BACKGROUND: During the mid to late 20th century, parts of Europe and North America began experiencing increasing incidence of inflammatory bowel disease for unknown reasons. Epidemiological studies carried out at the time determined that incidence rates and disease severity were higher in the northern latitudes than in the southern latitudes. LITERATURE REVIEW: In the ensuing years, an inverse association was established between ultraviolet radiation and incidence of Crohn’s disease, a finding that has not proven to be as robust for ulcerative colitis. This association was explored further and vitamin D was implicated to be the factor of ultraviolet radiation which was associated with increased incidence. Currently, all evidence implicating vitamin D in the pathogenesis of Crohn’s disease comes from epidemiological, animal, and in vitro studies, providing strong evidence for an association, but none of which can prove causality. Causality must be proven in prospective clinical trials, which, at present, have come up short in providing statistically significant findings. METHODS: The proposed trial outlined below provides a method of studying the question at hand in a way that has not been previously studied. This is a randomized, double blind, controlled trial which assesses the effect of supplementation of vitamin D in patients with active Crohn’s disease. DISCUSSION: Acceptance of the alternative hypothesis would be a big step forward in the management of Crohn’s disease. It would have wide-ranging implications, resulting in decreased healthcare costs, decreased use of toxic medications, and increased quality of life.

Introduction. Inflammatory bowel disease (IBD) is a condition affecting more than 3 million people in Europe and the USA combined. Patients report pain as one of the most severe and debilitating symptoms leading to a lower quality of life. Current analgesics lack efficacy for the treatment of visceral pain or produce unacceptable side effect profiles. New targets are needed. Aims and methods. The aim of this thesis was to examine the activation of primary visceral afferents in C57BL/6 mice in response to biopsy supernatants from paediatric patients with IBD (Crohn's disease and ulcerative colitis) and functional abdominal pain syndrome (FAPS). By comparing the expression of pro-inflammatory and pro-nociceptive mediators in these biopsy samples with patient pain scores and afferent nerve recording activation, we identified putative mediators likely to be responsible for causing pain. The ability of inflammatory mediators to drive visceral nociception was then examined by their exogenous application in recordings of mouse and human visceral nociceptor activity. Results. Nerve activation increased significantly in response to biopsy supernatants from FAPS, CD, and UC patients, when compared to controls. Supernatant IL-8, TNFα, IL-6 and IL-1β, levels were increased in IBD samples compared with control patients. Analysis of mRNA expression also showed high levels of pro-inflammatory cytokines and raised MMP-1, MMP-3, MMP-9, MMP-12, and MMP-19 in IBD samples. The expression of MMP-12 in biopsy samples from Crohn's patients significantly correlated with afferent firing suggesting a causative role. This was confirmed by exogenously application of MMP-12 stimulated afferent firing and sensitised responses to mechanical stimulation and inflammatory mediators. UC samples showed TIMP-1 as an effective inhibitor of afferent firing. Conclusion. Data from this study demonstrates that the bowel of patients with IBD and FAP releases pro-nociceptive mediators which stimulate visceral afferents. MMP's play an important role in the afferent activation mediated by IBD samples suggesting that exploiting the endogenous inhibitor TIMP-1 could be a key target for future therapeutic strategies.

