title: Heparins in ulcerative colitis: proposed mechanisms of action and potential reasons for inconsistent clinical outcomes.
abstract: Current drug therapies for ulcerative colitis (UC) are not completely effective in managing moderate-to-severe UC and approximately 20% of patients with severe UC require surgical interventions. Heparins, polydisperse mixtures of non-anticoagulant and anticoagulant oligosaccharides, are widely used as anticoagulants. However, heparins are also reported to have anti-inflammatory properties. Unfractionated heparin was initially used in patients with UC for the treatment of rectal microthrombi. Surprisingly, it was found to be effective in reducing UC-associated symptoms. Since then, several pre-clinical and clinical studies have reported promising outcomes of heparins in UC. In contrast, some controlled clinical trials demonstrated no or only limited benefits, thus the potential of heparins for the treatment of UC remains uncertain. This review discusses potential mechanisms of action of heparins, as well as proposed reasons for their contradictory clinical effectiveness in the treatment of UC.
authors: a 1 Division of Pharmacy, School of Medicine, Faculty of Health, University of Tasmania , Hobart, Tasmania, Australia.|b 2 Faculty of Pharmacy, University of Technology MARA, Puncak Alam , Selangor, Malaysia.
authors: Qi Ying
authors: QY
authors: Lean
authors: a 1 Division of Pharmacy, School of Medicine, Faculty of Health, University of Tasmania , Hobart, Tasmania, Australia.
authors: Nuri
authors: N
authors: Gueven
authors: c 3 School of Health Sciences, Faculty of Health, University of Tasmania, Launceston , Tasmania, Australia.
authors: Rajaraman D
authors: RD
authors: Eri
authors: d 4 Royal Hobart Hospital , Hobart, Tasmania, Australia.
authors: Rajesh
authors: R
authors: Bhatia
authors: c 3 School of Health Sciences, Faculty of Health, University of Tasmania, Launceston , Tasmania, Australia.|e 5 Breathe Well Centre of Research Excellence for Chronic Respiratory Disease and Lung Ageing, School of Medicine, Faculty of Health, University of Tasmania , Hobart, Tasmania, Australia.
authors: Sukhwinder Singh
authors: SS
authors: Sohal
authors: a 1 Division of Pharmacy, School of Medicine, Faculty of Health, University of Tasmania , Hobart, Tasmania, Australia.
authors: Niall
authors: N
authors: Stewart
authors: a 1 Division of Pharmacy, School of Medicine, Faculty of Health, University of Tasmania , Hobart, Tasmania, Australia.|e 5 Breathe Well Centre of Research Excellence for Chronic Respiratory Disease and Lung Ageing, School of Medicine, Faculty of Health, University of Tasmania , Hobart, Tasmania, Australia.|f 6 Health Services Innovation Tasmania, School of Medicine, Faculty of Health, University of Tasmania , Hobart, Tasmania, Australia.
authors: Gregory M
authors: GM
authors: Peterson
authors: a 1 Division of Pharmacy, School of Medicine, Faculty of Health, University of Tasmania , Hobart, Tasmania, Australia.
authors: Rahul P
authors: RP
authors: Patel
mesh_terms: D000818:Animals; D000893:Anti-Inflammatory Agents / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D000925:Anticoagulants / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use; D003093:Colitis, Ulcerative / Q000188:drug therapy* / Q000503:physiopathology; D006493:Heparin / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D006801:Humans; D016896:Treatment Outcome
chemical_list: D000893:Anti-Inflammatory Agents; D000925:Anticoagulants; D006493:Heparin
keywords: heparin; inflammatory bowel disease; low molecular weight heparin; mechanism; ulcerative colitis