# Effect of _Cynara carduculus_ L. var. _altilis_ (DC) in Inflammatory Bowel Disease
## 4 Discussion  
The plant _C. cardunculus_ L. is generally used in food, and it is also known to serve medicinal purposes throughout the Mediterranean basin. It presents several health benefits derived mostly from its high concentration of antioxidant components such as inulin and polyphenols such as caffe acid derivates, luteolin, and cymaroside [1; 31; 32; 33]. This plant has been shown in several studies to have the capability of being hepatoprotective, antioxidative, anticarcinogenic, antibacterial, anti-HIV, bile-expelling, urinative activities, an inhibitor of cholesterol biosynthesis, and low-density lipoprotein (LDL) oxidation [7; 9; 34; 35]. During the experimental study, colitic mice revealed an alteration of intestinal motility that suggests a correct induction of experimental colitis. However, the CLE treatment was able to attenuate diarrhea and the moderate edema present in the anus in comparison to mice that were not treated. Regarding changes in body weight, CLE treatment did not promote recovery of weight loss. These results were not expected since _C. cardunculus_ L. presents phenolic compounds in its constitution, and there are several studies that report the benefits of these compounds in weight loss [36]. In this case, the colon lesions may be so severe that the administered doses of _C. cardunculus_ L. were not able to recover the body weight reduction seen. Colon length, which is a parameter for tissue integrity evaluation, showed differences between groups, verifying a shortening of the colon in colitic mice, which is in agreement with other studies [24]. After CLE treatment, a statistically significant increase in colon length due to the phenolic content of this plant was verified, which several studies had reported as protection of the polyphenols against shortening of the colon [36]. However, the positive effect of CLE on the integrity of colon tissue is only achieved with higher doses, such as 500 mg/kg/day. Bloody stools are characteristic of IBD; however, they might be absent in mild diseases [37]. Therefore, to evaluate whether _C. cardunculus_ L. has an influence on the amelioration of the bloody stools, the fecal hemoglobin was measured and analyzed. In fact, colitic mice demonstrated an elevated concentration of fecal hemoglobin; however, the CLE treatment showed the ability to significantly attenuate it. Additionally, it was possible to confirm a dose-dependent effect. Thuds, the daily administration of _C. cardunculus_ L. can attenuate intestinal bleeding in a patient with IBD. Regarding ALP, colitic mice showed higher concentrations of ALP in comparison to healthy mice. ALP is expressed in the intestinal tissue, more specifically, on the enterocytes, and it has a protective role of the mucosa, so in the case of colon lesions, an increase of this marker is expected [24; 38; 39]. ALP levels were significantly reduced by CLE treatment, suggesting that _C. cardunculus_ L. has an important role in promoting enterocyte integrity. The usage of both doses of CLE (TNBS + CLE100 and TNBS + CLE500 groups) promoted ALP values similar to the control groups. TNF-\(\alpha\) is a pro-inflammatory cytokine, which is produced during the innate immune response of IBD. Colitic mice presented an elevated concentration of this cytokine, consistent with an acute model of inflammation [24; 40; 41; 42]. After daily treatment, both CLE doses exhibited a significant reduction in TNF-\(\alpha\). This effect might be due to the inhibition of NF-\(\kappa\)B activation promoted by CLE since TNF-\(\alpha\) expression is induced by this transcription factor [11]. This finding suggests that _C. cardunculus_ L. reduces colon inflammation, and for this reason, it can be a complementary therapeutic approach to the management of IBD. An evaluation of renal and hepatic functions is crucial in this animal model because IBD leads to extra-intestinal manifestations, as previously mentioned, and also, the tested therapeutic approaches can affect the renal and hepatic functions [38].