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1.
Proc Natl Acad Sci U S A ; 117(17): 9508-9518, 2020 04 28.
Article in English | MEDLINE | ID: mdl-32291345

ABSTRACT

Bacterial specialized metabolites are increasingly recognized as important factors in animal-microbiome interactions: for example, by providing the host with chemical defenses. Even in chemically rich animals, such compounds have been found to originate from individual members of more diverse microbiomes. Here, we identified a remarkable case of a moderately complex microbiome in the sponge host Mycale hentscheli in which multiple symbionts jointly generate chemical diversity. In addition to bacterial pathways for three distinct polyketide families comprising microtubule-inhibiting peloruside drug candidates, mycalamide-type contact poisons, and the eukaryotic translation-inhibiting pateamines, we identified extensive biosynthetic potential distributed among a broad phylogenetic range of bacteria. Biochemical data on one of the orphan pathways suggest a previously unknown member of the rare polytheonamide-type cytotoxin family as its product. Other than supporting a scenario of cooperative symbiosis based on bacterial metabolites, the data provide a rationale for the chemical variability of M. hentscheli and could pave the way toward biotechnological peloruside production. Most bacterial lineages in the compositionally unusual sponge microbiome were not known to synthesize bioactive metabolites, supporting the concept that microbial dark matter harbors diverse producer taxa with as yet unrecognized drug discovery potential.


Subject(s)
Bacteria/metabolism , Microbiota/physiology , Porifera/microbiology , Animals , Cytotoxins/metabolism , Genome, Bacterial , Symbiosis
2.
J Nat Prod ; 84(2): 544-547, 2021 02 26.
Article in English | MEDLINE | ID: mdl-33496582

ABSTRACT

LCMS analysis of an extract of the New Zealand tunicate Synoicum kuranui showed evidence for numerous new rubrolides. Following a mass spectrometry-guided isolation procedure, new hydrated rubrolides V and W (5 and 6), along with previously reported rubrolide G (3), were isolated and characterized using MS and NMR. The anti-bacterial and cell cytotoxic activity of the compounds were compared to the potent anti-MRSA compound rubrolide A; hydration across the C-5/C-6 bond was shown to abrogate antibacterial activity.


Subject(s)
Furans/chemistry , Urochordata/chemistry , Animals , Anti-Bacterial Agents/chemistry , HCT116 Cells , Humans , Microbial Sensitivity Tests , Molecular Structure , New Zealand
3.
Mar Drugs ; 18(7)2020 Jun 27.
Article in English | MEDLINE | ID: mdl-32605132

ABSTRACT

Global natural products social (GNPS) molecular networking is a useful tool to categorize chemical space within samples and streamline the discovery of new natural products. Here, we demonstrate its use in chemically profiling the extract of the marine tunicate Synoicum kuranui, comprised of many previously reported rubrolides, for new chemical entities. Within the rubrolide cluster, two masses that did not correspond to previously reported congeners were detected, and, following MS-guided fractionation, led to the isolation of new methylated rubrolides T (3) and (Z/E)-U (4). Both compounds showed strong growth inhibitory activity against the Gram-positive bacteria Bacillus subtilis, with minimum inhibitory concentration (MIC) values of 0.41 and 0.91 µM, respectively.


Subject(s)
Anti-Bacterial Agents/chemistry , Anti-Bacterial Agents/pharmacology , Furans/pharmacology , Urochordata/chemistry , Animals , Bacillus subtilis/drug effects , Furans/chemistry , Microbial Sensitivity Tests , Molecular Structure , New Zealand
4.
J Nat Prod ; 82(8): 2291-2298, 2019 08 23.
Article in English | MEDLINE | ID: mdl-31356078

ABSTRACT

An acetylenic 2-amino-3-alcohol, distaminolyne B (2), isolated from the New Zealand ascidian Pseudodistoma cereum, is reported. The isolation and structure elucidation of 2 and assignment of 2S,3S absolute configuration (AC) using the exciton coupled circular dichroism technique are described. Using a methodologically facile workflow, the same AC was also established by analysis of specific rotation, terminal methyl C-1 δC chemical shift, and NH δH and J values of the N,O-diacetate derivative.


