title: Mucosal protection by phosphatidylcholine.
abstract: The colonic mucus serves a first barrier towards invasion of commensal bacteria in stools to prevent inflammation. One essential component of intestinal mucus is phosphatidylcholine (PC) which represents more than 90% of the phospholipids in mucus indicative for a selective transport of PC into this compartment. It is arranged in lamellar structures as surfactant-like particles which provide a hydrophobic surface on top of the hydrated mucus gel to prevent the invasion of bacteria from intestinal lumen. In ulcerative colitis (UC), the mucus PC content is reduced by 70%, irrespective of the state of inflammation. Thus, it could represent an intrinsic primary pathogenetic condition predisposing to bacterial invasion and the precipitation of inflammation. Since PC was shown to be mainly secreted by the ileal mucosa from where it is assumed to move distally to the colon, the PC content along the colonic wall towards the rectum gradually thins, with the least PC content in the rectum. This explains the start of the clinical manifestation of UC in the rectum and the expansion from there to the upper parts of the colon. In three clinical trials, when missing mucus PC in UC was supplemented by an oral, delayed release PC preparation, the inflammation improved and even resolved after a 3-month treatment course. The data indicate the essential role of the mucus PC content for protection against inflammation in colon.
authors.affiliation: Department of Gastroenterology, University Hospital Heidelberg, Heidelberg, Germany. wolfgang_stremmel @ med.uni-heidelberg.de
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Stremmel
authors.forename: Robert
authors.initials: R
authors.lastname: Ehehalt
authors.forename: Sabine
authors.initials: S
authors.lastname: Staffer
authors.forename: Sabine
authors.initials: S
authors.lastname: Stoffels
authors.forename: Andrea
authors.initials: A
authors.lastname: Mohr
authors.forename: Max
authors.initials: M
authors.lastname: Karner
authors.forename: Annika
authors.initials: A
authors.lastname: Braun
mesh_terms: D000818:Animals; D002986:Clinical Trials as Topic; D003093:Colitis, Ulcerative / Q000188:drug therapy / Q000473:pathology; D006801:Humans; D007413:Intestinal Mucosa / Q000187:drug effects*; D009093:Mucus / Q000378:metabolism; D010713:Phosphatidylcholines / Q000378:metabolism / Q000494:pharmacology* / Q000627:therapeutic use; D020011:Protective Agents / Q000494:pharmacology* / Q000627:therapeutic use
chemical_list: D010713:Phosphatidylcholines; D020011:Protective Agents