Background: Not only does IBD lead to nutritional deficiencies, but also nutrients influence its pathophysiology: exclusive enteral nutrition (EEN) is an effective primary treatment in Crohn's disease; and vitamin D (VitD) is involved in its pathogenesis and course. Aims: We hypothesised that nutrients impact on the course of IBD. We therefore studied the effect of EEN i) on long term clinical course in children; ii) on CD58, a costimulatory molecule at the intestinal epithelial cell (IEC) lines, iii) adults with Crohn's disease. We examined the possible effect of serum vitamin D levels on the course of IBD and also the possible role of ethnicity in our paediatric and adult populations that were treated with EEN but also in our general adult population. Results Chapter II: 56 paediatric patients with Crohn's disesase were followed up for 5 years. 57% of patients achieved remission after 6 weeks of EEN. Achievement of clinical remission within 6 weeks of EEN was significantly associated with a longer time to relapse and to treatment escalation. VitD deficiency was common; and those patients who were deficient were significantly more likely to require corticosteroids and also needed thiopurines sooner. Chapter III: CD58 was expressed in the IEC isolated from IBD patients and healthy controls. EN down-regulated the expression of CD58 on IEC lines. Chapter IV: 22 adult patients with Crohn's disease with a mean age of 30.8 years were given EEN and followed up for a mean time of 1.9 years. 22.7% of patients went into clinical remission and 77.3% experienced a clinical response. By the end of follow up 63.6% (14/22) of patients had clinically relapsed and 36.4% required surgery during their follow up. There was no difference between South Asian and Caucasian patients in the disease outcomes after administration of EEN. Chapter V: Bangladeshis were more often vitamin D deficient than white Caucasian patients; however vitamin D status was not associated with the course of IBD. Bangladeshis developed perianal disease and required thiopurines earlier in their disease course. Bangladeshi patients with UC had more extensive disease. Conclusions: EEN, when successful, improves the long term outcome of Crohn's disease in children, possibly in part, by down-regulating CD58 on the IEC. VitD deficiency may influence the clinical course of IBD; however our results were contradictory between children and adults and significantly limited by the assessment of the vitamin D level at a single time point.

A Doença de Crohn (CD) e a Colite Ulcerativa (UC) são as principais enfermidades componentes das Doenças Inflamatórias Intestinais (DII). Embora existam vários medicamentos atualmente empregados para atenuar a inflamação descontrolada no intestino, tratar as complicações ou prolongar os períodos de remissão clínica, não há, ainda, uma terapia que seja totalmente efetiva para estas doenças. Os glicocorticoides (GCs), anti-inflamatórios comumente usados nas DII, possuem eficácia limitada e mais da metade dos pacientes se tornam refratários ou dependentes da medicação. Por outro lado, as estatinas são conhecidas por possuírem propriedades pleiotrópicas e seu uso concomitante com os GCs tem gerado boas perspectivas em várias doenças autoimunes e inflamatórias, inclusive nas DII. Apesar de já existirem indicativos de melhora de pacientes com DII pela utilização combinada destas drogas, ainda há escassez de dados que mostrem as alterações causadas no sistema imunológico. Assim, o objetivo desse trabalho foi avaliar os efeitos imunomoduladores do uso concomitante de GCs e estatinas na colite experimental induzida por dextran sulfato de sódio (DSS) em camundongos C57BL/6. Os resultados mostraram que o uso contínuo de GCs (dexametasona - DX), associados ou não a estatinas (atorvastatina - ATO), não alterou o curso da doença e antecipou a morte dos camundongos, enquanto que o oposto foi observado com o uso isolado de ATO. Tratamentos em curto prazo (3 doses) contendo ATO (isolada ou associada à DX) causaram melhora clínica e histológica dos animais doentes, diminuíram o número de leucócitos circulantes (principalmente monócitos) e de células mononucleares na lâmina própria (LP), a frequência de células CD11b+ na LP, a frequência de células dendríticas (DCs) CD11b+CD11c+ e CD11b-CD11c+ no baço e a frequência de células CD4+ produtoras de IFN- nos linfonodos mesentéricos (LNM). Entretanto, ambos os esquemas terapêuticos aumentaram a frequência de linfócitos T CD8+ no baço e LNM. Ainda, as terapias inibiram a proliferação de esplenócitos tratados in vitro, diminuíram a síntese de IL-6 e, quando em baixas concentrações, aumentaram a produção de IL-10. Diferencialmente, o tratamento combinado pareceu exercer os efeitos acima descritos de modo mais pronunciado do que o uso isolado de estatina. Adicionalmente, diminuiu