Subject(s)
Acetylene/chemistry , Alkenes/chemistry , Lipids/chemistry , Urochordata/chemistry , Alkaloids , Animals , Humans
5.
J Nat Prod ; 82(7): 2000-2008, 2019 07 26.
Article in English | MEDLINE | ID: mdl-31306000

ABSTRACT

Six new lamellarin sulfates (1-6) were isolated from the methanolic extract of the Pacific tunicate Didemnum ternerratum, collected from the Kingdom of Tonga. Mass spectrometric molecular networking through the GNPS platform was used to target the isolation of 1-6. Planar structures were elucidated through a combination of NMR and MS experiments. Through comparison of experimental and calculated ECD spectra, the absolute configurations of atropisomers 2-5 were determined, with their energetic barriers to racemization also determined computationally. The cytotoxicity of the compounds was tested against the human colon carcinoma cell line HCT-116, where lamellarin D-8-sulfate (5) exhibited moderate activity with an IC50 of 9.7 µM.


Subject(s)
Antineoplastic Agents/pharmacology , Colonic Neoplasms/drug therapy , Coumarins/pharmacology , Heterocyclic Compounds, 4 or More Rings/pharmacology , Isoquinolines/pharmacology , Antineoplastic Agents/chemistry , Antineoplastic Agents/isolation & purification , Cell Line, Tumor , Coumarins/chemistry , Coumarins/isolation & purification , Heterocyclic Compounds, 4 or More Rings/chemistry , Heterocyclic Compounds, 4 or More Rings/isolation & purification , Humans , Inhibitory Concentration 50 , Isoquinolines/chemical synthesis , Isoquinolines/chemistry , Isoquinolines/isolation & purification , Mass Spectrometry/methods
6.
J Nat Prod ; 79(3): 607-10, 2016 Mar 25.
Article in English | MEDLINE | ID: mdl-26670413

ABSTRACT

The first occurrence of an acetylenic 1-amino-2-alcohol, distaminolyne A (1), isolated from the New Zealand ascidian Pseudodistoma opacum, is reported. The isolation and structure elucidation of 1 and assignment of absolute configuration using the exciton coupled circular dichroism technique are described. In addition, a new N-9 hydroxy analogue (2) of the known P. opacum metabolite 7-bromohomotrypargine is also reported. Antimicrobial screening identified modest activity of 1 toward Escherichia coli, Staphylococcus aureus, and Mycobacterim tuberculosis, while 2 exhibited a moderate antimalarial activity (IC50 3.82 µM) toward a chloroquine-resistant strain (FcB1) of Plasmodium falciparum.


Subject(s)
Alkynes/isolation & purification , Alkynes/pharmacology , Antimalarials/isolation & purification , Antimalarials/pharmacology , Carbolines/isolation & purification , Carbolines/pharmacology , Urochordata/chemistry , Alkynes/chemistry , Animals , Antimalarials/chemistry , Carbolines/chemistry , Chloroquine/pharmacology , Drug Resistance, Bacterial/drug effects , Escherichia coli/drug effects , Inhibitory Concentration 50 , Microbial Sensitivity Tests , Molecular Structure , Mycobacterium tuberculosis/drug effects , New Zealand , Plasmodium falciparum/drug effects , Staphylococcus aureus/drug effects
7.
J Nat Prod ; 78(3): 530-3, 2015 Mar 27.
Article in English | MEDLINE | ID: mdl-25494238

ABSTRACT

NMR-directed screening of New Zealand marine organisms has led to the isolation of the modified tripeptide janolusimide B from the common invasive bryozoan Bugula flabellata. The structure was established by NMR and MS analysis, degradative hydrolysis and derivatization, and stereoselective fragment synthesis. The bryozoan natural product is an N-methyl analogue of janolusimide, previously reported from the Mediterranean nudibranch Janolus cristatus, a species known to prey upon bryozoa.


Subject(s)
Bryozoa/chemistry , Oligopeptides/chemical synthesis , Oligopeptides/isolation & purification , Animals , Marine Biology , Molecular Structure , New Zealand , Nuclear Magnetic Resonance, Biomolecular , Oligopeptides/chemistry
9.
Inorg Chem ; 53(19): 10159-70, 2014 Oct 06.
Article in English | MEDLINE | ID: mdl-25252249

