Effect of mesalazine on epithelial cell proliferation in colonic diverticular disease.
OBJECTIVE
Increased epithelial cell proliferation may be detected in diverticular disease, but antibiotics have failed in reducing it. We assess therefore the effect of mesalazine on epithelial cell proliferation in diverticular disease.


METHODS
A prospective study was conducted on 20 consecutive patients with a new endoscopic diagnosis of symptomatic uncomplicated diverticular disease. The patients were treated with mesalazine 1.6 mg/day for 1 year. The Ki-67 antigen index of the whole crypt and in the upper third was separately evaluated before and after starting the treatment.


RESULTS
Cell proliferation index was higher in diverticular disease patients than healthy controls both in the whole crypt (median 6.7%, range 2-9% vs. median 1.6%, range 1-3%, p=0.001) and in the upper third of the crypt (median 6.8%, range 2-8% vs. median 1.8%, range 1-3%, p=0.001). Cell proliferation decreased throughout the follow-up. In the whole crypt it was 6.7% at entry and 3.8% at the end of treatment (p<0.005), whereas it was 6.8% at entry and 2.9% at the end of treatment in the upper third of the crypt (p<0.005).


CONCLUSIONS
We found mesalazine effective in reducing the colonic cell proliferation in long-term treatment for colonic diverticular disease.
Tursi
A
A
Digestive Endoscopy Unit, Lorenzo Bonomo Hospital, Via Torino, 49, 70031 Andria, BA, Italy. antotursi@tiscali.it
Brandimarte
G
G
Elisei
W
W
Giorgetti
G M
GM
Inchingolo
C D
CD
Aiello
F
F
D000368:Aged; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage*; D001707:Biopsy, Needle; D016022:Case-Control Studies; D049109:Cell Proliferation / Q000187:drug effects*; D003113:Colonoscopy / Q000379:methods; D043963:Diverticulosis, Colonic / Q000188:drug therapy* / Q000473:pathology; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D004847:Epithelial Cells / Q000187:drug effects / Q000473:pathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007150:Immunohistochemistry; D007413:Intestinal Mucosa / Q000187:drug effects / Q000473:pathology*; D019394:Ki-67 Antigen / Q000276:immunology; D008297:Male; D019804:Mesalamine / Q000008:administration & dosage*; D008875:Middle Aged; D011336:Probability; D011446:Prospective Studies; D012016:Reference Values; D018570:Risk Assessment; D012720:Severity of Illness Index; D018709:Statistics, Nonparametric; D016896:Treatment Outcome
D000894:Anti-Inflammatory Agents, Non-Steroidal; D019394:Ki-67 Antigen; D019804:Mesalamine