Tripterygium wilfordii polyglycosidium ameliorates pouchitis induced by dextran sulfate sodium in rats (2023)


Restorative proctocolectomy with ileal pouch-anal anastomosis (IPAA) is currently the surgical treatment of choice for medically refractory ulcerative colitis (UC), as well as for patients with familial adenomatous polyposis (FAP) [1]. Although the ileal pouch serves as a reservoir for the stool and improves functional outcomes [2], pouchitis, an inflammation of this conduit, is a common complication in patients undergoing surgery for UC, and was reported to occur in approximately 50% of patients [3]. Symptoms of pouchitis include diarrhea, increased stool frequency, abdominal cramping, fecal urgency, tenesmus, and incontinence [4]. The pathogenesis of pouchitis remains incompletely understood but might be caused by altered mucosal metabolism [5], ischemia [6], bid acid cytotoxicity [7], recurrence of UC, and genetic susceptibility [8]. IL-1 receptor antagonist (IL-1 RA) and TNF are involved in the regulation of epithelial physiology and defense, suggesting mucosal barrier function may have a pathogenic role in pouchitis [9].

TWP is a traditional Chinese medicine extracted from the roots of Tripterygium wilfordii Hook F. (TWhF), and was reported to be therapeutically efficacious in the treatment of autoimmune and inflammation-related diseases such as rheumatoid arthritis, ulcerative colitis, and Crohn's disease [10], [11]. Triptolide is the major active component of TWP [12] and it is superior to placebo in inducing remission and preventing clinical postoperative recurrence in inflammatory bowel disease (IBD) patients [13]. WU et al. reported that triptolide reduced intestinal permeability and protected the intestinal mucosal barrier function by inhibiting TNF-α–induced tight junction protein changes in epithelial cells [14]. Therefore, TWP has attracted increasing attention and is widely used for clinical treatment both in China and worldwide [15].

However, the therapeutic effect of TWP on pouchitis remains rarely reported. The purpose of this study was to investigate whether TWP ameliorates pouchitis in a DSS-model of rats and to determine its potential mechanism of action.

Section snippets


Rabbit anti-occludin (bs-10011R) and rabbit anti-Zo-1 (PB0072) were purchased from BIOS (Beijing Bioengineering Company, China), and SABC kit (SA1022), and DAB kit (AR1022) were purchased from Boster (Wuhan Boster Bioengineering Company, China). Dextran sulfate sodium was purchased from MP Biomedicals (molecular weight 36,000–50,000 MP Biomedicals, Soho, OH, USA).


Male Sprague-Dawley (Laboratory Animal Center of Military Medical Science Academy of the PLA in Chinese people's Liberation Army,

General signs of pouchitis in rats

The pouchitis model in rats was successfully established. At day 35, there were no significant differences in the body weight of rats among the groups. As shown in Fig. 1, the weight of rats in the NI and NS groups continued to decline at 7days after the DSS intervention. The weight of rats in the TWP group was reduced initially, but at day 4 after TWP lavage, it began to increase (P<0.05) (Fig. 1). During the intervention of TWP and NS, weight loss in the TWP group (10.17±4.17) was


TWP, a Chinese herbal medicine derived from Tripterygium genus, has been widely used for the treatment of rheumatoid arthritis, skin disorders, CD, and other inflammatory diseases [11], [22], [23]. The most important active component of TWP is triptolide (T10), which has anti-inflammatory effects in various experimental models by inhibiting the production of immune and inflammatory factors such as nitric oxide (NO) and nuclear factor kappa B (NFκB) [24]. Wang reported a preventative effect of

Conflict of interest



This research was supported by the intestinal barrier research foundation of academician Jieshou Li (LJS_201008).

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