ABSTRACT

Two new pincer ligands have been developed that contain a central N-heterocyclic carbene (NHC) moiety linked to two pendant pyrazole groups by either a methylene (NCN(me)) or ethylene (NCN(et)) chain. The coordination of these two ligands to rhodium and iridium resulted in a variety of binding modes. Tridentate coordination of the ligands was observed in the complexes [Rh(NCN(me))(COD)]BPh4 (8), [Ir(NCN(me))(COD)]BPh4 (10), [Rh(NCN(et))(CO)2]BPh4 (13), and [Ir(NCN(me))(CO)2]BPh4 (14), and monodentate NHC coordination was observed for [Ir(NCN(me))2(COD)]BPh4 (11) and [Ir(NCN(et))2(COD)]BPh4 (12). Both tridentate and bidentate coordination modes were characterized for [Rh(NCN(et))(COD)]BPh4 (9) in the solution and solid state, respectively, while an unusual bridging mode was observed for the bimetallic complex [Rh(µ-NCN(me))(CO)]2(BPh4)2 (15). The impact of this diverse coordination chemistry on the efficiency of the complexes as catalysts for the addition of NH, OH, and SiH bonds to alkynes was explored.

10.
J Am Chem Soc ; 135(37): 13640-3, 2013 Sep 18.
Article in English | MEDLINE | ID: mdl-23971827

ABSTRACT

The two-coordinate cationic Ni(I) bis-N-heterocyclic carbene complex [Ni(6-Mes)2]Br (1) [6-Mes =1,3-bis(2,4,6-trimethylphenyl)-3,4,5,6-tetrahydropyrimidin-2-ylidene] has been structurally characterized and displays a highly linear geometry with a C-Ni-C angle of 179.27(13)°. Density functional theory calculations revealed that the five occupied metal-based orbitals are split in an approximate 2:1:2 pattern. Significant magnetic anisotropy results from this orbital degeneracy, leading to single-ion magnet (SIM) behavior.

11.
Chemistry ; 19(6): 2158-67, 2013 Feb 04.
Article in English | MEDLINE | ID: mdl-23292787

ABSTRACT

Comproportionation of [Ni(cod)(2)] (cod = cyclooctadiene) and [Ni(PPh(3))(2)X(2)] (X = Br, Cl) in the presence of six-, seven- and eight-membered ring N-aryl-substituted heterocyclic carbenes (NHCs) provides a route to a series of isostructural three-coordinate Ni(I) complexes [Ni(NHC)(PPh(3))X] (X = Br, Cl; NHC = 6-Mes 1, 6-Anis 2, 6-AnisMes 3, 7-o-Tol 4, 8-Mes 5, 8-o-Tol 6, O-8-o-Tol 7). Continuous wave (CW) and pulsed EPR measurements on 1, 4, 5, 6 and 7 reveal that the spin Hamiltonian parameters are particularly sensitive to changes in NHC ring size, N substituents and halide. In combination with DFT calculations, a mixed SOMO of ∣3d z 2〉 and ∣3d x 2-y 2〉 character, which was found to be dependent on the complex geometry, was observed and this was compared to the experimental g values obtained from the EPR spectra. A pronounced (31)P superhyperfine coupling to the PPh(3) group was also identified, consistent with the large spin density on the phosphorus, along with partially resolved bromine couplings. The use of 1, 4, 5 and 6 as pre-catalysts for the Kumada coupling of aryl chlorides and fluorides with ArMgY (Ar = Ph, Mes) showed the highest activity for the smaller ring systems and/or smaller substituents (i.e., 1>4≈6≫5).

12.
Biochem J ; 435(1): 1-16, 2011 Apr 01.
Article in English | MEDLINE | ID: mdl-21406063

ABSTRACT

Proteases are an expanding class of drugs that hold great promise. The U.S. FDA (Food and Drug Administration) has approved 12 protease therapies, and a number of next generation or completely new proteases are in clinical development. Although they are a well-recognized class of targets for inhibitors, proteases themselves have not typically been considered as a drug class despite their application in the clinic over the last several decades; initially as plasma fractions and later as purified products. Although the predominant use of proteases has been in treating cardiovascular disease, they are also emerging as useful agents in the treatment of sepsis, digestive disorders, inflammation, cystic fibrosis, retinal disorders, psoriasis and other diseases. In the present review, we outline the history of proteases as therapeutics, provide an overview of their current clinical application, and describe several approaches to improve and expand their clinical application. Undoubtedly, our ability to harness proteolysis for disease treatment will increase with our understanding of protease biology and the molecular mechanisms responsible. New technologies for rationally engineering proteases, as well as improved delivery options, will expand greatly the potential applications of these enzymes. The recognition that proteases are, in fact, an established class of safe and efficacious drugs will stimulate investigation of additional therapeutic applications for these enzymes. Proteases therefore have a bright future as a distinct therapeutic class with diverse clinical applications.


