Review article: the potential mechanisms of action of rifaximin in the management of inflammatory bowel diseases
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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Rifaximin may be therapeutically beneficial for IBD.
“Rifaximin, a non-systemic bactericidal antibiotic, may be therapeutically beneficial for IBD (134).”
From Stress triggers flare of inflammatory bowel disease in children and adults (2019) · cites this paper as [134]
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Gut Microbiome and Gastrointestinal Disorders
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Gut Microbiota and Inflammatory Bowel Diseases
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Redox nanoparticles in colon drug targeting
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Role of the gut microbiome in the pathogenesis of inflammatory bowel disease
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BindingDB Entry 50009336: Garcinoic Acid Is a Natural and Selective Agonist of Pregnane X Receptor.
BindingDB (2021) · UC San Diego · doi:10.7270/q23r0x9b
BindingDB Entry 50018581: Design and Optimization of 1
BindingDB (2024) · UC San Diego · doi:10.7270/q2qn6c1z
- Authors
- Sartor, R. B.
- Affiliations
- University of North Carolina at Chapel Hill (US)
- Corresponding author
- Sartor, R. B.
- ORCID
- 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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