Zeitschrift für Phytotherapie 2016; 37 - P12
DOI: 10.1055/s-0036-1584475

Mechanisms underlying the potential usefulness of the herbal preparation STW 5 in an experimental model of Crohn's disease

MT Khayyal 1, W Wadie 1, D Abdallah 1, M Schneider 2, T Efferth 2, O Kelber 3, H Abdel-Aziz 3
  • 1Department of Pharmacology, Faculty of Pharmacy, Cairo University, Egypt
  • 2Department of Pharmaceutical Biology, Institute of Pharmacy and Biochemistry, Johannes Gutenberg University, Mainz, Germany
  • 3Scientific Department, Steigerwald Arzneimittelwerk GmbH, Darmstadt, Germany

The herbal preparation STW 5 is a standardized multi-component mixture of hydro-alcoholic extracts of bitter candytuft, lemon balm, chamomile, caraway fruit, peppermint leaf, Angelica root, milk thistle, celandine herb, and licorice root. It has been used successfully clinically in functional dyspepsia [1] and irritable bowel syndrome [2]. We have reported earlier on its efficacy in experimental dextran sodium sulfate induced colitis as a model for ulcerative colitis [3]. The present study was conducted to investigate underlying mechanisms involved in its use in 2,4,6-trinitrobenzene sulfonic acid (TNBS) induced colitis as a model of Crohn's disease. Colitis was induced by instilling TNBS in the colon of male Wistar rats under light ether anesthesia. In a prophylactic setting STW 5 was given orally for 1 week before induction of colitis and continued for 3 days after. In a curative setting, STW 5 was given 48h after colitis induction daily orally for 1 week. Rats were sacrificed 24h after last treatment. Colonic tissue was assessed macroscopically while homogenates and serum samples were used to assess inflammatory and oxidative stress parameters. TNBS colitis led to severe ulcerative damage, inhibition of reduced glutathione and a rise in myeloperoxidase in colon homogenates. Relevant cytokines TNFα, IL-1β, ICAM-1 were elevated as well as LT-B4 and PGE2. Immuno-histochemical examination of colon sections showed a rise in calprotectin and IL-17A staining, both of which are reported to be relevant indicators for IBD in man. Pre-treatment with STW 5 reversed such effects in a comparable manner to sulfasalazine. In the curative setting, the preparation tended to normalize changes in reduced glutathione and myeloperoxidase and in ulcerative indices induced by TNBS. The findings lend good supportive evidence for the potential usefulness of STW 5 in Crohn's disease.

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