Subject(s)
Peptide Hydrolases/therapeutic use , Animals , Cardiovascular Diseases/drug therapy , Drug Delivery Systems/trends , Genetic Therapy/trends , Humans , Hydrolysis , Peptide Hydrolases/adverse effects , Peptide Hydrolases/pharmacology , Protein Engineering/trends , Recombinant Proteins/adverse effects , Recombinant Proteins/pharmacology , Recombinant Proteins/therapeutic use
13.
J Org Chem ; 76(21): 9151-6, 2011 Nov 04.
Article in English | MEDLINE | ID: mdl-21958335

ABSTRACT

Bioassay-directed fractionation of an extract of the New Zealand ascidian Aplidium scabellum has afforded the anti-inflammatory secondary metabolite 2-geranyl-6-methoxy-1,4-hydroquinone-4-sulfate (1) and a family of pseudodimeric meroterpenoids scabellones A (2)-D (5). The benzo[c]chromene-7,10-dione scaffold contained within scabellones A-D is particularly rare among natural products. The structures were elucidated by interpretation of NMR data. Scabellone B was also identified as a moderately potent, nontoxic inhibitor of Plasmodium falciparum.


Subject(s)
Anti-Inflammatory Agents/chemistry , Anti-Inflammatory Agents/isolation & purification , Anti-Inflammatory Agents/pharmacology , Antimalarials/chemistry , Antimalarials/isolation & purification , Antimalarials/pharmacology , Benzopyrans/chemistry , Benzopyrans/isolation & purification , Benzopyrans/pharmacology , Plasmodium falciparum/drug effects , Quinones/chemistry , Quinones/isolation & purification , Terpenes/chemistry , Terpenes/isolation & purification , Terpenes/pharmacology , Urochordata/chemistry , Animals , Molecular Structure , New Zealand , Nuclear Magnetic Resonance, Biomolecular , Plasmodium falciparum/chemistry , Quinones/pharmacology
14.
J Nat Prod ; 74(9): 1972-9, 2011 Sep 23.
Article in English | MEDLINE | ID: mdl-21846091

ABSTRACT

One tetrahydro-ß-carboline, (-)-7-bromohomotrypargine (1), and three alkylguanidine-substituted ß-carbolines, opacalines A, B, and C (2-4), have been isolated from the New Zealand ascidian Pseudodistoma opacum. The structures of the metabolites were determined by analysis of mass spectrometric and 2D NMR spectroscopic data. Natural products 2 and 3, synthetic debromo analogues 8 and 9, and intermediate 16 exhibited moderate antimalarial activity toward a chloroquine-resistant strain of Plasmodium falciparum, with an IC50 range of 2.5-14 µM. The biosynthesis of 1-4 is proposed to proceed via a Pictet-Spengler condensation of 6-bromotryptamine and the α-keto acid transamination product of either arginine or homoarginine. Cell separation and 1H NMR analysis of P. opacum identified tetrahydro-ß-carboline 1 to be principally located in the zooids, while fully aromatized analogues 2-4 were localized to the test.


Subject(s)
Antimalarials/isolation & purification , Antimalarials/pharmacology , Carbolines/isolation & purification , Carbolines/pharmacology , Plasmodium falciparum/drug effects , Urochordata/chemistry , Animals , Antimalarials/chemistry , Carbolines/chemistry , Chloroquine/pharmacology , Drug Resistance/drug effects , Molecular Structure , New Zealand , Nuclear Magnetic Resonance, Biomolecular , Stereoisomerism
15.
J Nat Prod ; 74(4): 888-92, 2011 Apr 25.
Article in English | MEDLINE | ID: mdl-21348447

ABSTRACT

Two new indole spermidine alkaloids, didemnidines A (1) and B (2), have been isolated from the New Zealand ascidian Didemnum sp. The structures of the metabolites, determined by analysis of 2D NMR spectra and confirmed via synthesis, embody an indole-3-glyoxylamide moiety linked to the N(1) position of spermidine, the latter motif being particularly rare among marine natural products. Didemnidine B and a synthetic precursor exhibited mild in vitro growth inhibition of Plasmodium falciparum with IC(50)'s of 15 and 8.4 µM, respectively.