os níveis de expressão de RNAm das citocinas IL-1, IL-17 e IFN- no local da inflamação, reduziu o número de linfócitos circulantes, de leucócitos no baço e LNM e de linfócitos T CD4+ nos LNM, além de ter aumentado a frequência de DCs CD11b-CD11c+ na LP e a concentração de Fas-L no intestino grosso. Considerando o uso em curto prazo com ATO isolada, foi observado aumento da frequência de DCs CD11b-CD11c+ nos LNM e de células Natural killer (NK) no baço dos camundongos doentes e diminuição dos níveis de expressão de RNAm de PPAR- no intestino grosso. O uso isolado de DX em curto prazo melhorou os aspectos histológicos, diminuiu o número de macrófagos e os níveis de IFN- no cólon, diminuiu o número de leucócitos circulantes (principalmente linfócitos), aumentou a frequência de células CD11b+ no baço e a síntese de IL-10 por esplenócitos ex vivo. Apesar da frequência de células T reguladoras (Treg) e da susceptibilidade dos esplenócitos à sinais reguladores não terem sido modificados após os diferentes tratamentos, nossos resultados sugerem que as estatinas usadas isoladamente preservaram a resposta inflamatória do organismo de modo eficiente e controlado, enquanto que o uso associado das drogas causou a imunossupressão dos animais doentes, contribuindo para as complicações clínicas decorrentes da colite experimental induzida por DSS. / Crohn\'s disease (CD) and Ulcerative colitis (UC) are the main conditions that comprise the Inflammatory Bowel Diseases (IBD). The conventional drug therapies for IBD aim to attenuate the uncontrolled inflammation in the intestinal mucosa, to treat the complications and to extend clinical remission. However, all available drugs have unpredictable or limited effects. Glucocorticoids (GCs) are commonly anti-inflammatory drugs, which are associated to refractoriness and/or dependence in over half of IBD patients. On the other hand, statins have pleiotropic properties and the concomitant use with GCs has shown good prospects in several autoimmune and inflammatory diseases, including IBD. Despite the putative clinical improvement after combined use of GCs and statins in IBD, there is a lack of data indicating their additive effects on the immune system. Therefore, the purpose of this study was to evaluate the immune modulatory effects of the concomitant use of statins and GCs in experimental colitis induced by dextran sulfate sodium (DSS). The results showed that long-term use of GCs (dexamethasone - DX), alone or associated to statins (atorvastatin - ATO), did not improve the clinical signs and increased the death rates of C57BL/6 mice exposed to DSS, while the opposite was observed after treatment with statins alone. Short-term use of ATO (3 doses), alone or associated to DX, improved the clinical signs and histological parameters in DSS-exposed mice, decreased the number of white blood cells (mainly monocytes), the number of mononuclear cells in the lamina propria (LP), the frequency of CD11b+ cells in the LP, the frequency of CD11b+CD11c+ and CD11b-CD11c+ dendritic cells (DCs) in the spleen and the frequency of IFN--producing CD4+ T cells in the mesenteric lymph nodes (MLN). However, ATO alone or associated to DX lead to increased CD8+ T lymphocytes in the spleen and MLN. Moreover, both therapies containing ATO inhibited the proliferation of in vitro-treated splenocytes, besides decreasing IL-6 and increasing IL-10 synthesis. Differentially, the association of drugs led to a more pronounced effects over the changes mentioned above than the single use of statin and additionally decreased IL-1, IL-17 and IFN- mRNA expression levels at the intestinal tissue, the number of circulating lymphocytes, the number of leukocytes in spleen and MLN and the frequency of CD4+ T lymphocytes in the MLN. In addition, statins and GCs increased the frequency of CD11b-CD11c+ DCs in LP and the Fas-L concentrations in the large intestine. Considering the short-term use of ATO there was increased frequency of CD11b-CD11c+ DCs in MLN, increased frequency of natural killer (NK) cells in the spleen and decreased mRNA expression of PPAR- in the large intestine. The short-term use of DX improved the histology parameters, decreased the number of macrophages and IFN- levels in the colon, reduced the number of circulating leukocytes (mainly lymphocytes), and increased the frequency of CD11b+ cells in spleen and IL-10 synthesis by ex vivo splenocytes. Finally, since both regulatory T cells (Treg) frequency and the splenocytes susceptibility to regulatory signals have not been modified after the different treatments, our findings suggest that single use of statins preserved an efficient and controlled inflammatory response, while the combined use of GCs and statins led to immunosuppression, which probably contributed to long-term clinical complications of DSS-induced colitis.

