Academic Journal
Reducing agents for induction and maintenance therapy achieve long-term remission of refractory ulcerative colitis: A case report and review of literature.
| Τίτλος: | Reducing agents for induction and maintenance therapy achieve long-term remission of refractory ulcerative colitis: A case report and review of literature. |
|---|---|
| Συγγραφείς: | Sylvestre PB; Pathology and Laboratory Medicine, University of Cincinnati College of Medicine, Cincinnati, OH 45229, United States.; Pathology and Laboratory Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229, United States. sylvespa@ucmail.uc.edu. |
| Πηγή: | World journal of gastroenterology [World J Gastroenterol] 2026 Jan 14; Vol. 32 (2), pp. 114222. |
| Τύπος έκδοσης: | Case Reports; Journal Article; Review |
| Γλώσσα: | English |
| Στοιχεία περιοδικού: | Publisher: Baishideng Publishing Group Country of Publication: United States NLM ID: 100883448 Publication Model: Print Cited Medium: Internet ISSN: 2219-2840 (Electronic) Linking ISSN: 10079327 NLM ISO Abbreviation: World J Gastroenterol Subsets: MEDLINE |
| Imprint Name(s): | Publication: 2014- : Pleasanton, CA : Baishideng Publishing Group Original Publication: Beijing : WJG Press, c1998- |
| Ιατρικοί όροι (MeSH): | Colitis, Ulcerative*/complications , Colitis, Ulcerative*/drug therapy , Colitis, Ulcerative*/pathology , Thioctic Acid*/analogs & derivatives , Thioctic Acid*/pharmacology , Thioctic Acid*/therapeutic use , Thioctic Acid*/analogs & derivatives , Reducing Agents*/pharmacology , Reducing Agents*/therapeutic use , Gastrointestinal Hemorrhage*/drug therapy , Gastrointestinal Hemorrhage*/etiology , Gastrointestinal Hemorrhage*/pathology , Thiosulfates*/pharmacology , Thiosulfates*/therapeutic use, Intestinal Mucosa/chemistry ; Intestinal Mucosa/drug effects ; Intestinal Mucosa/pathology ; Colon/chemistry ; Colon/drug effects ; Colon/pathology ; Remission Induction/methods ; Maintenance Chemotherapy/methods ; Hydrogen Peroxide/chemistry ; Hydrogen Peroxide/metabolism ; Humans ; Female ; Adult ; Administration, Oral |
| Περίληψη: | Background: Ulcerative colitis (UC) is a chronic and debilitating inflammatory bowel disease. Cumulative evidence indicates that excess hydrogen peroxide, a potent neutrophilic chemotactic agent, produced by colonic epithelial cells has a causal role leading to infiltration of neutrophils into the colonic mucosa and subsequent development of UC. This evidence-based mechanism identifies hydrogen peroxide as a therapeutic target for reducing agents in the treatment of UC. Case Summary: Presented is a 41-year-old female with a 26-year history of refractory UC. Having developed steroid dependence and never achieving complete remission on treatment by conventional and advanced therapies, she began treatment with oral R-dihydrolipoic acid (RDLA), a lipid-soluble reducing agent with intracellular site of action. Within a week, rectal bleeding ceased. She was asymptomatic for three years until a highly stressful experience, when she noticed blood in her stool. RDLA was discontinued, and she began treatment with oral sodium thiosulfate pentahydrate (STS), a reducing agent with extracellular site of action. After a week, rectal bleeding ceased, and she resumed oral RDLA and discontinued STS. To date, she remains asymptomatic with normal stool calprotectin while on RDLA. Conclusion: STS and RDLA are reducing agents that serve as highly effective and safe therapy for the induction and maintenance of remission in UC, even in patients refractory or poorly controlled by conventional and advanced therapies. Should preliminary findings be validated by subsequent clinical trials, the use of reducing agents could potentially prevent thousands of colectomies and represent a paradigm shift in the treatment of UC. (©The Author(s) 2026. Published by Baishideng Publishing Group Inc. All rights reserved.) |
| Competing Interests: | Conflict-of-interest statement: The author reports no relevant conflicts of interest for this article. |
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| Contributed Indexing: | Keywords: Case report; Colitis; Hydrogen peroxide; Inflammatory bowel disease; R-dihydrolipoic acid; Reactive oxygen species; Redox homeostasis; Reducing agent; Sodium thiosulfate; Ulcerative colitis |
| Substance Nomenclature: | 7NV2KHU5JA (dihydrolipoic acid) 73Y7P0K73Y (Thioctic Acid) 0 (Reducing Agents) HX1032V43M (sodium thiosulfate) 0 (Thiosulfates) BBX060AN9V (Hydrogen Peroxide) |
| Entry Date(s): | Date Created: 20260119 Date Completed: 20260712 Latest Revision: 20260712 |
| Update Code: | 20260713 |
| PubMed Central ID: | PMC12809231 |
| DOI: | 10.3748/wjg.v32.i2.114222 |
| PMID: | 41551825 |
| Βάση Δεδομένων: | MEDLINE |
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