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Evaluation of the effect of Aegle marmelos and Punica granatum in a murine model of dextran sulfate sodium-induced acute colitis

Background: Ulcerative colitis (UC) is a debilitating condition associated with many complications. The current treatment regimen includes the use of anti-inflammatory agents such as sulfasalazine and corticosteroids which are associated with multiple adverse effects due to which, patients of UC tend to have a reduced quality of life from continuing disease activity. Textbooks on Ayurveda, the Indian traditional system of medicine, have described plants with property to provide strength to the body tissues and protecting them from damage. 
 
Aims and Objectives: We planned to study the effect of two such plants, Aegle marmelos and Punica granatum individually and in combination regimens in a murine model of dextran sulfate sodium (DSS)-induced colitis. 
 
Materials and Methods: In Phase I, 42 Swiss albino mice were divided into seven groups (n = 6/group) and treated as follows: Normal control and disease control (normal saline), positive control (sulfasalazine - 100 mg/kg) and the four test groups with A. marmelos - 0.39 g/kg/day and 0.78 g/kg/day and P. granatum - 5.20 g/kg/day and 10.40 g/kg/day. In Phase II, 30 mice were divided into five groups (n = 6/group) as follows: Normal control, positive control, A. marmelos - 0.78 g/kg/day + P. granatum - 10.40 g/kg/day, A. marmelos - 0.78 g/kg/day + sulfasalazine - 50 mg/kg, and P. granatum 10.40 g/kg/day + sulfasalazine - 50 mg/kg. All groups received treatment from day 1 to 14 and the inducing agent DSS from day 8 to 14 (except normal control). Variables assessed were colon length, colon weight-by-length ratio (analyzed using one-way ANOVA) and disease activity index, colitis macroscopy, and colon histopathology (analyzed by Kruskal–Wallis test). A value of P < 0.05 was considered to be statistically significant. 
 
Results: The high dose of A. marmelos caused a significant improvement in all the variables (P 0.05) while the high dose of P. granatum only decreased the colon weight-by-length ratio. The plant drug combination significantly improved all variables except histopathology. A. marmelos + sulfasalazine - 50 mg/kg combination was not significantly different compared to positive control on all variables (P > 0.05), whereas P. granatum+sulfasalazine - 50 mg/kg significantly improved all variables (P < 0.05) except the colitis score and histopathology. 
 
Conclusion: The combination of A. marmelos + P. granatum and that of each plant drug with low dose sulfasalazine were as effective as the standard dose of sulfasalazine in the model of DSS induced colitis.