Dexpanthenol enemas in ulcerative colitis : A pilot study

To test the hypothesis that topical administration of pantothenic acid, a precursor of coenzyme A, might result in increased tissue levels of coenzyme A, improvement of fatty acid oxidation, and amelioration of ulcerative colitis. In an open-label pilot study, three patients with active left-sided u...

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Bibliographic Details
Published in:Mayo Clinic proceedings 1997-07, Vol.72 (7), p.616-620
Main Authors: LOFTUS, E. V, TREMAINE, W. J, NELSON, R. A, SHOEMAKER, J. D, SANDBORN, W. J, PHILLIPS, S. F, HASAN, Y
Format: Article
Language:English
Subjects:
Administration, Topical
Adult
Biological and medical sciences
Coenzyme A - metabolism
Colitis, Ulcerative - drug therapy
Dicarboxylic Acids - urine
Digestive system
Enema
Fatty Acids, Volatile - metabolism
Female
Humans
Male
Medical sciences
Middle Aged
Pantothenic Acid - administration & dosage
Pantothenic Acid - analogs & derivatives
Pantothenic Acid - metabolism
Pantothenic Acid - pharmacology
Pantothenic Acid - urine
Pharmacology. Drug treatments
Pilot Projects
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Summary:To test the hypothesis that topical administration of pantothenic acid, a precursor of coenzyme A, might result in increased tissue levels of coenzyme A, improvement of fatty acid oxidation, and amelioration of ulcerative colitis. In an open-label pilot study, three patients with active left-sided ulcerative colitis received nightly enemas that contained 1,000 mg of dexpanthenol for 4 weeks. Before and after the study, patients submitted stool specimens for short-chain fatty acid analysis and urine collections for measurement of pantothenic acid and dicarboxylic acids; they also underwent flexible sigmoidoscopy for procurement of biopsy specimens for histologic examination and measurement of colonic coenzyme A activity. A clinical disease activity index and histologic disease activity index were used to assess response. Despite increases in urinary pantothenic acid, no significant changes were found in colonic tissue coenzyme A concentrations, fecal short-chain fatty acid concentrations, or urinary dicarboxylic acid concentrations. Moreover, no significant changes in clinical or histologic disease activity were noted. Although stool frequency and rectal bleeding remained unchanged, all patients noted increased abdominal cramping, and one patient had an increased extent of disease. Topically administered dexpanthenol seems to be absorbed, but at the dose used in this study, it did not influence concentrations of colonic coenzyme A activity, fecal short-chain fatty acids, or clinical response in patients with active left-sided ulcerative colitis.
ISSN:0025-6196
1942-5546
DOI:10.1016/S0025-6196(11)63566-0