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FDA-approved drug can repair gut leakiness in types of bowel disease

Published on 05/12/19 at 11:16am

A team of biomedical scientists at the University of California has found that a FDA-approved drug for treating rheumatoid arthritis and ulcerative colitis can repair permeability in the gut’s epithelium.

The drug, Xeljanz, (tofacitinib) is used to treat ulcerative colitis, a type of chronic inflammatory bowel disease of the large intestine in which the lining of the colon becomes leaky. This affects one million Americans. The drug can also treat rheumatoid arthritis.

The study is the first to show that the drug has a direct effect on the cells lining the gut by correcting defects that occur in inflammation. Before, the effect on this part of the body was unknown.

Declan McCole, a Professor of Biomedical Science in the UCR School of Medicine, said: “We found that tofacitinib fixes the leakiness in the intestinal barrier. Specifically it fixes the epithelial permeability defects caused by ‘interferon-gamma,’ an inflammatory cytokines involved in autoimmune diseases like ulcerative colitis and rheumatoid arthritis.”

Anita Sayoc-Becerra, a graduate student in McCole’s lab, said: “By targeting specific molecules, the drug inhibits a pathway that is activated by inflammation. Our study shows that tofacitinib is not just acting on immune cells, as we first thought, but can have a direct effect on the epithelial cells that are the key factor in maintaining gut barrier function.”

Epithelial cells are found in the epithelium, a thin layer that lines the alimentary canal. These cells have gaps between them, making them selectively permeable and providing a barrier that keeps out pathogens, toxins and antigens from entering the gut, while allowing the absorption of nutrients. When someone has ulcerative colitis, the epithelial permeability becomes leaky, allowing bacterial products to cross into the gut and nutrients and water leak out.

The researchers plan to identify specific patients who may get the greatest benefit from the drug, allowing a more personalised medicine approach to the disease.

Conor Kavanagh

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