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Mesalazine + lactobacillus casei is a combination therapy consisting of mesalazine (also known as mesalamine), an anti-inflammatory aminosalicylate drug, and Lactobacillus casei, a probiotic bacterium. Mesalazine acts primarily by inhibiting cyclooxygenase and lipoxygenase pathways, reducing the synthesis of pro-inflammatory mediators such as prostaglandins and leukotrienes in the intestinal mucosa. Lactobacillus casei is a beneficial microorganism that modulates gut microbiota composition and exerts anti-inflammatory effects through immune modulation and competitive inhibition of pathogenic bacteria. This combination has been studied for maintaining remission in symptomatic uncomplicated diverticular disease (SUDD) of the colon and for its potential benefits in ulcerative colitis by reducing inflammatory cytokines, myeloperoxidase activity, nitric oxide levels, and expression of iNOS/COX-2 genes[1][2][3][8][10]. The synergistic effect appears to enhance clinical outcomes compared to either agent alone.
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