No description available.

In this thesis, I explore the meanings and experience of health and well-being in the lives of individuals with Inflammatory Bowel Disease (IBD). Taking an auto/biographical approach and utilising in-depth qualitative online interviews, I draw on the experience and narratives of seventeen individuals with IBD, including myself. The three main themes addressed are 'Living with IBD', 'Becoming a Patient', and 'Coping and Control'. I explore how IBD influences individuals' experience of personal relationships, and their medical encounters and treatments. I reflect on how and why these factors arise and the effect they may have upon the disease and its management and on individuals' feelings of well-being more generally. I look at the resulting illness narratives and the impact of IBD on the daily life experience and the identity of the individual. I interrogate existing research and add to it from my analysis. Throughout, the research highlights the importance of acknowledging the impact of biographical disruption on the life experience and identity of individuals along with changing illness narratives. There are implications for future research and for policy, including the time taken to reach diagnosis, the use of IBD guidelines in diagnosis and treatment, and patient control and choice as a contributing factor to influence future guidelines and treatment plans.

Introduction: There is an urgent need to find new ways of improving the quality and safety of healthcare whilst achieving efficiencies of service. E-health technologies offer exciting opportunities to support patients in managing chronic disease. Following continuous advances and increasing use, the Internet provides an ideal platform to empower patients. Previous studies have demonstrated that people taking a more active role in managing their health, experience improved outcomes. Based on these principles and funded by Crohn's and Colitis UK, a new web-based care package was designed for adults with inflammatory bowel disease. Specifically 'My IBD Portal' aimed to provide greater access to information, improved communication and encourage greater engagement. Following its implementation at a single centre NHS Trust, the new IBD patient portal was evaluated in the clinical setting. Methods: Following a literature review and significant patient involvement, 'My IBD Portal' was designed and implemented within a single centre setting. The system was evaluated over a 6-month period using a pre-post observational designed study. The primary objective was to examine patient experience. Usage, usability and satisfaction were measured. Secondary objectives included assessing factors that predicted use, analysed using logistic regression models. Changes in IBD knowledge, patient engagement, medication adherence and health utilisation were also explored using univariate analysis and multiple regression models. Results: 183 participants enrolled in the 6-month observational study. 63.4% of participants visited the IBD Portal more than once and were defined as users. In total there were 2080 individual visits to the Portal. The mean number of logins was 11.4 (SD 21.5) and median 3 (IQR 1-12). The mean duration of each visit was over 5 minutes. Individual use was highly variable. Approximately a quarter of participants never or only once used the IBD Portal, with an equal proportion visiting over 10 times. Satisfaction amongst users was high. 98% of respondents were either satisfied or very satisfied. 90% perceived the IBD Portal supported their management and 32% felt it helped with treatment decisions. An overwhelming majority expressed a desire to continue using the IBD Portal after completion of the study. Viewing test results (23%) was the most common section visited, followed by clinic letters (21%). 29% of participants reported sharing their access with a partner or family member. The qualitative data supported the quantitative findings. Many users expressed considerable benefit from online provision to their IBD health record. Comparing users to non-users, logistic regression modeling showed active disease was significantly associated with use. Changes in health outcomes were explored using both univariate and regression analyses. Following multiple regression modeling, an increase in patient activation was significantly associated with Portal use (p < 0.02). A positive trend was observed in perceived support (p=0.06). Improvements in IBD knowledge and medication adherence were not observed. Health utilisation was greater amongst users with more frequent outpatient and helpline contacts observed. Conclusion: Design and implementation of an IBD Portal within the NHS setting is feasible. Technological, human and organisational factors need to be carefully considered during development to support adoption. The IBD Portal was used by a majority of participants and was perceived to support their care. Following adoption in other NHS clinical settings, a cluster randomised controlled study would provide the optimal study design to complete the evaluation process.

