Cited by 62Inflammatory Bowel DiseaseGut microbiota and healthMicroscopic Colitis

Review article: the potential mechanisms of action of rifaximin in the management of inflammatory bowel diseases

Sartor, R. B.·2016·Alimentary Pharmacology & Therapeutics

Abstract

BACKGROUND: Gut microbiota dysbiosis contributes to the pathogenesis of inflammatory bowel diseases (IBD). Although the microbiota's role in IBD pathogenesis, specifically Crohn's disease (CD), provides a rationale for antibiotic treatment, antibiotic use in CD remains controversial. Rifaximin, traditionally identified as a nonsystemic bactericidal antibiotic, may be therapeutically beneficial for inducing CD remission. AIM: To examine the role of rifaximin in the management of IBD and its potential mechanisms of action. METHODS: A literature search using the following strategy: ('inflammatory bowel disease' OR 'Crohn's' OR 'ulcerative'), 'rifaximin' AND ('barrier' OR 'translocation' OR 'adhesion' OR 'internalization' OR 'pregnane X'), AND 'pregnane X' AND ('Crohn's' OR 'ulcerative colitis' OR 'inflammatory bowel disease'). RESULTS: In vitro data suggest rifaximin mediates changes in epithelial cell physiology and reduces bacterial attachment and internalisation. In experimental colitis models, rifaximin antagonised the effects of tumour necrosis factor-α on intestinal epithelial cells by activating pregnane X receptor, which inhibits nuclear factor-κB-mediated proinflammatory mediators and induces detoxification genes (e.g. multidrug resistance 1 and cytochrome P450 3A4). Rifaximin also inhibits bacterial translocation into the mesenteric lymph nodes. CONCLUSION: Accumulating evidence suggests that mechanisms of action of rifaximin in IBD may not be limited to direct bactericidal activity; therefore, rifaximin could potentially be redefined as a gut environment modulator.

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Crossref · 10.1111/apt.13436

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Authors
Sartor, R. B.
Affiliations
University of North Carolina at Chapel Hill (US)
Corresponding author
Sartor, R. B.
Venue
Alimentary Pharmacology & Therapeutics
Publisher
Wiley
Published
2015-11-30
Volume
43
Issue
S1
Pages
27-36
ISSN
  • 0269-2813 (ISSN-L)
  • 1365-2036
OpenAlex
W2188133886
Cited by
60
References
66
Citations by year
2026: 1 · 2025: 3 · 2024: 3 · 2023: 7 · 2022: 6 · 2021: 6 · 2020: 9 · 2019: 7 · 2018: 8 · 2017: 5 · 2016: 5
FWCI
0.76
Type
journal article
Language
en
Open access
closed
Locations
  • Alimentary Pharmacology & Therapeutics (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Inflammatory Bowel Disease
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Gut microbiota and health
  • Health Sciences › Medicine › Epidemiology › Microscopic Colitis
Keywords
rifaximin, inflammatory bowel disease, Crohn's disease, ulcerative colitis, gut dysbiosis, pregnane X receptor, intestinal epithelial barrier, bacterial translocation, TNF-α, NF-κB signaling, multidrug resistance 1, CYP3A4, antibiotic therapy
MeSH terms
Gastrointestinal Microbiome, Pregnane X Receptor, Rifaximin, Anti-Bacterial Agents, Colitis, Ulcerative, Crohn Disease, Humans, Intestinal Mucosa, Receptors, Steroid, Rifamycins, Tumor Necrosis Factor-alpha, Inflammatory Bowel Diseases, NF-kappa B

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