About this Research Topic

Background

Ulcerative colitis (UC) is a type of inflammatory bowel disease (IBD) that affects the mucosal and the submucosal layers of the colon and rectum and sometimes a short segment of the terminal ileum. Severe UC is characterized by fever, abnormal C-reactive protein and hemoglobin levels, and other signs of bowel inflammation. Estimates of the prevalence of UC range from 7 to 246 per 100,000 individuals. Complications of UC may be local, including hemorrhoids, perirectal abscesses, or anal fissures. The etiology of the disease is still unclear; however, it is suggested that UC is a multifactorial disorder that includes four elements: microbiota, mucosal immunology, genetic predisposition, and environmental factors (example: medication, food habits, smoking).
Especially, it has been proposed that UC is a high-grade inflammatory response mediated by the immune system, which may be a consequence of microbial dysbiosis and disruption. An increase in Proteobacteria and Actinobacteria microbial groups has been linked with UC development, as studies have shown. In addition, some molecules, such as toll-like receptors (TLRs), IgG antibodies, nuclear factor kappa B (NF-κB), and pro-inflammatory cytokines, are commonly impaired in individuals with the disease, which may contribute to its progression.

The main objectives of UC therapy are to induce the reduction of symptoms during acute inflammation and, second, to control chronic inflammation, thereby preventing the spread and perpetuation of the inflammatory process. With these objectives, one of the main strategies to effectively neutralize the exacerbated immune response is to interfere in various stages of the inflammatory cascade, mainly using corticosteroids, aminosalicylates (sulfasalazine or mesalazine), immunosuppressants (azathioprine). In recent years, biologic therapies, including tumor necrosis factor (TNF) antagonists and the anti-α4β7 antibody vedolizumab, have improved UC management compared to conventional therapeutics. Unfortunately, these treatments are associated with potentially serious side effects, such as gastrointestinal problems (diarrhea and abdominal pain), anemia, hepatotoxicity, nephrotoxicity, and hypersensitivity reactions, thus limiting their chronic use. In addition, when used for a prolonged period, these therapies may represent a high cost for patients. The development of new drug treatments that combine efficacy and safety is an important goal in UC therapy.
Researchers in the field have been working hard in search of new therapeutic strategies through the application of natural products. Some examples include medicinal plants, bioactive/ nutraceutical compounds of vegetable origin, animal and vegetable oils, micronutrients, prebiotics, probiotics, and symbiotics. Some of the studies with animals show that these strategies may be valid for the prevention and treatment of UC.

In this Research Topic, we welcome pharmacology-focused Original Research, Reviews, Clinical Trials, Methods, and Opinion articles that relate to the following aspects:
• Underlying novel mechanisms or pathways of well-defined composition from natural plants for prevention and treatment of UC (in vitro and in vivo).
• Development of molecular targets, the multi-targets, and synergistic mechanism discovery for compounds from plants.
• Investigation of the efficacy and safety of UC therapy.
• Clinical application of active ingredients in plants in the management of UC.
• The molecular mechanisms of UC occurrence and development.

Keywords: Ulcerative colitis, natural plants, well-defined composition, molecular mechanisms

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