A novel colon-specific steroid prodrug enhances sodium chloride absorption in rat colitis. Fedorak, Richard N, Ningren Cui, David R Friend, Karen L Madsen, Lonnie R Empey. Division of Gastroenterology, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada and Stanford Research Institute, Menlo Park, California
APStracts 2:0042G, 1995.
A recently synthesized novel colon-specific dexamethasone prodrug, dexamethasone-[beta]-D-glucuronide, delivers efficacious amounts of dexamethasone to the colon with limited adrenal suppressive effects. During experimentally-induced colitis in rats the dexamethasone prodrug is significantly more potent than free dexamethasone in improving colonic fluid and electrolyte absorptive injury. The present studies examined whether the improvement in colonic absorption seen with the prodrug occurred as a consequence of alterations in sodium and chloride epithelial transport. The efficacy of the dexamethasone prodrug and free dexamethasone were tested in an acetic acid-induced rat model of colitis. Healing of the induced colitis was assessed by measuring net colonic fluid absorption and surface area ulceration. Transmural unidirectional fluxes of 22Na and 36Cl across sheets of colonic mucosa were measured in Ussing Chambers. Treatment of colitis with the prodrug delivered 6-fold higher concentration of dexamethasone to the colon than did treatment with the free drug. The prodrug accelerated healing of colitis by returning in vivo colonic fluid absorption to normal and virtually eliminated colonic macroscopic ulceration, whereas, the free drug did not. In vitro transmural fluxes demonstrated that in addition to repair of mucosal integrity the prodrug enhanced electroneutral sodium chloride absorption over and above that seen in control animals or following treatment with the free drug. Both the prodrug and the free drug limited theophylline-mediated net chloride and sodium secretion, an effect that would be consistent with the antidiarrheal effect induced by these drugs in vivo. The results suggest that treatment of experimentally-induced colitis with the novel colon-specific prodrug, dexamethasone-[beta]-D-glucuronide, has distinct mucosal healing and antidiarrheal advantages over administration of its parent, free dexamethasone. Specifically, dexamethasone prodrug treatment enhances sodium chloride absorptive effects and limits cAMP-mediated secretion of colonic epithelia.

Received 18 August 1994; accepted in final form 21 February 1995.
APS Manuscript Number G306-4.
Article publication pending Am. J. Physiol. (Gastrointest. Liver
Physiology).
ISSN 1080-4757 Copyright 1995 The American Physiological Society.
Published in APStracts on 21 March 1995.