Subject(s)
Antiprotozoal Agents , Indole Alkaloids , Spermidine , Urochordata/chemistry , Animals , Antiprotozoal Agents/chemistry , Antiprotozoal Agents/isolation & purification , Antiprotozoal Agents/pharmacology , Indole Alkaloids/chemistry , Indole Alkaloids/isolation & purification , Indole Alkaloids/pharmacology , Leishmania donovani/drug effects , Molecular Structure , New Zealand , Nuclear Magnetic Resonance, Biomolecular , Plasmodium falciparum/drug effects , Spermidine/analogs & derivatives , Spermidine/chemistry , Spermidine/isolation & purification , Spermidine/pharmacology , Structure-Activity Relationship , Trypanosoma/drug effects
16.
J Am Chem Soc ; 132(51): 18408-16, 2010 Dec 29.
Article in English | MEDLINE | ID: mdl-21128626

ABSTRACT

A combination of experimental studies and density functional theory calculations is used to study C-N bond activation in a series of ruthenium N-alkyl-substituted heterocyclic carbene (NHC) complexes. These show that prior C-H activation of the NHC ligand renders the system susceptible to irreversible C-N activation. In the presence of a source of HCl, C-H activated Ru(I(i)Pr(2)Me(2))'(PPh(3))(2)(CO)H (1, I(i)Pr(2)Me(2) = 1,3-diisopropyl-4,5-dimethylimidazol-2-ylidene) reacts to give Ru(I(i)PrHMe(2))(PPh(3))(2)(CO)HCl (2, I(i)PrHMe(2) = 1-isopropyl-4,5-dimethylimidazol-2-ylidene) and propene. The mechanism involves (i) isomerization to a trans-phosphine isomer, 1c, in which hydride is trans to the metalated alkyl arm, (ii) C-N cleavage to give an intermediate propene complex with a C2-metalated imidazole ligand, and (iii) N-protonation and propene/Cl(-) substitution to give 2. The overall computed activation barrier (ΔE(++)(calcd)) corresponds to the isomerization/C-N cleavage process and has a value of +24.4 kcal/mol. C-N activation in 1c is promoted by the relief of electronic strain arising from the trans disposition of the high-trans-influence hydride and alkyl ligands. Experimental studies on analogues of 1 with different C4/C5 carbene backbone substituents (Ru(I(i)Pr(2)Ph(2))'(PPh(3))(2)(CO)H, Ru(I(i)Pr(2))'(PPh(3))(2)(CO)H) or different N-substituents (Ru(IEt(2)Me(2))'(PPh(3))(2)(CO)H) reveal that Ph substituents promote C-N activation. Calculations confirm that Ru(I(i)Pr(2)Ph(2))'(PPh(3))(2)(CO)H undergoes isomerization/C-N bond cleavage with a low barrier of only +21.4 kcal/mol. Larger N-alkyl groups also facilitate C-N bond activation (Ru(I(t)Bu(2)Me(2))'(PPh(3))(2)(CO)H, ΔE(++)(calcd) = +21.3 kcal/mol), and in this case the reaction is promoted by the formation of the more highly substituted 2-methylpropene.

17.
J Exp Med ; 197(7): 907-18, 2003 Apr 07.
Article in English | MEDLINE | ID: mdl-12682110

ABSTRACT

Natural killer T (NKT) cells are a unique immunoregulatory T cell population that is positively selected by CD1d-expressing thymocytes. Previous studies have shown that NKT cells exhibit autoreactivity, which raises the question of whether they are subject to negative selection. Here, we report that the addition of agonist glycolipid alpha-galactosylceramide (alpha-GalCer) to a fetal thymic organ culture (FTOC) induces a dose-dependent disappearance of NKT cells, suggesting that NKT cells are susceptible to negative selection. Overexpression of CD1d in transgenic (Tg) mice results in reduced numbers of NKT cells, and the residual NKT cells in CD1d-Tg mice exhibit both an altered Vbeta usage and a reduced sensitivity to antigen. Furthermore, bone marrow (BM) chimeras between Tg and WT mice reveal that CD1d-expressing BM-derived dendritic cells, but not thymic epithelial cells, mediate the efficient negative selection of NKT cells. Thus, our data suggest that NKT cells developmentally undergo negative selection when engaged by high-avidity antigen or abundant self-antigen.


