Therapeutic effects of Ginkgo biloba extract against acute ischemic colitis

Abstract

Ginkgo biloba extract (GBE) is a plant extract obtained from the leaves of G biloba tree. The aim of this study was to evaluate the clinicopathologic characteristics and therapeutic effects of GBE on ischemic colitis (IC).Forty-seven patients with IC were divided as GBE group (n = 30) and routine group (n = 17). The routine group was given routine therapy, and the GBE group was given routine therapies plus GBE intravenous injection. Clinicopathologic characteristics, endoscopy findings, serum antioxidant enzymes, and inflammatory mediators were evaluated.About 89.3% initial symptom was acute-onset abdominal cramping and abdominal pain followed with hematochezia. The lesions were mainly located in sigmoid colon (80.8%). Serum level of superoxide dismutase (SOD) in patients with IC was significantly decreased (P < .05), while methane dicarboxylic aldehyde (MDA), tumor necrosis factor alpha (TNF-α), and interleukin-6 (IL-6) levels were significantly increased (P < .05). However, serum procalcitonin (PCT) level showed no significant change. Treatment of GBE resulted in quick remittance of abdominal pain and hematochezia, and significant attenuation of colon macroscopic and histologic damage in all patients. Furthermore, the treatment also significantly increased SOD levels, decreased MDA, TNF-α, and IL-6 levels (P < .05).Acute-onset abdominal cramping or abdominal pain followed with hematochezia was the mainly initial symptom of IC, and sigmoid and descending colons were the common vulnerable sites. GBE exerted a beneficial effect on IC with faster symptom relief and better mucosal healing, possibly through scavenging oxidative-free radicals and downregulating inflammatory mediators. GBE may be a promising candidate for protection against IC.

Figure 1

Endoscopic and histopathologic findings of an ischemic colitis (IC) patient and therapeutic effect of Ginkgo biloba extract (GBE). A: Serious lesion of sigmoid colon before GBE treatment with macroscopic damage score 4. B: Markedly improvement of lesion with nearly normal mucosa after GBE treatment. C: Histopathologic hematoxylin and eosin (H&E) staining before GBE treatment with histologic score 9. D: Histopathologic H&E staining after GBE treatment with histologic score 1.

Figure 2

Endoscopic and histopathologic findings of a patient with ischemic colitis (IC) and therapeutic effect of routine treatment. A: Markedly lesion of sigmoid colon before routine treatment with damage score 3. B: Markedly improvement of the mucosal lesion after routine treatment with macroscopic damage score 2. C: Histopathologic hematoxylin and eosin (H&E) staining before routine treatment with histologic score 7. D: Histopathologic H&E staining after routine treatment with histologic score 3.