Background. Although irritable bowel syndrome (IBS) is a common functional gastrointestinal disorder with an absence of demonstrable pathology, it is associated with significant impairment of quality of life and causes a heavy burden on the health care system. As conventional IBS treatments are far from satisfactory, people turn to Complementary and Alternative Medicine (CAM). One of the most acceptable CAM treatments is acupuncture, which has been considered to be effective in alleviating abdominal bloating, increasing rectal pain threshold, and improving the general well being of IBS patients. However, the underlying mechanisms of these therapeutic effects remain unknown. This study is an investigation of the therapeutic mechanisms of acupuncture treatment of IBS. / Conclusion. Acupuncture attenuates visceral hyperalgesia by inhibiting 5-HT and c-Fos activity in the brain-gut axis. This observation may shed light on possible mechanisms by which acupuncture alleviates symptoms of IBS. / Study 1. A Neonatal Maternal Separation Stress Model (NMSS) was tested. Our results showed that this model was a reliable and stable model for IBS animal study and that visceral hyperalgesia was associated with increased serotonin (5-HT) and c-Fos activity of the brain-gut axis. / Study 2. Two methods were used to test visceral hyperalgesia in response to colorectal distension (CRD), namely Abdominal Withdrawal Response (AWR) and Electromyogram (EMG). There methods were compared for their effectiveness in measuring visceromotor response (VMR) in a NMSS rat model. Our results showed that EMG is the more reliable tool for evaluating VMR to CRD in NMSS rats. / Study 3. There were three parts to this study. First, we reviewed the TCM literature on the use of acupuncture in IBS and concluded that the two most commonly used acupoints for this condition are ST-36 and CV-12 and that, of the two, ST-36 may be the more appropriate acupoint for treatment. Second, we tested invasive and non-invasive sham acupuncture (placebo) and found that neither produces any therapeutic effect when compared to real electroacupuncture. Third, we used the NMSS rat as the animal model, ST-36 as the treatment acupoint, non-invasive sham acupuncture as the placebo, and EMG as the tool to evaluate VMR in response to CRD alter acupuncture intervention. Our results showed that acupuncture not only attenuated 5-HT and c-Fos activity but also reduced visceral hyperalgesia in the NMSS rat. / Ziea, Tat Chi. / Source: Dissertation Abstracts International, Volume: 70-06, Section: B, page: 3423. / Thesis (Ph.D.)--Chinese University of Hong Kong, 2008. / Includes bibliographical references (leaves 122-141). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Electronic reproduction. [Ann Arbor, MI] : ProQuest Information and Learning, [200-] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Abstracts in English and Chinese. / School code: 1307.

Submitted by Natalia Vieira (natalia.vieira@famerp.br) on 2016-05-19T22:35:49Z No. of bitstreams: 1 carlarodrigueszanin_dissert.pdf: 1343932 bytes, checksum: 87ed11d894ae43ccaba6aec342c754e8 (MD5) / Made available in DSpace on 2016-05-19T22:35:49Z (GMT). No. of bitstreams: 1 carlarodrigueszanin_dissert.pdf: 1343932 bytes, checksum: 87ed11d894ae43ccaba6aec342c754e8 (MD5) Previous issue date: 2015-07-31 / Irritable Bowel Syndrome (IBS) is a chronic gastrointestinal disorder that causes significant impairment on the patients´ quality of life. It is associated with anxiety, depression and stress. The objective of this study was to evaluate the impact of cognitive-behavioral therapy (CBT) associated with the conventional treatment of IBS . Fourteen adult patients (21 and 65 years old) participated in the study. They were attended once in a week during four months and had a six month-follow up in the outpatient clinic of a school hospital in the interior of São Paulo state . A convenience sample for the intervention groups (cognitive-behavioral therapy - CBT) and control (Conventional Treatment – CT) was used as selection standard. Hospital Scale of Anxiety and Depression ; Inventory of Stress-Related Symptoms; Scale of Modes Coping Problems; Quality of life; Visual Analog Scale (VAS ) and a register with sociodemographic data were used. Patients in both groups showed symptoms of anxiety, depression and stress, with reduction of symptoms in the evaluation after the four months and their follow up , in the CBT with significant clinical improvement of anxiety and depression and stress symptoms. No significant changes were observed in pre- and follow up of the CT G according to the symptoms of