Subject(s)
Antigens, CD1/physiology , Dendritic Cells/physiology , Killer Cells, Natural/physiology , Thymus Gland/cytology , Animals , Antigens, CD1d , Bone Marrow Cells/physiology , Epithelial Cells/physiology , Galactosylceramides/pharmacology , Lymphocyte Activation , Mice , Mice, Inbred C57BL , Mice, Transgenic , Organ Culture Techniques , Receptors, Antigen, T-Cell, alpha-beta/physiology , Stromal Cells/physiology
18.
J Am Chem Soc ; 131(13): 4604-5, 2009 Apr 08.
Article in English | MEDLINE | ID: mdl-19281174

ABSTRACT

Deuterium labeling studies indicate that base-induced intramolecular C-H activation in the agostic complex 2-D proceeds with exclusive removal of a proton from the methyl arm of an (i)Pr substituent on the N-heterocyclic carbene (NHC) ligand. Computational studies show that this alkyl C-H bond activation reaction involves deprotonation of one of the C-H bonds that is geminal to the agostic interaction, rather than the agostic C-H bond itself. The reaction is readily accessible at room temperature, and a computed activation barrier of DeltaE (double dagger)(calcd) = +11.8 kcal/mol is found when the NHC 1,3-diisopropyl-4,5-dimethylimidazol-2-ylidene is employed as the external base. Charge analysis reveals that the geminal hydrogens are in fact more acidic than the agostic proton, consistent with their more facile deprotonation.

19.
Dalton Trans ; 47(3): 769-782, 2018 Jan 15.
Article in English | MEDLINE | ID: mdl-29243762

ABSTRACT

Bromide abstraction from the three-coordinate Ni(i) ring-expanded N-heterocyclic carbene complex [Ni(6-Mes)(PPh3)Br] (1; 6-Mes = 1,3-bis(2,4,6-trimethylphenyl)-3,4,5,6-tetrahydropyrimidin-2-ylidene) with TlPF6 in THF yields the T-shaped cationic solvent complex, [Ni(6-Mes)(PPh3)(THF)][PF6] (2), whereas treatment with NaBArF4 in Et2O affords the dimeric Ni(i) product, [{Ni(6-Mes)(PPh3)}2(µ-Br)][BArF4] (3). Both 2 and 3 act as latent sources of the cation [Ni(6-Mes)(PPh3)]+, which can be trapped by CO to give [Ni(6-Mes)(PPh3)(CO)]+ (5). Addition of [(Et3Si)2(µ-H)][B(C6F5)4] to 1 followed by work up in toluene results in the elimination of phosphine as well as halide to afford a co-crystallised mixture of [Ni(6-Mes)(η2-C6H5Me)][B(C6F5)4] (4), and [6MesHC6H5Me][B(C6F5)4]. Treatment of 1 with sodium salts of more strongly coordinating anions leads to substitution products. Thus, NaBH4 yields the neutral, diamagnetic dimer [{Ni(6-Mes)}2(BH4)2] (6), whereas NaBH3(CN) gives the paramagnetic monomeric cyanotrihydroborate complex [Ni(6-Mes)(PPh3)(NCBH3)] (7). Treatment of 1 with NaOtBu/NHPh2 affords the three-coordinate Ni(i) amido species, [Ni(6-Mes)(PPh3)(NPh2)] (8). The electronic structures of 2, 5, 7 and 8 have been analysed in comparison to that of previously reported 1 using a combination of EPR spectroscopy and density functional theory.

20.
Pharmacotherapy ; 27(3): 425-33, 2007 Mar.
Article in English | MEDLINE | ID: mdl-17316153

ABSTRACT

Microscopic colitis is a common cause of chronic watery diarrhea. Its etiology is unknown, but use of nonsteroidal antiinflammatory drugs, aspirin, and lansoprazole may be risk factors for developing the disorder. Therapy is directed primarily at resolving the symptoms of microscopic colitis; bismuth subsalicylate, aminosalicylates, traditional corticosteroids, and budesonide have been evaluated. Compared with other therapies, budesonide has the strongest evidence for effectiveness in decreasing the volume and frequency of stools and improving the quality of life; it is, however, a costly drug. We reviewed all available primary English-language literature accounts of treatment of microscopic colitis. We performed searches of MEDLINE and International Pharmaceutical Abstracts, as well as reviewing the bibliographies from key articles, to procure pertinent reports. Microscopic colitis can be successfully treated with pharmacotherapy. Based on cost and adverse-effect profiles, antidiarrheals and bismuth subsalicylate are reasonable first options, but many patients may require budesonide to achieve remission.


Subject(s)
Budesonide/therapeutic use , Colitis, Microscopic/drug therapy , Adrenal Cortex Hormones/therapeutic use , Bismuth/therapeutic use , Cholestyramine Resin/therapeutic use , Colitis, Microscopic/pathology , Colitis, Microscopic/therapy , Humans , Loperamide/therapeutic use , Organometallic Compounds/therapeutic use , Salicylates/therapeutic use , Treatment Outcome
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