai, R.; Zhu, C.; Zhang, Z. Targeting Gut Microbiota and Immune Crosstalk: Potential Mechanisms of Natural Products in the Treatment of Atherosclerosis. Front. Pharmacol. 2023, 14, 1252907. [Google Scholar] [CrossRef]
- Wang, L.; Wang, C.; Huang, C.; Gao, C.; Wang, B.; He, J.; Yan, Y. Dietary Berberine against Intestinal Oxidative Stress, Inflammation Response, and Microbiota Disturbance Caused by Chronic Copper Exposure in Freshwater Grouper (Acrossocheilus fasciatus). Fish. Shellfish. Immunol. 2023, 139, 108910. [Google Scholar] [CrossRef] [PubMed]
- Zhang, F.; Ma, T.; Cui, P.; Tamadon, A.; He, S.; Huo, C.; Yierfulati, G.; Xu, X.; Hu, W.; Li, X.; et al. Diversity of the Gut Microbiota in Dihydrotestosterone-Induced PCOS Rats and the Pharmacologic Effects of Diane-35, Probiotics, and Berberine. Front. Microbiol. 2019, 10, 175. [Google Scholar] [CrossRef]
- Jess, T.; Rungoe, C.; Peyrin–Biroulet, L. Risk of Colorectal Cancer in Patients With Ulcerative Colitis: A Meta-Analysis of Population-Based Cohort Studies. Clin. Gastroenterol. Hepatol. 2012, 10, 639–645. [Google Scholar] [CrossRef]
- Lin, R.; Piao, M.; Song, Y. Dietary Quercetin Increases Colonic Microbial Diversity and Attenuates Colitis Severity in Citrobacter Rodentium-Infected Mice. Front. Microbiol. 2019, 10, 1092. [Google Scholar] [CrossRef]
- Xu, L.; Zhang, Y.; Xue, X.; Liu, J.; Li, Z.-S.; Yang, G.-Y.; Song, Y.; Pan, Y.; Ma, Y.; Hu, S.; et al. A Phase I Trial of Berberine in Chinese with Ulcerative Colitis. Cancer Prev. Res. 2020, 13, 117–126. [Google Scholar] [CrossRef]
- Kishi, M.; Hirai, F.; Takatsu, N.; Hisabe, T.; Takada, Y.; Beppu, T.; Takeuchi, K.; Naganuma, M.; Ohtsuka, K.; Watanabe, K.; et al. A Review on the Current Status and Definitions of Activity Indices in Inflammatory Bowel Disease: How to Use Indices for Precise Evaluation. J. Gastroenterol. 2022, 57, 246–266. [Google Scholar] [CrossRef] [PubMed]
- Hart, L.; Chavannes, M.; Kherad, O.; Maedler, C.; Mourad, N.; Marcus, V.; Afif, W.; Bitton, A.; Lakatos, P.L.; Brassard, P.; et al. Faecal Calprotectin Predicts Endoscopic and Histological Activity in Clinically Quiescent Ulcerative Colitis. J. Crohns Colitis 2020, 14, 46–52. [Google Scholar] [CrossRef]
- Walsh, A.; Kormilitzin, A.; Hinds, C.; Sexton, V.; Brain, O.; Keshav, S.; Uhlig, H.; Geddes, J.; Goodwin, G.; Peters, M.; et al. Defining Faecal Calprotectin Thresholds as a Surrogate for Endoscopic and Histological Disease Activity in Ulcerative Colitis-a Prospective Analysis. J. Crohns Colitis 2019, 13, 424–430. [Google Scholar] [CrossRef] [PubMed]
- Mak, W.Y.; Buisson, A.; Andersen, M.J.; Lei, D.; Pekow, J.; Cohen, R.D.; Kahn, S.A.; Pereira, B.; Rubin, D.T. Fecal Calprotectin in Assessing Endoscopic and Histological Remission in Patients with Ulcerative Colitis. Dig. Dis. Sci. 2018, 63, 1294–1301. [Google Scholar] [CrossRef]
- Laserna-Mendieta, E.J.; Lucendo, A.J. Faecal Calprotectin in Inflammatory Bowel Diseases: A Review Focused on Meta-Analyses and Routine Usage Limitations. Clin. Chem. Lab. Med. 2019, 57, 1295–1307. [Google Scholar] [CrossRef] [PubMed]
- Magro, F.; Gionchetti, P.; Eliakim, R.; Ardizzone, S.; Armuzzi, A.; Barreiro-de Acosta, M.; Burisch, J.; Gecse, K.B.; Hart, A.L.; Hindryckx, P.; et al. Third European Evidence-Based Consensus on Diagnosis and Management of Ulcerative Colitis. Part 1: Definitions, Diagnosis, Extra-Intestinal Manifestations, Pregnancy, Cancer Surveillance, Surgery, and Ileo-Anal Pouch Disorders. J. Crohns Colitis 2017, 11, 649–670. [Google Scholar] [CrossRef]