anxiety, depression and pain. All patients in both groups had pain at baseline, with a reduction in pain intensity in the post (4 months) at follow up (6 months), in the CBT, showing significant difference. At follow up (TC G and CBT G) a significant difference pointing out a decrease of pain complaints after psychological intervention in CBT G, suggesting that CBT has shown efficacy on the pain control treatment of IBS patients . Most of quality of life domains were assessed as unsatisfactory for both groups, with clinical improvement in post intervention assessment and follow up, in the CBT G. Comparing the follow up of the CT G and CBT G, data showed significant differences in the domains functional capacity, physical aspect, social aspect and emotional aspect, pointing out that psychological intervention plays an important role in the control and reduction of physical and emotional symptoms as well as showing significant difference in pre- and post intervention and pre and follow up in the CBT G. The least used coping strategy was facing the problem and social GTC in the pre and follow-up, the CBT G, the social confrontation was the least used in the pre. However, there was acquisition of coping strategies observed in post evaluation (4 months) and follow up (6 months) in the GTCC. The results showed some anxiety, depression, stress and impaired quality of life in this sample as well as positive impact of CBT for the control of physical and emotional symptoms and improvement in the quality of life and acquisition of coping strategies, demonstrating the need for appropriate intervention for patients with IBS. / A Síndrome do Intestino Irritável (SII) é um transtorno gastrintestinal crônico que acarreta prejuízos significativos na qualidade de vida dos pacientes e está associada à ansiedade, depressão e estresse. O objetivo do estudo foi avaliar o impacto da terapia cognitivo-comportamental (TCC) associado ao tratamento convencional da SII. Participaram do estudo 14 pacientes adultos (21 a 65 anos) em acompanhamento uma vez na semana durante quatro meses no Ambulatório de um Hospital de Ensino do interior paulista e follow-up de seis meses. A seleção foi por amostra de conveniência para os grupos de intervenção (Terapia Cognitivo-Comportamental - GTCC) e controle (Tratamento Convencional – GTC). Foram utilizados Escala Hospitalar de Ansiedade e Depressão; Inventário de Sintomas de Stress; Escala Modos de Enfrentamento de Problemas; Qualidade de Vida; Escala Visual Analógica (E.V.A.) e ficha com dados sóciodemográficos. Pacientes de ambos os grupos, apresentaram sintomas de ansiedade, depressão e estresse, com redução dos sintomas na avaliação, após os quatro meses e no follow up, no GTCC, com melhora clínica significante tanto dos sintomas de ansiedade, depressão e estresse. Não houve mudanças significantes na avaliação pré e follow up do G TC quanto aos sintomas de ansiedade, depressão e dor. Todos os pacientes de ambos os grupos apresentaram dor na avaliação inicial, com redução da intensidade da dor no pós (4 meses) no follow up (6 meses), no G TCC, mostrando diferença significante. No follow up (G TC e G TCC) houve diferença significante indicando diminuição das queixas de dor, após intervenção psicológica no G TCC, sugerindo que a TCC tem demonstrado eficácia no tratamento dos pacientes com SII para o controle da dor. A maioria dos domínios de qualidade de vida foi avaliado como insatisfatório para ambos os grupos, apresentando melhora clínica na avaliação pós intervenção e no follow up, no G TCC. Em comparação no follow up do GTC e GTCC, os dados mostraram diferenças significantes nos domínios capacidade funcional, aspecto físico, aspecto social e aspecto emocional, indicando que a intervenção psicológica desempenha papel importante no controle e redução dos sintomas físicos e emocionais, bem como apresentou diferença significante na avaliação pré e pós intervenção e pré e follow up no GTCC. A estratégia de enfrentamento menos utilizada foi o enfrentamento no problema e social no GTC na avaliação pré e follow up, no GTCC, o enfrentamento social foi o menos utilizado na avaliação pré. Entretanto houve aquisição de estratégias de enfrentamento observadas na avaliação pós (4 meses) e follow up (6 meses) no GTCC. Os resultados demonstraram a presença de ansiedade, depressão, estresse e prejuízos na qualidade de vida presentes nessa amostra e impacto positivo da TCC para o controle dos sintomas físicos e emocionais, bem como melhora na qualidade de vida e aquisição de estratégias de enfrentamento, demonstrando a necessidade de intervenção adequada para pacientes com SII.

