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Therapeutics
Cochrane systematic review
Extended colonic release low-molecular weight heparin (LMWH) not ready for use in ulcerative colitis
  1. Daniel C Baumgart
  1. Charité Medical School, Humboldt-University of Berlin, Berlin, Germany
  1. Correspondence to Daniel C Baumgart
    Charité Medical Center, Virchow Hospital, Department of Medicine, Division of Gastroenterology and Hepatology, Augustenburger Platz 1, 13353 Berlin, Germany; daniel.baumgart{at}charite.de

https://doi.org/10.1136/ebm1173

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    Commentary on:

    1. Chande N,
    2. McDonald JW,
    3. Macdonald JK,
    4. et al
    . Unfractionated or low-molecular weight heparin for induction of remission in ulcerative colitis. Cochrane Database Syst Rev 2010;10:CD006774.

    Context

    Ulcerative colitis (UC) is a non-transmural inflammatory disease (inflammatory bowel disease (IBD)) with episodic progression that is restricted to the colon. It results from an inappropriate immune response, in genetically susceptible individuals, to microbial antigens of indigenous flora of the gut. This inappropriate response is promoted by certain environmental factors. There is no cure for UC. Many currently available pharmacological treatments are associated with important adverse effects.1

    Low-molecular weight heparin (LMWH) and unfractionated heparin (UFH) best known for their antithrombotic properties were recently discovered to also have anti-inflammatory properties. One potential mechanism was accidently discovered in dialysis patients who were found to have lower tumour necrosis factor (TNF) binding protein levels. At dialysis a temporary rise in binding protein is encountered, which in turn inhibits the effects of circulating TNF – a key inflammatory cytokine in IBD. …

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    Footnotes

    • Competing interests None.