- Yanai, S.; Toya, Y.; Nakamura, S.; Matsumoto, T. Patients’ Preference of Topical Therapy for Ulcerative Colitis in Japan: A Web-Based 3T Survey. Crohns Colitis 360 2020, 2, otaa030. [Google Scholar] [CrossRef]
- Kane, S.V. Systematic Review: Adherence Issues in the Treatment of Ulcerative Colitis. Aliment. Pharmacol. Ther. 2006, 23, 577–585. [Google Scholar] [CrossRef]
Variable | 5-ASA Alone Group (N = 86) | 5-ASA plus Nutraceutical Supplementation (N = 115) | p-Value 1 |
---|---|---|---|
Age (years) | 40 (39–46) | 44 (42–47) | 0.642 |
Gender Male Female | 41 (47.7%) 45 (52.3%) | 66 (57.4%) 49 (42.6%) | 0.172 3 |
UC diagnosis (years) | 7 (2–17) | 7 (2–17) | 0.223 |
BMI (Kg/m2) | 23 (22.5–24.1) | 23.9 (23.5–24.6) | 0.404 |
Alcohol status 2 (yes) | 10 (11.62%) | 18 (16.65%) | 0.472 3 |
Smoking status (yes) | 22 (25.58%) | 27 (23.47%) | 0.712 3 |
Montreal classification E1 (ulcerative proctitis) E2 (left-sided UC) E3 (ulcerative pancolitis) | 15 (17.4%) 51 (59.3%) 20 (23.3%) | 18 (15.7%) 71 (61.7%) 26 (22.6%) | 0.926 |
5-ASA status Mesalazine Sulfasalazine | 84 (97.7%) 2 (2.3%) | 110 (95.7%) 5 (4.3%) | 0.439 |
5-ASA dose (mg) | 3200 (2400–3600) | 3600 (2400–3600) | 0.364 |
5-ASA dose class Standard (<3.6 g) High (≥3.6 g) | 46 (53.5%) 40 (46.5%) | 50 (43.5%) 65 (56.5%) | 0.16 3 |
EIM (yes) | 11 (12.79%) | 12 (10.43%) | 0.863 3 |
PMS | 4 (3–6) | 4 (3–6) | 0.986 |
PMS class Mild disease Moderate disease | 51 (59.3%) 35 (40.7%) | 69 (60%) 46 (40%) | 0.921 3 |
Faecal calprotectin (µg/g) 4 | 181.5 (92.7–317.5) | 210 (100–467) | 0.78 |
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Tursi, A.; D’Avino, A.; Brandimarte, G.; Mocci, G.; Pellegrino, R.; Savarino, E.V.; Gravina, A.G.; the HERICIUM-UC Study Group. Enhancing Oral 5-ASA Effectiveness in Mild-to-Moderate Ulcerative Colitis through an H. erinaceus-Based Nutraceutical Add-on Multi-Compound: The “HERICIUM-UC” Two-Arm Multicentre Retrospective Study. Pharmaceutics 2024, 16, 1133. https://doi.org/10.3390/pharmaceutics16091133
Tursi A, D’Avino A, Brandimarte G, Mocci G, Pellegrino R, Savarino EV, Gravina AG, the HERICIUM-UC Study Group. Enhancing Oral 5-ASA Effectiveness in Mild-to-Moderate Ulcerative Colitis through an H. erinaceus-Based Nutraceutical Add-on Multi-Compound: The “HERICIUM-UC” Two-Arm Multicentre Retrospective Study. Pharmaceutics. 2024; 16(9):1133. https://doi.org/10.3390/pharmaceutics16091133
Chicago/Turabian StyleTursi, Antonio, Alessandro D’Avino, Giovanni Brandimarte, Giammarco Mocci, Raffaele Pellegrino, Edoardo Vincenzo Savarino, Antonietta Gerarda Gravina, and the HERICIUM-UC Study Group. 2024. "Enhancing Oral 5-ASA Effectiveness in Mild-to-Moderate Ulcerative Colitis through an H. erinaceus-Based Nutraceutical Add-on Multi-Compound: The “HERICIUM-UC” Two-Arm Multicentre Retrospective Study" Pharmaceutics 16, no. 9: 1133. https://doi.org/10.3390/pharmaceutics16091133
APA StyleTursi, A., D’Avino, A., Brandimarte, G., Mocci, G., Pellegrino, R., Savarino, E. V., Gravina, A. G., & the HERICIUM-UC Study Group. (2024). Enhancing Oral 5-ASA Effectiveness in Mild-to-Moderate Ulcerative Colitis through an H. erinaceus-Based Nutraceutical Add-on Multi-Compound: The “HERICIUM-UC” Two-Arm Multicentre Retrospective Study. Pharmaceutics, 16(9), 1133. https://doi.org/10.3390/pharmaceutics16091133