Orientador: Luiz Claudio Di Stasi / Banca: Leonardo Noboru Seito / Banca: Silvio Luis De Oliveira / Resumo: Pfaffia glomerata (Spreng.) Pedersen ("ginseng brasileiro") é uma planta medicinal que apresenta um amplo espectro de usos como tônico, antiestresse e afrodisíaco. Esta espécie pertence ao complexo grupo de plantas medicinais conhecidas como "ginseng" e compõe um grupo específico de plantas denominadas adaptógenas, definidas como produtos capazes de aumentar a resistência não específica do organismo frente a diferentes estímulos estressores; considerando-se tal definição, é previsível que os compostos fitoquímicos presentes na P. glomerata sejam úteis no controle e prevenção de doenças na qual o estresse é fator etiológico, como é o caso da Doença Inflamatória Intestinal (DII). Dessa forma, o presente trabalho possui como objetivo avaliar a atividade anti-inflamatória intestinal da fração butanólica de P. glomerata (rica em saponinas), sobre o modelo de doença inflamatória intestinal induzida por ácido 2, 4, 6-trinitrobenzenosulfônico (TNBS) em ratos. Para tal, foram estudados parâmetros macroscópicos (escore da lesão, extensão da lesão, relação peso/comprimento do cólon, diarreia e aderência) e bioquímicos (atividade da mieloperoxidase e da fosfatase alcalina e quantificação da glutationa total) do processo inflamatório intestinal. Análises fitoquímicas mostraram principalmente a presença de triterpenos e saponinas, incluindo a ecdisterona, e indícios de compostos fenólicos. Os tratamentos com a fração butanólica de P. glomerata não foram capazes de impedir a formação lesões induzidas pelo TNBS e nem de auxiliar na resolução de um quadro inflamatório intestinal pré-existente, que também foi causado pelo TNBS. Com base nestes dados, a hipótese inicial de que um produto adaptógeno modularia o sistema imune por meio de sua ação antiestresse foi rejeitada nas condições experimentais utilizadas / Abstract: Pfaffia glomerata (Spreng.) Perdersen, also called Brazilian ginseng, is a medicinal plant which has a broad use as tonic, anti-stress, and aphrodisiac. This specie belongs to the medicinal plants complex known as ginseng and it is part of a specific group of plants called adaptogens, which are defined as products that are capable of increasing non-specific body resistance against different stressors; considering the definition of adaptogens it is possible to assume that phytochemical compounds present in P. glomerata are also useful in controlling and preventing diseases in which stress is an etiological factor, such as Inflammatory Bowel Disease (IBD). Thereby, this present work aims to study the intestinal anti-inflammatory activity from the butanolic extract of P. glomerata (enriched in saponins) in the TNBS-induced inflammatory bowel disease in rats. To this, macroscopic (score, lesion extension, weight/length ratio, diarrhea and adherence) and biochemical (myeloperoxidase and alkaline phosphatase activities and total glutathione content) parameters of the inflammatory bowel disease were studied. Phytochemical analysis showed the presence of triterpens and saponins, including ecdysterone, and signs of phenolic compounds. Treatments with butanolic extract from P. glomerata were not able to prevent TNBS-induced lesions nor were able to ameliorate in the resolution of the pre-existing intestinal inflammatory process also caused by TNBS. According to these data, the initial hypothesis that an adaptogen product would modulate the immune system by its anti-stress action was rejected in the experimental conditions utilized / Mestre